That's BLS, not BS

High School EMT Classes

2012-02-11T19:01:00.000-05:00

Apparently up in Myerstown, PA they are discussing whether or not to go ahead with a high school EMT class. JEMS has a lovely article on the subject with more details.

I'm a product of a high school EMT class, I took it my junior year of high school many, many moons ago. My class size was about 16 if I remember correctly, of that all but one or two tested, and all but three or four passed. From that class two of us are chiefs in our county, two are career personnel, and two are medics. Considering the fact that it's been 12 years I'd say those numbers are pretty good. My teacher is no longer with my county, she switched to another one, but I've been able to watch her academies progress thanks to the magic of facebook and I'm proud to say she's one of the best.

Not every teenager should be an EMT but the opportunity should be there if they choose to try it. For me, becoming an EMT at 16 taught me a lot and kept me out of a lot of trouble. It also caused me to disconnect from some of my friends when they'd complain that their weekend was spent at home because their mom and dad are just SOOOOOO MEAN!!! and my weekend included doing CPR on someone's grandmother.

Junior squads as a whole are getting smaller and smaller. When I was a junior our squad was considered small and we had 8 or 9 members. Now my department has one junior. If we can get these kids interested and involved maybe we can turn that around. One way is to make the EMT classes accessible for them and putting it in their high school is the absolutely best way to do this. Expecting teenagers to take a night class, which in my area is twice a week from 7pm until 10pm, is a lot to ask. It can also be a lot to ask of an adult, I realize that, but most people come home from work and aren't expected to do homework, apply for college, and deal with out of control hormones that make most teenagers a complicated piece of work. Unfortunately I do know some adults that still haven't figured out what to do with their hormones...

On a side note: I do think that every teenager should take CPR, if we can watch a teacher put a condom on a banana then we can watch rescue Annie get her life saved.

EMS Gnomes aren't real, and other bad news...

2012-01-28T13:57:00.002-05:00

Recently we were dispatched for smoke in a structure. Again, ambulances normally travel faster than fire trucks, so I found myself first on scene. Livestock was loose around the house and I asked the owner if they could secure them before the rest of the trucks got here. "Wait! You mean it isn't just you coming? You're sending fire trucks TOO??" Ok what the fuck did you expect to show up when you called 911 and said hey, I think my house is on fire! EMS Gnomes? YES there are fire trucks coming, too.

So in my years of arriving first on scene on structure fires I've been told the following:

you're not a fire truck! (is that a fat joke?)
THEY'RE SENDING FIRE TRUCKS, TOO?!? (nope but 15 police officers are on their way to arrest your fire extinguishers)
Um I asked for a fire truck (indeed, but for your safety and ours, we like to send band aid boxes, too)
Yall are from ___? (Yes, that's why my ambulance says that on it no less than 6 times)

Ladies and gentlemen, calling a dispatch center and complaining of a fire should always yield in the result of a fire truck, unless the fire is in your crotch. Then you're probably still getting a band aid box.

The other unfortunate news is my EMS Certifications have been renewed and I am now good as a medic for a few more years, and as a basic for 5 more years. Which is confusing because it's supposed to only be 4 but I'm not complaining.

You want me to do what with a vagina?

2012-01-11T20:56:00.002-05:00

Put it in someone's throat? I don't think I can do that!

come on, that's a straight up vag, right?? Thankfully my council doesn't use these, we use King airways, and for all I know these things are the bee's knees but...they look....like... a vagina....

This shit is bananas! B A N A N A S

2012-01-01T22:41:00.001-05:00

Uh huh, this is my shit...

Fire and rescue is a fancy name for "a bunch of middle school kids pretending to be adults when the tones drop." My apologies to anyone that expected something more profound, it really isn't. My full time job is in an office setting so I understand that any time you get a group of more than 3 people together you run in to rumors, back stabbing, disagreements, etc. However, we get to add in sex jokes, toilet humor, and adrenaline. Morality is incredibly important in a setting where our lives depend on our crew, and keeping morale high with the rumors, back stabbing, disagreements, etc is one of the biggest challenges I think a lot of departments face.

Sure, you can finally have enough people to fill your duty calendar but now you have more personnel conflicts. Take away enough people to fill a duty calendar and now you have a bunch of burned out people that are one comment away from going at each other like a bunch of teenage girls trying to get Justin Bieber's underwear. It's definitely a damned if you do, damned if you don't situation.

Over the years I've learned a lot about myself through the rumor mill. I've apparently had sex with quite a few people, one time while I was in a business meeting even (and sitting next to my brother who was a member at the time). I've been a lesbian, a cheater, a liar, a bitch... I've had my EMT card revoked, I've quit and joined multiple other departments, I've had an orgy...the list goes on and on. For the record, the only one that's true out of all of the above is the bitch part, yeah I'll admit I'm not the easiest person to get along with, but I get my job done. What do you do?

Handling rumors and back stabbing as the accused person isn't easy. If you confront someone then they either lie or just think you're trying to cover your ass and don't believe you. If you ignore it then it continues to grow. As an officer dealing with rumors and back stabbing is a bit easier, I can, and have, easily suspend a member for causing trouble. But then the accused person is blamed for being a tattletale and oh look, here we are back in the "damned if you do, damned if you don't" room.

Unfortunately for some people, I ain't no hollaback girl...

911 call does not equal spectactor sport

2011-12-30T21:54:00.002-05:00

Recently I ran a call for a patient that could not find a pulse in one of their extremities. I never really figured out why they were checking their pulse in their extremities, especially with a house full of people, but hey whatever helps you pass the time I guess...

When we arrived on scene I noticed there were about 7 kids and 5 or 6 adults all standing around the patient. One person came out to greet us and give us an idea of what we were there for. Upon entering the room I figured some of these people would move out of the way, I figured wrong. As I attempted to talk to my patient I had 3 kids standing within a foot of me. My crew had no place to set the bag or the Lifepak down because of the crowd. I made a comment about how we could use a little breathing room and was rewarded with an entire inch more of space. As I crouched in front of my patient to find this pesky missing pulse, I'm joined on the floor by a few of the kids. I announce to the patient that I have located the AWOL pulse as well as all other pulses available, plus the Lifepak shows that they do indeed have a heart beat. The patient decides that they are no longer in need of an emergency room so we do the refusal dance and gather our equipment.

As we head to the ambulance the kids start singing a Christmas carol for us. Apparently the look on my face was "WTF are you serious" as my crew starts giggling and runs to the ambulance. They all follow us out and invite us back in an hour for the full performance, and maybe some egg nog wink wink. I politely declined.

My general thought on kids and 911 calls is that unless they're the patient, or an infant held in your arms, they should probably be put in another room or at least outside of my "stranger danger" zone. And for the love of all that's holy don't make them sing to me!

If I shove a pen and a watch up your butt, will you remember it then?

2011-12-21T14:32:00.000-05:00

This was the first question I asked my EMT students last night. They've been in class for 3 months now, and within the first week several instructors (including me) made it CRYSTAL CLEAR that a pen and a watch should always be brought to class. Especially on practicals days where vital signs are included. Last night we had a practical night, as the students filtered in I asked about watches and pens. About 5 people had no watch and one didn't have a watch OR a pen.

How in the hell do you come to ANY class without a writing utensil? Holy sheep stuffing, batman, how in the hell am I supposed to think you will ever be prepared to run duty if you can't come to class prepared? It's not like class pops up out of the blue like a random 911 call, IT'S ON A CALENDAR!

I also had a total melt down moment that ended with no one addressing me by anything but my title and looking at their shoes. I don't need to be addressed by my title, I'll answer to anything. However, when I'm trying to talk, and it's my turn to talk, it's your turn to shut it. If I am trying to tell you how the practical stations are set up then I'm obviously trying to tell you something important. STOP TALKING OVER ME.

It's definitely time to pick up a dog training clicker from Petco and see how that works. You want to talk? Oh I'm sorry, try doing it over my clicker!

Martha Stewart's nightmare

2011-12-19T18:16:00.004-05:00

I don't know Martha Stewart but I imagine her nightmares have to include any house seen on the show "Hoarders." Oh and probably memories of the whole prison time stint but that's another post. I'm pretty sure I was in her nightmare the other day when I ran a call in a house that made me want to vomit, and that's saying something. There was mold on stuff in colors that I'm pretty confident even Crayola couldn't name. Junk, food, crap...all piled everywhere. There were small little paths through the stuff to different key parts of the house, like the sink that apparently isn't used and the TV that apparently was very used. Sometimes the hardest part of being an EMT is keeping it light when all you want to do is to tell your patient I'd rather come back in a hazmat suit if you don't mind, because I'm pretty sure I'm going to catch something just standing here.

This is far from the first time that I've ever been in a house like this. I've had my foot fall through floors, I've watched rats run by while I started IVs, I've refused to set my bags down and stood there for 30 minutes holding an oxygen bag while we got a patient refusal. So when I walk in to a house that's clean but maybe a little cluttered with day to day stuff, I laugh when they apologize for the mess. I'm not so sure they believe me when I say we've seen worse but seriously, we've seen worse. Here are a few helpful hints for you to use to see whether or not your house will end up as an EMS war story:

Do you use any of the following items more than once a month: house hold cleaners (green or chemical), broom, vacuum, mop?
Look around the room you're currently in. Now can you get up and do a jumping jack? Without knocking over a pile of "found goods?"
You've never been contacted by the CDC so they could do research on the toxic mold in your refrigerator, right?
Can people actually come visit your house and not leave within 5 minutes?

If you're able to answer "yes" to these questions then don't worry, we won't be worried about being attacked by a rabid pack of rats while standing in your house.

Pocket Guide #22: Things you don't argue with your FTO

2011-12-12T15:43:00.004-05:00

FTO= Field Training Officer, or preceptor, or person you follow around until you are able to wipe your own ass. Whatever you prefer. For the record I've actually dealt with every one of these arguments.

Hypo vs Hyper. I had this argument this weekend. If I keep telling you that HYPER means high, think of it as a HYPER child, then telling me "but the patient's temperature is 104, even with hypothermia!" is going to make me stab you in the eye with a spork.
"That's not how they did it on tv" Are you freakin' kidding me?!
"C-spine really isn't that important." No, you're right it isn't, I mean who wants to walk and have control of their bowels?
ALS is not a "catch all." Telling me you'll just call ALS for everything makes me want to cut your EMT book up in to little pieces and force feed it to you. Yes, call for ALS when ALS is necessary. Don't call for ALS because you don't feel like learning your skill. Most calls are BLS.
"I don't have to listen to you, you don't run at my department." What are you, 5? Are you going to tell me I'm not your mother, too? You're right, I don't run at your department, but I have three things going for me; experience, a medic card, and a white helmet. Let's respect each other, mmmkay?
"We don't really have to call medical control like in class. We have standing orders!" Yes and unfortunately for you, the standing order that we are currently discussing says "EMT-B: Call Medical Control" you can't argue what's in black and white, my friends.
"Why bother to wash it? It's going to get dirty again on the next call." Would YOU want to ride in pigpen's car? No? Then wash the band aid box.
"We have to cut the clothes off of every trauma patient!" okay but after you second or third set of old balls because grandpa has been free ballin' it ever since grandma went to the rehab center for her broken hip...you'll probably be a little choosier on the clothes cutting.
"That didn't REALLY happen." If I tell you a rule then it's for a reason. So when I say no open toed shoes, I tell you that because one day some girl showed up in flip flops and was offended that I wouldn't let her on the ambulance.
"We don't really have to check all of the vitals on every patient." Of course not, kitten! Why would we waste the time to do a complete assessment? Would you mind calling your mother for me? why? Oh I'm going to set up a time so that I can smack her for conceiving you...
"I can give any drug the patient is prescribed!" really? including Viagra? Because that could make for an awkward turtle ambulance ride.

It's the most wonderful time of the year...elections!

2011-12-05T11:36:00.001-05:00

Almost all of the departments in my county have their elections this month. Normally the county meetings in January show a few new faces but mostly the same old ones keep coming back year after year.

Prior to my lay off I had thought about going for chief instead of staying with assistant chief. Since I doubt I'll have a job between now and our elections this week I'll have to stay as the AC. I don't want to take a primary position and then find out I can't attend 99% of the meetings. I've also been campaigning hard to give up the role of training officer but I haven't exactly had anyone beating down my door to learn how to take over the position.

The biggest issue most departments face is a lot of positions and not a lot of asses to fill those positions. Just because someone CAN hold a position doesn't necessarily mean that they SHOULD. Being an officer, whether it's operational or administrative, requires effort and follow through. The white helmet on calls and the nifty little portable don't really help you get the chicks at the bar, trust me I've tried.

An unexpected benefit of volunteering

2011-11-16T20:34:00.001-05:00

As I make my way through this job search to replace the day job I've come to realize that my volunteering experience has been more beneficial than I'd ever realized. When I list my skills I include all of the usual medical billing/clerical stuff but I can also include fun things like "can legally poke you with needles and cut your clothes off."

In an interview today I was asked how I perform under pressure. Wonderfully, I replied, you see I can handle MCIs on the interstate so anything I run in to in an office? Cake walk. Not a problem at all. Today when I said I'm the only female in the county ranked as high as I am, the lady interviewing me asked how I could handle a man's world? No problem. Born to do it and love almost every minute of it. Okay, well maybe just half.

Some kids volunteer before heading off to college because it looks good on their college applications. It also looks good on resumes and gives you job experience that not many other hobbies or professions can offer. Do I sound like I'm trying to sell volunteering? Probably. That's okay, though, because bottom line volunteering has been the best experience of my life. Except that one time I got drunk and...oh nevermind. I couldn't be too sappy, it makes me itchy.

Things I learned at Symposium

2011-11-15T09:14:00.001-05:00

Despite knowing a ton of people going, I mainly only ran in to people I didn't want to see.
Of those people I knew going, only a hand full actually run calls so apparently the ones that don't just like to learn. Which is cool I guess, but if you're learning you should probably apply that info somewhere.
A ton of cool stuff in the "When is dead really dead?" lecture by Mike McEvoy
That I'll never do a ride along in Phoenix because holy hell some of the stories I heard made me realize I'm not down with gang wars and stuff like that.
That Norfolk, VA is still as scary as it was when I was younger. A shooting happened half a block from our hotel, we heard the shots and saw the police, ambulance, and fire truck come and do their thing. I thought the hotel staff was bad until that happened. Though the front desk clerk was a cross dresser, that wasn't something we see in BFE very often.
Organ donation is important! (I already knew that but sometimes need to remind people, also organ donation has nothing to do with the shooting above. That guy only had minor injuries)
Next year we're staying at the Marriott as I feel like they have a lower crime rate.
The housekeepers at our hotel be crazy. We had to ride an elevator with one that kept muttering to herself and carrying on then apologizing because she was upset.

When blog posts come true....

2011-11-06T19:05:00.001-05:00

Actually all of my posts are based on true stories but today I was reminded of my last post, Pocket Guide # 21: Ways the public is trying to kill us when a citizen attempted to be helpful by directing traffic. through the middle of my scene. with people everywhere.

I politely asked him to explain his thought pattern to me. And by politely asked him I mean I screamed "what the fuck are you doing, trying to get us killed?!?!" when I almost got hit by a vehicle that shouldn't have been there. The engine crew took over the shut down of the traffic shortly after that.

Thank you, Mr John Q Citizen, for proving me right!

Pocket Guide # 21: Ways The Public is Trying to Kill Us

2011-10-25T09:45:00.000-04:00

Do you ever feel like the general public may actually out to kill us? That's because they are. The general public is a lot like a cat, they're constantly plotting your demise but can sometimes be held off with a nice gesture, like saving their life or offering tuna.

