In this line of work, you have a lot of firsts. Your first dead person, which I got on my very first call, your first child death and on the other end your first child birth. (neither of which have happened yet) There is that first time you get your 50% discount at Outback(sweet) and that first time you say to a patient, "You called an ambulance because of what??!!!!" (i.e. stubbed toe, or chipped tooth, or i couldnt get to sleep)
The other day I had a major first happen to me. My partner and I, along with the Rez Fire Dept, ran a call for a 65 year old male who had passed out in his back yard. When we arrived, he was laying on the ground but talking to us and describing what was going on. We loaded him up and put him in our bus and prepared to give him an IV. He said he was deathly afraid of needles, and my partner told him that we had to stick him to get him some fluids and stated again that he was deathly afraid of needles and would pass out.
Well guess what, he wasnt kidding. At this point he went into cardiac arrest, no pulse, no breathing, turned purple. One of the firefighters said, Damn he wasnt kidding. We started CPR, shocked him a couple of times, got him intubated and what do you know, we got him back. And all of this is before we even leave his driveway. On the way to the hospital, he went into cardiac arrest once again and my partner and the firefighter riding with us got him back once again. At the hospital his heart kept stopping and the ER staff worked on him for about two hours.
I am happy to say, that he has had bypass surgery, was taken off the vent yesterday and doctors expect a full recovery. Its a great feeling to know that you made a difference. I have had 15 patients in which I performed CPR, and this gentleman was the first one I helped get back. Its just awesome.
On the lighter side of this call, my partner said this call required him to do more paper work than he had ever done on a single call and he has been doing this for 12 years. I told him he could have saved a lot of time by writing the report like this:
65 yo m, sweating perfusly w/left arm pain, short of breath. Showed pt iv needle and he died. I saved him. Showed pt needle again, he died, saved him again. Diagnosis, pt is truly deathly afraid of needles.
Yall all have a blessed day.
Wednesday, April 23, 2008
Wednesday, April 9, 2008
Mr Brothers and My Heroes
I ask that you watch, and say thank you. Please watch till the end of the video for the Final Call.
Thank you.
Gabe
http://www.youtube.com/watch?v=mWlB6kikOww
Thank you.
Gabe
http://www.youtube.com/watch?v=mWlB6kikOww
Friday, March 21, 2008
Back from Tennessee
Well, we just got back from our vacation to the Nashville area. We had an absolute blast and cant wait for our next visit. We stayed at the Gaylord Opryland Hotel and made sure to take pictures so those of you who have never been there can get an idea of what its like.
The first pic should be of the view as we enter the hotel. The second is the view from our room, the third is my girls and the rest are random shots.
The first pic should be of the view as we enter the hotel. The second is the view from our room, the third is my girls and the rest are random shots.
Sunday, March 9, 2008
Friday, March 7, 2008
Ladys and Gents, I present to you the Rules of Emergency Care.
The First Law of EMS:All emergency calls will wait until you begin to eat, without regard to the time.
Corollary 1: Fewer accidents would occur if EMS personnel would never eat.
Corollary 2: Always order food "to go".
The Law of Time:1. There is absolutely no relationship between the time at which you are supposed to get off shift and the time at which you will get off shift.
2. Given the following equation: T + 1 Minute = Relief Time, "T" will always be the time of the last call of your shift. E.g., If you are supposed to get off shift at 08:00, your last run will come in at 07:59. (Or if you have early relief coming in you will see you relief sitting at the first stop light from the station, waving!)
The Law of Gravity:Any instrument, when dropped, will always come to rest in the least accessible place possible.
The Law of Time Versus Distance:The distance of the call from the Hospital increases as the time to shift change decreases.
Corollary 1: The shortest distance between the station and the scene is under construction.
The Rule of Random Syncronicity:Emergency calls will randomly come in all at once.
The Law of Respiratory Arrest:All patients who are vomiting and must be intubated will have just completed a large meal of Barbecue and Onions, Garlic Pizza, and Pickled Herring, all of which was washed down with at least three cans of Beer.
The Basic Principle for Dispatchers:Assume that all field personnel are idiots until their actions prove your assumption.
The Basic Principle for Field Personnel:Assume that all dispatchers are idiots until their actions prove your assumption.
The Axiom of Late Night Runs:If you respond to any Motor Vehicle Accident call after Midnight and do not find a drunk on the scene, keep looking: somebody is still missing.
The Law of Options:Any patient, when given the option of either going to Jail or going to the Hospital by a Police Officer, will always be inside the Ambulance before you are.
Corollary 1: Any patient who chooses to go to Jail instead of the Hospital has probably been in my rig in the past.
