I got to be a real paramedic!

You may have wondered why I haven't posted much lately about being a paramedic. It's because the last few months have been BORING not slow, not un-busy but boring. Modern EMS runs a lot of calls but the great majority of those calls are for colds, flus, cuts, scraps, falls, anxiety, minor car wrecks and the always popular - "the patient was choking but they coughed the item up and they're breathing on their own now but can the ambulance come and check them out anyway just to be sure." Because apparently 21 century adults are too stupid to figure out if someone is breathing and talking independently and don't require medical intervention. That and people themselves are too stupid to figure out if they personally require medical intervention to help to talk and breathe and want a paramedic to tell them that they're okay. Well, duh....you were choking now you're not- my medical opinion is- CURED!

But last shift I had a couple patients who were actually in danger of dying. That's right I got to really do the job I trained for and save lives! Woohoo! Course that means someone else had a really bad day but since I can't control that I can only be glad I was in the right place at the right time to be of assistance in the manner in which I trained to be. After weeks, months of being a medical taxi cab I need to run a real call to help remind myself why the hell I keep doing this job - and it's not the money.

Yeah, I get a decent paycheck so I'm not poor (though I was when I was a rookie medic- can anyone say 3 jobs) yeah, I get decent benefits (though like the rest of the county those are being scaled back ;o( ) and yeah when I get enough sleep I get 20 full days off a month rather then those poor schmooes that work 8-5 and only get 8 full days on the weekends (suckers!) but I also get a interactive, front row seat to the crap of the world. I get to see the worst of humanity and we're not even a third world country. Be grateful for small miracles cause I know that I could see a helluva lot worse.

Did I mention that I got racially discriminated against last week? You'll love this. So I'm transporting a young, black teenage male after suffered a sports injury. Nothing major, he'll live. Nice enough young man and we chit chatted on the way in and at one point he asks me-

HIM "You make a lot money as a medic."
ME "I do alright."
HIM "You probably make a lot of money."
ME "Not as much as you think."
HIM "Well, you're white, so you probably don't think it's as much as I do."
ME "Excuse me?"
HIM "You probably get paid more."
ME "No...it's a government position-we're all paid them same. Besides, I don't come from money. My parents nearly lost the house when I was 15 when my Dad was out of work and when I was born we lived in a trailer for the first year; although I don't remember that of course."
Him "Well, we don't have a house."
Me "Look, I had to earn my own way. The Army paid for my college education."
Him "You were in the Army? Did you have to do push ups?"
Me "Yes, I did, the real ones not the fake girly push ups."
Him "Well....you probably didn't have to go down very far because you're chest is so big."
Me "I did real push ups. However you want to rationalize it my family isn't rich, I've worked since I was 15 and I've had to earn every bit of my own way. And this conversation is over."

Seriously, I really had this conversation. I didn't get mad at him and everything was spoken calmly because really he's just an ignorant kid that's been raised in an environment that expects him to believe that all white people are on easy street and that we receive golden tickets at birth. Sheez, I wish! Being a paramedic has taught me that everyone, everywhere is exactly the same. Everyone can be wonderful or crappy. Everyone can be deep or shallow. Everyone can be generous or cruel. Everyone can be openminded or racist. Seriously - everyone is just as good or bad as they choose to be based on nothing but their personal choices.

See ya!

Soy Tarts - product review of 2 Virgos Designs

Jackie of 2 Virgos Designs makes this interesting Soy Tarts which I had been thinking of trying and finally did a couple of weeks ago. First, here's Jackie's description as she says it better than it can:


You will not believe your eyes! Exciting and unique product! 2.5 ounce 6 individual breakaway soy wax lotion tarts, 2 products in one! Place one cube in your tea light burner or electric burner, and you have a delightful home fragrance. Blow out flame or turn off burner, then lightly dip you fingers in the melted soy wax and apply to hands and skin, you then have the BEST lotion you have ever used with shea and cocoa butter and triple refined certified EMU oil and the warm lotion feels wonderful on your hands. Superb for cracked dry skin and eases hurting hands with its warmth. I get a special buy on my fresh triple refined emu oil and can pass along the savings to you.

If you have used lotion after lotion with little to no benefit, you must try this! One cube lasts for about a week using it daily as a lotion. Soy wax is a green product, clean burning, and melts at a lower temperature than regular wax, no fear of burning yourself, just don't touch the bowl of the burner, it's hot! No wick to sully the wax lotion. Dye free! Only skin safe ratios of fragrance oil or genuine essential oils used. Treat your skin special today, you will wonder how you lived without this!

My Review

Jackie offers these in several of her own custom design scents as well. I ordered Royal Dragon.

