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Ambien made me post this…

2 comments

Seriously. It did. I take ambien for sleep(12.5mg XR), as the chances of me sleeping on my own are not so good. But if I am awake past that first 40 minutes it makes me do crazy crap. Like post on my blog. Or clean out the fridge. OR trim, cut and cure 40 lbs of deer meat for Jerky slices. I’ve rearranged my 75 gallon aquarium and not remembered. I’ve don a LOT of things and not remembered.

It is mildly terrifying to know how much can happen with so little control. MY wife sure like the cleaning version of me though, so I doubt I’ll be changing over soon.

Do any of you have first hand experience of the crazy things meds made you do?  We hear stories all the time from patients and coworkers, but I’d like to hear your own stories.

ON a clinical note, what do we need to look for with these odd situations? Can a patient sedated with ambien be reliable?

Drop me a line!

 

Ambien Side Effects

Ambien Dosage:

Dosage in adults

The recommended dose for adults is 10 mg once daily immediately before bedtime. The total Ambien dose should not exceed 10 mg per day.

Special populations

Elderly or debilitated patients may be especially sensitive to the effects of zolpidem tartrate. Patients with hepatic insufficiency do not clear the drug as rapidly as normal subjects. The recommended dose of Ambien in both of these patient populations is 5 mg once daily immediately before bedtime [see Warnings and Precautions (5.6)].

Use with CNS depressants

Dosage adjustment may be necessary when Ambien is combined with other CNS depressant drugs because of the potentially additive effects [see Warnings and Precautions (5.5)].

Administration

The effect of Ambien may be slowed by ingestion with or immediately after a meal.

Posted by on October 5, 2011 • Filed under: ems-health-safety, ems-topics, father, firefighter-safety-health, HELP, Home, husband, medic, news, patient-management, Uncategorized, videos

Still in there…

1 comment

One of the most common, and hardest patient encounters for me as a medic is that of someone who has lost their ability to do things. They still have all of their cognitive function…. they are just unable to do the things that you and I take for granted every day. Things like opening the milk, buttoning our pants, or driving the car. All gone, in what seems like a flash.

All of the sudden we are thrust into a moment where our patients are exposed for their weakness: they can no longer care for themselves. They KNOW they can do these things…. they just can’t actually complete the task. Our brain tells us we can do the things we’ve done countless times over our lives… but our bodies just don’t cooperate.

Today we had a patient at a local retail store. Found by staff in the bathroom. On the floor, covered in feces. He seemed alert, but was too weak to stand. To weak to grasp, to move. We arrived on scene found him sitting in a power chair, running into the wall… then the sink. Repeat.

It was obvious we were in one of these dreaded moments. Where it had to be explained to him that he needed help. Perhaps family has tried. Or maybe they haven’t. Maybe they’ve left this up to a stranger. To me.

As I explain to the man, who just knows he can take care of himself that I can’t let him drive. That I think we should take him in to get checked out–even though I don’t think he actually needs an emergency room–I see that look in his eyes. I see that he knows that he can’t do this anymore.

But he can’t let go. When he lets go of this he knows the rest is soon to come. That every piece of independence he loses is another piece of his dignity, all but forgotten.

While these patients can be frustrating, because it should seem like common sense that grandpa can’t drive, or grandma can’t climb the stairs anymore… families are in a hard place… taking the dignity from their elders. So take the time, the compassion to try to approach things delicately. Remember that some day, someone is going to have to tell you that you too are unable to do the things you’ve done all of your life. That you know you can do.

Despite being slower, weaker, and unable to complete seemingly simple tasks…. they are still in there. There is a soul in there still needing our compassion.

Posted by on September 1, 2011 • Filed under: ems-topics, medic, patient-management

Merry Christmas, friends

1 comment

image

As I head into day two post sinus surgery and Christmas day, I realize I have much to be thankful for. So much I won’t try to list it all here.

So….. Merry Christmas, my friends. To those of you working the streets: be safe, warm, and come home in one piece.

Godspeed, friends.
M3

Posted by on December 25, 2010 • Filed under: ems-health-safety, ems-topics, fire-rescue-topics, Home, medic

“Service”

1 comment

Are we “service” professionals? Do you view patients as “customers”?