The First Rule of Equipment:Any piece of Life-saving Equipment will never malfunction or fail until: a)You need it to save a life, or b)The salesman leaves.
The Other Rules of Equipment:Interchangeable parts don't
Leak proof seals will
Self-starters won't.
The First Law of Ambulance Operation:No matter how fast you drive the Ambulance when responding to a call, it will never be fast enough, until you pass a Police Cruiser, at which point it will be entirely too fast. Unless you are responding to an"Officer Down" call then it is physically impossible to be travelling fast enough!
EMS Bathroom Rules:If a call is received between 0500 and 0700, the location of the call will always be in a Bathroom.If you have just gone to the Bathroom, no call will be received.If you have not just gone to the Bathroom, you will soon regret it.The probability of receiving a run increases proportionally to the time elapsed since last going to the Bathroom.
General Principles Concerning Dispatchers:Given the opportunity, any Dispatcher will be only too happy to tell you where to go, regardless of whether or not (s)he actually knows where that may be.
Corollary 1: The existence or non-existence of any given location is of only minor importance to a Dispatcher
Corollary 2: Any street designated as a Cross-street" by a Dispatcher probably isn't.
Corollary 3: If a street name can be mispronounced, a Dispatcher will mispronounce it.
Corollary 4: If a street name cannot be mispronounced, a Dispatcher will mispronounce it anyway.
Corollary 5: A Dispatcher will always refer to a given location in the most obscure manner as possible. E.g., "Stumpy Brown's Cabbage Field" is now covered by a shopping center.
The Law of Triage:In any accident, the degree of injury suffered by a patient is inversely proportional to the amount and volume of agonized screaming produced by that patient.The Gross Injury Law:Any injury, the sight of which makes you want to puke, should immediately be covered by 4x4's and Kerlix.
The Supervisor Equation:Given the equation: X +Y = QQ = Quality of CareX = the care that you render Y = the assistance supplied by any Supervisor.If you can eliminate Y from the equation, the Quality of Care will improve by X².
Corollary 1: Generally, Field Supervisors have no business in the Field.
Corollary 2: The level of technical competence is inversely proportional to the level of management.
Corollary 3: Technology is dominated by those who manage what they do not understand.The
Law of Protocol Language:The simplest Protocol Directive will be worded in the most obscure and complicated manner possible. Speeds, for example, will be expressed as "Furlongs per Fortnight" and flow rates as "Hogsheads per Hour".
Corollary 1: If you don't understand it, it must be intuitively obvious.
Corollary 2: If you can understand it, you probably don't.
The Law of EMS Educators:Those who can't do, teach.
The Law of EMS Evaluators:Those who can't do or teach, evaluate.
The Law of Light:As the seriousness of any given injury increases, the availability of light to examine that injury decreases.
The Law of Space:The amount of space which is needed to work on a patient varies inversely with the amount of space which is available to work on that patient.
EMS Relativity:The number of distraught and uncooperative relatives surrounding any given patient varies exponentially with the seriousness of the patient's illness or injury.
The Theory of Weight:The weight of the patient that you are about to transport increases exponentially by the number of floors which must be ascended to reach the patient and the number of floors which must be descended while carrying the patient.
Corollary 1: Very heavy patients tend to gravitate toward locations which are furthest from mean sea level.
Corollary 2: If the patient is heavy, the elevator is broken, and the lights in the stairwell are out.
The Laws of Non-Transport:A Life-or-Death situation will immediately be created by driving away from the home of patient who has just thrown you out of their house.The seriousness of this situation will increase as the date of your trial approaches.By the time your ex-patient reaches the witness stand, the Jury will wonder how patient in such terrible condition could have possibly walked to the door and greeted you with a large suitcase in each hand.
The First Rule of BystandersAny bystander who offers you help will give you none.
The Second Rule of Bystanders:Always assume that any Physician found at the scene of an emergency is a Gynecologist, until proven otherwise. (Unless the emergency is obstetrical in nature, then the bystander will be a Dermatologist.)
The Rule of Warning DevicesAny Ambulance, whether it is responding to a call or traveling to a Hospital, with Lights and Siren, will be totally ignored by all motorists, pedestrians, and dogs which may be found in or near the roads along its route.
Corollary 1: Ambulance Sirens can cause acute and total, but transient, deafness.
Corollary 2: Ambulance Lights can cause acute and total, but transient, blindness.note: This Rule does not apply in California, where all pedestrians and motorists are apparently oblivious to any and all traffic laws.
The Law of Show and TellA virtually infinite number of wide-eyed and inquisitive school-aged children can climb into the back of any Ambulance, and, given the opportunity, invariably will.