Pros:

1. Royal Dragon is a rich, deep scent which is somewhat masculine but not overly so. It's a strong but not cloying scent. I get migraines and one of my triggers are overly cloying scents which is why I don't wear perfume and don't use most air fresheners, etc. This tart burned all afternoon filling my house with a rich smell which never triggered any headache and remained enjoyable to me all day. First thing my husband said when he got home, "What smells so good?"

2. I couldn't wait to try the lotion option because I have chronic dry skin and it worked just as Jackie said. It left my skin feeling smooth and soft but not greasy or oily.

3. Melts quickly and evenly without any type of smoke or additional irritating residue.

4. Scent lasted as long as the votive candle was still lite.

5. Comes in numerous scents and a vegan option if you prefer not to have Emu oil used. Jackie says the tart result is the same.

6. Great artist and seller. I've have several interactions with her both personal and business and I've found her to be reputable and she offers high quality, unique products.

Cons:

1. You only get 6 tarts with each order but since each tart lasts several days if melted just for scent that's not too bad. It's not the cost that really an issue since the product is very high quality but makes you want to horde them. :o)

2. If used for the lotion option you'll go through it quickly since I found I had to dip my fingertips in a few times to cover both hands.

3. While the lotion option works well and doesn't leave an oily residue there is a waxy layer that takes awhile, hour+, to absorb/wear away. So don't do anything grip sensitive, like monkey bars for bit afterwards.

4. Requires a votive style burner to use, but these are common and inexpensive so not so much a con as something to remember when purchasing.

I haven't tried her other scents in the soy tarts but I have smelled her scents in other products and they are all bold, rich, comforting scents. I definitely recommend this product and this seller for unique, interesting products for yourself and gifts for your loved ones!

2 virgos designs

Settrac Conference

What, you ask, does SETTRAC stand for? SouthEast Texas Trauma Regional Advisory Council....that's a mouth full and that's where I spend all day Thursday learning and relearning current medical knowledge and interventions.

I thought I might share a few of the more interesting high points from that day of mentally thrilling lectures. Some of this information was already known to me from my own experience and some I learned at the conference. It's interesting to hear physicians and other medical experts discuss aspects of our profession that I have long suspected or believed to be true. I guess that means I'm on the right track!

1. During a cardiac arrest if the victim does not receive CPR or defibrillation (shock) prior to 5 minutes then their prognosis (success) of resusitation is very poor. By resusitation I mean they live to walk out of the hospital. And yet most of the public refuses to perform CPR, even on their own families! We don't usually arrive before 5 minutes because we're still subject to the laws of physics. The lights don't create wormholes or time dilations either. Crazy huh?

2. If a cardiac arrest patient receives CPR for over 4 minutes without spontaneous return of heartbeat and/or breathing then their prognosis is also very poor. Ever watch the Princess Bride? Remember the scene when they're trying to save the man in black? The wizard tells them that there are stages of death: Slightly dead is still mostly alive and mostly dead is still slightly alive. If a patient recieves CPR and further medical treatment in that Mostly alive stage than things can go well, but that Mostly dead stage tends to stay dead. Early and immediate intervation by everyone is known as the chain of survival, without that first link of CPR there's no chain.

3. Patients that are dead tend to remain dead. There is no coming back from dead beceause brain death begins to occur within 4-6 mins after breathing and heart rate has ceased. Even if the heart is started after that time the brain is non functional. (except in specific cases such as electrocution, drownings and cold environment situations)

4. The American Heart Association (the premier experts on heart health and research, google it!) determined in 1992 that cardiac arrests that showed no improvement during EMS resusciation on scene should be pronounced dead at the scene and NOT transported to the hospital. If a patient does not response in a very short amount of time then they won't respond. Their research has determined that once a cardiac patient becomes asystolic (flatline) their chance for successful resuscitation is less! than 1%. Dead is dead. The rest is window dressing for the family and high risk for the EMS crew and innocent traffic. God forbid that people learn how to accept death as a natural and sometimes more dignified state of being.

5. Someone that has been killed because of trauma such as a motor vehicle accident has a .08% of successful resusitation. Assuming that their injuries are compatiable with life; meaning that they still have their head and all their major organs in the anatomically correct locations. Every traumatic arrest (death due to massive injury) that I've worked has never survived. If it's enough to kill you out right then you're staying dead.

6. Tourniquets are really good for stopping massive bleeding. (the medical profession randomly decided years ago that tourniquets are bad). I've seen how our current methods for treating massive bleeding, which don't include tourniquets, don't work well if at all.

