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I told myself I wasn't going to go there…

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But… I have to. I had decided yesterday I wasn’t going to talk about this particular patient. It is just one of those, need to get it out of your head, please don’t make me see it again, how could this happen–calls.

20 minutes left in our shift, we had gone Bravo and we were pulling into the garage–when The tones come out. Called for a 3 mo with “Burns” at one of our local problem clinics. Code 3.

We’re thinking it’s a BS Call. A) Who would take their baby with severe burns to a clinic and not call 911 or go to the hospital. B) it’s 20 min till the end of our shift and we’ve done a good job annoying the dispatcher today with our demand for details(we were sent on two transfers and when getting to County he didn’t even have the right building… sorry for wanting to know where to pick up the patient from…)

We walk in the clinic and the nurse starts spewing out details. 2nd and 3rd degree burns to 15-25% of the baby. That would be bad if it happened to me. If it happens to a baby–that can be deadly, and quick.

To boot, mom is a Nurse. Says she was on her way home and the Nanny called. Freaking out. Said that “something happened”. Yeah, no shit.

Apparently nanny had been trying to “wash” off some poo from a diaper change gone wrong. Apparently nanny was able to make Tap water eat skin and fless. Yeah.

My ass. The burn patter isn’t one of running water from a faucet, and it wasn’t one from sitting the baby down into the water. Seriously, the only thing I can see is if water was gently poured from a bottle or pan–you know, the kind you BOIL things in. Cause really, what Water faucet produces water that could cause these kinds of burns–and how couldn’t you feel the heat radiating out of the sink.

My chubby ass gets hot doing dishes in luke warm water. How could you not feel the heat coming at you. She claims she just forgot to check the water.

My faith in humans couldn’t be much lower–well, I guess we’ll see about that in a few hours…

Emergency!

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So it’s pretty much just awesome that the folks over at NBC have given us access to free episodes of EMERGENCY!

1500-0300, then On the road!

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So tomorrow I’ll be on 1500-0300. My first Metro overnight. I’m hoping to cover the Main. Stabbings, shootings, cops who can only hit suspects in the legs…(no, really…)

The real exciting part is as soon as I’m done I’m hopping in my car and driving home to see the wife. I should be there before 8am. It’s been since last Wednesday–and we haven’t spent that much time apart since I lived 2k miles away.

Hopefully the little monster dog will just quit her aucky cycle by then… realistic–no.

Sanity for the Paramedic Student

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Rookie Bebe over at Sanity for the Paramedic Student and The Rhythm of Life has got some great stuff going!

Hopefully Bebe can find some good study material for his site(and we should pitch in where we can!).

Check out Rookie’s work over at Sanity for the Paramedic Student and The Rhythm of life.

New Template and please saw with caution…

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I’m guessing you’ve figured it out! Completely new template! Let me know what ya’ll think of it and if it needs some tweaking.

At first I couldn’t find anything too exciting but I like this one a bit.

Today we got a nice finger lac/amputation. Fingers 4/5 gone, remaining are iffy. They toned out a hellicopter too. Funny thing is… we were to the ER doors before it would have been on scene.

PS, I hate nursing homes. I love nurses. I hate nursing homes. We were called to a 87 year old man who had a fever(dispatch: Sick One). While getting report from his nurse–who seemed to give me more personal knowledge of patients than I’m used to, something clicked. They called for a fever x3 days. Neg Influeza-A, etc. But then she said that on the 1st that he had a SP02% of 81%. They gave him 2L via nasal. Are you shitting me? 81%(he had sats of 98 on the 30th according to his chart…) and you let it sit there for 3 days on 2L of o’s?

No… I couldn’t have heard you right… This was for a “fever”? You didn’t think that maybe you should call us because your patient is going into heart failure? You didn’t think that maybe 81% was bad. Ironically–this was a real Nurse–not a CNA who was covering 40 beds. This is a 5-1 facility. WTF?

So, as a refresher class, what do we do when you get Oxygen sats in the 80′s that are supposed to be there…. Yes, wait. That’s it.

I'm going to let this one speak for itself

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I’m going to let this one speak for itself. Get the whole story by clicking the link. Something just don’t deserve me rambling them to uselessness. Many of you may have seen this one. Some of you may have not. Either way, take the time to go over it one more time–and keep doing so every week/month/year whatever it takes to keep it fresh in your mind.


The Day Joy Died

Medical Economics

It’ll soon be the anniversary of my OB patient’s death. Twenty years ago, I stood in the ICU, holding her limp hand. Her name, in stark contrast to her present condition, was Joy. Her mother was the only other person in the room.

The patient was brain dead, the result of an anesthesia catastrophe. In preparing her for her C-section, the nurse anesthetist had accidentally intubated the esophagus and failed to put a pulse oximeter alarm on her. She became severely anoxic during the operation, went into V fib, and was shocked back to sinus rhythm. The airway was corrected by an anesthesiologist who responded to the code, but it was far too late.

The patient was a beautiful, healthy 21-year old. She was well known locally as a singer. She and her husband had family all over the area. She came to me for her OB care because her mother had told her, “Go to Dr. Brandeland, he’s always been so kind and polite when he gets his messages.” Her mom worked at the telephone answering service I used.

So, I saw her and her husband at every visit. I was 18 months into my career after finishing my family practice residency in the same town. The practice was thriving. I couldn’t have dreamed of something this bad happening to a patient, a family, and my life. I thought I might someday miss a diagnosis and have a malpractice suit, but this was like getting hit with a telephone pole.

Read the rest by clicking the title above!