I work for a corporate system and I am having a hard time wrapping my head around some of corporate nonsense they are using in employee publications as of late.

What do you think of calling “patients” “customers”?

My first impression…. I was under the impression “customers” “bought” things…. not took them for free?

Posted by on November 5, 2010 • Filed under: ems-health-safety, ems-topics, medic, patient-management

Reality Check

59 comments

As usual, the EMS blogosphere has found itself in yet another little tiff. This time Timothy Clemans and Medic22 are in a bit of disagreement about proper use of ALS, among other things.

Timothy seems to believe that ALS skills are wasted on patients that are not in risk of losing life or limb. While Medic22′s way of responding to him might be over the top, I can TOTALLY understand how and why that would happen. See here and here. We all take this pretty damn seriously, so I understand the frustration.

Because I agree with Medic22′s thought process on this, I thought I would chime in a little bit.

If it was up to me I would eliminate prehospital ALS except in cases where ALS care prevents the need for hospital/clinic care and in cases where evidence demonstrates that ALS saves lives. That said, Medic 22 did bring up an excellent point about prehospital pain management.

Is it really that simple? Simply put, I’m out of a job. All of us are. In a systemsign-realitycheck with 11,000 calls a year, we’d be able to pay one medic. Thats it. After the sob story of me being unemployed is over, we’ll address the real issue: why is it that you have to be dying to get compassionate, adequate, respectful care?

If you are sick or injured, but not dying, Timothy is saying that you should only get a taxi ride to the hospital(where you will wait in triage for an hour(or more) and then wait for a nurse to complete an assessment, then a doctor, then maybe get your treatment started).

Are there ALS skills that need to be reviewed? Absolutely, but until you have had to sit in a truck with patients puking their brains out(on your new, shiny boots) you will not understand the validity of our skills that are in between taxi driver and super hero. Pushing Zofran for that nausea not only helped to relieve the discomfort for that patient, it also helped prevent them from further dehydrating themselves (or like a patient a week ago… going into vfib every time she puked… Seriously).

Managing pain in patients is one of the best skill sets we offer(and either the most avoided due to paperwork or most abused by patients).  Allowing grandma some comfort for the 15 mile ride through my Wintry Mid-Western city riddled with potholes and ice chunks is the least I can do after she allowed my whiny ass to stay alive all this time.

I can’t agree more with you! I have been battling this topic for 7 years to no avail. At one point we had our agency MD on board yet the other program MDs in the county voted against it! Again, “nobody ever died of pain” was just one reason. Another was/is the potential abuse issue, especially with fentanyl compounded by the fear ketamine could be stolen off the trucks by youngsters for their Rave parties. Subsequently, our patients receive a proper induction via etomidate but very infrequently the administration of diazepam and morphine post intubation (only a few of us religiously use the agents). What you end up with is a patient who doesn’t remember undergoing paralysis and intubation but wakes up being paralyzed and intubated on a bumpy ride to the hospital.

All this says is that local MDs have zero faith in their medics. If you can’t secure your narcotics, you have no business being in this business. There are dozens of ways to secure them. This is simply an excuse for someone who is afraid to allow their medics the ability to treat.

Medic 22 a dehydrated girl with a low BP and tachycardia needs a line and a fluid blous. That’s ALS. Not an emergency… but something that a paramedic can, and SHOULD do.
Me: what’s the benefit of the prehospital als in that case? if it doesn’t save a life or shorten hospital stay what’s the point
Medic 22: It’s GOOD PATIENT CARE. Its what competent, caring prehospital care providers do.

If the care by paramedics could prevent the need for hospital then I’m all for it. Unfortunately in the case wouldn’t you just be delaying hospital care and doing something just to do it?

First of all, you are assuming we are delaying care. Like I said before:

My scene time consists of a brief primary assessment, possibly a 12 lead and loading the patient where I begin the rest of my treatment–unless the patient absolutely needs other interventions prior to departure. That being said, when I am 15 minutes away from the hospital with someone puking(and further dehydrating themselves) or someone who has moderate wheezes, why shouldn’t I begin treating them?

Again…. It seems that you assume there is some abundance of Life or Limb calls in EMS. Honestly, those exciting calls just don’t come all that much. What we get a lot of is sick baby boomers, indigents, drunks, and people who don’t know any better. Does that mean we shouldn’t treat them while we can?