Some things to look out for include;

I can TOTALLY drive through this standing body of water/climb up this rock face. Oh, oh wait no I can't. Crap. call 911! Yes, because I want to put myself in to danger saving you when you drove right past the sign saying "do not enter" or walked by the sign saying "do not climb in bad weather." Thanks!
Their reply to you asking medical history: Oh no, I don't have any, I'm pretty healthy. Their reply to the nurse asking medical history at the ER: Oh I have hep a, b, c, hiv, and gonorrhea!
Oh look! Flashing lights and people wearing safety vests. Let's pretend we're bowling!!!! Ever feel like you're in a bad version of Frogger because people are trying to hit you?
Dispatch: Your 750 pound patient is located in the highest room of the tallest tower with the steepest steps that are circular and there are 15 cats as well as 10 small dogs that cannot be contained to assist you. Crap.
I've showered recently! If by recent you mean two weeks ago. And it's August. And I've drank more alcohol than the average brewery produces. And I've quite possibly gone to the bathroom on myself. Exhaust vents why are you only the side of a soda can? CUT ME A BREAK HERE!
Don't mind Fluffy, he hardly ever bites. Fluffy? You mean the gigantic German Shepherd that currently has my partner's arm in her mouth? Great. (For the record I'm not saying all German Shepherds or dogs in general bite but I've had one or two in my day try to make me a snack)
How'd you like my driveway? You call that a driveway? I call that a Tough Mudder contest, holy hell, you should add a few fire breathing dragons at the end.
I've been having chest pain/difficulty breathing all morning, but I decided that it shouldn't stop me from my 3 mile hike up the Appalachian trail. Awesome. Me? Difficulty breathing? Oh, no sir, I normally sound like this after hiking... now could you share your oxygen mask?
You're going to DROP ME!!!!! If you keeep randomly grabbing shit to stop us from walking then yes, we probably are. Now give yourself a big hug before I make this an unconscious patient call.
I haven't shaved my legs/underarms today. I didn't think I'd be calling 911! Um, that's just from one day? Because bigfoot called and he was wondering if you could give him some advice on leg hair braiding techniques...

I'm not a miracle worker

2011-10-17T10:49:00.003-04:00

We've all heard the saying "don't put the cart before the horse" This is something I regularly tell people new to my department when we discuss training and their ideal paths with us. Waking up one day and deciding to become a ff/medic is an awesome idea, however, if you've never seen the inside of an ambulance except on TV then you're putting that cart in the wrong spot. I might sound a bit like a Debbie Downer here but I'm really just trying to be realistic. EMS and Fire Services is not like knitting, you can't spend $50 on some supplies, give it a shot then say eh..this doesn't work for me, and then put the knitting supplies in the closet never to be seen again.

I recently tried to explain this to a new member but realized that this was going to take more than a good saying to get my point across, this was going to take a miracle. You want to be a FF/Medic? Great. But let's start with the simple things, like CPR, then maybe run some calls. Then let's get you in an EMT class once you get an idea of how the system works. No, I can't answer your questions about how long it will take you to "get it" or how much time you should dedicate to trying to "get it." I can't predict the future.

Ladies and gentlemen at some point you have to take responsibility for yourself. We can teach you only so much before you have to take over and ask questions, participate, and be willing to show up and do whatever it takes to learn. I told the basic class I'm assisting with I'll put as much effort in to you as you are willing to put in this class.

On a side note, I had a drunk guy offer me a mammogram this weekend. Awkward.Turtle.

Hello my readers...

2011-10-10T09:37:00.002-04:00

If you know me on twitter or facebook then you've already heard the news but for those that don't, I was laid off last week from my real job. The plus side is I have a job until the end of the year. The down side is..well I don't have a job! I try to focus on the positive but you all probably know by now I'm not a super positive person to begin with. I do think that a divorce and being laid off in one year is a bit much (are you listening, universe? Cut me a break here) BUT it could always be worse.

So, since my day job isn't my EMS job I'll still be posting and all that jazz. My EMS experience offers me another field to try and get a job in so that's great. I just wanted to check in real quick since I hadn't posted in over a week. I haven't been up to witty and brilliant, just bitter and angry.

On a side note, I was teaching backboarding to the new EMT-B class on Saturday and I ended up going off on a 10 minute tirade about the importance of a good narrative. I have no idea how I thought the two related, besides backboarding is an important skill as is narrative writing, but they all listened and asked questions. Maybe, just maybe, a few of them will go on to be excellent narrative writers.

I'm going to go be thankful for my coffee now, at least while I still have electricity and water to brew it...

ePCR: Perfect solution or another reason I cry myself to sleep?

2011-09-29T11:06:00.001-04:00

Since I started in 2001 my department has always used some form of computer reporting. Up until four or so years ago we used a paper PPCR that would later have key information entered in to a program written by Moses, made in to a file, then uploaded to the state. Then we started doing a PPCR on scene then entering all of the info online after a call. That was system was okay but the double work was kind of irritating. Now we have laptops in every ambulance and the ePCR starts as soon as our patient care starts. When the laptop works, or the EMT remembers their login info, or the laptop is updated and not trying to sync info right now...

What I've noticed about the ePCRs is information is now sucked in to a black hole. Providers that used to be highly detailed on their paper reports are not so much on the electronic report because they checked a box here or there so why should it be in the narrative? People, I don't care how many boxes you've checked (that's what she said), you still need a good narrative. After uploading reports to the state today I had some reports kick back as only 11 or 12% completed. They had not checked the correct boxes and when I went to the narrative to get this info to fix these charts the info necessary wasn't there. Now we have kicked back charts that are due tomorrow. A good narrative can make or break you and it is imperitive to focus on becoming great at them. I understand that some people struggle but good patient care is not just bedside manner and knowing your protocols, it starts from the second you sit in the ambulance and doesn't end until you get back to the station. I personally don't feel that enough time in class is spent on narratives anymore. When I took the class we had to do practice narratives and turn them in and I make my rookies do the same. I also critique their narratives when working on their patient contacts.

A few tips for writing a narrative:

Paint a picture. Your narrative starts with when you arrived on scene until you dropped the pt off (and preferably where) I should be able to pick up your narrative and recreate the entire scene without wondering how you found the pt, how they got to the ambulance, and whether or not you actually did something en route. I see you did vitals judging by activities but did you mention it in your narrative?
Don't use words you don't understand. If you can't remember whether it's distal or medial or medieval times, use common words.
If a patient tells you something make sure you note "Pt states they haven't felt well since they slayed that dragon last week." That way anyone reading this says "oh hey, it's not the EMT that thought it was the dragin slaying that caused the issue but the pt that thought that"
Focus on your narrative. It's easy to get distracted but take a few minutes to read it over, check for spelling mistakes and punctuation. A sloppy narrative can be held against you.

Bottom line, folks, is don't take your ePCR for granted. It's an excellent tool that is here to stay, it will continue to expand and improve over the years but don't let it make you become a lazy provider. There is never an excuse for that.

Last Comic Standing? Not so much

2011-09-16T11:55:00.005-04:00

Apparently patients that just had an injury due to a pothole do not enjoy you quoting the Geico Pothole commercial as much as you enjoy quoting it.

But damn it was funny...to us.

K, Bye!

You can't choose your family...

2011-09-13T19:14:00.005-04:00

While attending an awards ceremony for my significant other I noticed that one of the key points they kept coming back to was being thankful for the families that support the officers. They took time to thank the husbands, wives, mothers and fathers (lowly girlfriends don't get any credit, yo) for allowing them to work the midnight shifts, the holidays, for being patient with last minute shift extensions, and supporting them through the tough incidents. After having a weekend where nothing went according to plan due to his job this was actually pretty good timing because it reminded me that my inconvenience of a last minute plan change could be someone's life saved. Or it could be a donut's life saved...however you want to look at it.

It also made me think about my family and friends as part of the last minute change of plans this weekend was me hastily jumping out of my friend's vehicle to assist an injured bicyclist and asking her to drop off my purchases to me at a later time. I believe it's important to have friends that are outside of the EMS World as they help balance my sanity, they aren't telling me all about the call they just ran or asking me for advice on what to do about this fire department issue or that rescue squad problem. They provide me with my "normal" time. This isn't something I get much of with my actual family as my brother was an EMT that got me in the business and is now a police officer, and I'm dating a police officer that is also an EMT. So you can see how, in my world, most of my focus revolves around someone's emergency whether it's departmental or 911.

My non-public safety related friends and family are understanding and let me do things that people not as committed would be like, oh hell no, I'm not putting up with that shit. Changing plans and interrupting meals so I can run a call, knowing to just pay and bring me my leftovers when it happens...those are traits of some awesome people. They're patient when I show up to our plans so exhausted that I'm begging for coffee the second I see them because I was up all night running calls or out all day teaching EMT class. When I'm angry and upset over a call they listen, even if the details gross them out or they have no idea what I'm talking about.

So, while I may not get to bring my friends or family to an awards ceremony to show them the appreciation for what I do, I'm reminded that I need to thank them for their continued support and patience. They'll probably never fully understand just how much it means to those of us in this public safety business to have someone on our side when sometimes it seems like everyone, especially the dispatchers*, are against us.

*Dear dispatchers: That's not meant as an insult it's just that sometimes we think that you have cameras on us and know when we're trying to eat/sleep/pee/etc.

please help the guys in kilts

2011-09-06T16:01:00.003-04:00

get your donations in before they all get committed for running around in their kilts.

I'd participate but they won't allow me to carry a gun for the safety of others...

Another round of "dumb questions I answered"

2011-09-04T22:33:00.000-04:00

Labor Day weekend brings the same old standby that I've had to do for the past 5 or 6 years now. This weekend's questions included:

Is the storm coming? Nope! We evacuated the entire place because we enjoy fire drills. Oh and the noises that you hear that sound like thunder? yeah, that's sooo cannon fire. The motherfuckin' British are coming and they're rolling in deep.
Do you have an ace bandage No, sorry. Um are you serious? no, I'm only kidding. Hold on, when I hit this red button here my ambulance turns into a CVS. It's magical. Need tampons, too?
Is this a first aid tent? We need Neosporin. No, we don't have any. Okay, so where is the first aid tent? We need Neosporin. Ummm there are no "first aid tents." Instead you have "lots of aid ambulances" Little Jane will be fine until you get home.
*holding fake severed head* Can you fix this?? No. I also can't fix stupid. Just saying.
Can you tell me about this event? Sure, they pay us a shit ton of money to bring ambulances out here. We sit and watch you all do your thing while we do ours. Oh that isn't the answer you're looking for? Sorry. The funnel cakes are over there! Oh? That's also not what you're looking for? Maybe you should ask someone in a kilt instead of someone in an EMT uniform.
Is soandso here? How the fuck would I know?
Can I park here? Sorry, I don't know. Well can you find me someone who DOES know? No, you see I'm not a parking attendant. I'm also not your bitch. Drive on.
I'm an EMT and my child is having an emergency, can I just use your ambulance? Sure, why not. Just be sure to clean it when you bring it back.
My child fell in some mud, can you clean them up? Umm...any injuries? Oh, no! They're perfectly fine! Just muddy! I suggest tossing him in the wash machine on the gentle cycle, and air dry. Do you think my ambulance has a bathroom? A sink? A shower? I have sterile water and a trauma dressing, that's the best I can do.
What do I need to do to get mouth to mouth? Well, I'd start off by not being such a creepy douche, then you won't have to pretend to be unconscious for attention.
Do you have water for my dog? No, sorry I just have sterile water and I doubt they should drink it. This is something I actually wish I could have answered differently. Next year!
Have you had any major events today? Yes, I almost walked in on a guy in the portajon because he didn't change the door to occupied. I feel that this was a major event. Oh you mean like people dying and all that? No, I've saved several lives with band aids today.
What's your problem? My counselor says I have PTSD and need more hobbies that don't include dead people. So tell me, what's YOUR problem? Sir? SIR??

Kilted to Kick Cancer

2011-09-01T10:30:00.003-04:00

I don't have a prostate personally, I mean I have one that's available to me but I don't think I can count it as mine. Though I do carry his testicles in my back pocket if you hear him talk... Anyway! September is Prostate Cancer Awareness Month and if you haven't heard about the Kilted to Kick Cancer project then you're living under a rock.

Sadly I don't have a kilt, though I did learn that women should go the same route that guys do under their kilts, so the only support I can offer this year is through my blog. Throw on your kilt and check out their site, and don't forget to visit AD's site for a fundraising challenge with some cool prizes. Most importantly, if you're a proud prostate owner and over 40 be sure to get checked out.

I always feel like somebody's watching me....

2011-08-25T21:42:00.000-04:00

Any time you are wearing anything fire/rescue related or in a piece of apparatus you are being watched. The citizens are always on the look out for things that you say and do. This can be a good thing and a bad thing. It's a good thing when you set a good example, show that you give back to the community, and so on. It's a bad thing when you're doing something dumb. You can help grandma cross the street, save 10 kittens from a burning tree and give every kid in an orphanage a new home and no one will notice. You park at an angle in a parking lot and then citizens notice.

Whether you're paid or volunteer the bottom line is, you work for the community. Yes, yes, I know,you pay taxes, too. However, you understand things that Joe Schmoe doesn't, like how you're not necessarily parking like an asshole, you're making sure you can get out quickly if you get a call. Or the ambulance isn't running because we're afraid of a little cold weather, we're not trying to freeze the IV bags that we may have to use in the next 20 minutes. I recently told a citizen that had a concern that sometimes we only have a small window of time to make an impression on people around us, sometimes as quick as the 30 seconds it takes to go through the intersection, so the odds are stacked against it. However, it's our job to do our absolute best. Yes, there will be mistakes. I've made my share of them, but after all we ARE human.

PS. If you're in the cab of an emergency vehicle and you don't have your seatbelt on you're setting a really bad example. And you're an idiot. Just sayin'

Panties Optional

2011-08-23T11:09:00.000-04:00

Your mother always told you to change your underwear every day because you never know when the paramedics will see them. I agree with this statement whole heartedly...unless you're a good looking guy, then I suggest going commando and giving me cause to cut your clothes off. Hey, I'm an EMT, I can do this legally!

Now ladies, let's talk about panties and EMS. I'm a big fan of thongs..

but not when I'm wearing EMS pants...I mean trousers. I made the mistake one day of wearing a thong while I was on duty and I had forgotten my belt. I may or may not have been a little hungover when I got dressed that morning. That afternoon we had an extrication on the interstate and while I wasn't in the vehicle I was helping the guy that was then helping get the patient out. Old Navy jeans are not meant for extrication and neither are thongs. When we finally got the patient out and the firefighters lifted the backboard on to the stretcher, I sat back on my heels and realization struck me. "My, it feels a bit drafty in here..." I turned around and realized two state troopers were standing there staring at my thong that was peeking wayyyyy out of my jeans that had shifted around in my course of crawling around on the interstate. They did NOT seem to mind. In fact, they were grinning and I think one of them had a camera phone out. I apologized for mooning them and they about fell all over themselves assuring me that it was quite alright.

So in general I try to stick to a nice boy short or brief, not a granny panty mind you but something that offers a little more coverage. I like something with a little lace to help balance out the super sexy 5.11 boot socks I wear.

See? now doesn't she look happy in her lacy boy shorts? I bet she's never had to crawl around on the interstate...

Today's post is brought to you by popular demand on Twitter. For another fun post, see my Guide to Dirty Talk in EMS.

Not all questions are good

2011-08-14T22:27:00.000-04:00

Like when I walk by two guys standing in the ER with coolers and ask if they have anything good in there. It wasn't until after they grinned at me and said "not yet!" that I realized they were there to get organs.

Yesterday I assisted the Enhanced class by being an evaluator for practicals. At the end of the day I made them all put tourniquets on their arms and leave them on for a few minutes. I know they're learning technique and there are a lot of steps that go in to an IV start practical but I really felt bad for the dismembered arm that sat there with a tourniquet on for 5 minutes. Is it possible to have sympathy pains for a fake arm?