7. Unless the patient has a injury that is time sensitive, such as heart attack, then whether they arrive at the hospital in 10 mins or 30 mins won't change their outcome. And most patients don't have time sensitive injuries therefore EMS rarely needs to race with lights and sirens to the ER. Generally speaking racing to the hospital to save 2 minutes of transport time only increases the risk for accidents and doesn't change the patient's outcome what so ever; except in those very small percentage of time critical injuries. And yet everyone assumes that ambulances always drive emergency and get offended when we don't do that for their family member. We do that in less than 5% of our calls and we run over 25,000 a year right now

8. Unintentional injury is the number 1 cause of death for those 65 and younger. I've long believed that about 90% of the things that happen to people are due to their own poor planning, decision making or lack of forethought-that fits the unintentional injury stats. Next time you're doing something that includes an element of risk; stop and think about every step of your plan. Assuming you have a plan. Ask yourself- Is this really a smart way to do this? Do I really need to do this now? Had a guy fall 30 feet out of a tree years ago and shatter his neck causing full paralysis. He was trimming the tree AFTER DARK because he was 'almost done'. WTF? Would you allow your kid to do this? Then you probably shouldn't either.


WOW! My experience has confirmed these statements from the conference. In 16 years I've had 1 cardiac arrest patient walk out of the hospital. Just 1, and I've probably ran at least 1 cardiac arrest call a month for 16 years on average...so that's 192 patients and 1% of that is 1.92...so that's about right. That's not including the calls that the other medics have worked.

We also give false hope to families during cardiac arrests because everyone expects us to work miracles. But for all our education we have yet to equal God in the ability to control life and death. (Thank God for small favors!) We do all these treatments and race to the hospital just so the family can get a huge bill and be told all over again that their love one is STILL dead. These families tend to follow us to the hospital (which is illegal and very, very dangerous because they put their "magic" flashers on and think that this somehow protects them against red lights and they tail gate us through intersections even after we tell them not too. They rationalize that they're 'helping' their loved by doing this although I have yet to see what positive assistance tailgating an ambulance provides the patient since we don't allow them in the back with us anyhow.)

Most families already suspect that their loved has died and are upset but still rational. If we began approaching the situation as a -work at the scene or not- but declare death when death is confirmed then the families can began to deal with the reality in a more appropriate manner. Hope can be a torture when others know that hope is lost.

We have a saying in EMS. It's harsh but oh soo true. Most cardiac arrests are dubbed FPO - For Practice Only. This mean we realize immediately that this patient will not improve, that they've been Mostly Dead All Day and nothing we do will change that. But the thought is we don't want to upset the families or get sued and hey...we can always use the practice. So we toss in the kitchen sink, soak ourselves in sweat and drive like NASCAR champions to the ER (I admit it, driving emergency is a blast!). The family races behind us and coagulates in the ER- "Is he Okay? Is he breathing? Is he alive?" No, no and still no is your answer but at least we 'tried everything'. They thank us for trying (that part is rough when you're thinking FPO) then begin their temporarily delayed grief in the impersonal hospital.

The EMS walks out of the hospital and in the privacy of their ambulance shake their heads and say, "That was a good FPO code...let's get some lunch."

Sometimes you can tell

For some reason I've been thinking about adding this post regarding the physical appearance of death. Don't really know why it's been hanging around in my head but here it is.

Sometimes when someone dies you can tell if their death has been quick and relatively painless or traumatic and painful. I suppose it isn't necessary to know these things for most people but I've found that when I'm dispatched to a location for either cardiac arrest or DOA I'm curious to see what physical expression the patient's body and face are in. When someone's heart stops (which is known as clinical death) their blood immediately begins to settle (called lividity) and the process of rigor mortis slowly begins. Environmental conditions will effect the speed and duration of the various stages of rigor mortis but it generally takes about an hour for the newly dead to slowly stiffen.

The body will tend to stiffen in the exact pose/position that remained at the time of death. Sort of like when your mom told you that your face would freeze that way if you kept making that silly face; only this effects the entire body.

I've found that most people appear peaceful at their death. Faces are relaxed, body is in some sort of position of comfort and their overall condition appears to be calm, maybe surprised but nothing unusual. I like to believe that these souls passed peacefully.

But then there are those that do not pass peacefully. Their expressions are horrified, shocked and/or grimaced in what looks to be pain or some other type of suffering. These poor souls did not pass smoothly. I believe in most circumstances that it's good to fight to live but I also believe in death with dignity. Traumatic or unexpected death for most people tends to leave its traces and I have seen truly horrific expressions on some patients' faces and occasionally their entire body.