It is our job to treat patients, and as long as I have time in the back of my truck, I am going to do everything I can to make them more comfortable, happier, and healthier–if at all possible.

Posted by on March 9, 2010 • Filed under: Blogroll, ems-health-safety, ems-topics, medic, patient-management, Protocol, training-development • Tagged:

Stubborn

3 comments

stubbornI am a stubborn guy. I know when I’m right, and I don’t back down. As a matter of fact, my insistence on being right has alienated more than one person in my life. I just can’t handle people who won’t admit they are wrong.

That being said… When I’m wrong, I admit it. I might not be happy about it–often I beat myself up over simple things. But I admit I’m wrong. In this line of work admitting you are wrong is more important than always being right. Knowing when to ask someone smarter than you is one of the most important things in EMS–hell, all of medicine.

If you can’t admit you are wrong. If you can’t understand that asking for help is a virtue, not a fault… Then maybe this business isn’t for you.

Posted by on March 8, 2010 • Filed under: medic, Stress • Tagged: ,

Lost in Translation

4 comments
We picked up a young Hispanic couple this evening along with their 5 children. I can only presume they were their children, as they did not speak a lick of English. There were no injuries. No complaints, but they wouldn’t get out of my ambulance. When we got to the hospital, the youngest child(4) speaks in clear English while the others freak out in Spanish…
“Hey taxi man, this isn’t our house”

We picked up a young Hispanic couple this evening along with their 5 children. I can only presume they were their children, as they did not speak a lick of English. I tried and tried but no one responded to my pleads in English or my piss poor attempt at Spanish.

There were no injuries. No complaints, but they wouldn’t get out of my ambulance. When we got to the hospital, the youngest child(4) speaks in clear English while the others freak out in Spanish…

“Hey taxi man, this isn’t our house”

Posted by on February 18, 2010 • Filed under: Crazy Calls, medic

The Drive Home

3 comments

In EMS there are a few tools we use as coping mechanisms. CISM(Critical Incident Stress Management) is the most common, despite many organizations not having active CISM systems. While I find CISM to be useful, it is rarely deployed for run of the mill EMS calls. Death and Dying is our business, and if we had a CISM meeting(which includes everyone from first responders to ED doctors and Medical Directors) for every death in the field, we would spend more time in meetings that in our trucks.

This leads many of us to find our own personal stress management tools and techniques. Some people vent to coworkers, some people blog… Some people pray, or drink, or work out, or smoke. Me…. I drive home.

Every morning when my shift gets over at 0700 I hope for a partly cloudy sky. This winter has been good to me. With crisp, cool winds, light cloud cover and beautiful sunrises, I have done more call reviews on my drive home, alone with Country Music in the background than any CISM meeting or Jack and Coke could provide me.

I use the 9 mile long, 15 minute drive to go over the night before. By the time I am home, I always feel better than I started. The roads are clear in my direction, everyone headed into the city for work while I head out on my way home. I drive a hilly road straight into the sun and every morning is a great reminder that the cycle keeps going.

People live. People die. In between we can only keep on trying. Finding a tool to review, learn from, and sometimes forget bad shifts is one of the most important things I have done in my short bid in EMS. Without my drive home to a different kind of chaos, I really don’t know what I would do.

Fortunately I don’t have to.

Posted by on February 18, 2010 • Filed under: Coping, ems-topics, Home, medic • Tagged: ,

Uninspired.

9 comments

For months I have struggled to keep this blog alive. I have posts inside me. I have posts started. I just can’t muster them out. This is really the way a big chunk of my life is going. I am incredibly happy with my wife and son, but something is amiss.

I am often distracted, barely able to pay attention to the simplest of things. Medically, I am an undiagnosed ball of annoying symptoms–not debilitating but the sum of them is wearing me–and my family–out.  I stugle to be the man I promised my wife I would be, while being a father I respect and a paramedic I would trust.

That is all I want–to be a good husband, father, and paramedic. Just like the subtitle to my blog. That is me. There is little more to me than those three things. Sure, I am a son, a brother, a friend. But the sum of these three things defines the man I am today.  Yet I find myself uninspired. I have an amazing wife, an adorable 1 year old son and a job I love doing and I am just uninspired. When I get home, I kiss my wife, hug my son, and go to bed. I fail miserably at sleeping all day and then repeat the cycle.

