So what will happen with poor, no idea what in the hell-is-going-on-in-this-truck noob girl gets thrown into the masses? Well, we will see? We’ve given her a week of riding along, doing whatever. But next week the cord is cut. Time to run from mommy and be a medic!

We were called to Jim’s house by a 3rd party. Actually a fourth party. Jim had missed a lot of work so his boss called his next of kin–and estranged daughter–she called a neighbor and between the neighbor and his boss, made the decision to call the ambulance.

I was greeted on the rickety steps by a confused looking gentleman I learned to be Jim’s boss. As I walk past him he tells me Jim had fallen and was on the ground all night. Jim says he’s not hurt. He says he is fine. Every word he speaks is enunciated in booze. The fruity smell of cheap vodka and cheaper beer permeate through his pores. Even the feces he has all over himself smell of sweet, cheap alcohol.

But Jim is adamant that he isn’t hurt. He knows where he is, he knows what day it is, but he just can’t admit that he is hurt. He just can’t admit that he needs help.

See months earlier Jim lost his mother and sister in a week or two. Jim, already an alcoholic took these double crosses and stumbled back to the ropes. He bowed out and lost control. Now the alcohol has control.

See, Jim isn’t fine. You can see the cellulitis has eaten at his legs. He’s not eating. Not bathing. Not doing anything other than getting delivered in cheap booze. Intentional or not, he’s killing himself. He’s of sound, if not sane, mind. He by law, can make decisions for himself. People are allowed to let themselves die here.

But after I’ve spent a considerable amount of time trying to get Jim to go to the hospital today, with me in the ambulance, his family arrives. His estranged daughter, her husband, and the granddaughter he hasn’t seen in a year. I try to “prep” them for what they are going to see. This isn’t going to be the “dad” you’re use to. But she walks right by.

And the crying, and the begging, and fighting begin. PD tells me they have no grounds to hold him. No threat to self or others. See, Jim insists he’s in contact with his lawyer, who is going to take him to the doctor on monday. The problem is, he can’t tell me his lawyers name. If you ask Jim how much he’s been drinking he changes the subject. If you ask Jim to stand(knowing he can’t) he changes the subject again.

Jim wants to stay home and drink another day. I think he knows that if he manages to stay home and drink enough days his body will finally give in to his mind and end this all.

But just because someone thinks they want to die a miserable death doesn’t mean we SHOULD stand idly by. I had walked out, as the city around me is imploding with 911 calls and transfers, I’d given up. Nothing was working. I waked out, got my signatures and was getting into the truck when the daughter came up to me.

“Please help me”. I don’t want him to die here. I don’t want him to die alone”. I try to explain how little there is I can do. I’ll be honest, I don’t expend a great deal of energy trying to get people to go to the hospital. If people say they don’t want or need me, I send them on their way.

But not this time. I’d already spent 50 minutes on scene, a few more won’t hurt. I walked back inside, daughter trailing behind me. We walk past an unopened box of “Omaha Steaks” with a postmark before Christmas. What kind of man leaves a box of meat–tasty meat–on their front stoop?

Inside the front door Jim’s son-in-law and granddaughter are sitting there. Granddaughter is crying. I walked up to Jim and said flatly…. “if you can stand, I will leave you alone forever”. So he tries to stand up. And flails and fails miserably. Sad, but in a way, what everyone needed to see.

I kneeled down to his now low level. Firmly, but compassionately I said…

“Jim, look. Look around this room. These are all people that care about you. Your daughter. Your granddaughter. Your boss. Your neighbor. Even me and my partner. If we didn’t care, the easy way out presented itself 100 times or more. But we didn’t take it. I stuck around. WE all stuck around. Because I’m scared that we’re going to come back tomorrow morning and pick you up in a different way. In a black bag and instead of going to the emergency room we’l have to go to the morgue. I’m terrified that I’ll have to look at this little girl over here and tell her that her grandpa is dead because we couldn’t convince him to go to the hospital to take care of some moderate medical problems. I’m scared that I won’t be able to sleep if I don’t do right by you. You have a chance to go out with some pride. Go out on your own, not be drug out of area against your will or in a body bag. Do this for your pride, if nothing else. Your pride is going to kill you”

and all he said to me:

“Well I don’t wanna hurt your beauty sleep. You need all you can get. Lets go”

And so we went. Quietly and calmly. At first he was defeated, but then the relief swept over him and the fear faded away.

In my longest scene time ever(1 hour, 48 minutes) I actually did something. More than I do on every major trauma or code or stroke I go on.

When the powers that be wanted to talk to me about the scene time delays I told them to read the narrative. I wasn’t going to justify it any other way. I wasn’t going to say sorry. I got a sick person to go to the hospital.

THAT is my job.

Damn it, Jim.

I’m not sure. But I’m hoping to be back, more often. Life has caught me off guard over the last year, but I’m doing a better job of managing my time and hope to spend some time posting here.

Welcome Back, Welcome Back, welcome baaaaaaaaaack. to me.