I've had occasions when I've explained to family members that have yet to see their dead loved one, that perhaps not seeing the body in that particular condition is a better idea. If those traumatic scenes stay clearly within my memory (and I never knew the person in life) then how much more cloying would these same scenes be for those who knew and loved them? Usually the family members take my advice and allow the professionals to collect and prepare the body before they view it but sometimes they don't and their expressions tell me that they will never forget how their loved one died.

Sometimes ignorance is bliss and when I don't have to have these memories engraved into my brain (which they will do because I tend to remember most things to the eternal grief of my husband lol) then I will avoid allowing them in. But if I can't spare myself the memory the least I can do is spare the family.

Health Care Reform?

There's been a lot of controversy regarding the health care reform situation. While I agree that the health care system is SERIOUSLY flawed; and I've had a front row seat for almost 16 years, going to a national Socialism-based system will be a horrible mistake. I've been watching the town meetings, speeches and difference options on TV and if you pay attention the goal of the current administration is to have a Single Option, Fed controlled health plan for everybody. The money has got to come from somewhere and guess where...everyone who makes middle income and above will have higher taxes to support themselves and those who make at and below poverty income.

Don't get me wrong...I'm all for programs to assist those who need assistance. I firmly believe that everyone has the Right (morally not constitutionally) to receive life or limb saving care regardless of race, religion, income, etc. As a paramedic , and personally, I could no more NOT help someone (even if I knew them and didn't like them) then I could deliberate cause someone malicious harm.

However, I don't believe that everyone has the Right to all levels of all medical care. Since when did any health care become an entitlement and not a privilege? Should someone who can't pay receive cosmetic surgery just because they have the right? Should someone who doesn't have a job because they don't want to work (not because they can't) have the right to expect the rest of society to support their medical financial needs or wants because they have the right to any level of medical care?

Daily I transport patients who call for an ambulance (that they medically do not need) to transport them to the emergency room because they want:

1- to be seen faster and don't want to wait in the waiting room at all - nevermind that patients are seen by level of severity regardless of how they arrive. Showing up in an ambulance does not get you to the front of the line but it does get you a large bill and takes that ambulance out of service for patients who do need it.

2- to travel in 'luxury' because they can 'lie down' in the ambulance. It's a 350 truck chassis and thin, plastic mattress; very, very not comfortable and very, very bumpy and nauseating.

3- a free taxi ride because they have medicaid/medicare - but medicaid and medicare will only pay for medically NECESSARY transports which means you'd better be dead, dying or at serious risk of dying or losing a limb

4- to be catered to and spoiled - had a patient asked me if they could get something to drink and where the bathroom was ON THE AMBULANCE! Hello - it's a truck not a bus. Would you like an in-flight movie with that?

Why the rant? If you think that's bad; with socialized medicine it will only get worse. People will realize that they can get a free ride and start calling for even more ridiculous reasons. What does that mean for the serious, law abiding, rational citizens? That means that there will be fewer ambulances available for your heart attack or your grand child drowning or any number of serious life threatening emergencies.

BTW- did you know that there's a national shortage of paramedics. Why? Because they are generally underpaid, overworked, under appreciated and seriously abused by the general public. With the new plan it will be more difficult to get transports paid for which means local taxes will increase to make up the difference to pay for the medics and supplies. You pile on less pay for a career which is already short staffed and more insane public abuse of the system which equals more psychological stress on the medics. (Trust me on this, you try to keep distance from the emotions and frustrations but you can't maintain it)

More medics will quit or not join which means less ambulances for everyone. And this is just EMS. The snowball will definitely roll downhill throughout the entire medical system. Top notch care and staff costs money and if there isn't enough people paying their fair share then there isn't enough money for everybody. Which means higher taxed on those with money.

Ethically it's nice to think we can provide top notch care for everyone regardless of income but it's just not feasible. It will bankrupt an already flawed system. Ideals aside - money makes the world go round and experts in any field need to make a real paycheck. And the more education you have usually the more school loan debt hence the need for a large paycheck. Most doctors spend decades paying off their loans and don't forget the malpractice insurance premiums. There just isn't enough money for socialism medicine.

Bottom line: America offers an unique opportunity to work your ass off and pull yourself up through society. I joined the military to pay for my degree. My parents couldn't afford to pay for my education but they still made just a bit too much money for social assistance. So I got a GI Bill and worked up to three jobs to make my life they way I wanted it. I researched hundreds of programs for minorities to obtain free or low cost education but my low middle income parents disqualified me for them all and I still made it. There are tons of assistance options but the reality is one still has to earn their own way and do the work. If you don't or won't contribute to help yourself then why should anyone else work their ass off to help you?