I make goals–to work out, eat better, spend wiser, study harder–yet I never follow through with any of them. I set these goals again and again and I always end up where I started. Uninspired.

I have the desire to move past all of this, but I just need the right push? What will that push be?

Posted by on February 10, 2010 • Filed under: Boredom, Changes, Coping, Failure, father, HELP, Home, husband, medic

Being an EMS Dad

14 comments

I’ve been a paramedic for about 19 months. Not very long, really. My first year was spent working for two teeny tiny services with teeny tiny call volumes. The last seven months with a service that runs right around 10,000 calls a year with 3 trucks covering. Needless to say, I have experienced a lot more in the last 7 months than I did in the year prior to this.

I have been a father for just under a year. 11 months and 7 days, to be exact. As a father I know I will be learning what to do for the rest of my life. My son is amazing and if I didn’t have the amazing wife that I do–well, there isn’t a shot in hell I could do this on my own.

What I didn’t expect was for the lessons EMS would teach me about being a father. The skills I’ve learned since becoming a father are less about medical procedure and more about communication, lessons, and reality.

Reality is the hardest part. Shit happens. Inevitably Asher will get hurt. Inevitably Asher will get sick. Inevitably Asher will make us mad, and I’ll be forced to discipline him. Some how, working in EMS has taught me some skills to be better prepared(or so I am hoping!).

The most surprising skill tune up I’ve gotten while working on the streets came in the form of communication. My communication skills suck. I bottle things up, take them out on those I love, and then don’t understand when they get mad about it. I can be hot tempered, ill mannered, and down right inappropriate. Dealing with frustrating, rude, and down right worthless patients over the last 19 months has taught me that sometimes despite what you think and feel about someone, you have to be able to do your job with self restraint.

Self Restraint. Compassion. Patience. Even now when Asher is so young and innocent, these qualities are getting more fine tuned. After a long night at work, coming home to a screaming baby isn’t easy. Then again, Mrs. MedicThree was home alone with him all night–I don’t imagine me coming home and ignoring them helps her get out the door much either. Before being a medic, father, and husband it was all about me. Now, it rarely is.

Being a medic has taught me how to diffuse situations that could otherwise end badly. Calming a psych patient down, giving stern advice to someone abusing the system, and making sure I am doing so within the bounds of being a Paramedic–and not a judge–is more than a challenge at times. When I first started doing this, I would jump down someones throat for “wasting my time”. Now I understand that sometimes it is easier and better to spend a minute or two trying to figure out(and make the patient) what the hell is going on.

When it comes to life at home, it is more logical to take a breath and treat my family with the respect they deserve. Does this mean I am always cool and calm? Nope. I get stressed. But I like to think that when big things come up I can handle myself–this is something that prior to EMS I’m not sure I could do.

The most unexpected part about being an EMS dad is how being a dad has changed being a medic. Pediatric calls give me a different chill I couldn’t imagine pre-fatherhood. The way I communicate with patients and families has evolved greatly since being married and becoming a father. I spend a little more time trying to make my patients feel better than I did before–most of the time this is done by talking. Sometimes I am a little stern–call it honest–but sometimes that is exactly what the patient needs, and sometimes it is what they want.

Trying to pick and choose the parts of EMS I bring home to my family is the hardest part. Learning how to cope with the realities of my job and the challenges of being a husband and father will continue to be the hardest thing I encounter on a daily basis–but I’m excited for the challenge.

In this line of work it is easy to try and separate your personal and professional lives completely–but it is impossible to succeed. Finding a way to allow them to compliment each other is the key to survival.

Posted by on January 12, 2010 • Filed under: Asher, Changes, Coping, ems-topics, Failure, father, Home, husband, medic • Tagged: , , ,

False Hope.

6 comments

As EMS providers, we have a very limited scope of tools to help our patients. We are obligated to follow our protocols and treat was is evident from our assessment. This means your assessment is likely the most powerful tool you have in providing medical care. Ironically our most powerful tool, communication, is often completely forgotten by EMS providers.