Talking in circles

2011-08-12T08:47:00.000-04:00

A.K.A. your average monthly business meeting

I've been attending business meetings since I was a wee lass of 17. Over the years my role at these meetings has changed from "you don't have an opinion, junior" to "hey president you realize you're in charge, right?" I no longer run the meetings but still have a heavy hand in them as I handle a few of the topics. One thing I've learned is no matter what these meetings are basically the same no matter what the topic is or who the person behind it is.

Here's how I prepare for a business meeting; the week of I start keeping notes on my daily comic calendar. I try to think of who is going to be for/against some of the ideas I need to discuss, and I try to formulate a defense and alternate ideas. Sometimes I start putting out feelers a few days before to get a little support in the meeting. The night of the meeting I come in and handle the 40 million "honey do" tasks that await me as some members only see me at meetings/drills. The meeting gets under way so I sit in the back and text and giggle until I'm called on. I present my idea and wait for the argument. The arguments never fail to appear, however, sometimes the topics I anticipate issues over won't get a peep and topics I don't anticipate anything issues over get a full on riot. 99.999 of the time I can calmly present my idea, defend it, and go from there. .0001% of the time I get flat out angry and have been known to get in to a screaming match. I try to limit these occurances but I am a red head after all. After the meeting we're all best friends again and you'd never know 30 minutes ago we were at each others throats.

Sometimes I feel like we're just talking in circles and people are arguing just for the sake of arguing. I'm open to opposition and differing opinions, there are times when members will point something out that I didn't think of. However, there are some people that I can tell just by the look on their face that they're arguing just for the sake of arguing because it's funny to them. This is why my mom took away my sling shot all those years ago when I first started going to meetings...

How EMS Providers view each other

2011-08-12T08:22:00.001-04:00

This is hilarious

I'm moving up in the world

2011-08-11T11:49:00.002-04:00

Thanks to a very nice gentleman, I now have a fan page on facebook. Look out world, I may actually figure out how to use it next!

Well, that didn't take long...

2011-08-09T20:41:00.000-04:00

Almost 3 months after our department started to host a 24 hour medic unit our volunteers have apparently given up. This is very disheartening to me but I have no idea how to get them involved. I've heard a variety of excuses over the past week as to why running duty now is no longer necessary. I've attempted to refute as many of these as I can but the bottom line is I can't force someone to run duty. This was an issue prior to the medic unit so it's not like it's a new problem, and it's definitely an issue every volunteer department faces. I'm just so disappointed to see the members step back and say it's okay, paid staff has it.

My favorite thing to do is run calls. It's the calls that make the paperwork, meetings, and other tasks I handle as an officer bearable. If I get frustrated or burned out with being in a leadership position all it takes is one good call to snap me back. I can't wrap my mind around the mindset of "let them handle it and I'll stay home." Then again I have members that can't wrap their mind around the fact that I commit at least 3 days a week to the department.

So where do we go from here? I wish I knew. There have to be some changes but none of us are exactly sure where to start. Well, I always start with my underwear, thankfully I have about 50 pairs...

What are vitals?

2011-08-07T21:42:00.000-04:00

Vital: (adjective)

absolutely necessary or important; essential.
Indispensable to the continuance of life

Well, that pretty much sums it up. With a definition like that it's impossible to argue that vitals are not an important part of treating and assessing your patient. Actually, if you try to argue with me that they aren't you need to send me your address because I am going to show up at your door with a baseball bat and make sure you see it my way.

It's imperative that accurate vitals are taken and recorded throughout your patient care. I don't care what method you use to get them as long as they are taken and correct. Please, for the love of all that is holy, do not tell me that you think the pulse is this and the blood pressure seems to be somewhere around that. I will accept answers such as "I think the blood pressure is this, but it was hard to hear so I am going to try again" or "I'm having trouble, can you help me?"

Since I'm not a medical expert I won't get in to every vital sign and why it's important. We're all trained to look for certain things in vitals like shock. We SHOULD all be trained to take good vital signs. We SHOULD all be trained on a lot of things, but as I meet EMTs in my career I find that this is not always the case.

Pocket Guide #20: Your guide to being the new kid on the block

2011-07-28T13:40:00.000-04:00

Step one, break out the denim jacket and the high top sneakers. Oh wait, I don't mean THAT kind of New Kid on The Block...

Finding a good department isn't always easy. Each department is run a little differently but they all have the same kinds of people. A good department will interview you and find out your goals and expectations before putting you through any of the process. Some people take an EMT class prior to joining a department just to get a feel for things and the people.
Once you're in you'll start to meet all kinds of people. They will vary from not wanting anything to do with the new kid to eager to assist the new kid. Hopefully you get more of the latter than the former, but it will just depend. Pace yourself. Be eager to learn new things and get to know everyone but don't latch on like a bad foot fungus or you will get annoying.
Keep your mouth shut and your ears open. For the first 6 months to a year you really just need to lay back and listen, see how things go and how people act in different situations. You'll learn a lot this way without seeming like the know it all new kid who has no clue. Don't be afraid to ask questions, yes I say this often, there's a reason for it.
Don't lie. Don't make stuff up. Don't throw someone under the bus to try to get ahead with someone else. The truth always comes out eventually and then you look like a douche bag. Some examples of things I've heard over the years include:

"I was almost a firefighter but then something came up." Come to find out the person did a ride along one time on a fire truck. By that standard a lot of us were "almost firefighters." Almost only counts in horse shoes and hand grenades.
"I'm like, Tony Stewart quality of a driver" Um yeah except you drove straight in to a pole. Not backed in to it, STRAIGHT IN TO IT.
"Oh I know how this works! I've done it a million times!" Ok so why are you putting the BP cuff on the patient's forehead?
"I'm great in high stress situations! Oh you want an example of one? Um.. do the SATs count?"

Know your role and respect my authoritay! When I joined my brother was chief, this did not give me any authority. This made me the chief's little sister. That's it. I did not try to take advantage of this situation but I have seen others try to. (I did pull the "my brother will kick your ass!" card a time or two, but that was in jest and with a member who was also a family friend) Trying to look cool by riding on someone else's coat tails will not get you far, and as one person just learned, can cause major operational issues. If you don't know what you're talking about just shut up and listen.
There's a reason for introductory or probationary periods, it's easier to get rid of you if you're a fucktard in this period than it is once you become a full blown member. Most people really don't have to worry but you will come to learn that there are some people you will be very glad were just probationary.
Find a half naked Indian to be your guide. If you can't then find a fellow member that you can trust to help be your guide. But um..don't ask them to be half naked when they guide you, this might get you in some trouble. After watching the people around you it will be pretty easy to pick up on who you can trust and who you can't.
Attend meetings, drills, etc even if you don't have to. This shows that you're making an effort to be a part of things and it helps you figure out how things work.
Know that you'll get picked on, a big part of this is just to see how you take it. If you roll with the punches then we're good, if you fall to the floor crying then we're not so good. Unless they insult your mother or dead dog or something, then you can fall to the floor crying. You will be given the crap jobs and will hear "let the new guy do it!" quite often, it's part of how we learn, we've all done the crap jobs. Also, know that there are no such things as red light oil, left handed wrenches, left handed gloves, etc. There ARE blue flares, though, as I recently learned.
Enjoy your time of no responsibility, because if you're eager you will eventually start to volunteer for stuff. Then one day you look around and go shit, I wish I was a junior/rookie again and holy hell how can they possibly have THIS many meetings I need to attend?? It's also easier to get away with mistakes! Just don't run the ambulance straight in to a pole, seriously.

All this new fangled technology...

2011-07-26T13:05:00.000-04:00

It wasn't that long ago that the only way information was spread around my department was at business meetings, training drills, phone calls or the ever so popular rumor mill. We had a web site that had the bare minimum of information for the community to visit and learn about us. A few of us would email back and forth but we had to wait until a squad function to get the word out on anything important. Now we have a nicer web site, a facebook page for the department, a facebook group for our members, an email group for all of our members and our duty calendar is online (google calendars, AWESOME!).

Recently someone we helped stopped by our facebook page to say thank you and the people that were on the call knew within minutes after a text or two. (This prompted me to write a blog post today about communicating with your members and your community. Facebook is something a lot of people have now (though I have one member who refuses to get on it, his kids are on it and they show him our page from time to time). It's a great way to get information out to the community about weather events, fundraisers, or even general reminders of things such as the move over law. We also include pictures of different standbys and parades to give people an idea of who we are and what we do. We haven't ventured on to twitter yet but with a few hundred friends on facebook we seem to be doing a pretty good job of putting ourselves out there. We maintain our web site and have added more information, a frequently asked question section, a paypal link, and information on ways to donate that don't involve money such as movies.

Our duty calendar went online a few years ago and has been a great tool. Only a few members can make changes to cut down on confusion but it has cut way back on the "I didn't know I was supposed to run!" excuse because it's included in every email. Depending on what's going on we can have one or two emails a week or more, though we do try to keep them to a minimum as well as short and sweet. Almost all of our members get their emails to their cell phones so information has gone from a once a month thing to right in your pocket! Or holster..or pink fluffy purse...whatever they carry it in. This has been a huge help on many occasions when I need information right away but I'm not sure which member has it (like who stole the portable out of that ambulance? Oh you took it home on accident? Ok cool)

Some of our members still fuss a little at the use of technology but they've all warmed up to at least an email address. They even agree to check it more than once a month! Texting is my next goal for them but we're taking it slowly!

Hello out there!

2011-07-25T08:42:00.000-04:00

I'm not dead, I promise. I've been on vacation and am now trying to settle back in to my daily routine. Luckily I had a pretty quiet vacation and only dealt with a few minor squad issues, unlike last year when I had a few major ones to deal with while on the beach. Apparently I missed a hell of a heat wave, too.

I'll be returning to my regularly scheduled whining, I mean blogging, here soon.

All the world's a stage

2011-07-12T13:35:00.001-04:00

It's intimidating to have people watching while you're working on a patient, especially since the mathematical theory of the amount of people watching is directly proportional to how quickly they're circling the drain. It's like a vacuum force, drawing people in. However, it is a necessary evil of EMS. Like vomit.

Recently I ran a call where we had an entire market of people watching and when I told my rookie to put oxygen on the patient she took one look at all of the people looking at her and froze. After my third call for oxygen went unanswered another person on scene grabbed the tank and did what was needed. When we returned to the station I had her take me through the steps and she knew them by heart so I have faith in her, we just have to get her over her stage fright.

Also, it's f'in hot outside people. If you don't have air conditioning then find other ways to keep cool and no matter what, HYDRATE.

Why it's important to change your damn gloves

2011-06-30T20:05:00.000-04:00

GERMS, PEOPLE! They're everywhere you go, at home, at work, at school, at play, and especially in an ambulance.

Over the years I've seen glove changing recommendations vary from after every procedure to at least after every patient. I try to find a good middle ground. I normally change my gloves at least once on a call (after initiating the IV and doing a clean up), or a few times if it's ...juicy...enough to require it. Any time I notice a rip or tear in my gloves they're immediately changed, no matter what. Who is the most important person on a scene, kids? You are!

GLOVES DO NOT BELONG IN THE FRONT OF AN AMBULANCE unless they're brand new and never been used. DO NOT drive with gloves on. Do not touch the radio with gloves on. Do not touch the keys with gloves on. Do you get my point? After a call everyone will wipe down most of the surfaces in the back of an ambulance. Rarely do they hop up front and wipe off the door handles (inside and out), the radio, the steering wheel, GPS, radio, rear view mirror, seat belt, the list goes on and on my friends.

There are so many things and surfaces that we touch over the course of a call that it would take me all night to list all of them. Pens, radios and grab rails are most often overlooked when it comes to clean up. Please people, if it's warm, wet and sticky and doesn't belong to you then don't touch it. If you absolutely HAVE to touch it then follow good BSI precautions!

This post might paint a good picture for you, my dear readers, as to why I can't even go near a Chuck E. Cheese.

Why training videos should be more like informericals

2011-06-22T21:31:00.000-04:00

And maybe less like 70's porn.

The other day I was watching a training video online and spent more time keeping a tally of how many times I could have said "THAT'S WHAT SHE SAID!!!" than notes. The material was airways and let's face it, that's boring as hell. The music in our videos after the scenarios makes me feel like I should put on eye protection to save myself from the 70's bush that is flying around.

If training videos were more like infomercials I think they'd be more fun to watch. Take a simple subject, like using a BVM, an idiot and give them an audience. Our opening scene is an EMT attempting to use a BVM on a patient's ear, the patient and the EMT both look distressed. Announcer: Have you ever struggled with your BVM on a call? Do you wish using a BVM could be easier? EMT: It's just...so...hard! (that's what she said!!!) Announcer: Well, we are here to save the day with this handy dandy 30 minute video. After watching this video you will be able to seemlessly use your BVM in any kind of condition! Call now and we will throw in a video on how to hook up oxygen! EMT: Thanks infomercial guy! You sure saved me! At this point the patient, after being properly ventilated, looks up with a cheesy smile and gives a thumbs up.

On another note, I probably shouldn't write blog posts while high on Imitrex...

Today's theme: Alcohol and guns!

2011-06-20T14:40:00.000-04:00

Every call I had the other night included alcohol and guns, whether it was the patient with a gun or the multiple law enforcement officers (and boy did I see plenty of them that night). It's funny how an entire shift can have one single theme of calls. I've had cardiac days, diabetic days, Church days, and alcohol days. The best days are the Church days because I normally get food out of them.

One of my calls required me to be more of a counselor than an EMT. The physical wounds were minor but the emotional ones had taken their toll on my patient. I tried to offer some guidance and encouragement without going over the line of it's none of my business and I'm not here to dispense advice. It's hard to sit and keep quiet, however, when the patient is asking you questions that make you want to scream "GET OUT! Run!" I have a feeling I'll be back to that person's house in the future, and it won't be pretty.

There are times when I struggle with calls hitting close to home. This is true for any one in this kind of business but it's also not something we talk about very often. It took a divorce for me to realize that everyone deserves to be treated well, so when I run a call with a patient wondering how their spouse can treat them that way I'm reminded of when I asked that very same question. Having kids is another example of this situation. I don't have any, so when I run a pediatric call I can't really directly identify with the parent's fears while my crew members that have a little one at home can say "Yeah, I've been there. I understand how you feel."

There's more to being an EMT than ABCs and SAMPLE. We can't teach you that in class, you have to learn it along the way.

I'll get you my pretty! And your little dog, too!

2011-06-18T16:09:00.000-04:00

Apparently the current rumor is I have a complex network of spies and I record every move that is made at my department whether it's paid or volunteer. Yes! YES EVIL MINIONS! Do my bidding!

Ok really folks? REALLY? Unfortunately for this rumor only one person believes it but they're sure trying hard to get it around. Actions speak louder than words, my friend. I don't have enough time or patience to monitor everything everyone does. We're talking about 30 people here that I'm supposedly monitoring. All while holding down a full time job and finding time to sleep and shower!

Stay out of my sand box!

2011-06-17T11:53:00.000-04:00

My county is a combination system of paid staff and volunteers working together. The paid department does not have it's own ambulances or fire truck, nor does it have it's own building to run calls out of. They have their main office and then they work out of the volunteer's departments. This system has evolved over the years from just a few people paid to provide ALS services to 50 or 60 employees working every day. Last month we went from supplemental staffing to 24/7 paid staffing at our department. So far we've had only a few minor bumps in the road and everyone seems to be adapting well to the change. Our entire dynamic as volunteers has changed but I am proud to say that the members are handling it well. It's involved hard work from both sides but I see us continuing on this path over the years.