Remember - God helps those who help themselves.

Tragic Fate and Strong Nails

After 16 years as a paramedic I've learned that the vast majority of tragedies are the end result of poor decisions made by persons unable or unwilling to look towards the future possible consequences of their actions. However, there does exist the small percentage of unlucky persons who just happen (or not depending on your belief in Free Will and/or the Will of God) to be in the wrong place at the wrong time.

These unlucky people end up having a piano squash them to death on a city sidewalk, or a stray piece of large metal junk is flung by a large pro lawnmower through the windshield of their car - killing them instantly. (That actually happened, the second one).

Anyhow, so we responded to a call early this morning in which an elderly woman happened to be walking past a large, tall pile of heavy wood beams being stored at their home for future repair. These wood beams, for whatever reason, slipped longwise down from their shelf and struck the woman in the neck. Unfortunately, the beams were several feet long and the hallway she was in wasn't. Essentially pinning and hanging her against the wall by her neck. One can only hope that her death was instantaneous and painless due to a broken cervical spine. Imagine, walking casually through your own home and suddenly BAMMO! your dead for no good reason.

Lesson - always be ready to be dead today or tomorrow or have a loved die because right now is all any of us ever really have and life doesn't come with guarantees, ever.

On a happier note my mom recommended Trind nail repair to me last week. You can only buy it in select stores or online; just google Tring nail repair... So I became a believer in this product in less than 1 week because it is seriously bad ass. My nails grow fast and are healthy but tend to be dry (have dry skin) and so they sometimes break and fray easily no matter what I do. After just one week of using this $20 product my nails are gorgeous and in several situations when I would have normally broken a nail not only did it not break but it didn't even fray/bend/split or chip. I will continue my personal experiment and update as I learn more about this cool product.

First Shift Back and Crappy Environments

My first shift on the ambulance in 3.5 months was much easier than I expected. I was a bit anxious that I'd be rusty but it's like falling off a bike. No problemo! That's when I realized that I've spent for more time on an ambulance than off. I've been working full-time and OT/second EMS jobs for 16 years so 3.5 months wasn't nearly enough time to lose my edge; fortunately.

Luck was even on my side! My partner and I responded to a minor assault call in our district. During that same time the neighboring unit responded to another call in our district which turned out to be a cardiac arrest. Working an arrest is lots of sweaty hard work, drug calculations and a high level of skill all combined. And the majority of cardiac arrest patients are unable to be revived - so lots of work with usually very little return.

My partner and I cleared our call and decided to stop by with the other unit to help since they were near by and I got to meet a new young, female medic that was hired during my absence. She was very nervous since she was attempting to obtain an airway for the patient (which can be difficult and is the "star attraction" during a cardiac arrest) and her partner was one of our most veteran medics who is known for not being supportive of rookies (especially female rookies). His obvious lack of support and her being the center of attention was making her so nervous that her technique was off and she was unsuccessful.

As I witnessed this I attempted to offer my own support and give her calm, clear advice (which earned me a look of contempt from the senior medic) and she attempted to follow the advice but unfortunately the environment was too far gone and nothing I could do or say ended up helping. The senior medic in charge of the cardiac arrest finished the airway successfully and they left for the hospital.

EMS is a naturally stressful job and senior medics always challenge and harass rookies which seems harsh but is necessary to a degree because the entire team needs to know what the rookie's breaking is and if they can handle themselves confidently in real life stressful situations. However, I've always felt that along with the good-natured harassment there needs to be a mentally and emotionally supportive atmosphere for all rookies. But there will always be those medics that have no patience for rookies even though we were all rookies once upon a time.

Have you read the Etsy Wars article?

I'm a follower of Etsy Bitch, sometimes I agree and sometimes I don't but the posts are usually very interesting either way. Here's the latest post about a magazine article that is soon to be published and it's pdf version is readable through on Etsy Bitch, here's the link --

Etsy Wars

Check it out!

Surgery Time!

Had my doctor appt today for my second ultrasound and a decision was finally made this afternoon. I will be getting a hysterectomy, probably sometime in the next week or so. They're going to call me tomorrow to schedule it. I have a grapefruit sized fibroid and a mass (which she thinks is endometriosis) growing around both ovaries. Bummer. So we're going to do a full abdominal incision so that she can clean everything out, see exactly what the mass is and be able to save as much of my ovaries as possible to avoid early menopause. We're not concerned about cancer at this point but we don't want anything abnormal left in to create future problems. So, that's the big decision...I'll have a 2 night stay in the hospital and a 6 week recovery.