The hardest part about our job is being honest with patients and their families. Often times we are present in end of life situations. These are difficult in controlled atmospheres–let alone the seemingly claustrophobic nature of EMS scenes. When a patient is dying we need to be honest with them and their loved ones. We need not be brutally honest, but most certainly we can not allow false hope.

False hope is a natural defense mechanism in the grieving process. Denial. Even as EMS providers we sometimes hold on to false hope in difficult calls to get by–but this is neither practical nor healthy in the end. Allowing and providing for false hope will create more shock when reality strikes. Death is a natural process–not always a pleasant process–but natural none the less.

As providers it is our duty to assist our patients and their families in understanding the reality of their situation. Does this mean saying “you’re going to die”? Not at all. But it does mean being clear that the patient is very ill, and you are doing all you can but 1) they need higher level of care 2) they may not make it to that higher level.

Does this make the process of dying easier? Absolutely not. For patients and their loved ones knowing their impending doom can be equally troubling. But it is still our duty to be truthful with our patients. Where I believe this honesty to provide an important relief to EMS is in the all to difficult cease or withholding of resuscitation talk we find ourselves in during these types of calls. Being honest with a patient and their family gives them more time, possibly only seconds, for reality to sink in.

When termination of resuscitation becomes part of the discussion, patients families are often unprepared. Giving them the truthful answers to questions about the reality of the condition of their loved ones will certainly help them to make the decisions to terminate care when necessary.

How do you handle these difficult moments in patient communication?

Posted by on December 11, 2009 • Filed under: Coping, ems-topics, medic, patient-management • Tagged:

Stuck in mud.

8 comments

As you might have noticed I haven’t posted a great deal lately. Over the last few months I have tried to cut back on overtime since I felt like I was missing a huge chunk of my little guy’s life. The drawback is that created financial stress on my wife and I that added a whole different problem.

That being said, work just hasn’t been that exciting lately. I haven’t had a “good” call in weeks. Run of the mill, drunks, flunks and morons occupy most of my nights. The last 4 shifts have had a total of 5 calls for our crew, which is wayyyyy below the norm. Sometimes the break is nice, but it really leads to boredom. I’ve attempted to write several posts and I seem to get stuck about halfway through every time.

For one I feel like my head is clouded all the time. Do I have ADD? Maybe. Something really messes with my focus and has for years. I get stuck in a pattern that just repeats and repeats and repeats. Well…. I’m doing what I can to stop this cycle. First, my wife and I are starting back up on P90x. I plan to make a quick post about it everyday, but using the recent past of medicthree.com might make it easy to realize I will likely fail at this.

Second, my wife and I are going to talk with someone about our budget, and more importantly our debt. The combination of several horrible financial decisions, in combination with several piss poor decisions in college have left us in a heap of debt. Almost enough to buy a decent house.  We’ve decided we can not handle ignoring this any more and it is time to do something about it before we set this as an example for Asher. Admitting this to myself was hard. Admitting this to you all was next to impossible and in the even that I hit “publish” with this intact, don’t judge me too strongly…

The last year has been tough on Mrs. Medicthree and I. Our marriage is stronger than ever, but so many changes–my jobs, her job, having a son, moving, moving again, being broke, being really broke, and the list goes on–will take a toll on any relationship. Without her, I couldn’t have done any of this. I wouldn’t be able to do the job I do. Coming home to her and Asher is what makes my day. Work is just work. Coming home is my life and all I really care about. I know I don’t get to tell her this enough, but it really is.

If you follow me on twitter you might have seen that I went deer hunting in November. I got both my Buck and a Doe. My Whitetail buck was by far the best deer I’ve ever shot. At 7×7 it isn’t huge by whitetail standards, but considering he was shot smack in the middle of Mule Deer country makes it pretty impressive to me. I convinced the Mrs. to let me get it mounted(European style) and I’m damn excited about that.

Anyways, enough of my worthless ramblings. It is breakfast time here in the land of M3. Lets see if I can accomplish something worth posting about in the next few days.

Posted by on December 6, 2009 • Filed under: Boredom, father, husband, medic

Please tell me you didn’t…

2 comments

66642775v5_225x225_Front

Call 911 because you couldn’t sleep. Please tell me dispatch didn’t dispatch me code 3 for this “emergency”. Please.

