You my friend, you need a taxi(or that car in your driveway will do just fine.)

3 calls. 1 transport. None needed.
Call 1-
Code 3 response to an Assault. Usually, this gets me excited(morbid-maybe). Trauma, Cardiac emergencies–you know, playing with our cool toys. Laryngoscopes, Needle decompression, drugs, the Defibrillator. Those are the nifty little gadgets that suck us all in.

But you can tell if a call is going to be exciting when you walk up. If it’s bad(in the “good” way) PD is panicking on scene, FD looks like their heads are going to explode. Cop cars are parked all over(they seem to let their fellow officers know when the good shit is going on) and looky-loos are all over the place.

None of that here. Matter of fact, a new young female officer being FTO’d was in control of the scene. 3 Sergeants and not one of them was even out of their car… Bad news. This “assault” had resulted in a scratch–deep mind you–to the face. He needed a doctor, but not an ambulance.

See, most people don’t get a difference between the two. You can go to the ER on your own. I don’t have to drive you. As a matter of fact–if you stand up when I walk in your door, say “ready to go?” and look at me with a smile–I do NOT want to drive you. We’re not a taxi. We are well trained medical professionals who are supposed to respond to EMERGENCIES.

Now I get it. PD was following procedure. But we did not need to come Code 3. We didn’t need to risk our lives and the lives of others to get to a guy who has a cut that isn’t even so slightly oozing blood.

The day gets better though!’

Code 3 response, called as a “FALL”. I’m sure you remember the “falls” from yesterday… the luck returns.

This time though, it wasn’t a gray haired 80 year old grandma ready to talk me into a coma. It was a 12 year old girl with a mother who apparently thinks 911 is the answer to saving herself a trip to the urgent care clinic that is 3 blocks away(nearest hospital… 2 miles… hospital of choice–across town.).

Seems our young friend was running and hit one of the few remaing ice patches. Biffed it a little and scuffed her knee up pretty good. Range of motion is great, CMS intact, no swelling, etc, etc.

It WAS a good scuff–but it was a knee scuff. How many of us have scuffed our knees up good? How many of us call 911 for it? Gimme a break!

I understand being concerned about your kids. That’s what you’re supposed to do. But there is a difference between that and gaming the system.

CALL 3, Code 3 response… “Sick Person”

Our 59 year old male patient was at the Urgent Care clinic with flu signs and symptoms. He’d been in earlier this week and they’d drugged him up good, but had been worse and thought he should get checked out. So, like the responsible, unassuming gentleman that he was, he had his wife drive him to the nearest weekend clinic.

It was his Doc that felt he needed to go to the hospital–and somehow couldn’t tell dispatch enough info to prevent them from sending us at 80 MPH. Sure, he was sick. But he wasn’t dead sick. He really didn’t even want us to take him–but complained of some heart palps so we felt it better to give him a nice monitored ride. His BP/Pulse/resprs were all great. 12 lead negative for AMI. No other S/S of a Cardiac event so we transported with comfort in mind–though my 2 IV attempts on his dehydrated and rolling veins prob didn’t help him tooooo much.

One of those days I guess. You win some, you lose some. Mostly, the system loses. I don’t want to discourage you from calling 911. But remember, If I’m with you, I can’t help someone who might need it more. So if you aren’t sick/dying/dead someone is likely going to need a lot more than you. Hospitals do love it when we bring you in though–saves them from triaging and asking all those silly questions—so long as they listen to me give report and actually pay attention so they don’t have to ask them all over!

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http://blog.mlive.com/saginawnews/2008/03/crash_victim_thanks_the_parame.html

Not many times in my career do I expect to have this happen. What you see from this that is more incredible is how reserved the medic was about this. He isn’t cocky. He isn’t selfish.

I get that with Hipo’s(yes, I know) new regulations events like this are harder and harder to make happen–but just every now and then making a success story sink in to rescuers isn’t such a bad idea…

And… I miss home. I miss my wife. I miss my dogs(who apparently keep running to the door at every sound… thinking it’s me…). I just miss home. I’ll be back soon!

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Falls happen–and pretty regularly. But 3, back to back falls… c’mon… what’s crazy–all three were dispatched as something else. Unknown medical, unresponsive, seizure. Ok, No, No.

1 refused transport–so he got to ride in with PD since no body thought he should be driving. The other 2, well, they talked to me like all nice little old ladies do in the back of the ambulance……

OW! STOP THAT! (slapping at hands). “Ma’am, I’m really sorry but we need to get an IV started so we can give you something for the pain.”