I'm not excited about major surgery but I'm really excited about getting this resolved and starting on the road of recovery.

CPR is important!

My co-workers and I have noticed a disturbing trend the last several years. The public has stopped performing CPR whenever they've witnessed a cardiac arrest; even when it's their own family and friends. I remember when I was first in EMS I saw the public performing CPR quite often. This trend seems to be stopping. In fact, the public as a whole seems to have decided to limit participation in rendering any first aid to those in need; when they decide to give any first aid at all.

The most common excuses...I'm mean Reasons are:
1) I wasn't sure what to do
2) I thought it was best to wait for the professionals
3) I panicked

I suspect that most people (for various reasons) don't understand how important first aid and especially immediate CPR really is. Various studies over the last few years, many completed by the American Heart Association, have proven the immediate, strong chest compressions during a cardiac arrest are the best way to prolong a person's chances for resuscitation prior to EMS arrival. A rescuer doesn't even have to give mouth to mouth breaths, just really strong, really fast chest compressions. This effort provides a minimal circulation which can extend the dead person's chances for recovery.

Remember, that without oxygen brain death begins in 4-6 minutes! Unless EMS is in the immediate area during a cardiac arrest it take at least 5-10 minutes for paramedics to arrive on the scene. At that point everything we do is behind the clock, especially if there has been no bystander CPR prior to EMS arrival.

I would say over 90% of cardiac arrests that I've responded to in 15 years are not successfully resuscitated and most of those have no bystander CPR or first aid. The public can make a huge difference in the recovery of patients if they would only choose to participate.

I know that most people are afraid of getting involved, they are afraid of being sued. The Good Samaritan Law is in most (if not all states) and says that if an untrained bystander renders aid in good faith with good intentions; they can NOT be sued for their actions if the end result is negative.

So often I seen results that have been bad directly because no one helped their neighbor. But these same inactive people LOVE to watch. They love to stand nearby and be Looky-Lous and ask nosey questions and pretend that their involved without having to take any risks.

Next time you have a chance to help your neighbor and aren't sure what you should do, ask yourself...what would you like your neighbor to do for you if your positions were reversed?

People are insane!

I will never understand why people make some of the choices they do. During my shift we were called for one person who had been in a car accident a few hours earlier and refused medical care/transport at the scene. They went home and decided that they wanted to go to the hospital after all. They didn't have a family member drive them to the hospital, they called 911 to have us, the ambulance drive them to the ER. This person was fully dressed, calm and ambulatory but decided that they wanted an ambulance to drive them "just in case". And this person has no insurance and little money so they won't be paying for any of this.

Ironically, a couple hours later during this same shift another person calls us for shortness of breath. This person had been laid off and lost their insurance/job. So they're obviously concerned about money so they don't call 911 right away or have a family member drive them to the er. No, they decided to wait 3 hours until their breathing is significantly worse then call 911. Since they lost their insurance, this person stopped ALL of their high blood pressure medications and within weeks their blood pressure had increased to the point that their blood was backing up in their heart and lungs because of progressive heart failure.

Once this starts it will continue to worsen without medical intervention. However, this person decides that they don't want us to take them by ambulance to the closet hospital; they want us to transport them past 5 major hospitals to the downtown "free" county hospital. Unfortunately, as a paramedic I can't agree to this because if the worse happens (they stop breathing/heart stops which is very likely) I'm criminally liable for their death. I could lose my license at least and money and possible jail time because I didn't take them to the closet hospital.

This person decides to refuse ems transport and have his family take him instead because he can't afford the hospital bill. I tried several times to explain to this person that they could DIE before they reach this hospital which is 45+ mins away and the other hospital is 10 mins. They still refuse against medical advice and we leave. We can't take anyone against their will unless they are a minor or the are unable to answer basic competency questions or are threatening to harm themselves.

It's still amazing to me that the people who don't need ems and don't plan on paying anyone call us all the time and expect transport regardless while the people who really do need us and may or may not be able to pay don't call or refuse transport. Money is important but jeez! It's your health/life and if the free loaders aren't going to pay and aren't going to be held accountable then the others who have the need and right intentions shouldn't feel bad about using us.

And yet it continues.....

Media Frenzy regarding head injuries

If you haven't heard yet the actress Natasha Richardson, wife of Liam Neeson died this week from a head injury. She fell from a standing position onto snow while learning how to ski on the bunny slope. Reports say that after the fall she denied any complaints and refused any medical care. She was taken to her hotel room and about an hour later complained of a headache and other worsening head injury symptoms such as: dizziness, nausea, loss of consciousness. Since she was over an hour away from a hospital she was unable to survive the massive cerebral bleed and died about a day later.