Please tell me you didn’t expect me to be able to fix this… And please, please don’t get mad at me when I suggest you get a job as a means of tiring yourself so that you might be able to fall asleep at night.

Please.

Posted by on November 25, 2009 • Filed under: Dispatch, medic, Moron • Tagged: , ,

Cause…

1 comment

I couldn’t have said it any better, I’ll just Let EPIJUNKY do it for me.

We should all follow her lead. I think this is really what we should focus EMS 2.0 on. If we can’t stand up for our patients, what business do we have THINKING for them…

Posted by on October 28, 2009 • Filed under: administration-leadership, ems-health-safety, ems-topics, medic, patient-management

EMS LODD RSS

5 comments

loddI’ve always found it important to inform my readers of EMS LODD notices. I use an email alert to do so, but found this wasn’t always easy when I was away from my computer. Thus, I contacted Kris Kaull at ems1.com and asked them to add an RSS feed for their LODD notices. I’ve added it to my site at left, and here are the links you need for them. There is both now an LODD page and and LODD RSS feed.

Share, use, and most importantly thank ems1.com for their help on this. They always seem to have the most up to date notices.

http://www.ems1.com/DutyDeaths/

http://www.ems1.com/ems-rss-feeds/duty-deaths.xml

EMS-ambulance-thx

Posted by on October 28, 2009 • Filed under: ems-health-safety, ems-topics, line-of-duty, LODD, medic

Unspoken

7 comments

Often times on a call, it is what ISN’T said that is most important. As paramedics we are trained to ask a set of questions necessary for assessing our patients, but more often than not, we know the important answers. We know when our patients are sick. We know when they hurt. We know when they can’t breathe. Those things are usually obvious.

The hardest thing we often know without a word spoken… we know when our patients are ready to die. The look–or lack there of–in their eyes, their posture, their sound–they all tell the tale all too well.

no_evilThe trouble is that we are trained to prolong life. Little about our training prepares us for letting allowing watching someone die. We are trained to do everything possible to prolong life–whether that is what the patient wants or what is best for them. We are trained to give drugs, artificially ventilate, pace, defibrillate, and otherwise interfere in the dying process. We are not trained to let people die.

So what do we do when the ultimate time comes? Outside of a DNR most systems won’t allow you to cease rescussitation. My system takes the word of a family member very seriously–outside of suspicious circumstances, we honor the wishes of an immediate family member. We also take the time to educate them on what will happen either way. I find it important to make sure someone knows that even if we get them to the hospital alive, they very well might never wake up.

My job isn’t as cut and dry as most think. I rarely save lives. Most of what I do has little to do with medicine or emergencies. Most of my night is spent dodging drunks or other frequent fliers. In the last 6 weeks my partner and I had 4 or 5 really “exciting” calls. Maybe I’m sick/twisted/strange/gross, but the exciting calls are the ones that make you go “aw shit…”. Most of the time we are running call after call of No Ambulance Needed or PD to Transport. But every so often we actually run a “real” call. Every so often we come across a sick patient.

Every so often that patient has already made up their mind that theypain can’t fight anymore. Who are we to decide otherwise? Does what we do make a difference other than to prolong a life of pain and discomfort? Are we doing harm in interjecting in what is the obvious end of the dying process? Are we causing pain? Obviously we are bound by our protocols/guidelines. Obviously we are bound as medical professionals to follow the medical standard. But at what point are we doing MORE harm?

Posted by on October 26, 2009 • Filed under: Coping, ems-topics, Heart Strings, medic, patient-management

On the Clock

2 comments

The time has come for my 9 glorious days of time off/recovery to be over. Sadly it wasn’t the vacation you’re all envisioning, but it was a nice distraction from the world of work. Now that I’m back and on the clock, I’m hoping for an easy night or two but not optomistic…

We’ve been getting snow for the last few nights that, while gone by mid day, is a real pain in the ass for us competent people in the moring. See, incompetent people don’t seem to understand that just like last year and every year before, snow comes, causing the pavement to get wet and sometimes slick. This means you HAVE TO ADJUST YOUR DRIVING APPROPRIATELY! Seriously people.