Corollary 1: No emergency run will come in until they are all inside the Ambulance and playing with the equipment.
Corollary 2: It will take at least four times as long to get them all out as it took to get them in.
Corollary 3: A vital piece of equipment will be missing.
The Rule of Rookies The true value of any Rookie, when expressed numerically, will always be a negative number.The value of this number may be found by simply having the rookie grade his or her ability on a scale from 1 to 10. Medical skill: 1 = Certified Health Hazard, 10 =Johnny and Roy.Driving ability: 1 = Obstruction to Navigation, 10 = Mario Andretti.The true value of the rookie is then found by simply negating the Rookie's self-assigned value.Corollary 1: Treat any Rookie assigned to your Unit as you would a Bystander. (See The First Rule of Bystanders, above.)Corollary 2: We were all rookies once upon a time....
The First Law of EMS:All emergency calls will wait until you begin to eat, without regard to the time.
Corollary 1: Fewer accidents would occur if EMS personnel would never eat.
Corollary 2: Always order food "to go".
The Law of Time:1. There is absolutely no relationship between the time at which you are supposed to get off shift and the time at which you will get off shift.
2. Given the following equation: T + 1 Minute = Relief Time, "T" will always be the time of the last call of your shift. E.g., If you are supposed to get off shift at 08:00, your last run will come in at 07:59. (Or if you have early relief coming in you will see you relief sitting at the first stop light from the station, waving!)
The Law of Gravity:Any instrument, when dropped, will always come to rest in the least accessible place possible.
The Law of Time Versus Distance:The distance of the call from the Hospital increases as the time to shift change decreases.
Corollary 1: The shortest distance between the station and the scene is under construction.
The Rule of Random Syncronicity:Emergency calls will randomly come in all at once.
The Law of Respiratory Arrest:All patients who are vomiting and must be intubated will have just completed a large meal of Barbecue and Onions, Garlic Pizza, and Pickled Herring, all of which was washed down with at least three cans of Beer.
The Basic Principle for Dispatchers:Assume that all field personnel are idiots until their actions prove your assumption.
The Basic Principle for Field Personnel:Assume that all dispatchers are idiots until their actions prove your assumption.
The Axiom of Late Night Runs:If you respond to any Motor Vehicle Accident call after Midnight and do not find a drunk on the scene, keep looking: somebody is still missing.
The Law of Options:Any patient, when given the option of either going to Jail or going to the Hospital by a Police Officer, will always be inside the Ambulance before you are.
Corollary 1: Any patient who chooses to go to Jail instead of the Hospital has probably been in my rig in the past.
The First Rule of Equipment:Any piece of Life-saving Equipment will never malfunction or fail until: a)You need it to save a life, or b)The salesman leaves.
The Other Rules of Equipment:Interchangeable parts don't
Leak proof seals will
Self-starters won't.
The First Law of Ambulance Operation:No matter how fast you drive the Ambulance when responding to a call, it will never be fast enough, until you pass a Police Cruiser, at which point it will be entirely too fast. Unless you are responding to an"Officer Down" call then it is physically impossible to be travelling fast enough!
EMS Bathroom Rules:If a call is received between 0500 and 0700, the location of the call will always be in a Bathroom.If you have just gone to the Bathroom, no call will be received.If you have not just gone to the Bathroom, you will soon regret it.The probability of receiving a run increases proportionally to the time elapsed since last going to the Bathroom.
General Principles Concerning Dispatchers:Given the opportunity, any Dispatcher will be only too happy to tell you where to go, regardless of whether or not (s)he actually knows where that may be.
Corollary 1: The existence or non-existence of any given location is of only minor importance to a Dispatcher
Corollary 2: Any street designated as a Cross-street" by a Dispatcher probably isn't.
Corollary 3: If a street name can be mispronounced, a Dispatcher will mispronounce it.
Corollary 4: If a street name cannot be mispronounced, a Dispatcher will mispronounce it anyway.
Corollary 5: A Dispatcher will always refer to a given location in the most obscure manner as possible. E.g., "Stumpy Brown's Cabbage Field" is now covered by a shopping center.
The Law of Triage:In any accident, the degree of injury suffered by a patient is inversely proportional to the amount and volume of agonized screaming produced by that patient.The Gross Injury Law:Any injury, the sight of which makes you want to puke, should immediately be covered by 4x4's and Kerlix.
The Supervisor Equation:Given the equation: X +Y = QQ = Quality of CareX = the care that you render Y = the assistance supplied by any Supervisor.If you can eliminate Y from the equation, the Quality of Care will improve by X².