I don’t really care what you need to do that for! You’re not doing it!

“Ma’am… I’m sorry, but it really will make you more comfortable in a few minutes. We’ll give you some morphine and it’ll make the ride a lot easier.”

NO. (as I push the needle in… she slaps my hand again… blown vein 3 for the day) “Ma’am, that isn’t going to help any. Now we have to try again.” (not really. I’m not going to make you feel better if you don’t want me to. If you wanna ride in this bumpy truck for 45 minutes with no pain meds, so be it.)

I didn’t even get her insurance info. Waited till the ER got it and took it from them. Sometimes the nicest, sweetest old ladies can turn into…. well, the devil.

Upon transfering care at the ER she screamed at me as I walked out… “Thanks for nothing, buster”

Glancing at the RN by the door… “good luck…..”

And away we went!

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Day 1. Uno. Eins. Oinos. One.

My internship officially started today at noon. Well, 11:30…

It is definately going to turn out to be a huge learning experience–which is good–because if it was a waste and I had to be 4 hrs from home–I can’t even explain how pissed I’d be.

It’s wasn’t an increadibly busy day–but 4 calls in 8 hours is busy-ish.

We had the run of the mill cardiac, a SOB(shortness of breath–not what you’re thinking!), a “why the hell did you call the ambulance you’re healthier than I am” and a guy that had gone a few turns around the bend.

That guy was special. PD was on scene when we arrived. They were doing a good job of getting him real nice and worked up for us.
Nothing makes me happier than a nut job who is ready to take a few heads off because PD has spent 25 minutes interogating him.

Leave the patient alone. Step back. Count to 10. Grow up. Take control.

Whatever– once we got him in the rig he was a generally nice guy who was more emotional than scary.

The hard part for me to get used to is going to be the waiting… So much waiting… It’s like the lottery too. You don’t know if you’re going to get called out for a shooting or a lady who needs an ambulance about as much as I need an extra hole in my head–despite what some may think.

Just remember–I am not a Taxi driver–even though one of my first patients during my “ride along” shifts asked me, and I quote: “so… how long have you worked for the cab?”

Excuse me you little SOB(what you are thinking this time–not shortness of breath…)–This isn’t a damn cab. “No, you called 911, not Yellow Cab.”

puzzled look. “What?”

“Oh, medicaid doesn’t pay for taxi’s so calling 911 in cheaper?”

Yeah, not one of my finer moments in compassionate care. Whatev. Life goes on. He’ll still call 911 next time(and know exactly what to say to dispatch to get that Code 3 response so he isn’t waiting around all day like he would be if he called Yellow Cab). Maybe Yellow Cab should have a response time goal!

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Since 09/11/01 President Bush has insisted that he is a strong supporter of EMS and Police services. Well, his 2009 budget is telling a whole new story. Already dwindly Medicare/Medicaid reimbursments will get smaller. Pretty much typical for a presidency who is more concerned with seeming to be helping out America and it’s saftey–even the Department of Homeland Security is going to be facing cuts.

To make things worse, the Rural EMS programs are being all but eliminated in his proposal. Hospitals, Nursing homes, and ambulance services that aren’t able to pay the bills now will certainly fall to the wayside and will further stretch already bursting-at-the-seems metro services and flight programs.

President Bush Needs to provide for those who provide health, safety, and comfort to our communities.

Untill then All is Not Well. WE are in Distress.

http://www.jems.com/news_and_articles/articles/Proposal_Slashes_Cash_for_EMS.html
http://www.freewebs.com/jeffhead/liberty/flagdistress.htm
http://www.uni-muenster.de/PeaCon/global-texte/g-a/Upside%20down%20flag%20is%20distress%20signal%20-%209-28-01%20-%20NCTimes_net.htm

So Anyways!
Life is taking all kinds of shapes these days. We had orientation today for our internship and it’s going to be a pretty grouling 300 hours/30 days. The reality is that I’m really not even sure how I will cram all of this info into my head. I already feel like a bumbling idiot after taking those blasted finals and now… it’s on to the real world.

Sure,
We get the comfort of having 2 medics there to make sure we don’t kill anyone… but after that it’s just a few days of testing and then I’m onto the “real world”.