I was incredibly intimidated to be in a leadership position when this change over happened. If it wasn't handled just right then I would forever be blamed for "letting the paid staff take over" and "ruining the department." Now that we're balls deep in it I have to say I'm proud to have been in the position I'm in, because we've helped navigate our department through the major changes and we've come out on the other side still smelling like roses. And smoke, someone always smells like smoke.

However, I'm kind of in the middle of all of this. I'm a volunteer officer/medic but I am also employed by the county to teach EMT classes. They're going to help me get certified as an EMT-B instructor over the next year or so. I love teaching and have done tons of classes for no pay, or just CE hours, but when they offered me money (at a time when I so desperately need it) I couldn't say no. It was something I debated, as I've heard people called all kinds of names for "jumping ship" to the other side. Come to the dark side, we have cookies! However, I need the money, I want the experience, and if it saves my department money from having to pay me to get the instructor cert then it's a win-win situation. Oh and teaching gives me GREAT material for the blog!

Yeah it doesn't work that way....

2011-06-15T08:02:00.000-04:00

While assisting with a class last night we had a student tell us that they would just use their prescribed medication for a patient instead of what we carry on the ambulance. After trying to explain to this person that this is very illegal and would get them and everyone else in trouble they still insisted.

So folks, here's a better example. I've been prescribed birth control but that doesn't mean I can just run around handing it out to people, no matter how bad I think they need to use a form of it.

You know you're in a rural department when....

2011-06-11T14:10:00.000-04:00

You get a phone call asking what they should do about the bull running around the department's parking lot. Apparently suggesting that they "Cowboy up" was not what they wanted to hear.

For more on this subject, please refer to my Pocket Guide #13: Rural vs Urban

Where the hell have I been?

2011-06-07T19:17:00.000-04:00

Not running calls, that's for sure. Oh well we did have one. Let's talk about assisting law enforcement...

I'm a big fan of the boys in blue (well actually our options are grey or brown) and when they ask for assistance I am all over it. However, asking me to take a blood sugar of a child because they're acting wild and crazy is a stretch. Yes, that WTF look I just gave you and the parents is genuine. I really want to know what the fuck you're thinking. The only thing I can think of is they had no clue WTF the parents were thinking so they wanted to share the confusion.

To the person that saw us with the windows down in the ambulance singing songs as we headed to the parade, my apologies. To the juniors that were stuck in the response car with me as I sang Bohemian Rhapsody a la Wayne's World, I'm deeply sorry. I know that's a moment in time you will never be able to erase from your memory.

Kids these days...

I have a few things to get off my chest...

2011-06-01T13:20:00.000-04:00

Sorry, guys, my shirt isn't one of them!

We have six pieces of apparatus and in the last two weeks all but two of them have broken down. One of them has broken down repeatedly. Within 12 hours of being out of the state I had my first vehicle emergency to deal with and thankfully the company we bought the unit from is on top of emergency repairs. If you know me on facebook you know I made the joke that maybe one day I can go on vacation and actually GET a vacation. I also dealt with one personnel issue while out of the state but that could not be helped.

My divorce is final, I have my name back and can begin rebuilding my life. The limbo of the past three years is over and I'm relieved. This has been hell on my finances but I'm getting by and I keep telling myself this is a temporary situation, it won't always be like this. I try to tell my credit cards that, too, but they don't care and still want payment!

We had an issue with a non-member of our department and the person turned around and did the exact same thing at their home department. You can lead a horse to water but you can't make them drink. I know that every system has the same kinds of people, the overachievers, the just barely achievers, the slackers and the fuck ups. It's just frustrating to see the fuck ups try to tear apart what everyone else is doing.

We had a member quit over how I ran the department. Apparently following the rules is uncool and there are better places to run, places without rules. Every decision I make is based on what I feel is the best decision for the department, even if it means it inconveniences me. As long as I can defend my reasoning and end the day knowing that I did the best I could then I'm confident in myself and my ability as a leader. It doesn't lessen the sting, though.

A good man will sit quietly while his girlfriend cries on the floor of his bathroom over a migraine and stress from money and the squad. I know the rule is to let your crazy out little by little, but when you're dating someone that's also in fire & rescue they've seen you in just about every kind of situation (and time of day, and with drool on your face, and with helmet hair...) It's also challenging in a way because as officers we're both expected to set an example but I have to be incredibly careful, as the ranking officer, not to show any kind of favoritism. I've been told that so far I've done well but it's something that's always on my mind. I did threaten to suspend him at dinner last night, though.

And that sums up another round of EMS Chick's thoughtless ramblings!

Oh wait, dear 911 gods. Holy hell you're killing me. I don't even remember what the interstate looks like. GIVE ME A DAMN CALL!!!

heart breaking

2011-05-27T09:42:00.000-04:00

sometimes you read a post and all you can do is wipe away the tears. This one by Transport Jockey did just that.

One of my favorite sayings is "time heals all wounds." this was first told to me when my father was killed and has been my mantra for years. Words can never take away grief, but sometimes you need a thought to cling to.

And finally...to keep you entertained: EMS Chick showers with a back board

2011-05-25T10:06:00.003-04:00

This was a popular post for awhile. FYI for other popular posts scroll on down my page, I'm not sure how they're chosen but the ones on there kind of crack me up.

The Hidden Joys of EMS
Have you ever showered with a backboard from your ambulance? I have. It's called dedication (and a lot of mud). More on that later.

Cleaning an ambulance and your gear is not something they spend a lot of time on during your training in EMT. At least they didn't in mine, beyond "hand washing is the number one way to prevent the spread of disease." I doubt anyone becomes an EMT just so they can clean an ambulance inside and out, from top to bottom.* I call cleaning an ambulance a hidden joy of EMS, along with paperwork and cleaning up after your coworkers or other volunteers. It's not something we're going to put on our recruitment posters but it's a necessary evil to provide good care.

Last night we had a muddy call that took us forever to clean up from and I'm pretty sure there is still some mud hidden in that ambulance somewhere. You don't realize how many little places for mud, or other things like blood and germs, can get in to. Stethoscopes, pens, and driver's compartments are often overlooked in a full decon of an ambulance. Underneath a stretcher and in between cushions on a bench seat are places that we just don't think about. I like to start from the top and work my way down, focusing first on restocking and cleaning up bags and getting them put away so there's less stuff to move around when trying to clean everything else. My local ER doesn't have a hose outside** so when I got to the mud covered backboard last night I scraped and scraped then had an epiphany, in the equipment room there is a little shower. Perfect! I admit that I ended up wearing lots of water splatters and mud splatters but at that point I was almost as dirty as the ambulance was so what can you do. Halfway through my shower with the backboard a volunteer from another station walked in, he stood and stared at me for a second then started laughing. When I asked if he had any better suggestions he told me no and to carry on. I think he's just jealous that I thought of it before he did.

When all was said and done it had taken 3 people over an hour to get all of the mud and dirt out of all of the nooks and crannies in the ambulance. Just when we thought we were done we would see a large splatter and had to start all over. Thankfully this call went out at the end of the shift so when we got back to the station all we had to do was turn off the lights and head on home to a warm shower and clean clothes.

For a good article on cleaning an ambulance and why it's important visit Life Under The Lights, and don't worry, he has a great article on paperwork, too!

*If you did join for this reason please request an application to my station in my comment section. Thank you.

** Due to us being at least 20 minutes from our ER we have to get the ambulance back in to service as soon as possible, that means doing a lot of clean up at the ER itself . If we leave the ER and head home to clean up it is guaranteed we will get a call halfway there and show up at the next house with a muddy ambulance. Murphy's Law # 1345

Don't forget to send questions!

Keeping you entertained part deux

2011-05-23T10:01:00.002-04:00

This one was a bittersweet post from 2008 about a call I had in 2005. This was my worst trauma call for awhile until last year when it was replaced. I haven't dreamed about the 2005 call in awhile but it still stays fresh in my mind.

Another story from the past...
I was reminded of this story while reading this post: http://callitasiseefit.blogspot.com/2008/05/what-did-your-phone-just-say.html

This was about 3 years ago during the summer when we were dispatched for a MVA involving a motorcycle and a guard rail. As you can imagine, what we found on scene wasn't exactly great. The river of blood in the rumble strips was a disturbing sight and the patient's friends begging us to do something, anything, is something that will stay with us all forever. Our first medic to arrive on scene was relatively new and saw a rhythm of PEA. He wasn't 100% sure that this was PEA or a workable rhythm so, erring on the side of caution, we worked it. We load the patient into the ambulance while two more medics arrive to help. This patient is nothing but injuries, even with leathers on, but where do you start with any patient? ABC. Airway, Breathing, Circulation. I am bagging the pt per the medic's instructions while he gets the airway roll and tells me to move so he can begin intubation. He's struggling to get the tube placed so we are going between bagging and intubating when suddenly, as he is trying to see the vocal chords, his cell starts to ring and we hear "You want a man with a slow hand... you want a man with an easy touch..." We all stop and stare at the medic. His cell is in his pocket so we can't reach it. The song eventually stops, followed by his ring tone for messages (The theme from Godfather).

The patient is pronounced and life moves on. It's a call that to this day is still fresh in our minds, it's one we tell the rookies when we're sitting around and they're asking for war stories. It's one we still occasionally dream about. But it's also one we learned from....never pick a ring tone you wouldn't want to play when you're working on a patient.

To keep you entertained....

2011-05-21T09:54:00.002-04:00

Since I will be out of town for a few days I wanted to keep you all entertained while I was gone. Now now, there's no need for tears, I will be back just in time to teach a training drill and get back to duty the day after that. Trying to plan trips around meetings, drills and duty is quite an art form.

Let's take a cruise on back to 2008 with my original pocket guide:

A pocket guide to what is/isn't an emergency:

An Emergency requires an EMERGENCY Room Visit. A NON Emergency requires a trip to your PCP.

EMERGENCY: Excessive bleeding from a wound
NONEMERGENCY: no period...pregnancy tests can be done at home.

EMERGENCY: Can't breathe
NONEMERGENCY: Can't find your Viagra prescription and need a new one

EMERGENCY: Exposure to radiation
NONEMERGENCY: Exposure to an STD

EMERGENCY: High fever in a child
NONEMERGENCY: You got high and are worried that it may harm you later on down the road.

EMERGENCY: Heart attack
NONEMERGENCY: Herpes attack

EMERGENCY: Loss of limb
NONEMERGENCY: You suspect your daughter lost her virginity and "want her checked."

Feel free to print this handy dandy list out and keep it in your pocket in case you ever have to stop and think "Huh... I just lost my hand, should I go to the ER?"

PS...these are real reasons I have seen people visit the ER and normally have had to explain why their insurance didn't view the nonemergencies as...well...nonemergencies.

Don't forget to send me your questions!

Do you have questions? I have answers!

2011-05-18T09:06:00.000-04:00

Of course I will not guarantee that any of them are useful answers but by golly, I'll come up with something!

I'm looking to expand my Q&A a bit as I know 99% of my readers still wonder wtf an Enhanced is. That's okay, they've changed our name again so now we're Advanced EMTs. I now have three different titles just for my ALS card and we won't get in to my officer titles at the squad. I'm going to start writing them out like a self important person, EMS Chick 9 EMT-E/Shock Trauma/Advanced EMT, Assistant Chief, Training Officer, QA/QI Extraordinaire, Expert Meeting Attender. No? Ok probably not.

Anyway, readers this is where you come in. Have a question for me? A story? Advice? Hey I'm open to it all.... leave me a comment, hit me up on twitter, or shoot me an email to the handy dandy email address listed on the left. I have posts set up to go while I'm on vacation this weekend, a little blast from the past to get some of my older stuff back out there, and then when I'm back I'll answer questions.I'm open to anything, though if you ask me what color underwear I'm wearing I might answer you privately. Okay, probably not...purple today!

So glad to be back to the day job...

2011-05-16T08:15:00.000-04:00

Wow what a weekend. It wasn't busy with calls (only had one) but our 24 hour staffing started over the weekend, our heavy rescue broke down and one of our ambulances went out of service. This wouldn't be a big deal if we didn't already have another one out of service.

Adjusting to "life with the paid staff" will take some time for all of us. Thankfully we have pretty good crews, I haven't met them all but so far so good. I'll be the only one still putting up a staffed from the station unit so my crew and I will get the most exposure to them. We worked everything out at the beginning of the shift and the only hiccup we had was their ambulance barely making it to the first call we had. Thankfully since my crew was out for lunch we went ahead and brought our ambulance instead of a response vehicle so we swapped people around and all went on our merry ways.

Then the rescue breaks down...again. Same issue as always. This time we didn't have to get it towed so that's a major bonus but having a repair guy come out on a weekend? Yeah. Ouch. Sorry Mr Bank Account.

Apparently I muttered "I miss being a junior" under my breath several times. I do remember actually yelling it across the bays at my captain at one point. I do miss being a junior. I couldn't be there past 10 pm on a school night, if I didn't have good grades I couldn't run, my only responsibility was wiping my own ass, not everyone else's asses.

Other news to share; I'll be acting chief again soon for another 2-3 month stint. My divorce should be final within the next two weeks or so. I tried a new hair product that's totally awesome! I'm broke as hell...wait that's not news...

happy EMS week!

Pocket Guide #19 :Common misconceptions about ambulances

2011-05-09T09:31:00.000-04:00

It's a common misconception that arriving by ambulance automatically means you will get treated faster. Yesterday while on a call that did not require an ambulance transport the patient's parent said "well, we can take them but you know an ambulance would get them seen quicker." I explained to the parent that this is absolutely not true and that we would most likely walk the patient through the ER department and straight to triage and then the waiting room, just like they would do if they brought the patient in POV. I heard the parent ask the Deputy on scene if what I said was true or if I just didn't "feel like doing my job." The deputy backed me 100% and told the parent that if we took the patient we'd also have to pay a fee. That really helped to make up their mind.

Another misconception about ambulances is that they can stop on a dime when you decide to cut them off while they're responding. Unfortunately we don't have super duper ultimate brakes on the units that allow them to come to a full stop in the blink of an eye. They were an option but were just too pricey to consider... jackass.

Ambulances are not mobile pharmacies or doctor's offices. We don't carry Advil, Claritin, tampons, sunscreen, gum, candy, condoms, etc. At some point in my career I've been asked for every one of those items except condoms. We also cannot diagnose your child's rash or illness. We can take you someplace that can but it's normally cheaper, and better for the system, if you see your pediatrician for non emergent issues.

An ambulance is not as comfortable as your bed or your car. It is totally awesome that your top of the line Mercedes comes with it's own butler, but this was built for speed and function. More function than speed, and only kind of. Yes, the cot is uncomfortable. Yes, the ride is bumpy. Ever heard of EMS Rule # 12, Sick people don't bitch? Just sayin'...

This isn't Monopoly, an ambulance is NOT a get out of jail free card. If you're drunk and "the po-po" know it, they will still have you blow in the PBT and they will just follow us to the ER to place you under arrest there. Don't worry, they get paid over time if they have to wait on you to get released by the doctor before going to the jail. While I cannot outright tell an officer I suspect drugs or alcohols, I've noticed that most officers are normally smart enough to figure it out on their own. Also, don't ask me what tickets you think you'll get or whether or not they will arrest you. I have EMT training, not law enforcement, I don't know the codes and I don't care what you get.

Tallyho!

2011-05-08T19:15:00.000-04:00

Here's a quick run down of what my standby brought:

A guy asking me in a gas station if, "as a paramedic", I was trained to tell if he had a fever. I told him that a thermometer can do that.
A lady that almost caught herself on fire while trying to light her cigarette.
Three requests for advil, two of them asking what kind of ambulance this was if it didn't carry advil.
three band aids given...aka three lives were saved.
One brand new released medic telling me repeatedly that without him I could not function.
One laughing so hard I almost threw up moment. One young rookie male + three drunk women = hilarity.
A nap.
Being told that I can't go home no matter how many times I asked, even if I asked politely. Followed up by them bringing me random offerings of mountain dew.
No sunburn thankfully but I forgot my allergy medication.
A new friend and time with some old friends.
The knowledge that anyone below an Intermediate simply cannot function without a medic. It was amazing that I could use the bathroom on my own.