It's official… someone noticed!

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EE over at BackboardsandBandaids.blogspot.com gave me some incredibly kind encouragement this evening.

I appreciate any response from anyone, but being given the best advice(that we wish we could take… but I feel like I’m clenching the needle with my teeth while I pull the tourniquet tighter) I have to give a big thanks to EE and Future PA over at http://backboardsandbandaids.blogspot.com for the props!

Take the time to check them out! They’ve got all kinds of goodies going on over there!

I’m planning to keep them at the top of my “to read” list so give them a try!

Look Ma! No Swearing!

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I’ve somehow managed to make it through this whole damn blog thus far without swearing(because of this I had to just add a hidden f-bomb on this page to see if you could find it. I’ll send you a cookie if you do–without cheating).

If I could make it through a day without swearing… that’d be great. I have started to learn a few valuable lessons though!
1) It doesn’t matter how much time your patient is wasting. You get paid the same.
2) It doesn’t matter if your patient needs an ambulance or not–you get paid the same.
3) It doesn’t matter how much you stress about being in an abused system–You get paid the same.
4) No matter what, some shit just stinks. You still get paid the same.(ok, so there, I let one slip.)
The Blog-O-Cuss Meter - Do you cuss a lot in your blog or website?
Created by OnePlusYou

It apparently doesn’t work worth a damn either. Now if someone can figure out how to get these god forsaken templates to stick I’ll be less likely to kill someone on my next shift(0700–times running out)

You can safely say I miss my puppies…

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Do you think this could get me goin?

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We all know its a fact of life for me that I sleep like crap. Today has proven that. 2.5 hrs of sleep at best. Maybe the Zoll can give me the kick i need….

nah. Bad idea.

Our dog thinks she's a cat

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We are trained.

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We are trained to save lives. We are trained to get up early, rush to work, do what it takes, and get to the scene. We are trained to push through blood/guts/tears/vomit/feces to find the cause. We are trained to decipher the difference between minor symptoms. 
We are trained to treat. We are trained to diagnose. 
We are trained to respond. We are trained.

But are we trained to take it all home at night and deal with it?
I’m not sure. Sure, CISM is there to help–but you have to reach out for that. De-briefings are standard sometimes… But even then, you have to go to bed at night with everything you’ve done in your head. You have those pictures there. How do we decode that into something to strengthen us–not tear us apart.

Maybe that’s part of what being a seasoned medic means. You learn how to deal. You learn how to cope. Hopefully that isn’t what has turned so many of the medics I think of as “burnt out” or disgruntled away from their love for the field.

Someday I hope to answer that question a little better.

I'm a moron, time goes slow, I miss you.

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So I’m a moron. I am on 1500-0300 fri/sat and somehow that got into my phone as 0500-1500…. I’m brilliant. So not only do I work overnight, but I don’t get to go home till Sat morning. I can handle overnights–but Since I didn’t get to go home last weekend we were looking forward to spending friday-sunday together. Now it’s Saturday moring following an overnight +4hr drive.

Did I mention I can’t wait to go home. I can’t wait to see my wife, my dogs, my bed… my tv… my wife… Did I mention I miss my wife?

I miss you!

Not a lot to write about from the field. I didn’t go today as I’ve been sick since sunday. I did however have a bad enough shift on Sunday that I’m just not going to talk about it. Sometime you have to let thins go, and move on. This is one of those time.

4 days baby.

Google Goes to Mars

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They didn’t seem to think I was cut out for it…

Well, you’re distressingly normal and could conceivably adjust to life as a deep space pioneer, though we recommend instead that you leave the Mars missions to the serious whack jobs who scored over 130 and instead finish year 3 of law school, tuck your toddler into bed, design Web 2.0 applications, run for Congress or do whatever other normal, healthy, middle-of-the-road thing you’re currently doing with your normal, healthy, middle-of-the-road life. If you’re determined to give Virgle a try, though, you can submit your video here.

Maybe you might be able to make it stick… http://www.google.com/virgle/application.html#virgle_assessment

If you haven’t figured it out yet, this is part two of one of the most brilliant April Fools Jokes of all time.

Do you think Sir Richard would do a cameo over here for me?

Yes, I get it, none of these are relevant to my blog. I get it. But sometimes, you just need to occupy your mind with something useless. Go buy a DeLorean–apparently they are making new builds now too–for real–not April Fools…

Gmail goes back in Time!

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We’ve all done it. We’ve needed to go back in time. Supposed to email that report in before 5pm… done–even though it’s 9 pm 3 days later… Forgot your dad’s birthday…. Not anymore…

The folks at gmail are simply brilliant. What will they come up with next… A Delorean that takes you Back into the Future

clipped from www.google.com

Ever wish you could go back in time and send that crucial email that could have changed everything — if only it hadn’t slipped your mind? Gmail can now help you with those missed deadlines, missed birthdays and missed opportunities.

Pre-date your messages
You tell us what time you would have wanted your email sent, and we’ll take care of the rest. Need an email to arrive 6 hours ago? No problem.

Mark as read or unread

Take sending emails to the past one step further. We let you make emails look like they’ve been read all along.

Make them count

Use your custom time stamped messages wisely — each Gmail user gets ten per year.

Worry less

Forget your finance reports. Forget your anniversary. We’ll make it look like you remembered.

Learn more about Gmail Custom Time »

blog it

If that isn’t enough… Get your own Flux Capacitor…

Only 220 bucks!
http://www.tfaw.com/Profile/Back-To-The-Future-Flux-Capacitor-Replica___311677

Oh, and an FYI… april fools.