Get your friends on board!

Smell of alcohol on the breath. There is a very poor correlation between the strength of the smell of alcohol on the breath and the BAC. Pure alcohol has very little smell. It is the metabolism of other substances in alcoholic beverages that produces most of the smell. This explains why a person who drinks large amounts of high-proof vodka (a more pure form of alcohol) may have only a faint smell of alcohol on the breath. On the other hand, a person who drinks a modest amount of beer may have a strong smell of alcohol on the breath.

 

This is hammered on by DUI lawyers, with mixed results:

“I Smelled a Strong Odor of Alcohol on the Suspect’s Breath”

Posted by Lawrence Taylor on June 23rd, 2006

You will never see a DUI case where the officer does not report an odor of alcohol on the suspect’s breath. Never. The officer expects to smell it and it is a psychological fact that we see, hear and smell what we expect to see, hear and smell. In fact, most police DUI reports are formatted for the usual symptoms: there will be a box for “odor of alcohol”, which the officer checks off. There are often three boxes, labelled “strong”, “moderate” and “weak”; there is no box for “none”, so that is not an option for the officer.  The ”strong” box is almost always checked.  Presumably, the stronger the odor of alcohol, the more intoxicated the person arrested.

Assuming the officer actually does smell an odor on the breath, what he is smelling is not ethyl alcohol but the flavoring in the beverage. And the flavoring can be deceptive as to the strength or amount consumed. Beer and wine, for example, are the least intoxicating drinks but will cause the strongest odor. A much stronger drink, such as scotch, will have a weaker odor. And vodka leaves virtually no odor at all.

Consider a simple experiment. Have a friend drink a can of “near beer” — the stuff that looks, smells and tastes like beer but has no alcohol in it. Then smell his breath. You will smell an “odor of alcohol” — and maybe a strong one.

And, of course, there can be any number of causes of an “odor of alcohol” on a person’s breath: mouth wash, throat spray, cough syrup. Illness, indigestion or simple bad breath has been the cause of more than one officer’s trigger-quick conclusion that the suspect has an “odor of alcohol on his breath”.

The point of all this is that the odor of alcohol has very little relevence in a drunk driving case. It may or may not indicate that the person has consumed alcohol. It has absolutely no evidentiary value on the much more important question of how much the person has consumed — orwhat he had to drink, or when. Depending upon circumstances, a person with a single drink can have a “strong odor of alcohol on his breath”, and an extremely inebriated person can have a “weak” odor. And an experienced and honest DUI officer will readily admit this….if he is ever asked.

Unfortunately, evidence of the odor of alcohol on a person�s breath can have a significant impact on a DUI case. This is because most officers who pull a driver over for some driving irregularity at night are looking for further signs of drunk driving. When the officer approaches the driver’s window and smells alcohol, that confirms his suspicions. Since few can pass the “field sobriety tests”, particularly under the conditons in which they are given, an arrest is likely.

Are there any scientific studies to back up my claim that breath alcohol odor is largely irrelevant yet disproportionately weighted as “evidence” of intoxication?

In 1999, the same scientists whose federally-contracted studies became the basis of the so-called “standardized” battery of field sobriety tests conducted another study on the effectiveness of alcohol odor in detecting intoxication. These researchers used 20 experienced officers working with 14 subjects who were tested at blood-alcohol concentrations (BACs) ranging from zero to .13 percent. Over a four-hour period, the officers smelled the subject’s breath odor under optimal conditions, with the subjects hidden from view.

The conclusions of the study: Odor strength estimates were unrelated to BAC levels. In fact, estimates of BAC levels failed to rise above random guesses. Further, officers were unable to recognize whether the alcohol beverage was beer, wine, bourbon or vodka. According to the scientists, these results demonstrate that even under the best of conditions, breath odor detection is unreliable. Moscowittz, Burns & Furgeson, “Police Officers’ Detection of Breath Odors from Alcohol Ingestion”, 31(3) Accident Analysis and Prevention 175 (May 1999).

 

On EMS news, I ran my first call at “second job” today. 9 shifts, 1 call.   LOVE IT!

Kohler. Or maybe “Sir Pterry(the Pterrydactyl) quackin duck.”

The other day I went through my cardiac arrest statistics. Dispatched to 91 cardiac arrests since I became a medic. ~30/year. I have worked approximately 50% of those. I have EXACTLY 1 cardiac arrest save.

ONE!.

If this were baseball, I’d have a batting average of 0.01098901098901099.  OOOH! If we call all of the no start calls “sacrifices” I’d have an average of 0.021739130434782608. If we only say that the ~45ish times I’ve actually worked an arrest count as “at bats”, then I have an amazing 0.022222222222222223.

In baseball the record for lowest career batting average for a player with more than 2,500 at-bats belongs to Bill Bergen, a catcher who played from 1901 to 1911 and recorded a .170 average in 3,028 career at-bats. I’m well below the “Mendoza Line”

What is YOUR batting average?