All in all it wasn't a bad day.

It's that time again!

2011-05-06T14:48:00.000-04:00

Tomorrow is our twice yearly standby at ye olde horsie event. My crew consists of one person that is an EMT and has run 10 calls total and the other person that is not an EMT and has run two calls. This will be fun. I'm looking forward to the drunken entertainment that I know will be there. The funny thing is, a lot of people on my facebook have been commenting that they're looking forward to my stories. I've thought about directing them here but I have some level of anonymity here that I need to maintain.

And! Why does every damn thing want my location now? I'm at my desk. I don't even want the people who know me to know my every little move, why do I want the entire internet to know? Tiwtter, facebook and now blogger all beg you to check in to let everyone know where you are. I don't care. Do you really care where I am every minute of the day? I doubt it.

Don't ask....

2011-05-02T13:01:00.000-04:00

Don't ask me what department I'm from then insist I'm from another. I can read my own shirt, can you?
Don't ask me what happened if you aren't going to listen to my reply.
Don't ask me what my problem is after you ignore me when I'm talking. I'm in a restaurant and I'm here to eat before my tones drop, leave me alone.
Don't ask me to take "especially good, good care" of your friend as a favor to you if the last thing you did as a favor to me was steal something. Besides, I give the same good care to every patient.
Don't ask me if my worst day is a quiet day. No, my worst day is explaining to a kid why mommy is dead or to a wife how her husband died instantly. A day with no calls is far from my worst day.
Don't ask me to order more supplies for the stock room just because you feel the need to stock one ambulance with 4 boxes of the same size of gloves. Each box contains 100 gloves, we run an average of 50 calls a month. Even with frequent changes on bloody calls you're still pushing it. Especially with 7 more boxes available if needed.
Don't ask me how much it costs to get the grass cut. I don't know, I don't care, I don't handle it. It's freakin grass! Want to know how much our ambulance cost? Or how much a box of those gloves you want is? Then I'm on it!
Don't ask me where the V went to...no, not MY V but the V in the "volunteers needed" sign. I guess "olunteers" still gets the point across.
Don't ask me why I'm grumpy. I just am.

NO WAY!!!! Really? And other moments of faking it

2011-04-27T08:50:00.001-04:00

For some reason the FNGs (F'in New Guys) come to me with every thought that bounces through their fresh young mind. Oh right, I'm training officer, they're supposed to...damn. Anyway, some days it's really hard to fake it after the millionth time of hearing "Do you know what we need to do?" Listen, I know you're ready to take on the world and I applaud that. I remember the days when I was ready to do the same, now I'm just old and grumpy. Do me a favor, though, don't act like you're sent from the 911 gods with the 10 Commandments with your revelations of what we need. Chances are we've already figured out what we need. I'm not saying that if you have an idea for something we shouldn't do it, oh no, I'm just saying before you start complaining that I don't care or I'm just burned out, ask nicely why something isn't or hasn't been done. Maybe it has been, maybe it was successful but we haven't had the chance to do it again or maybe you've come up with something brand spanking new. It's all in how you approach someone.

So here we are with the FNG's 10 Commandments:

Do you know what we need? More staffing! No shit, Sherlock. Recruitment and retention is not easy, that's a problem most volunteer agencies have no matter what field they're in. We all do our best but the bottom line is we can't do a draft for a volunteer agency and force people in.
Why don't people clean up after themselves? I'm the only one that cares! No, you aren't. We all care about a clean station. The problem is we all have different definitions of "clean." My definition of clean is no trash laying around, some guys I know will look at a table covered in trash and ask "what mess?"
No one checks out the ambulances the right way! My way and your way are different, again we have different definitions of this. I don't need to spend 30 minutes going through the check list piece by piece because I don't need to learn where stuff is on the ambulance. You do. I have certain things I check at the beginning of each shift, if I get on a call and don't have what I need then I adapt and overcome.
We need to do fund raising! Why? So you can have your fancy electricity to keep the ambulances plugged in to? Yes, we need to do fund raising. Every department has their "thing" and almost all of us send at least a letter a year asking for money. It's not easy to get volunteers to do a shift a week AND show up for events. The departments that run Bingo have the highest level of disgruntled volunteers in the world. Ok I made that fact up but it's probably true.
We need more training! This one I can't argue with. Practice makes perfect, or as close to perfect as you'll ever get. However, you do have a responsibility to do stuff on your own time, even if it's just reading JEMS. The department has a responsibility to provide good and (hopefully) regular training.
There's nothing for the members to do! This place would be better if we had an X,Y,Z. Fun stuff comes and goes, normally as it gets destroyed or even stolen. My station currently has tons of "fun stuff" that is rarely used. We buy something new and after 3 months we're told there's nothing to do, it's like going to the grocery store then coming home and saying "MOM! there's nothing to eat."
We need more member appreciation! Okay, then plan something. It's hard to fit everyone's schedules and some departments can't afford big awards banquets. I've found that in our department even having a cook out on a drill night is enough to make people happy.
The person doing the schedule is an idiot! I handle scheduling at my department and it is isn't easy. Most people handling the schedule do the best they can, and honestly you're lucky if your department even has a schedule. My department is the only one in our end of the county that does one. We also use google calendar for ours to make it easier for everyone to see.
You're an idiot! You should do X, Y, Z. Before you criticize someone, walk a mile in their shoes. You may not agree with a decision an officer makes but before you decide they're too stupid to tie their own shoes, ask them why they made that decision. If they explain their thought process and you still don't agree then that's okay, but at least give them the chance. And, when asking their thought process it's better to ask "I was wondering about this and why you came to that conclusion" instead of "WTF WERE YOU THINKING?!?!"
So-and-so is an a-hole so I'm quitting and going to another department. Bye! Don't forget to write! Oh and in 6 months, tell me who you find at the new department that's an a-hole because every department has pretty much the same people, just different names and faces. Instead of quitting, which isn't hurting the a-hole, minimize contact with them. Grin and bear it. Life is full of pricks, you have to learn to deal with them.

I don't even hear crickets anymore

2011-04-25T08:45:00.000-04:00

36 hours of duty this weekend. 36 whole hours and not even one call, and for the time I wasn't on duty (12 short hours) we didn't get a call. The 911 gods are angry, I think it's because we made 4 boxes of pudding and didn't offer them any.

I've talked before about how our department will be housing a 24/7 paid medic unit. Well, we're housing the crew and providing the unit. Other departments keep telling us how lucky we are to always have a crew. I agree in that aspect but they're not thinking about some other stuff. Vehicle maintenance and wear and tear will increase as we will now automatically be added on every call in our end of the county. Water/electricity/etc bills will go up as they will now be in use way more than before. There will be people there ALL of the time. That means we'll have to respect their space as a common courtesy but doesn't allow us to get our "down" time. (Flip side, they will have to deal with some of my guys for 12 hour stretches and that may not be so pleasant for them lol)

Their new supervisor is not getting off on the right foot with us. I view this as a guest situation, the paid staffers are guests in our house. We welcome them and provide them with a lot of perks such as a full kitchen, very nice tv with cable, Wii, pool table, snack and soda machines, wireless internet, etc. This we do for us and for them and has served us well over the years. New supervisor has decided we need to add a few things for the new crews and we will pay for them and have them in place ASAP, no ifs, ands or buts. I don't know about you, but I was raised better than that. You don't demand thing at a host's house, you can ask nicely or suggest, or even ask if you can procure said items and find a place at the department to put them. Demanding will not get you far.

What they don't tell you in EMT class

2011-04-21T13:34:00.001-04:00

It's not like TV, you actually have to inflate that NRB bag.
We don't save people as much as you think. There are very few calls where we actually make a huge difference besides getting the pt from point A to point B.
Whether you're paid or volunteer you will have to deal with people you don't like, sometimes on a regular basis. Sure, you can quit, but you'll just find the same kind of people at any department you go to.
Those perfect text book scenarios you ran in a comfortable class room? Yeah, SO not happening in the field. Mother Nature is a bitch and patients never follow text books.
You can't be taught everything you will need because sometimes all you need is common sense and good problem solving skills.
A good sense of humor is a must. We can't teach that to you, either.
Blood can get in every nook and cranny imaginable in an ambulance. Clean up is a necessary evil.
what crepitus really feels like, and boy is it an icky feeling.
That vomit through a tube can reach the ambulance ceiling and will splatter.
That hot/cold packs can and will explode when trying to activate them. When they do it will look like it's raining in the ambulance. No, I'm not speaking from personal experience. *whistles innocently*
How to clean up after yourself. If your parents didn't cover that then there's nothing I can do.
That being an officer requires some verbal two-stepping. And a LOT of meetings and paperwork.
People skills. They're important for patients, family members, fellow crew members, etc. I don't care how smart you are, if you can't interact with a patient you're not going to gain their confidence.
Emergency vehicles are invisible to the naked eye, no matter how many lights they have or how loud the sirens are. People will do stupid stuff in front of you. There will be several ass-puckering near collisions.
Equipment WILL fail, there are no ifs, ands, or buts about this. It will happen so adapt and overcome.
Writing narratives is a pain in the ass but is incredibly important to do and do well.
That pen you just put in your mouth? Yeah, that probably has a shit ton of germs on it. Literally and figuratively. So does the steering wheel so wipe that down, too.
You'll get up close and personal with your crew and your patient so make sure you wear deodorant and don't pile on the perfumes/colognes.
The exhaust vent in an ambulance is ridiculously small and is a cruel joke played on you by the manufacturers. You will think it will save you from that icky smell but really it just makes a loud noise.

On Vacation...

2011-04-16T12:55:00.000-04:00

Vacation, noun, meaning an extended period of recreation, especially one spent away from home or traveling.

I'm away for a short trip and had not been out of the state 12 hours before I received my first email requesting rescue squad assistance. This one I let go as the person didn't know I was out of town. Then the next came...and then the next. Seriously guys, I made it clear that I'm out of town until Monday. The chief is in town so I am no longer acting chief and not a damn thing I've gotten messages about has been important.

grumble...

an open letter

2011-04-14T09:14:00.000-04:00

They say apologizing is a sign of weakness but I still can't help wanting to say I'm sorry. I'm sorry it's come to this, I miss the friends we used to be, the man you used to be. It wasn't 6 months ago that you had people singing happy birthday to me in a parking lot. You have so much potential but it's hidden behind the attitude. I know your life hasn't always been easy, boy do I understand that, but that isn't an excuse to treat everyone like crap. I know I'm now the enemy and this is the fight that we won't recover from, and I know you don't care that it breaks my heart.

One day I am hoping you will look back and realize I did what I had to do. My decisions were made in the best interest of the department as a whole, not as my department or yours. At no point was I going after you specifically I was just making sure you and every member knew we had no tolerance. This is how a department has to be run whether or not you like it. Trust me, it isn't always fun to be the grown up.

the worst call

2011-04-09T22:32:00.000-04:00

When people find out you're in EMS they often ask you what your worst call was. After looking over some stuff from when I first started and thinking back over the years I realized my worst call changed as I experienced more calls. When I'm asked what my worst call was I normally ask worst in what way? Worst call involving a MVA? Worst call involving a dead body? Worst call that still haunts me to this day? There's no simple answer I can give for this question.

There are scenes I can still see clearly in my head, and sometimes I can even recall the smell. There are things that I've heard from patients or family members that I can still hear clear as I did the day they happened. On the flip side, there are happy calls that I still remember fondly or follow up visits that stick with me when the patient or family thanks me and my crew.

My first worst was probably the patient refusal turned CPR call. At the time I was 17 and no matter how much training I had, it didn't prepare me to be talking to a patient that was dead 5 minutes later. My next worst was a motorcycle fatality, one where I actually had to throw away all of my clothes and change in to a fresh pair while responding to another call in a different ambulance because the first one was a filthy mess. After that was another CPR, worst because I knew the patient and because of things the family members said while we worked. Then there's the accident where the kids saw their parent die, the call where the body had been there for a week, the call where the patient was obviously being neglected and before the investigation could be completed the patient passed away... These are small snapshots from my EMS career but you see why I can't answer that question simply?

The best calls are the ones where mom and dad are being maybe too cautious and call us to check out their little one. When we arrive the patient is happy, smiling, playful and far from needing an ambulance. Or when we can really make a difference in someone's life even if it's only by helping the old lady down the street back in to bed. The ones where we see the people a few weeks later out around town and we don't need to look for the nearest exit because no one wants to look up and see the person that was just doing CPR on their loved one.

And at the end of this post I realize that this wasn't the particular direction I meant for this to go in, but it's the way it happened.

Ch-ch-changes...

2011-04-01T14:41:00.000-04:00

Soon I will be eligible to be a Lifetime Member of my department, the requirements for this elite position are 10 years of service with the department and to be an active senior member at time of nomination. Then someone has to write a letter saying how awesome (or not awesome) I am and the membership votes on whether or not I get to be included in the cool kids club. This event looming on the horizon, along with a lot of personal changes in my life and some major changes coming to my department, have prompted me to write this post.

When I first started volunteering I was 17, I had just graduated high school, had my EMT card for an entire year and decided to do something useful with it. At the time we had supplemental daytime staffing provided by the county two days a week and the rest of the time it was up to us. I ran one shift a week.

At 21 I got married, became secretary of the department and our supplemental staffing had gone up to five days a week. I had debated taking an ALS class but my county no longer offered them for free so I would have had to pay out of pocket. $5000 is a lot of money to put up for a class that you may not pass so I continued along in B-land.

At 25 my marriage had started to fall apart due to my husband's untreated depression. Still, we continued on, faking it till we made it. Our supplemental paid staffing had dropped to four days a week but there were more stations staffed than ever before. The county created an Enhanced class (aka shock trauma aka advanced emt aka kind of ALS without the cardiac) and I enrolled, busted my ass, passed and became a released provider. I had been President of my department for two years at this point. I was also running a minimum of two shifts a week and attending meetings weekly.

The next year I hopped the fence and became Assistant Chief. I found the courage to ask for a divorce (will be final soon) around the time I realized we had spent more money on counseling than our wedding and yet we were still miserable. Lies, alcohol, depression and my PTSD didn't do us a lot of favors. Our supplemental staffing remained the same and I figured out how to be an operational officer through some trial and error. I continued with my two shifts a week and never-ending meetings as being AC meant I was supposed to attend more meetings.

Now, I'm 27 (for realsies, yo, I was recently told I sounded older in my posts). Still assistant chief, almost done with the divorce (waiting period) that cost more than the honeymon. I'm in a great relationship and I have been told that I've done a complete 180 in attitude and overall happiness. I used to think I was hiding how miserable I was very well, now I realize I wasn't even close. I continue to do my shock trauma thing but times are changing my friends. Our supplemental staffing will be 24/7/365 starting next month. Funny enough, their start date would have been my 6th wedding anniversary. Guess I won't forget? Even though we are the biggest department in our end of the county we are the only one with the accommodations to support staffing 24 hours a day. This means good things for our community and surrounding communities, if someone goes on vacation we aren't scrambling to find help. I don't necessarily have to run two days a week, every week. There's always someone there to help. It also means my one constant, that's been there throughout all of this, will be changing.

So here we are, I'm done with that chapter and am on the edge of the next. We'll see where it takes me. I won't give up volunteering any time soon, my favorite place is still my ambulance. The relationship is very promising and I see good things in the future with that. Hey, maybe I can figure out what I want to be when I grow up now?