Much of our job is the result of stupid people doing stupid things. Often times these stupid antics cause innocent people to be hurt or worse die. When you roll out onto the roads this winter(yes I know, it is only Fall, but Mother Nature changed her damn mind this year and I can’t control that) please take your time getting where your going. Worse than you getting hurt, is you hurting someone else. To my EMS/LEO friends: Watch your backs. Wear those stupid vests. No one can protect you like you can.

Godspeed friends.

Back to work…..

Posted by on October 13, 2009 • Filed under: medic • Tagged:

Awake.

2 comments

Living days while working nights has proven to be a challenge. It seems as though every night I fall asleep with little effort, but wake up every night between 2 and 3 am–like clockwork–and just can’t seem to fall back asleep.

Tonight I woke up and it was like a switch had been clicked. Wide awake. I hate it. I want to sleep when I’m home, and want to be able to function during the day when possible. Honestly, I wish when I woke up NORMALLY it was that quick.

I am sure part of this is from getting up with Asher for soooooo many nights at nearly that exact time, but I know most of it is from my Night work schedule. It has proven to be a challenge I didn’t expect.

I know that the final key to the puzzle is a little anxiety. Honestly, we’re just skating by financially and have been going through several other medical issues between Mrs Medicthree, Asher, and myself. Asher’s Kidney draining issue is still undiagnosed, despite nearly 30,000 dollars in tests and doctor visits. Mrs. MedicThree’s problems seem to be in the clear, but will require frequent monitoring to be sure. As for myself, I am scheduled for Nissen Fundoplication surgery on Tuesday for my Acid Reflux/Gerd and I am rather anxious to get it over with. I have such frequent reflux that it is a serious burden on our lives. I’m also hesitant because of some of the terror stories out there about the side effects, but I feel as though I have no choice at this point.

Anyways, I plan on fininshing up a few posts in the making this morning/tonight, so please keep coming back to see what I’ve got.

Godspeed, Friends.

Posted by on September 30, 2009 • Filed under: father, husband, Life, medic, sleep, Stress • Tagged: , , , , ,

Writer's Block

6 comments

Yup. I’m still alive, just in a perpetual state of writer’s block. You might have noticed my twitter updates are a bit slim too. Since starting the new job, stress is better, but still there. The Mrs and I have kind of a lot going on. I’m trying to get the go ahead to do nissen fundoplication for acid reflux, Asher is still batteling his kidney issues and the Mrs has a few medical issues going on too.
Hope to be back at it soon, but just wanted to let you all know i’m still alive.

Godspeed all.
Posted by on August 25, 2009 • Filed under: father, husband, medic • Tagged: , ,

Paramedic News on Twitter

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Follow @ParamedicNEWS for every paramedic/emt tweet on Twitter! Check it out and let me know. It will update several times a day with the latest Tweets about paramedics/emt’s. For the original Tweet click the link provided.

Follow @medicthree for more randomness. You can view all tweets about www.medicTHREE.com by clicking the twitter logo on the bottom right of this page in the Wibya toolbar.

Thanks!

Posted by on August 7, 2009 • Filed under: medic • Tagged:

Take Note:

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2 grams of Coke, plus a dash of PCP will make you f’ing nuts. Psycho Nuts.

It might just make you so nuts that you decide that your Super 8 motel room is the set of the next episode of The Detonators.

Step one. Ingest Coke, plus PCP. Step two: Freak the F out! You can ALWAYS identify a PCP high when they have destroyed the porcelain god! Always.

We wondered in through shards of drywall and porcelain, mixed with cheesy drywall and some shards of mirror to find 6 police officers with their knees on the back of a 165 lb man who was all but throwing them around. He had been shot 8 times by less than lethal rounds, OC’d twice, and was now restrained but by no means controlled.

Law Enforcement didn’t know what to do at this point, and honestly, we really didn’t either. While he may have taken that much Cocaine, the PCP has altered that reaction from what would be barely breathing to going nuts. Way nuts. We improvised and chose a less than perfect solution: face down backboarding with hand and leg irons in place. There was no doubt his airway was intact based on the repeated “I’ma fuck you up!” followed by the incoherent screams and spitting. During transport and IV was established and but narcan was NOT given, as symptoms did not match that of a narcotic overdose.

Once we got to the hospital the irons were replaced with leathers, and he was able to be restrained facing supine, but the battle still raged. During the 20 minutes we were there, they gave him 40 mg Valium and 20 mg of Ativan–enough to require you breathe for me–and he still lerched his back and gave the trademark PSYCHO look.