Corollary 1: Generally, Field Supervisors have no business in the Field.
Corollary 2: The level of technical competence is inversely proportional to the level of management.
Corollary 3: Technology is dominated by those who manage what they do not understand.The
Law of Protocol Language:The simplest Protocol Directive will be worded in the most obscure and complicated manner possible. Speeds, for example, will be expressed as "Furlongs per Fortnight" and flow rates as "Hogsheads per Hour".
Corollary 1: If you don't understand it, it must be intuitively obvious.
Corollary 2: If you can understand it, you probably don't.
The Law of EMS Educators:Those who can't do, teach.
The Law of EMS Evaluators:Those who can't do or teach, evaluate.
The Law of Light:As the seriousness of any given injury increases, the availability of light to examine that injury decreases.
The Law of Space:The amount of space which is needed to work on a patient varies inversely with the amount of space which is available to work on that patient.
EMS Relativity:The number of distraught and uncooperative relatives surrounding any given patient varies exponentially with the seriousness of the patient's illness or injury.
The Theory of Weight:The weight of the patient that you are about to transport increases exponentially by the number of floors which must be ascended to reach the patient and the number of floors which must be descended while carrying the patient.
Corollary 1: Very heavy patients tend to gravitate toward locations which are furthest from mean sea level.
Corollary 2: If the patient is heavy, the elevator is broken, and the lights in the stairwell are out.
The Laws of Non-Transport:A Life-or-Death situation will immediately be created by driving away from the home of patient who has just thrown you out of their house.The seriousness of this situation will increase as the date of your trial approaches.By the time your ex-patient reaches the witness stand, the Jury will wonder how patient in such terrible condition could have possibly walked to the door and greeted you with a large suitcase in each hand.
The First Rule of BystandersAny bystander who offers you help will give you none.
The Second Rule of Bystanders:Always assume that any Physician found at the scene of an emergency is a Gynecologist, until proven otherwise. (Unless the emergency is obstetrical in nature, then the bystander will be a Dermatologist.)
The Rule of Warning DevicesAny Ambulance, whether it is responding to a call or traveling to a Hospital, with Lights and Siren, will be totally ignored by all motorists, pedestrians, and dogs which may be found in or near the roads along its route.
Corollary 1: Ambulance Sirens can cause acute and total, but transient, deafness.
Corollary 2: Ambulance Lights can cause acute and total, but transient, blindness.note: This Rule does not apply in California, where all pedestrians and motorists are apparently oblivious to any and all traffic laws.
The Law of Show and TellA virtually infinite number of wide-eyed and inquisitive school-aged children can climb into the back of any Ambulance, and, given the opportunity, invariably will.
Corollary 1: No emergency run will come in until they are all inside the Ambulance and playing with the equipment.
Corollary 2: It will take at least four times as long to get them all out as it took to get them in.
Corollary 3: A vital piece of equipment will be missing.
The Rule of Rookies The true value of any Rookie, when expressed numerically, will always be a negative number.The value of this number may be found by simply having the rookie grade his or her ability on a scale from 1 to 10. Medical skill: 1 = Certified Health Hazard, 10 =Johnny and Roy.Driving ability: 1 = Obstruction to Navigation, 10 = Mario Andretti.The true value of the rookie is then found by simply negating the Rookie's self-assigned value.Corollary 1: Treat any Rookie assigned to your Unit as you would a Bystander. (See The First Rule of Bystanders, above.)Corollary 2: We were all rookies once upon a time....
Friday, February 29, 2008
To all of my friends born before 1977
My daughter asked when I and her mommy where born. We told her I was born in 76 and mommy in 72. She explained that she remembered more things about the 70's than I did. This made me wonder what I did remember about that time. The only thing I could think of was this......http://youtube.com/watch?v=ucii4kApEGo
Thursday, February 14, 2008
Talk about pruning a tree
So we get a call on hwy 471 near hwy 43 for a single car accident. We are about half way there and the fire chief calls us up an says, "Patient is stable, but we aren't putting her on a backboard or moving her till you get here. She has a tree branch impaled in her leg." It was incredible. She totalled her truck, was ejected, was thrown against a tree at which time the branch impaled her thigh, and then her weight snapped the branch and she fell to the ground.
Amazingly, that was her only injury. She should have died but she didnt. There were no arteries hit, no major nerve damage. Just a big stick through her leg. This made up for all the bs calls we went on earlier in the day. It was great.
Amazingly, that was her only injury. She should have died but she didnt. There were no arteries hit, no major nerve damage. Just a big stick through her leg. This made up for all the bs calls we went on earlier in the day. It was great.
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