Pocket Guide #18: A guide to dirty talk in EMS

2011-03-30T19:11:00.000-04:00

I'd hit that! This can go one of two ways. When you hear this please take a moment to look around, do you see a hot girl standing near by? Then this is most likely REAL dirty talk. If not, do you see a guy with veins that could easily be hit by a dart from 50 paces? EMS Dirty talk.
The left one's really popping today. Again, look for the hot girl with a possible wardrobe malfunction. Don't see it? Look to the veins. For the record my left AC is really prominent today, it kind of makes me want to poke it but I'd pass out.
I want the clothes off immediately! Are you alone with your significant other? If yes, that's my kind of dirty talk! No? then chances are the AIC just wants the patient exposed due to trauma.
Man, I want to spread that... Does the person have the jaws of life/Hurst tool in their hand? If so then this is actual EMS Dirty talk. If not...shame on you.
Are you in yet? No guy wants to hear this, unless you mean with an IV.
Oh, you can just throw that in my box. Normally means you can put whatever item you're holding (oxygen bag, clip board, etc) in the ambulance. At my department this can also mean mail box as every officer has their own. If you meant it the other way then please use proper PPE!
EMS: You call, we come! Dial 911! Oh yes, hit that button, right there, that's the...oh um. Hi! Where were we?

So! There you have it, another handy dandy pocket guide to carry around with you in case you're ever in doubt.

doing something for someone else

2011-03-29T11:27:00.002-04:00

The other night my crew and I were eating dinner at a local restaurant. I had just gotten my food when a gentleman walked over and asked for a favor. If you've been approached like this before you know that moment of "oh great, what could THIS be." Over the years I've been asked for everything from a band aid to whether or not I minded taking a look at little Timmy's rash and let's just drop his diaper right here in public. The gentleman introduced himself with his name only and said that it was so cool to him that his first name was the same as our department name and he wanted a picture with one of us. The crew sat and stared at me so I said sure, then asked if he'd rather take a picture with the ambulance since our name is plastered all over it.

After taking the picture the man apologized for interrupting our dinner. I told him it was no bother as at least I actually got to go back and finish it. He said I know what you mean, I was in Iraq and our dinner was frequently interrupted. When I said his job was a lot harder than mine and couldn't compare he just smiled and said not really, because he's home now.

When I sat back down with my crew they asked if I was famous no. I said no he just wanted a picture, and it's okay because he's a solider. He was in Iraq and now he's home. If I can make his day by taking a picture then really, that's the least I can do. It's such a small thing. Sometimes it's too easy for us to forget the men and women serving away from their family.

Excellent post about dealing with death

2011-03-28T09:43:00.000-04:00

Over at Motorcop's blog he talks about dealing with death and other bad things we see as first responders.

I used to be #3, I dealt with it by compartmentalization. He's right, it didn't end well. Humor is my normal go-to for anything but after awhile I just bottled it up. At the time I was married to someone who wasn't involved in this stuff and had no idea how to handle it. His responses to my venting would just piss me off, it wasn't really his fault but something I can look back now and say didn't help us. (It was not our down fall but it sure didn't help matters any). Part of the reason I started this blog was to get stuff out of my head so I could deal with it. I've learned how to better deal with things over the past few years and now know do a much better job handling calls. I still compartmentalize to a point, you have to in a way, but now I have a better support system and am with someone who understands.

Facebook posts you WON'T see

2011-03-24T11:48:00.000-04:00

If you have Facebook then chances are you've seen the chain status updates telling you to repost this if you're a parent, a sister, a spouse, a cop, a firefighter, a soldier, a candlestick maker, and so on. I've made a few funny ones about being an EMT but here's one that I would never post, no matter how much I'd love to:

I shape young minds. I juggle schedules. I take care of behind the scenes work to make sure you're safe and covered. I make sure you have the items you need to do your job. I wipe asses. I hold hands. I clean up after you. No I'm not your damn mother for the 400th time I'm your chief now pick up that damn spit cup for the last time before I suspend you. And it won't kill you to change the batteries in the Lifepak, either! There's more to this title than the pretty white helmet you snot nosed little brat. You don't even know how much crap I do because you're too busy in your own little world. Think about that the next time you say you can do a better job as chief then say but you won't do paperwork or duty schedules. It doesn't work like that! THESE THINGS DON'T MAGICALLY DO THEMSELVES!!!!!

Ah...much better...

Pocket Guide #17: Your patient will lie to you

2011-03-15T09:12:00.000-04:00

There are four kinds of patients that we deal with in EMS, here's a handy dandy guide to deciding which patient you have the next time you're out on a call.

The TMI Patient: You ask this patient a simple question and get stories from when they were 5 and fell out of an apple tree. Does half of the information they are providing pertain to why they called 911? Probably not. Do you have to sit through every story to eventually find out that the patient's chest pain is severe and oh look at the 12 lead, they're having a heart attack? Yes. I once had a patient ask me if they should start at birth, childhood or adolescence when asking their medical history. I attempted to ask more specific questions and got their vaccination records.
The Direct Liar: When asking this patient a question they will willingly lie to you. I have no idea why as sometimes the lies are as simple as "no I haven't taken anything" and then when you get them to the ER they tell the nurse "oh I took 2 Benadryl before calling 911" to which the nurse responds by glaring at you wondering why you didn't tell them that. However, they're still lying liars with their pants on fire. If I suspect I have a lying liar I will mention that I need the truth to give them the best care possible. Sometimes I'm successful in obtaining more information, sometimes I'm not.
The Omitter: This patient leaves out very important details, normally about some communicable disease they carry but don't think falls under medical history. Sometimes you find out after asking for the third time, sometimes you find out when the nurses call you and ask if you knew that patient had Gonosyphilaids. One thing I've learned is if the patient asks "what do you mean by medical history?" you need to explain "things like asthma, diabetes, cancer, hepatitis, etc" I recently had an Omitter that exposed quite a few people. A variation of this is the Trauma Omitter. This person complains of a headache or neck pain and it isn't until they've conducted an orchestra symphony, done jumping jacks and shown you how it hurts when they "bend like this" that they mention they fell off a ladder 3 days ago and oh yeah, is loss of consciousness a bad thing?
The Prepared Patient: You ask this patient their medical history and they hand you a piece of neatly typed piece of paper listing all history, medications and doses, doctor names, etc. Sometimes they even have more than one copy so you don't have to worry about returning the one you've been handed. When asked a question they give you complete answers that pertain to the question you have asked. This is a rare species indeed but you can help people be more like the Prepared Patient by educating your community and doing programs like the Vial of Life.

oh hell yes

2011-03-09T08:57:00.000-05:00

I had my first flyout last night where I was the primary medic. I've had a lot of flyouts since being released but normally I'm outranked by an Intermediate or Paramedic. It's never really an issue as I like the I/P guys that I work with but ...it's kind of cool that it was just me.

I also got to break in my brand new fire gear! And boy did I break it in, I think there's enough blood on it to do a voodoo dance.

Things can change in a blink of an eye

2011-03-06T19:26:00.000-05:00

There are pros and cons to being an anonymous blogger. Rarely do I struggle with my anonymity but today is a day that I do. We recently had an incident happen that I want to discuss in detail but can't. So bear with me as I try to do a post without saying too much. Things can change in the blink of an eye. In our line of business this is something we are reminded of pretty often but rarely is it something close to home. We all read articles of stolen ambulances, wrecks involving emergency vehicles, injuries, etc in other areas of our states or the country and think "wow...glad that's not us."

Safety has come a long way since I first started running. Until the last few years I can't remember anyone wearing a safety vest or having chevrons painted on the back of their emergency vehicles. For my non emergency readers this is an example of what I'm talking about...

We also didn't enforce the rules of having a piece of fire apparatus backing up an ambulance on any call on major roads, even if it was just an illness. Now a truck is automatically dispatched to help give us scene protection, we don't step out of the unit without a vest on to increase our visibility, and while my department doesn't have chevrons we have made sure our lighting package is the best available. I fought with a member in a meeting one day who wanted to put an old light bar on a new vehicle, I insisted on an LED light bar, he insisted I was just trying to make it "look pretty." Absolutely not. I'm trying to make it more visible. Compare an old light bar to an LED light bar and tell me which one you can see easier night or day.

The other day I was on the interstate and as we were walking up to our ambulance I was walking backwards to face traffic. One of the guys asked if I was practicing my moon walk. Nope, but I want to see that car that's coming towards me or my crew, if only to dramatically scream "oh f***!!!!!"

So to my emergency readers please remember, safety first. Scene safe, BSI. If that means you're wearing a neon orange safety vest that washes you out and clashes with the color of your hair (ok I've heard that a lot, shutup people) then it hopefully also means you're going home that night. Be aware of your surroundings, protect your scene with a big fire truck, use lots of flares and proper positioning, and don't be afraid to ask for more help. Never be afraid to ask for more help.

Excited Delirium

2011-03-05T20:14:00.001-05:00

Recently I attended a class that included a lecture on Excited Delirium, this condition was also recently covered in EMS World Magazine. Basically a patient goes in to such a state of excitement caused by drugs or mental issues that eventually their body just shuts down and the patient cannot be resuscitated. The article cited gives more detail and education on the subject than I can as I'm not qualified to teach it but I found it to be a very interesting topic so I decided to write a quick post.

This condition has only recently been accepted as a diagnosis but has been noted in cases for quite some time. Normally brought on by drugs this condition has a sudden onset and can only be stopped with sedation. It's not covered in my protocols so we have no standard to deal with it, nor do we have the training in my area to recognize it as we should. During the lecture we were told that taking the patient's temperature, or at least noting what we see/feel (ie sweating, hot to touch) in our reports helps the doctors pinpoint the diagnosis.

So take some time, read the magazine article or gather info from other trusted sources and learn something new!

I'm too sexy for my fire gear...

2011-03-05T10:31:00.000-05:00

Ok maybe not. Ladies, let's chat. We know that uniforms and fire gear are not flattering for women. I won't say that I'm trying to be sexy while on duty but I also try not to be confused with a boy. The other day I made a comment that no matter how much Victoria Secret I wear, as soon as those 5.11 socks go on it's ruined.

I wear Elbeco's Women's Choice pants. They just came out last year and I was thrilled because, let's face it, the pants available before that were not made for females with any kind of curve. I'm average size but baby, these hips don't lie. I like 5.11 socks despite their super sexy grey pattern...

Oh yeah baby, that really brings out the color of my pedicure right there.

Aren't you so glad I compose blog posts while in the shower??

A different perspective

2011-03-02T08:51:00.000-05:00

Being in fire & rescue gives you a different out look on life, as I'm sure many professions do. When climbing a ladder I can't help but think if this height is worth a ride in the bird or when a near miss happens on the high way I think about what would happen in the auto accident. It can be a humbling experience as it makes you realize just how short life can be and hopefully helps you appreciate your friends and loved ones more. This isn't something I dwell on normally but this morning it popped in to my mind. I dumped some extra cleaning solution from my Spot Bot (little carpet cleaning machine) down the drain in my tub then hopped in a few minutes later to take a shower. As you can imagine the floor was slippery and I did quite the ballet move, barely saving myself from falling down and not being able to get up. help, I've fallen and can't get up! All I could think of was "I wonder who is on duty since they're about to see me naked" and that was sobering enough to make me realize I would not call 911 if my life depended on it.

I'm not your friend

2011-02-28T10:15:00.000-05:00

I'm your line officer. I would love to do both but this isn't a perfect world and there has to be a line that we can't cross. I try to keep that white helmet in the locker as much as possible and let you do your thing but when you deliberately provoke me I have to act. I cannot and will not be walked all over. It goes against everything I am as an officer and as a human being. Don't pull the friend card on me, I try very hard not to show favoritism in any decision I have to make so it's fair to everyone. If you insist on the friend card let's look at it this way, a good friend would look at everything I'm dealing with right now personally and professionally. A good friend would know the rules and follow them so I wouldn't be put in the position of having to act in the first place. And, please don't threaten me as I will not change my mind. This job that I was elected to do HAS to be done, departments need officers to handle the day to day tasks, the behind the scenes stuff, and make sure we're all on the right track. I'm not here for a power trip, I'm here to make sure my department continues to excel and grow. That's what an officer should focus on and not look at how cool my helmet is. (Though my helmet with the new stickers is pretty damn nifty if I do say so myself but I sure can't pick up chicks at a bar with it.)

Discipline in a volunteer department is a much discussed topic. At a paid department you can send someone home without pay, or put a letter in their file that could eventually be used in their termination. In a volunteer organization all you can really do is suspend someone. I've been told that to most people it's like suspending someone from school, so you want me to sleep in and take some time off? Don't mind if I do! Thanks! To me a suspension would be more than a glorified vacation, it would embarrass me and I truly do love running so I would hate to miss out on my crews. What do you say to the member that dares you to suspend them? This is a question that I've struggled with for quite some time now and unfortunately I don't see an answer in sight. If you push too hard they quit but if you let them treat you like a door mat then no one is happy and sometimes bad or dangerous decisions are being made. If Robert's Rules could include a how-to guide for dealing with this stuff it would be awesome.

On a happier note, the patient from last week that I didn't expect to see the next day is still fighting for life.

Oh the weather outside is frightful...

2011-02-22T08:57:00.000-05:00

Over the weekend we had so many brush fires going on in and around our county that at one point dispatch asked for any available suppression unit to respond. Then later told all incident commanders that every available unit was committed, so you're on your own. This morning we woke up to ice and snow. While the county was relatively quiet last night when it came to wrecks, it's still a big jump in a matter of 3 days. I'm pretty confident I can speak for every one in the county that ran over this past weekend that we're all still recovering.

After all of that, however, I am glad we are not back here because one year ago we were recovering from our third and final blizzard. So give me a little bit of icy snow mix. Give me back to back calls and an illness on top of it. But DON'T give me a blizzard.

Don't quote me on that

2011-02-21T09:46:00.000-05:00

One of my juniors had to interview me over the weekend for a paper she is writing. Ordinarily this is no issue as I can normally put together some fluff, however, no sleep and being sick made for some interesting, rambling quotes. I can't wait to see how THAT turns out...

Thank goodness that's over

2011-02-19T21:10:00.000-05:00

We haven't had a "snot slinging" Friday night shift in awhile so the 911 gods blessed us with one last night. We ran non stop calls back to back to back, including one that was a major "oh shit" call. On top of all of this I had just seen a doctor earlier in the day for a sinus infection AND tonsilitis and had strict instructions to rest. I'm not so sure he meant run calls all night in the cold wind as rest but I consider doctor's advice more like guidelines anyway. By the end of the night I had two officers pissed off at each other, a broken down piece of apparatus, an expensive tow bill, ten exhausted crew members and the intense urge to just fall over dead right there.

During our oh shit call I was one of two medics working on the patient. It's habit for me to start telling people what we need done, I normally say "I need vitals, oxygen, backboard, etc etc" and not necessarily in that order. The medic I was working with doesn't mind this one bit and my crew is used to it. I always try to use a calm, clear voice and make sure I ask everyone to be involved and to constantly re-evaluate our patient and what needs to be done. This is not easy to do when you don't have a voice and a brand spanking new guy that is taking vitals every 3 minutes and yelling them at me. I give him a gold star for trying, we sure can't say we didn't have info for trending in the patient!

What a night, please let my shift tomorrow be a little calmer because I have a fuck load of paperwork to be done.

Give me a class room any day

2011-02-14T15:45:00.000-05:00

I recently had a CPR call that started in a car and provided a hell of a lot of challenges. Now we all know that no call is as perfect as that class room scenario they gave us in school but holy hell was that hard. One of the guys with me is brand spankin' new, he had never been on a CPR call prior to that day and hadn't really run a lot of EMS Calls. After the call he asked me a few questions about how we handled this or why we did that, and I've included his questions here.