First off I want to say what a horrible and sudden tragedy this is, she was only 45 and in excellent health. I hate for any family to deal with pointless tragedy.

Unfortunately, the media is using this as an opportunity to extol the extreme virtues of wearing helmets and considering making helmets mandatory to skiing. That's not to say that wearing appropriate safety gear isn't important but people have been skiing and falling for centuries without helmets and thousands survive.

What happened to Ms. Richardson is a horrible, one in a million freak accident that is (in my opinion) God's way of reminding us that we are mortal and to not get to big for our britches. If it truly is your time no amount of man made safety equipment or medical intervention will make any difference. I've seen patients whom I thought would not survive walk out of the hospital and I've seen patients who seem normal and healthy drop dead unexpectedly and we were unable to save them. I'm not disagreeing with using safety equipment what I'm try to say is that we should never believe that any type of safety equipment or medical care gives us any guarantee of life or health.

We should always make fully informed, rational decisions about anything we decide to undertake. Instead of completely trusting equipment or doctors to "save us";
I feel it is better to:

1) Learn how to fall properly (yes there are techniques to avoid serious injury, talk to any acrobat or martial artist and most people don't bother to learn these very simple techniques)

2) To take full responsibility for our actions, to remain completely and utterly focused on what we are doing and the situations surrounding us,

3) Learn how to drive properly and defensively (there is a wrong way - hence so many SUV rollovers because people don't learn to drive them properly. They don't handle like a car and are VERY easy to flip with or without Firestone tires, lol!)

4) Accept that everyday may well be our last on earth no matter what you do right or wrong because there are NO GUARANTEES in life, there are no doctors or paramedics who can predict the future regardless of how many tests they run on you or how often they "check you out"

5) Learn how to avoid panic every time the media discovers a new "danger" in life, News Flash: Life is full danger, will always be full of danger and no matter how much bubble wrap you coat yourself and your children in, it will never be enough if you don't learn how to make good choices.

6) You are better off learning how to prepare and calmly deal with the unexpected and teaching your children how to do so as well, because at the end of the day you can only depend on your ability to save yourself and your family because the government will not or can not save everyone all the time. (Financial Crisis? Hurricanes?)

7) You are your own best advocate for your life, no one else will make those hard decisions for you and you'll be stuck holding the bag because even deciding not to decide is a decision. Just a really bad decision with limited opinions.

America is lacking independence, common sense and responsibility and I see it daily as a paramedic. Just in the last decade I've seen more and more people who call 911 (the government) to come to their home at all hours and tell them what to do, how to do it and asking for a guarantee if things don't work out well. It will only continue to get worse and I just pray that I survive it with my health and soul intact.

Long shift

So I just got home this morning from a long 48 hour shift. I did a favor for a coworker who needed Friday off. That's the only time I pick up an extra shift anymore. To help someone out. I don't work extra shifts just because my employer is always short staffed and is always needing paramedics to stay over. I stopped working OT over a year ago because I was worn out and tired of enabling their lack of long term problem solving abilities (or unwillingness to solve those problems) But I'm home now and have to be back on shift tomorrow but I get next Saturday off! That means I'll have thur, fri, sat, sun and mon day next week! Woohoo!

Overall the 48 hours were busy but uneventful medically. These days we call it "ran a lot of calls, didn't use anything". Which means that lots of people wanted or needed to go to the hospital but nobody was sick or hurt enough for us to utilize large amounts of equipment or supplies. Basically just taxi rides to the ER. EMS is changing. Even just 10 years ago we might not run but 2 calls in a day but they were serious, life changing calls. We didn't always sleep all night but we did more often. And when we were up it was usually for a serious reason. Now people call all day and all night for fevers, one episode of vomiting, broken toe/finger, "my doctor said to call 911", anxiety attacks, drug/alcohol interventions, (and my personal fav - I want to go to a hospital an hour away because that's where my doctor is but I don't want my family to drive me because what if something happens even though I feel fine right now and I don't want to go to the hospital that I live next to because I my doctor won't come there) you name it we respond to it.

We still have serious calls that challenge us as medics but the great majority of our calls are not medically challenging and usually don't require an ER visit let alone an ambulance ride to get there. This is the future of EMS and it's only going to get worse. So think about this when you're having your heart attack and the ambulance that responds takes 20 mins longer to arrive because the closer ambulances are already transporting 30 years old with the flu because they think they'll be seen faster if they arrived by ambulance. (which isn't true!) Persons are ALWAYS seen in order of severity of illness/injury not how they arrived. It's called triage, google it.