Wait…
Not really…   by the real wold I meant starting out being FTO’d and pounded into the dirt some more just for posterity’s sake. Sure, life goes on–but this has proven to be one of the most abusive experiences of my life. First–our instructors give us our final test on DAY ONE. Then we go through Pathophys in 3 days. Cardiology in a month. Medical in less than a month. All while we’re getting pushed around the hospital by nurses on a mission to rid the world of medics….  Ok, so maybe it wasn’t all that bad–but you can imagine right?

Something like 3 days till I get to see my wife and puppies… then 5 days on–2 off–then 5 on, 1 off, 7 on, 3 off, 980238234 on. 

I can’t wait.

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Internship officially begins tomorrow! Pretty excited to get it started–but I’ll be more excited to finish it up so I can get home to my wife–I think I’ll have to save her from the puppies by then…

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Normally I’d go off a lot longer about why I support him. About why I think he can and will win. Normally I’d really just lay out a rant. Today, I’m going to let it go. I support Barack Obama for President–and I think you should consider it too.

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The trouble of a new blog… getting readers… my problem…
 

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Do you ever find yourself talking yourself out of the answer? Well, I proved today that I do just that.

After My Finals Re-takes I got to write out why I’m a moron about 40 times because I managed to talk myself out of answers that–for the most part–I knew.

Life goes on I guess.

2 days. Excited–sorta. Anxious–definately. Sad to leave—more than you know.

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So… You’ve gone through your entire Paramedic program, from scene safety to HazMat. You’ve passed(80% or better). You’ve averaged over 90% on everything. Never missed a clinical, and missed merely 1 day of class.

It’s finals week. 12 or so tests that decide whether you learned anything at all. And apparently I didn’t. Neither did half of my class…. But we get to retake them… Is that good? What does a test mean if it doesn’t really matter if we pass?

When you make a final exam that no one can pass–ok, one person passed it–what is the point? Challenges are the focal point of our field, but failure–what does that teach us?

We’re going to fail. We’re going to make mistakes–we just hope we don’t kill anyone. Primum Non Nocere–first do no harm. 

Do no harm. I get it–but at our training level–Entry Level Competent Paramedics–how do you know. Hopefully you’ve got a rock star partner that guides your through–but how do you know.

We all make mistakes. We did it in clinicals–we gave the SQ injection too deep, pulled the IV out, missed the tube, or blew countless veins. Where do you get that confidence that we HAVE to have to survive on the streets. When do you convince yourself that you’re going to help the sick rather than kill them?

That time is now. When you realize that what you know isn’t just a bunch of vocab words–but you know skills, and you know the reason why you know those skills. You understand why the PC02 is high or why the BP is plumetting.

Days away from my 300 hr field internship with tests to retake everything just clicked. It went “BOOM” inside my head. I know I don’t know everything. In fact I know that I don’t know a lot of stuff. I do know that I know enough to stop me from killing someone–and I know that I have what it takes to learn what it takes to save lives. Scary that I have to differentiate between the two? Maybe. Am I alone on this–I bet not.

EMT Oath
Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.

While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot.
So help me God.
http://www.naemt.org/aboutEMSAndCareers/emt_oath.htm

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Only 4 days till the beginning of my intership in MPLS. It’s one of those happy to do it, sucks to be leaving feelings. I will be incredibly busy, doing 260 hours in 30 days, but the time I have off will be minimal–and a bit lonely too. I’ll be leaving behind my wife… my dogs… and nervously… my fish tank. I’m really not even sure what to expect yet. It’ll be the first time Erin and I have spent more than a few days apart, and I know… life goes on, but I’d much rather be here at home with her in our little piece of the ghetto.

I’m going to do everything I can to keep up to date with this and write something every day. It should be interesting enough that I won’t have any trouble coming up with some interesting antics to fill the page and decompress my mind.

Anyways–Just remember to “Start your day with a D.O.A. …. Dooo da…. dooo da…”

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Thanks for stopping by Daily DOA, the Cheating Death Blog. I’ll rant/rave/whine/complain about my journey through my Paramedic Internship and then into my career(ya know… after I pass like 433,3454,543 more finals, my CBT exam, my practical exam, etc, etc, etc).

We’ll start off with a little bit about me….

I’m a 24 year old guy from Sioux Falls, SD, Married to my incredible wife Erin. We have 3 dogs, a fish tank that takes up way too much of my time, and spend our free time watchin TV, taking the dogs to the park and generally being huge dorks!

Keep in touch for more to come!

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