How do you do CPR inside of a car? You don't, that's why we moved him. (He didn't see this part.) Flat, hard surface is best. Backboards are your friends, make it easier to secure and move the patient without arms escaping.
Do you practice IV starts in a moving vehicle in class? HAHAHAHA...no. But we should. It takes practice and lots of it. As a side note, I'm still amazed I got that IV as that was sheer damn luck.
What do you say when the family asks if he's gone? Or anything like that? We're doing everything we can for him/her. Yes, it sounds like a cheesy blow off line but it's the best thing you can say. It's the only thing you can say.
How did you tell the family members to move? I asked them gently to let me in so I could do what I needed to. It's tough to ask a loved one to move out of the way but it's necessary.

It was a busy day and none of the calls were easy. I realized at the end of the day that every one of my calls involved law enforcement, two involved vomit and two involved urine. I love this job.

Continuing Education

2011-02-06T16:31:00.000-05:00

This is aimed at the newer EMTs but is something I'm currently dealing with at my department. Let's start from the beginning...

The first certification you obtain is your CPR card. This is a pre-requisite for becoming an EMT in any state. Once you obtain this certification you have to maintain it. I know, this is shocking news, but if your CPR expires your EMT is no longer valid. In my department that means you're removed from the roster as you also cannot be "just a driver" without a CPR card.

After your CPR card is obtained you get your EMT card. This expires after so many years, I believe the standard is 4. In Virginia you are required to do 36 hours of training in that 4 years to obtain an eligibility letter to test again or get signed off by your OMD. There are 8,766 hours in one year, times this by four and you have 35,064 hours to do 36 hours of training. Virginia has online training that allows you to complete these hours, and classes are available, so there is really no excuse NOT to get these hours in.

I'm of the crazy mind that doing the bare minimum is great but you should try to do more. There are tons of ways to continue to train, whether it's by reading the challenges in EMS magazines, watching videos (even if they won't give you CE hours), EMS conferences, blogs, anything. Things change and it's your job to try and keep up so you can continue to provide the best patient care possible.

Dear Rookies...

2011-01-30T23:49:00.000-05:00

I know that by the industustry standards, my years of service makes me old, not quite ancient yet but definitely old. I know that you're new and fresh faced and full of ideas. I also know that you won't listen to a damn word I say right now, maybe you will later, but not right now.

Right now you have all the answers and have your EMS career planned out. Fresh out of Basic class you're ready for the next level because you feel that getting it behind you now will be easier. It isn't. You hear me say you can't be good ALS until you're good BLS. That is the damn truth. I can find tons of medics to back me up on this and not because we're just a bunch of old people trying to ruin your fun. It's because we know what we're talking about. Rushing from BLS to ALS too quickly without getting your feet wet is a bad idea. You don't learn good assessment skills, you don't learn good patient skills, you don't give yourself the chance to fully stretch your Basic wings. It's not like getting a driver's license where you can go ahead and obtain the certification but avoid all the major highways because you're not quite ready. Once you obtain that certification you have a duty to act.

And for fucks sake...don't skip college that will be paid for to go straight in to a career job. If someone is willing to pay for your education then you're a damn idiot to say no. The jobs will be there in four years because you have to remember, the turnover rate is normally five.

Over the hill and through the woods

2011-01-25T08:58:00.000-05:00

My system is rural, this is something I've discussed a few times. Recently we had a structure fire on a road that is not ambulance friendly, let alone fire truck friendly. When going up this road for medical calls we often comment to each other that if there's ever a structure fire up there then there isn't much hope. We proved that point. We had a quick response out of most departments, we left as soon as the call was dispatched, yet it still took 25 minutes to get there. To the people waiting it was an eternity. And the fact that the first thing they saw was an ambulance and not a fire truck was a little tougher. Overall the scene went smoothly, we had very few issues and the fire was under control and out as quickly as it should have been. The structure was still a total loss. Had it been in town would they have saved it? Maybe. There's no way to know really but 30 minutes until the first piece of fire apparatus arrived is hard to overlook.

I posted about frequent flyers not too long ago and received a few comments. One of the posters told me about his EMS system and how no one is more than 8 minutes from an ambulance. To me, out in B.F.E., that is an amazing thought. Even people that live in town sometimes wait longer than that for an ambulance if the first pull is already on a call. The increase in career personnel and changes in dispatch procedures has made it a lot faster to get emergency services over the past few years in my areas. The system will never be perfect. For example, during our structure fire there were two other calls; one was medical and the other was another fire. Dispatchers scrambled to find departments available to help. All of the calls were met as they should have been thanks to station fills and the dispatcher's hard work, but it's still a tense moment for me as an officer to be standing on a scene of one call knowing that my station most likely won't be able to put up another ambulance.

This has been another episode of how the tractor wheel turns...

Hey wow...thanks y'all!

2011-01-16T17:00:00.000-05:00

I'm the proud new owner of a Medicademy winner badge. Thank you to whoever nominated and voted for me!

For the complete list of winners (and an awesome blog, I've followed her for awhile) head on over here

Pocket Guide #16: There's more to being an officer than the helmet

2011-01-14T09:53:00.000-05:00

This is inspired by some recent events I've dealt with. Sometimes I think people take a position so they can mark up on the radio with their bad ass new rank. So here are some handy dandy tips to being an officer in a volunteer agency...

Marking up on the radio with your rank is cool but it also makes you the responsible party. It's not just about you now, it's about you, the patient, your crew, crews from other departments, bystanders, law enforcement, etc etc.
Doing the bare minimum does not make you a good officer. Step up and do your job in its entirety, then look around and see what else you can do to help. You don't have to take on the world but you should be able to at least wipe your own ass.
It's not always easy to make tough decisions in a few seconds, however, that's part of the job as an EMT or firefighter at any level. As long as you try to make the best decision and can give good reasons for why you made a decision it's okay. If your answer is "I don't know, it sounded good" then maybe you need to work on that.
Good decision making skills are necessary on the scene AND at the station. You can be a damn good officer on scene but that needs to continue when you get back to the station.
Set a good example. People are looking to you for guidance, try to keep them on the right path.
Know when to ask for help and when you can't handle a job. We all have tasks we just can't do (me + spiders = oh hell to the no) don't hide it, just be honest about it.
Sometimes you need to step back and realize that it's about the good of the department, not your personal thoughts. Sure, we all have days when we want to tell everyone to go f themselves but the knee jerk reaction of "f it I quit!!!!" isn't always the best one. This goes hand in hand with the EMS rule of "if it felt good to say it to the patient/bystander then you probably shouldn't have said it."
You don't get any added bonuses. Sorry.

Guest Article: Mesothelioma effects on EMTs

2011-01-12T09:00:00.018-05:00

Her name is Stella. She and her three kids were driving home from a week of vacationing in Florida. They were nearly home when their SUV tire blew out. They flipped, again and again, and Stella was thrown from the car. She should have died out there on that highway in the middle of the night. But someone knew what to do. Even though he was off-duty, he performed an emergency tracheotomy that saved her life.

EMT’s bear so much of the pressures that accidents and emergencies can create. When my Aunt Stella lay dying on the asphalt, it was the bravery and training of an EMT that brought her back. They are trained to handles the chaos when we can’t. They are healers and life-savers with quick minds and steady hands. But it may take more than know how to keep EMT’s out of harm’s way.

Prior to the mid 1970’s, car parts, and home insulation, dry wall, and heating appliances contained a natural mineral called asbestos. Because of its heat and fire-resistant qualities, asbestos was supposed to make homes and families safer.

But when disturbed and inhaled, asbestos fibers can cause a deadly lung cancer. Mesothelioma symptoms are often subtle and can be confused with symptoms of more common, more treatable illnesses.

Don’t wait for symptoms of mesothelioma to show. Because of an extremely long latency period (20-50 years), symptoms often don’t lead to diagnosis until the cancer has metastasized. Treatment then becomes difficult or impossible and life expectancy is usually no more than a few months.

Because EMT’s and other emergency response professionals are required to work in places like car accident scenes and older homes and buildings, they are at high risk of asbestos exposure. Though the government has created assistance acts for those already exposed to the poison, prevention is the best solution to the problem.

To help prevent mesothelioma and to help save the lives of those who work to save ours, share what you know. Information is powerful and knowledge can promote mesothelioma screenings and the elimination of all asbestos use.

EMTs are there when we need them. It’s our turn to help save them.

This article was written by Matthew Phillips, he is a student at the University of Central Florida who is trying to find his voice in writing.

Matthew contacted me about doing a guest article and after reading his proposed article I was impressed. You see the commercials for asbestos workers who are diagnosed with mesothelioma but I know I personally never thought it was a risk to me as an EMT. So if you learned something from this, please leave a comment for him to see!

Do you have your discount card with you today?

2011-01-10T09:31:00.000-05:00

I've felt like asking patients this, the "valued return customers" or as we like to call them, the "frequent flyers." Every area has at least a few and we all have the same frustrated feeling when we hear or see that address once again. These calls present a few different problems for an EMS system. First and foremost, they are tying up resources that could be better used elsewhere. I've been on a few frequent flyer calls when I've heard my department dispatched for a major call and struggled with knowing that there isn't another ambulance available for immediate response so that CPR, child with difficulty breathing, MVA with ejection, etc will have to wait a little longer than they would have had I not been transporting my frequent flyer. (Note: I don't feel that I'm God's gift to EMS, just figure that my albuterol could be making that child feel better instead of taking the guy to the ER that drinks too much booze and his ulcer flares up. Like it did yesterday, the day before, the day before, etc etc etc)

Another issue we run in to, and this goes hand in and with the above, is complacency. We very easily fall in to the trap of oh, it's you again. Ok let's do our same song and dance we always do. Sometimes this causes us to overlook things when the patient is actually having a true emergency. Ideally, every patient should be treated the same. Realistically this probably isn't happening.

My last issue with frequent flyers is sometimes they cause more burn out in an EMS provider than the major incidents. I spend more time talking to providers about taking so and so to the hospital...again...than what that last CPR call did to them.

Unfortunately with our current EMS system there isn't much to be done about repeat valued customers. Our current protocol of "you call, we haul" doesn't allow for us to say this doesn't require an ambulance transport. I can only guess as to why this is and I'm sure the sue happy attitude of people in this country has a lot to do with it. Maybe my next pocket guide should be "Frustrating things we can't change in EMS."

Some days you're the dog, some days you're the hydrant

2011-01-05T20:54:00.000-05:00

It's been a particularly stressful week over here at ye olde rescue squade. Apparently all of the minor troubles have gone elsewhere and they left the major troubles behind to handle the front lines. If today goes without a problem it will be the first day this week, too bad we have a meeting tomorrow and every meeting brings a problem. Or several problems. And problem people along with it.

I think they need to expand the subjects taught in an EMT class to include more time spent on why things happen, how things happen, and how to fix them (IE don't just put oxygen on a patient because protocol says to, do it because you know the result will be X Y Z), how to write a good narrative and why it's important, and ambulances do not magically appear in the bays for you to use. There's a lot that goes in to that ambulance being in that bay and it wouldn't hurt for some of you young whipper snappers to learn that. The money tree doesn't grow enough to buy the $160,000 ambulance. The Supply Fairy doesn't come by and leave that expensive Lifepak and Styker in the box. Hell, she won't even leave the ink pens for you to use.

Since they probably won't ever let me teach Being an Officer 101, I guess I will focus on my disappointment in the lack of depth in the training. I've recently had to explain several things to new EMT students because their class never touched the subjects and I'm sorry but I feel that some time should be spent on things like posturing and other brain injury related reactions. One class I taught last year thought giving Insulin to a patient with a blood sugar of 25 was a good idea. had it been just one person I could have just blamed them, but after the 5th student said they were calling medical control for permission to give Insulin I ran outside of the class room and began beating my head against the wall. Lucky for the wall they make me wear a helmet where ever I go.

Oh Friday, you're so close and yet so far away.

Looking back...ah f it

2011-01-01T16:17:00.000-05:00

I'm not bothering to look back. We had no calls New Year's Eve (and still haven't had any) so it was a quiet evening spent with the fire/rescue family. Most bloggers are looking back over what they've learned and done over the year...I'm not going to because I'm done with 2010. It's a year I never want to repeat and I don't want to dwell on. Bottom line, I ran a ton of calls, pissed off some people, made some major changes and took on the role of assistant chief again for the year 2011. Let's see what it has to bring, it already looks to have promise.

December Handover edition posted

2010-12-31T17:51:00.000-05:00

Over on Just My Blog's page, please check it out. One of my posts is featured along with tons of other good ones.

On a side note, I'm staffing the ambulance tonight. Let's see what the New Year has to bring!

random observations from my holiday weekend

2010-12-28T14:46:00.000-05:00

too much alcohol can lead to puking. This is normal and does not require an ambulance or a hysterical melt down.
Seat belts save lives...and trees
Just run over the damn animal that's in the road. Your life isn't worth the squirrel's or other small mammal's.
Duuuuude... if you look and act like a stoner you should probably keep on the down low, yo.
A c collar and head blocks should be in place before moving a patient. ALWAYS. I don't care how cold it is. Do your damn job or bugger off and let me do mine.
Yes the flight nurse is hot, no you can't ride along with her.
Some EMTs are freakin awesome and should be told so often. Thanks for the IV set up and pre-heating the ambulance.
law enforcement officers gossip just as much as beauty parlor women.
possibly even more.
"smoke coming from a chimney" is not a good on scene report. WTF else do you expect to see coming from the chimney? Santa? Evil Monkeys? Water? My bra?
our protocols state oxygen is important so let's try putting it on the trauma patient, ok? Let's just see how fun it is.
while we are discussing protocols, vitals are also important per the written word. They're also important for my treatment of the patient. I really shouldn't have to ask 3 times for vitals, neither should anyone running a call. Hop to it.
Intestines coming out of the body happens. Deal with it accordingly (not sure what to do? protocols!)
Cutting off an ambulance in the middle of a snow storm is a stupid idea. Flipping off the EMT who offered some air horns for your intelligent move is just bad karma. Had I not been focused on traffic I would have given you a double bird back. Why? Because I'm a volunteer, you can't fire me, so suck it.

C'est la vie...part deux

2010-12-24T14:29:00.000-05:00

Brad over at Trauma Shears & Pocket Guides wrote a post about a lesson he recently learned about running calls and social media. I recommend reading his post before coming here to read mine, go ahead, I will wait... la la la....mmmm Starbucks...... oh look a butterfly.....

After his discussion with his chief, Brad and I spent some time discussing the issue at hand. We are on opposite ends of the spectrum with this, he isn't violating HIPAA so he didn't think he was doing anything wrong. I would read his posts on facebook and twitter and feel a little uncomfortable. We discussed this prior to me writing this post so I'd like to say a few things here, one I am giving my point of view as an officer, an assistant chief. Two, Brad and I have talked extensively about this and see each other's point of view. Three, and this is the most important, I am not attacking him in the slightest way.

I maintain a level of anonymity on my blog and my twitter because I live in a rural area. I also will not post every detail of any call. Before blogging about a call I pick one detail I want to focus on, like a bystander telling me stupid shit, and kind of blur or stretch the rest of the details to make a story without giving all the info. Let's face it, some of the stuff we see is just too priceless not to share in some way. I've run over 130 calls this year and if I posted about every single one of them I would lose readers and hey, I can't afford to do that!

Now, I won't give you all of the details of HIPAA but we will settle with you can't identify a patient in any way. A call's location and nature is public knowledge because it comes across a scanner, and anyone can listen to a scanner. My issue with the public knowledge being posted on a public forum is you are identifying who is on the call. Normally, this isn't an issue, however, when someone decides to sue EVERYONE is going down. In the Commonwealth of Virginia a runsheet cannot be requested without a subpoena so the crew information is protected, unless it was posted on facebook. In a small town setting you're bound to run in to someone who knows someone who knows someone else who was there.

Is this covering your ass to a new degree? Probably. But since I will be named in the law suit of my member posting stuff in public, I'd like to keep mine covered thank you very much. Recently an EMT that I know was sued over pictures posted on facebook and information about a fatality. The chief, assistant chief, fire department, member and the county were all named in the lawsuit. They settled out of court but for a few months that was an incredibly stressful time for everyone involved. It's just not worth it, ladies and gentlemen. Be excited to run calls, have a good time, learn, and help people but don't cross the line. Whether it's over social media or in the local Piggly Wiggly (grocery store for those of you not in the south) no information should be revealed. It could come back to bite you in that ass you didn't cover.

Pocket Guide #15: Things you don't want to hear as soon as you arrive on scene

2010-12-16T08:35:00.000-05:00

"Um...I think we're going to be starting CPR soon" oh, joy! This happened to me the other night. We managed to avoid doing CPR but we weren't far from it. Definitely a pucker factor moment. Also, don't walk out of the house to your ambulance then look at me and tell me you need an item off of your ambulance. It's your ambulance, you're standing right next to it, I don't know where stuff is on your ambulance because again, it's your ambulance and you're standing right there. Oh and me? Yeah I'm now in charge of this scene, not the go get it monkey. That's your job.
"I'm not so sure he's breathing." ....really? Did ya think to check?
"The deputies are helping him find his underwear." Well, that's special. I'll just let them finish that before I go in.
"We're missing equipment and/or all our batteries are dead" Excellent! Next time check out your unit BEFORE you go on the call.
"I'm not sure what to do with this patient, can you take them?" Uh....sure? Do I have a choice?
"I don't know if it's ALS or BLS but since you're here let's make it ALS" That's not how it works, I will not do ALS procedures on a BLS patient just because I can. I will, however, practice IV sticks on you...dumbass.
"Whoops! Wrong house." Can you read? Just curious.
"We don't know what he/she took but there's a fuck load of pills here." Awesome! Let's just slam narcan and see what we get.
"The patient was unconscious so they tried to help him/her eat a candy bar." OH good, I know what I will be digging out of their mouth for the next 30 minutes. Mmmm, Snickers...
"I don't have any patient info." Acceptable only in rare cases, did you try ASKING? No? Ok good.
"The snow plows will take about 45 minutes to reach the patient's house. Maybe. Hopefully." Oh good, that gives me plenty of time to book my flight to Hawaii.
"The patient refuses to go to x, y, z hospitals because their friend's cousin's aunt's sister's long lost mother's uncle died there." Awesome, let's drive 45 minutes to another hospital. It's okay, I didn't want to keep my first due staffed.
"You can have my rookie if you want." Rookies are not trading cards! Thanks! Unless they're cute, hhmm....

A good post to read....

2010-12-10T08:37:00.000-05:00

Over at Life Under The Lights

It's an excellent reminder that just because we can keep going through the good times and the bad, it doesn't always mean we should. I've learned that recently myself...

Forget beauty queen I'm going for rodeo queen

2010-12-07T08:28:00.000-05:00

Recently I had to sit on a combative patient's lap while trying to start an IV, unfortunately for the patient I'm female and the crotch shots had no effect. Fortunately for all the men in the room there was some hot girl on girl action as I pinned the patient's legs down and two guys pinned her arms down while I did my IV/D50 thing. I'm wondering how many cold showers were taken after that one. At one point a firefighter looks at me and asked if we had restraints, he was not impressed when I said "Yeah! You."

We also apparently left the other department's ride along on the scene as he had wandered off. My advice to ride alongs and new people...don't leave your crew. Wandering off is never a good idea and it seems like common sense would say "let me stay with my crew." Ah, if only common sense were actually common...

My PSA For the day:

It's not me, it's you

2010-11-27T16:33:00.000-05:00

The power vents on ambulances are not nearly large enough for the job that they do. Stinky patients have a tendancy to overtake an ambulance pretty quickly. After running one call we left all of the doors open to let it air out for a good 20 minutes. Unfortunately we were dispatched to another call and we realized the smell continued to linger. I had to hop on another ambulance to upgrade theirs and suddenly I realized...the smell...still....lingers. The rest of my crew back in my ambulance realized, the smell went away.

F...

Discovered human feces on my boot. That I had to scrub off before I could eat my dinner. I stunk up two ambulances and a fire department that wasn't mine.

I love volunteering...

Burn out? Oh no, it's just a flesh wound...

2010-11-23T11:54:00.000-05:00

The latest Handover Edition is on burn out and how we have handled it. This is a hot topic in EMS as well as any public safety occupation. Lack of sleep, inability to eat like a normal person, bad calls, crappy co-workers/volunteers, and the people you deal with have a way of wearing you down.

My happiest place on Earth is on an ambulance. As my personal life has fallen apart slowly over the past few years I've found myself picking up more shifts and spending more time running calls than I had ever done before. Now that I'm smack dab in the final 6 months of personal hell I have pretty much glued myself to the captain's chair. Why? Because that ambulance is the only place in my life that makes sense right now. I'm in control, I know what to do when something happens and if something unexpected comes up I either roll with the punches or ask for help. I always have free advice from my protocols, another medic, my crew, or my OMD.

However, this is just my current mental status. After 10 years of being an EMT I've had ups and downs. (And they say EMS averages 5 years so either go me or wtf am I thinking). During my Enhanced class I was the definition of burn out. Full time job, class, rotations at the ER, rotations in the ambulance, rotations at a clinic, no sleep, constant feeling of "holy crap I can't do this wtf am I thinking." Oh I was a real charm to be around. I'm pretty confident that when I go to bridge from E to I/P most of my friends will disown me. I've had other cases of just being done with the ambulance, the rescue squad, and every a-hole that comes with it. One weekend I had multiple fatalities and I was exposed to a patient's blood, by the time my shift ended I was a mess. When we were dispatched 30 minutes after my shift for another fatality I turned my minitor off. That wasn't like me, but I couldn't handle another call. Another death. Another family broken. I just couldn't do it.

What has gotten me through the ups and downs over the years are my friends. I have friends that are in EMS and understand what it's like to be there when someone dies, and know what it's like to question yourself as to whether or not there was something you could do to change that. I also have friends that have never been in an ambulance and don't quite understand what I mean when I've had a bad shift. I rely on my friends in different ways and I'm thankful that they've stuck with me through my random anger over a call or the tears. I also have my friend Jack Daniels, but I don't rely on him too much. It's a bad road to go down when you start relying on alcohol, sleeping pills, etc.

Another resource available to us are the CISD meetings. I've been to one and I hated it, I've refused to do another since then. I've also since been told that it was run incorrectly and it shouldn't have been like that. Personally I like to talk to someone one on one but you have to find what works for you.

Burn out is something we can't avoid in this business, but it's something we can learn to deal with properly. Be aware of the signs, keep an eye on your crew and don't be afraid to ask for help when you need it. I've heard so many times over the years that a provider doesn't need help because he will just get over it, or she will just deal with it...and those are the people I've watched leave the service or make very poor decisions that do a lot of damage in their life. The most important person on a call is you, but that rings true after the call is over.

Dedication or stupidity?

2010-11-21T20:03:00.002-05:00

Possibly a mix of both. I had to stay later on my shift because the next person couldn't pick up at the normal time. One of the rookies said "wow, that's dedication." My brain, that is screaming at me that two hours of sleep is not enough for a 15 hour day, is telling me I'm stupid. I think volunteering requires a little bit of both. Sure, I'm dedicated. I run my two shifts every week, I pick up when others can't run partly because it's in my job description and partly because I'm normally available. I'm also kind of stupid as I could have gotten shit faced drunk last night with a friend. Well, that's probably kind of smart, too, but whatever. Don't bore me with details, they won't compute anyway.

I just ran a call where the homeowner asked if we really needed all of our fancy fire trucks. Luckily the person with me answered before I could ask if they were f'in serious. No, we don't need all of those fancy fire trucks. It's just as easy to watch your house burn to the ground with one truck instead of ten. However, since you probably like your house and don't want it to burn to the ground it's probably a good idea to have all those fancy fire trucks. And it's not all just for you, we like knowing we have the man power to keep our guys safe. We're selfish that way. Sure it's embarrassing to have five trucks sitting outside of your house with the lights flashing but it's better than any of the alternatives that could happen.

Besides, my fire truck isn't fancy. It's a band aid box.

editing to add that no EMS services were needed...

Have you heard?

2010-11-19T15:56:00.000-05:00

Oh and The Handover is pretty awesome, too. I've done a few posts for past Handover editions and I look forward to participating in the latest concerning Burnout hosted by Rescue Monkey.

So after you've read this month's edition called "Wearing is Caring" head on back to your blog and start working on your entry for the next edition. And if you want to host one contact the guys at The Handover and let them know. This is a great opportunity to get traffic to your blog as well as learn something from another point of view.

They say the third time is the charm

2010-11-17T21:48:00.000-05:00

And that makes me a little nervous. I've had two codes in two weeks and I am a firm believer that things like this come in threes. Dear 911 gods, do me a favor and don't give it to me at 4:30 in the morning again. Or if you do, let me remember my glasses. Oh and thanks for letting my last patient wait till we got to the ER to code.

I love that our dispatch puts anything that they can't figure out under the nature code of stroke. Most of the time after our patient assessment we find absolutely no symptom that is even close to a stroke. I believe "general illness" would probably be the best catch all category but apparently the dispatchers do not agree with me. Stubbed toe? Stroke! Unconscious and moaning? Stroke! Conscious and moaning? Stroke! Fell down a flight of stairs? Stroke!!

I also love that our dispatch likes to argue with us. The newest batch of dispatchers have never seen an ambulance or fire truck in person and yet will tell you that you do not need another ambulance or fire truck when you specifically request it. I'm sorry, are you on my scene? I think not. Until you ARE on my scene and know how to run my scene, don't tell me I don't need another ambulance. I'll make that call, thank you very much, that's why I'm the one with the pretty little card that says EMT.

Well I won't be winning a beauty contest anytime soon...

2010-11-10T08:56:00.000-05:00

Let's recap... 3 hours of sleep. 4:30 call that goes from simple to "OH SHIT!" in literally one minute. Forgot to wear my glasses so I can see up close but not far away. 4:30 am=morning breath. 4:30 am= most likely there is drool on my face. When I get to the ER I have to cover my left eye and sit 6" from the monitor.

Put the crown away, boys...

You want me to do...what?

2010-11-03T21:07:00.000-04:00

I am absolutely confident that my years of training did not help me hide the look on my face when my patient asked me if I could just stitch them up on scene. Sure, I'd love to whip out my needle and thread while we are sitting outside with a bunch of drunk people watching us and stitch you right on up. The problem is, however, I am not a combat medic and this is not a war zone. The next problem, dear patient, is you are about to pay $500 for a glorified taxi ride to the hospital. While this isn't my personal problem I do hope you look back fondly on your transport when you open the bill. I know I will look fondly back on this call for years to come...

Also, why is it that stupid people flock to one shift? Shouldn't there be a limit of how many you have per 12 hour period? The next call took us to an unconscious person that obviously had too much to drink. They also apparently do this quite often as they had a bottle of mouth wash next to a bottle of liquor in their door. This person felt the need to announce their job title quite often, I assume to try and get some "professional courtesy," but my thought about professional courtesy is this... if you're going to break the law, and you are in law enforcement, the only courtesy you should get is only one person gets to pistol whip you with your own gun instead of the entire night shift. Just a thought.

Interesting...from post secret

2010-11-02T08:27:00.000-04:00

From Post Secret

I don't think anyone is really prepared for what we end up facing in the field. No one can tell us all of the challenges we will face and the patients we will meet.

Pockets? But I have rookies!

2010-10-27T12:16:00.000-04:00

This month's Handover edition is about your uniform and what you carry in your pockets. The thing about being a volunteer is we have no uniform requirements, as long as you're dressed fairly nicely and preferably have a squad shirt on you are good to go. I normally wear jeans and a squad t shirt though I do sometimes break out the EMS pants, especially if I am teaching or going to an event. Not having an official uniform has it's pros and cons. Pro: Saves the department money. Con: we sometimes have to remind members that seeing their boob cleavage or butt cleavage is not necessary. We have also had to explain that if your perfume can gag a maggot, cause the hazmat team to randomly show up, or your jewelry hits the patient in the face when you lean over them then you need to rethink your style.

The only items I regularly carry on duty are:

ink pen because I'm picky about pens. Touching my pen is hazardous to your health.
EMT/CPR certs in case my OMD decides he wants to rip it up one day.
gloves because BSI is important, mmmkay?
Minitor IV because you can't run a call if you don't know you have one. I will grab the portable while on the actual call to ask for help if need be but I just shove it in a pocket instead of using one of the fancy straps.

Any other item is either in my equipment bags or on a rookie. The newer guys quickly learned that I wasn't necessarily trying to feel them up, just borrow their pen light. Well, sometimes I AM trying to feel them up...

Things I wanted to say over the weekend...

2010-10-26T09:06:00.000-04:00

one of the rules in EMS is if it felt good to say it then you probably shouldn't have. Since I couldn't say 99% of what popped in to my mind I bring it here to share with you...

I may be mean but at least I'm not stupid
reading comprehension, not our best skill now is it?
Step one: Pull your head out of your ass. Step Two: Put your big boy panties on. Step three: forget I exist.
Would you like me to wipe your ass, too, or do you think you can handle that complicated step?
I love going in circles on the interstate instead of eating dinner. It helps me lose weight.
Do you work hard to be that obtuse or does it come naturally?
You're the driver, you talk on the f'in radio. I'm providing patient care. That's why I'm in the back and you're in the front. You get to play with the big wheel, I get to hang out with the patient. After more years in EMS than I've been alive I'd figure you'd know that by now. SILLY ME.
The reason you have to keep pushing that broom around is because absorbent doesn't pick up anti-freeze, genius.
When you're driving through an auto accident scene and there are multiple state troopers around, put your damn seat belt on. Also, if your car is about to explode you might want to get that looked at.
hey, remember that time you cussed me out in front of my house? You wanted to know how I could give good patient care if I was such a b*tch for not talking to your drug dealing friend. Well how would you like to review my care now? I made every effort to be so sweet to you that I may or may not have developed diabetes on the trip over.Why? Because I do that with every patient.
Why yes, I am a little bitter. thank you for noticing.

I'm so sorry my medical skills interrupted you...

2010-10-17T20:47:00.000-04:00

People have expectations when they call 911. Depending on the person, and the reason for calling, it can be difficult to pin point exactly why they called in the first place. Out of the four calls I ran this weekend only one of the patients actually seemed happy that we were there to help them. One of them should have been happier we were there and gone with us instead of getting shiny new bracelets and a ride in a cruiser but hey, that's their choice...

Responding to medical emergencies in churches is always an interesting experience. A lot of times the service won't even stop when you come in but they normally let you do your thing. I always, always, try to be quiet and respectful of the service while keeping the patient's care in mind. Today it took all I had not to throw myself on the floor and start speaking in tongues or tell them all to go F themselves right in the middle of the service. You called 911 for a medical emergency. I came to fix that medical emergency (after throwing away half of my lunch and trying to eat the other half and talk on the radio). Do not greet me at the door and start demanding that I immediately carry my patient to the lobby and treat them there, especially when I have no idea if this patient will be able to walk or not. There are things I need to do before I move my patient like, ya know, figure out if they're BREATHING or not. Once I determine whether this is a load and go or stay and play I will be more than happy to help the patient out of the room but until then, hold your damn horses. You realize you're in a church, right? You're supposed to be nicer than me. If the patient is in such great condition that we can focus more on the service than the patient then why the hell did you call us? Just curious!

I also had a bystander today tell me the patient on another call was fine and I could leave. When I asked the ambulance crew if I could leave because a bystander told me to they looked at me like I had three heads. We all know how much I love bystanders so I just thanked this one with one of my patented icy death stares. And for the record, the patient and crew actually did need my help.