Ask yourself: How can we all be more personally responsible for using all of our public services appropriately for the overall benefit to the community instead of selfish, unnecessary reasons that may very well contribute to the death of your neighbor.

Soapbox rant officially over! :o)

Top 10 grossest things that can come from/out of the human body.

For those of you that don't like gory details then you should probably stop reading right about now. For the rest of you out there that just have to hear all the disgusting aspects, please continue. ;o)

TOP 10 GROSSEST THINGS THAT CAN COME FROM/OUT OF THE HUMAN BODY

10) BLOOD : Okay, you're probably thinking that blood is very gross but in reality it's not really that bad. Blood circulates inside a sterile closed system of veins and arteries and as long as it's not actively infected with anything contagious and the person's immune system is working correcting then it's okay. Most people can't stand the sight of blood and often faint (we make a lot of those fainting calls) but blood doesn't smell bad and cleans up easily. HINT: use hydrogen peroxide to get blood out of clothing/carpet/etc, just soak and resoak and rinse the foam. HP breaks down blood and tissue, which is why it's bad to use it excessively on injuries.

9) GERIATRIC DUST: You've probably never heard of this. It's when someone is very old, usually over 80, they usually have extremely dry, poorly maintained skin. They are covered in a layer of dandruff-like powder. Doesn't sound too bad right? Try picking this person up with a full body hug after they've fallen and can't get up. You end up covered in dandruff that has a slight odor and is difficult to brush off, ick.

8) BIRTH FLUIDS: Need I say more. Babies are beautiful, the miracle of human birth is beautiful, actually participating in the spewing, bloodly, amniotic fluidly explosion: not so much. And yes, I have delivered babies in the field.

7) MUCUS: I'm not talking about the clear, piddling amount that you blow into a tissue when you've got the flu. I'm talking about that thick, yellow-greenish sludge that collects in the lungs of people with severe lung disease. I'm talking about the malleable missile that shoots from the diseased lungs with a strong cough; the sticky mess that ends up flying over 6+ feet and you had better duck!

6) URINE: Oh you know it had to be on this list! Urine is a funny thing. Doesn't look like much but the smell will stay for hours. Especially the dark, concentrated urine from someone that rarely drinks water. Fortunately, urine is like blood. As long as there's no active infection it's mostly sterile.

5) VOMIT: You know that chunky style. The type of vomit that still smells just a little bit recognizable as a previous meal. Or pure gatorade vomit, yuck! It has a sickly, sweet smell that will stay in your nose for hours! But like urine and blood it's mostly non-contagious.

4) PUS: If you've never experienced the full range of major skin infection such as gangrene then you've never really experienced the joy of rotting human flesh. This also includes smelling a week old corpse; especially if the body is not in a cool environment. The smell will ooze out of a home for yards and you'd better not be downwind! Been there, done that; maggots and all.

3) FECES: You think stepping in a dog pile is bad then try stepping in a human pile. Oh yes, I've done that. Not on purpose though! Human feces is probably one of the worse smelling, longest lasting stenches you'll ever come across. I washed my boots a half a dozen times that day and still I could smell it! Keep in mind that my sniffer isn't so awesome. A lifetime of sinus infections have severely damaged my sense of smell. But at least I can still smell baking cookies, YUM!

2) COLOSTOMY: You ever heard of a colostomy? It's when someone has a bowel disease and must have a section of their colon removed . The have a temporary or permanent hole, a stoma, incised into their abdomen and a plastic bag is secured over the stoma to collect the contents of their colon. It doesn't exit the body from the rectum as normal. Okay, so the contents of a colostomy bag is a horrible combination of vomit and diarrhea. It's feces that hasn't been completely formed and it stinks like you wouldn't believe. I helped an older woman years ago that had been changing her bag and spilled it all over herself. Wow, had to step outside for fresh air on that one!

And the number 1 grossest thing from the human body!!!!!!!!!!!!!!!!

1) GI BLEED: GI stands for gastrointestinal and it means when someone is bleeding internally in their esophagus, stomach and/or intestines. Blood by itself isn't too bad and feces is bad enough alone, but you combine the two and OMG! The blood usually sits in the GI tract for hours or days before person realizes that they're bleeding so it decomposes and is partially digested and irritates the internal linings. Human blood is very corrosive to the internal organs and the body doesn't like being exposed to blood outside of the cellular level. The end result is the most disgusting, reeking, sticky, dark black mess you'll ever experience. Especially if the person is vomiting and crapping this mess simultaneously. Whatever you do, DO NOT get it on you! And yes, I've witnessed, treated and cleaned up after that fun, too.

Doesn't this list make you glad you don't work in the medical field?