Before we departed they ended up RSI’ing the young fella for both his and his providers safety. His thrashing had caused him multiple cuts and it was only a matter of time before one of the people trying to care for him would be taken out too.

Goes to show just how gonzo’d you really can get!

Posted by on August 7, 2009 • Filed under: Crazy Calls, medic • Tagged: ,

Hypothermia… In August?

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Called at 0700 for a a Man Down. As we near the scene the update indicates it is a 93 year old woman in her driveway, confused and cold. I honestly expected the typical fall, and, it being 60 degrees out, she was likely a bit chilly….

What I FOUND was actually much more serious. We found a woman, lying on the driveway, wet clothes, and COLD. Very cold. No longer shivering cold. Cardiac dysrhythmia cold. She could tell me her name, and that was it. Neighbors had found her while out walking, and told me she lived alone in this huge old house in the old money neighborhood of little big town.

She was cold. Seriously cold. It is August, we’re not supposed to have hypothermia cases… but a few things left her little chance… She weighed… soaking wet, might you say… 80 pounds. I suspect that even without the dampness she would be damn cold. I suspect she has been down a long time. She has abrasions on her hips and shoulders from dong what some call the “crappie flop”. Further, at 0700, it is rare to find an elderly fall victim fully dressed. She had jeans, blouse, and shoes on. Most of our early morning fall victims have their pajamas on still.

What got me was that she was wet. Not damp, but soaked. No sprinklers near, no pool. I KNEW she had been out since 10pm last night… in the middle of a 3/4 inch downpoor. Poor thing had laid in her driveway, alone and affraid in the middle of a god damn thunderstorm. Then laid out all night, till a passerby noticed her–and I don’t know how they did! She lives on a secluded street up a bendy driveway. Lucky, if you can call her that.

In the field we can do little for cases like this. Warmed IV fluid, blankets, and heat packs in the arm pits is all I had. Fortunately it is a short jaunt to the ED.

Guess her core temp….

84.7 degrees. Yup. Thats cold. Beyond Stage 3 hypothermia. She was in V-Tach(which we did NOT treat due to temp), respiration of 9, but her eyes were open, almost as if they were trying to say something to me….

I’m not sure if she survived. Often times Stage 3 Hypothermia ends in Organ Failure and cell death. This call just goes to show you that you can’t walk into a call close minded. It is flipping August and I just ran a severe hypothermia call.

Posted by on August 4, 2009 • Filed under: Crazy Calls, medic, Wow. • Tagged: , ,

The Handover

1 comment

The Handover is up at Trauama Queen. Check out everyone’s submissions. Here is mine.

Posted by on July 31, 2009 • Filed under: Handover, medic • Tagged: ,

Is there a Doctor in the House?

1 comment

Kal from Trauma Queen has a great post up over at Doc2Doc. Check it out. Tell him I sent ya!

I have a great deal of respect for doctors. But, emergency medicine is a whole different ball of wax. Hell, what WE do in the field is rarely “medicine”. Often I think of myself as an emergent pit crew member. Throw some tape, fill em up with fluids, and drive like hell. Sure, I believe in the medicine we CAN practice, but often what we do is a simple game of racing the clock to get our patients to a doctor who IS qualified to handle the situation. That does not mean ANY doctor, however. A GP, oncologist, or podiatrist is very unlikely to be the doctor of choice in a car vs pedestrian accident.

That being said, I believe that (most)physicians have earned my respect. No one gets my respect for free. I do not find it appropriate to be rude to them on scene though. Often informing them that if they feel the need to intervene they will be required to come along for the duration of the transport does the trick in getting them out of our hair.

Unfortunately, just like everything else in life… when you NEED a doc on scene, you can’t even get them to come to the phone!

Posted by on July 30, 2009 • Filed under: medic • Tagged:

Despair

1 comment

Ambulance Driver has a post up, “Despair“. It is too eloquent for me to even comment on, other than to say that this is the real battle we face in EMS. Those who fall into the gap somewhere between fakers, gamers, scumbags and the sick, dying, and injured.

Posted by on July 19, 2009 • Filed under: medic • Tagged: