Archive for the 'Rants' Category

23
Oct
11

A view from the other side.

By Jeramedic Leave a Comment
Categories: Good Medicine and Rants
Tags: , , , , , , , , , ,

Lately I have been spending some time in other parts of the company other then the back of an ambulance. I must admit that I was a bit apprehensive when I started to take on some duties behind the scenes. But I found it to have been a very eye opening and educational experience in the world of EMS, especially from the prospective of a field provider.

I thought I would share a little of what I have learned with you, in the hopes that perhaps you will think a little different about your job the next time you pull into the station, or are dispatched to a call.

So here are a few things that as a field provider, you may not of necessarily known was going on while you were out running calls.

  • You are posting, or on a move up because other units are busy. its as simple as that. Its not because the dispatcher doesn’t like you, or because “those knuckleheads at station 18 can’t handle their area”. It’s because coverage is being lost left and right, and you are one of only a small number of crews left in the city.
  • Document Document Document. I know that may sound obvious, but if you knew how many calls come through every day from lawyers asking for patient care records, you would think twice about what you’re signing.
  • No one likes to run the non-emergent, “BS”, system abuser calls. It’s one of the issues being handled in EMS 2.0. But would you believe that many people, (sometime several a day) call non emergency phone numbers, asking for simple BLS transport for things like: Chest pain with shortness of breath. Altered levels of consciousnesses. Seizures. And Obstetrical problems.
  • It really takes a lot of time, money, and energy to keep “your” ambulances and equipment in working order. So please take care of them when you’ve got them.
  • Dispatch is not a cushy job. Its had work. It might just be me, but I found dispatching to be more challenging and stressful then any field work. So when the dispatcher does’t copy you back, understand that sometimes it’s loud, business phones are ringing, while emergencies are coming in, while neighboring cities are calling for mutual aid, and any number of other distractions. So please… Give them a minute.
  • And finally, and this one is important so pay attention. We all know that reputations mean everything in this industry. When you are in a position where you can watch over fifty field staff working throughout a shift, and over multiple shifts, you realize that it doesn’t require much effort to stand out from the crowd, in both positive and negative ways. And that should be your take home message. Small changes in your behavior and work ethic, really make big differences.
So there you go, just a few tidbits of insight from the other side. Do with it what you will, but do good, and be safe.
12
Oct
10

The Community of Paramedicine: Pt 2

By Jeramedic 5 Comments
Categories: Good Medicine, Rants and Uncategorized
Tags: , , , , , , , , , , ,

So in part one I discus the idea of an “EMS Brotherhood”, and that we are all one and the same (even if your partner or common perception tells you otherwise) But after looking at how the industry is set up, and even still how we as members of this industry interact with one another, I am starting to look at things differently.

EMS does not have a “brotherhood” (at least not in the way as defined be our colleagues in Fire and Law) because we already have something . We have a community. And just like any small or mid sized town, we all know each other, we see each other around town, we share stories and ideas, we drive similar yet personalized cars, we all live and work in different areas, and we take pride in our little town, no matter how small it may look compared to the bright lights of New York city.

But how did we all become residence of “EMSville” ? And how can we expand? Well, like often mentioned, the connections and friendships made with social networking sites combined with the face to face interactions at regional and national, and even international conferences has helped to strengthen the community tremendously. The fact that you are reading this, and even care what I have to say is proof of that.

But Why?

Well, we need more friends. Both in, and out of EMS. We make these friendships by taking a leap, and talking to strangers.  Ever since many of us were little kids, we were told to never talk to strangers. While this was done out of a concern for our safety, many of us have carried this mantra over into adulthood. But its okay now. I don’t think the EMT ride-a-long thats with the other company, or the ER Doc, or the police Sergeant is going to lore you away with a bag of skittles and lost puppy story. And if you are still stuck on the ridiculous notion that “I wear blue, they wear white, we’re not from the same tribe.” All I can say is, Evolve already.

By not talking to, and getting to know your neighbors, you (and we as a community) are losing out.  Your best friend, fellow supporter of a cause, Jedi master educator, or ever your future medical director could be standing next you, and you would never know.

I used to work in an area where my main hospital was also the regional trauma center. Three fire departments and two private ambulances would all transport there, not to mention all the non emergency transport services as well. If you ever wanted a melting pot, the wall of that ER was it. I would talk to everyone, and guess what? I made friends. Friends that had on different uniforms, and made less then me, and who made a lot more then me. And it pays off. When I needed help with a patient, they were there. When then needed help with CE’s or a new job, we were there. Its like borrowing  cup of sugar.

Expanding a small town community into a thriving city is the same for EMS as it is a real town. Strong relationships must be made, trust must be built, and Infrastructure put in place.  There must be a sharing of recourses, and so on. Whats good for you, is good for your neighbor. We are not stealing secrets, we are sharing knowledge.

But How?

First off,  introduce yourself.  Say where you’re are from and what department or company you work with. Don’t think that just because you are in uniform that your patches and badges will speak for themselves.

Take a genuine interest in the other person. Hard to admit, but we all like to talk about ourselves. So Let them talk. Who are they? What are they doing in their career? Where do they want to go? Afterward, remember somethings about that person and the conversation. Next time you see them in the ER, or elsewhere, you’ll have something to talk about.  ”Hey Jen, how’s that fire science class going?” “Mike, I did not see you last week, did you take that vacation you were talking about?”

People like it when you remember their names, and something about them. You may have only just met lest week, but it creates a bond. Before you know it, you’ll have a study buddy, or a great reference for an application. And they will benefit too.

Also, and I must stress this. No egos allowed. When making friends, leave the deck of certs in your pocket. No one uping stories, no Medic vs EMT  rubbish. When speaking to someone with less experience and education then you, remember where you came from. When speaking to someone with more experience and education then you, still remember where you came from. Just be human.

And these gestures of peace are not just for personal gain. These are the people that are going to have your back on a major incident. building a strong relationship with not only your fellow EMS workers, but also Fire, Police, and Hospital staff  is something the strengthens the communities you serve. These were the driving principles behind the TAK Response conference I attended in September. And the San Bruno gas explosion the week before was a great example of expanding their our community aided in the response, fire fight, and patient care.

The community is growing, and with the help of friends like you, it is getting bigger and brighter every day.

06
Oct
10

The Community of Paramedicine: Pt 1

By Jeramedic 4 Comments
Categories: Events, Good Medicine and Rants
Tags: , , , , , , , , , , , , , ,

Last week I spent my time in Dallas at this years EMS Expo. It was a wonderful experience of both personal and professional growth, and something a recommend everyone attend at least once. But this post is not about the event, or the speakers, or the podcasts, blogger meetups, or even the “shhhh, super secret high-viz, bluetooth  enabled airway adjunct/C-Spine translator backpack gurney, that is going revolutionize the way we…”

This is more of an observational post about what happens at events like EMS Expo, and in the online communities. Something that I am seeing more of, but not as much as I’d like. Our friends in Fire Suppression and Law Enforcement have had a “brotherhood” for nearly a century. That unspoken bond that removes the illusion of rank and department and simply says “we are.”

Granted, Fire and Law have had about a century’s head start. And when it comes to the method and delivery of Fire protection and Law enforcement, a  near uniformity exists from one department or city to the next. But when it comes to EMS, there can be near poller opposite within the same county. Private, Public, Volunteer, Hospital based, Progressive protocols, and antiquated equipment, BLS, ILS, ALS, all sharing boarders. And any combination of the above could respond in teams from one on up to six plus. They could be in a car, ambulance, fire engine, or a private vehicle.

No wonder we struggle to find an identity, let alone a brotherhood. In many ways we are our own oppressors. Thanks to the “popularity” of privatized/for profit ambulances, we are treated like numbers, and view other providers from other services as competitors rather than colleagues. This is a an unfortunate and foolish mistake. We are all EMTs and Paramedics. We went through the same testing, we have same card(s) in wallets, we take care of the same people. So can we just be done with this whole tribal nonsense already?

The funny thing about all this, is that it only happens in the field. What is it about driving around in different colored ambulances that makes many of us act this way? You see, I don’t believe that this is our true nature. I don’t act this way, and I know many other who don’t either. But for some reason only at EMS conferences and on social sites like twitter and facebook do these  walls come down on a large scale.

There, out of uniform,  we stand as equals. Its in this space, in person and online where a student from Ohio can be mentored from Louisiana. Where providers from opposite coasts can feel like old friends, when in fact they just met. And where Medics from around the world can come together and create something bigger then themselves, and give back to the community that helped create it.

This community is what strengthens us as a profession, and as individuals. Its this community that wanted EMS 2.0 when its was just called “I wish things were better.” And its this community thats going to gets its wish. We all agree that it take a special kind of person to do this work. Well, what kind of person is it who will take time off of work, and spend money to go be surrounded by work? This is EMS Expo, and this is the community of paramedicine.

This kind of community is what we need when the boots hit the ground. I wear a blue shirt, you a white shirt, and others red and green, But we are all on the same team, and until we start playing like a team, none of us will win.

More to  in part 2.

08
Aug
10

What’s The Blood Pressure?

By Jeramedic 12 Comments
Categories: Rants

Recently I have been taking 90% of my blood pressures with an automated cuff off of a LifePak 12. Cool, right ? Not really. You see up until now, all my blood pressures have been done manually with a cuff and stethoscope. Now some would argue that the “convenience” and “accuracy” of this technology is an asset to modern Pre-Hospital care. And that I should get with the times. (I’m young and only 4 1/2 years in… I’m with the times)

To be honest, I don’t like it. And I don’t like what its training our Paramedics and EMT’s to do. And that is to play the monitor like a penny slot in Reno. Before I get into that, I’ll highlight the pros of an auto BP cuff, to which there are some.

First: Yes, it is convenient. And who could argue with data storage, and the ability to transmit that data to the ER or an e-PCR… That’s about it. What I see are providers doing their assessments, and when the auto PB pops up its reading, their is a moment of contemplation. The questions is do i like this Blood Pressure? Or, Do these numbers make sense? sometimes there is even an exchange among care givers that goes something like: “you ok with that?… sure” or “you like that one?… nah, try it again”.

So what happens if you don’t like the first BP? take it again. How about the second? No? well we’ll try it one more time. So now after 3-5 minutes, you have 3 different BPs and what?

There are many factors that can interfere with an Auto Cuffs reading. Things like: A moving ambulance. A moving patient. An incorrectly sized cuff. A patient that is especially Hypo or Hypertensive, and so on. Yes, movement of the patient and the ambulance can disturb the process of taking a manual BP, but by holding the patients arm, it allows you to support and stabilize the arm, while also discouraging the patient from moving it.

The deal is, when I take a manual BP, and its 230/110, I know it is because I heard the pulse at 230, saw the needle bounce at 230, and followed it down to 110. Same goes for 88/60. I saw it, heard it, felt it. I find another advantage to manual BPs, is that you can assess skin signs, respiratory effort, and you can hear and feel the strength and rhythm of the pulse. If you allow it, a manual BP can tell you a lot about the cardiovascular status of your patient.

Now I’m not calming that my ears, or anyone else are the best in the world. And  of course there are times when you just cant hear anything, and a few other situations when an Auto BP cuff can help, but generally, I prefer a manual. In the end it all comes down to a good assessment , and an accurate Blood Pressure  is a major piece of that assessment.

Do good, and treat well.

22
Jun
10

Believe Me

By Jeramedic 2 Comments
Categories: Rants
Tags: , , , , , , , , , , , , ,

In this day of computer aided dispatch (CAD) systems, GPS locators, and EMD (Emergency medical dispatch) algorithms, one could argue that the process of getting the closest and most appropriate resources to the scene of an emergency, has been greatly stream lined. There is however two things these technologies are lacking: Eyes, and judgment.

You see no matter how much tech we load into a response vehicle and or dispatch center, there are still humans that need to operate the system, update the information, and make treatment and transport decisions. Field providers, dispatchers, and hospital staff need to be able to communicate effectively with each other, and most of all, believe each other.

What follows are two examples of a break in the communication trust.

Example 1:

30min before the end of my shift, and I am en route back to the station. My partner and I notice a large cloud of black smoke rising up a few blocks away. It was 12:30am, and radio chatter was lite. We did not hear anything relating to a fire go out, and so we thought we would go investigate. What we found was a two story house, fully involved in flames, and no one was around. No crowd of neighbors, no police, and no fire engines. Me: “Base, 1116”. Dispatch: “go ahead 1116”. Me: “1116, who do you have responding to the structure fire on 132nd street?”. Dispatch: “ummmm, no response. There is no fire on 132nd street”. Me: “yes there is, I’m looking at it” Dispatch : “umm, ok? Well we don’t show any fire calls in your area. Where are you?” Me: “At 123 132nd street, and there is a house that is VERY much on fire”. Dispatch: “……. Oh! There it is… ok, well show you on scene”. Me: “Thank you”

Example 2:

At a red light, a car pulls up behind the ambulance, and two men exit the car. “this is when we get robed” I jokingly said to my partner, Bobby. The two men begin pounding on the window, they did not speak english, but it was obvious that they were asking for help, and not for our wallets and cell phones. I flipped on the amber secondaries as Bobby followed the men back to their car. As I stepped out of the ambulance I saw Bobby’s eyes get wide. “Its a GSW” (Gun Shot Wound) he shouted. I met him with the gurney at the back of a blood soaked SUV. The patient was quickly loaded into the ambulance, and I was on the radio. Me: “802, were at the corner of Any street and Somewhere Blvd, With a still alarm GSW, we need PD!”. Dispatch: “can you repeat?”. I repeated. While I waited for a reply, I helped Bobby assess and and start treatments. The patient was a male in his late teens. He was pale and moist with labored respirations and diminished lung sounds on the left. He had a a 2cm entrance wound to his left upper chest, mid clavicle. And a 3-4cm exit wound just below his left scapula. Dispatch: “whats the gender of the patent?” Me: “Male! Is PD en route?” I handed Bobby an occlusive dressing and asked if he was ready to go, “yeah, lets get moving” he said. I got into the drivers seat just as a county sheriff pulled up. I gave him a 10 sec report and left. Me: “dispatch 802, we are transporting code 3 to Saint F’s “. Dispatch: “do you need fire to respond”. Me: “No thank you”.

I understand that dispatching is not always the easiest job, and that there are protocols and procedures that must be followed. But when I ask for help, believe me. I promise I don’t make things up just to complicate things.

We are a team. And if we cant communicate and trust one anothers information, we loose points on the field. I am not ragging on dispatchers, I’m just promoting better professional trust. I encourage you to get to know your colleagues in the little dark room, offer a ride along, and play nice.

31
Mar
10

The Seven Dollar Dent

By Jeramedic 3 Comments
Categories: Rants
Tags: , , , , , , , , , , ,

Today I was out and about town. This morning I took my car to the mechanic for some passed due maintenance (Thanks Chronicles of EMS) Then this afternoon was I off to the good doctor (and family friend) for some passed due personal maintenance.   Then off to the office supply store, and a quick phone call to headquarters to enquirer about some new uniforms. All and all, I’d say it was a productive day. Yup… the well oiled machine of society was running smoothly… or was it?

On my home, I needed a phone number that had been emailed to me. I turned into the parking lot of a shopping mall to (safely) access the internet on my cell phone. On my way out of the parking lot, I noticed a homeless woman sitting on a wall near the exit. And there it was, the familiar feeling we all get. That uniquely human sensation brought on by a cocktail of guilt, remorse, empathy, sympathy, compassion, frustration, anger, helplessness, and denial. I don’t know what to call it, but it’s “that” feeling. Perhaps us EMS folks feel it a bit stronger then others do. The sight or thought of someone in need can at times wreak havoc on our caring nature. It urges you to do something while stabbing you in the back with the knowledge that it’s never enough.

As I got closer I could see she was in her late 30′s. she looked healthy enough, and had some luggage with her (Clean, new luggage.) She also had a large, detailed cardboard sign, “Homeless with two daughters”- I couldn’t read on… There was traffic behind me, so I had to pull out on to the street. I circled the block and went back.

It’s wrong. The well oiled machine of society was broken… It broke a long time ago, and no one seemed to care. “as long as my Iphone  doesn’t get scratched, and Starbucks doesn’t run out my triple shot ignorance late’ then all is good…” No, I’m sorry. It’s broken. “But that’s like why I go to Starbucks, because I care… Cuz like, their coffee is all free trade and stuff… I think… right?… what does free trade mean again?”  *head desk*

In a parking lot full of luxury cars, in a world enamored with money, and this woman had nothing. After working in any branch of emergency services, you become intimately aware of society’s dirty truths that it wishes you didn’t see. The drugs, the violence, the corruption, and the injustice. Because of that, you become quickly skilled in reading people. She was not a drug addict, or a prostitute, or mentally ill (not that any of that should matter) she was a person.  I’ve had coworkers argue that, “I bust my but all day picking up bums. They are not getting my money or time when these boots come off.” Yes, on duty you have a legal responsibility to these people. But what about your human responsibility? The human responsibility that lead  you to this job in the first place…

In my wallet I had seven dollars cash. Seven dollars that was left over from money I had borrowed. It was her’s… I drove back to her corner of the lot and parked next to the Mercedes Benz she was near. “I want you to have this” I told her. She thanked me, and the society machine got a much needed drop of oil.  One thing I learned from my father was to give. He is a very generous man, even when he has little  him self.  He never told me I had  to be this way. He never explained its importance. As a child I would just watch him do it with grace and humility.

Seven dollars would not fix this woman’s problems, or fix society. But it made a dent. It showed this woman that someone cared. It set an example to everyone who watched and did not act. It made a dent… This is what we do, try and try, one little dent at a time. The sad truth is that after that, I saw at least a dozen more people who needed a dent.

I know the readers of this are compassionate people. We may have never met, but I know you. I encourage every one of you to go make dents, in what ever way you can. What am I saying… I know you make dents. I guess I’m saying don’t stop making dents, or even better make more.

This is what we do, try and try, one little dent at a time.

28
Feb
10

I Am Medic, Hear Me Roar

By Jeramedic 8 Comments
Categories: Rants
Tags: , , , , , , , ,

I am Medic, and for that I am quite an interesting creature. I come from a military ancestry. My family was in all of the great wars, and the not so great as well.

In the the mid 1900′s I slowly grew and fought for a place in the world. In the 1970′s, a landmark television show told my stories every week And helped to introduce my mission to the public.

During the 1990′s and early 2000′s, I educated my self  and battled legislation and health care reform.

Now today I am once again in the media (a bit more then in the 70′s) and I am preparing to move forward in my life.

But as glamorous as my life may sound, there is another side. The side that is lost and confused. The side that is poor. The side that is disrespected and misunderstood  by the public and my medical piers. The side that is expected to work faster, better, longer, 24/7 no matter what.

I am the bastard child of health care and the foster child of the fire service. Neither of my parents know what to do with me, and they get mad at me when I ask them for help.

I care a lot about my self and for the people in this world, but I find it harder and harder to do even the minimum anymore. Some times I feel like I should run away and leave the world and my so called “friends” behind. To leave them alone to handle their own emergencies them selves. maybe once I’m gone they’ll realize how important I was, and how wrong the were to treat me that way.

The sad part is that no matter how bad it gets, I don’t think I could ever leave. I’ve been here too long. The need is so big and I care too much to go now. I would work for free and drag myself on bloody stumps to just help one more unfortunate soul.

I am lost. I am confused. And I really need to sleep. What can I do?

Well let me think…..

I am extremely resourceful, and can do more with less. Hell what can I say, I’m used to it.

I can do five things with two hands and never break a sweat.

I have never met you, but in 10 minutes will know everything about you.

I can diagnose from across the room.

I have never been to medical school, but have gone toe to toe with many physicians .

I know my community intimately and it’s citizens better then any mayor has.

I will care for you when you are ill. I will hold your hand when you are afraid.

I will witness horror and tragedy without flinching, and find the good in any situation.

I am honest, caring, trustworthy, smart, professional, resilient, and unrelentingly passionate about  helping others.

I am Here, and the time for change is now. And I’m not going down without a fight.

I Am Medic, Hear Me Roar!

24
Feb
10

ALS Kills People

By Jeramedic 37 Comments
Categories: Rants
Tags: , , , , , , , , , , ,

While I was in Paramedic school, my instructors would say things like “you’re not a real medic until you’ve killed someone” and “soon you will all have your P-cards and a license to kill”

Studies show that ALS interventions give little to no benefit to trauma patients, and in some cases cause harm. We also still have no hard evidence that ACLS drugs are effective during cardiac arrest.

Systems across the country are downsizing their scope of practice, and losing medications and procedures because mistakes are being made in the field. And some medical directors are feeling like ALS is more of a risk then a gain.

The logical conclusion? ALS Kills People. Well, let me be a bit more specific. ALS kills people when it is used inappropriately and or incorrectly.

Don’t get me wrong, I am a firm believer in the benefit and need for ALS care in the field. But it must be done right. Otherwise you run a high risk of  killing someone.  I know you have heard it before, but its BLS before ALS. And it takes a good EMT to be a good paramedic. And I of course agree, I would also add that a well educated Paramedic with BLS equipment will give better care then an average Paramedic with ALS equipment.

So where am I going with all this? The answer is education, more emphasis on high quality BLS care, followed by appropriate ALS interventions. ALS care,well any level of care for that mater is a two way street of skill and knowledge. With out a thorough education base to start from, is it any wonder why intubation success rates are low and pneumonia patients are receiving Lasix. Not when you consider the fact that some clinical sites don’t allow students to intubate, or that some schools teach airway in a 8hr block and then move on. Another reason ALS is often harmful and seen as a liability, is because many of our new (under educated and under trained) providers go into the field and are so excited to play with their new toys they forget BLS and are unnecessarily aggressive with ALS. Again, this all comes back to more education.

Up until recently, the general consensus has been to remove procedures that are considered “an opportunity for error or that are infrequently used”,  rather then provide more training and education to prevent errors and keep less utilized skills current. Why Is it so taboo  to want more for our patients and our profession? Should a police department get rid of it’s SWAT team because it’s been 15 years since a hostage situation? Should  fire engines respond without lights and sirens because it’s potentially dangerous to other drivers? So why should EMS stop using medications that are harmful when Improperly Used? Or remove procedures that are only used on 5% of the patients.

This is an opportunity to adopt some things from our colleagues in Fire and Law Enforcement. Because as different as our roles are, they are also similar.  I am a big supporter of frequent In service trainings and drills. The Fire service often trains and drills for operations that may have  been done in the field only a few times in the history of the department, in addition to training on daily operations.  Police Officers are frequently at the firing range, even though they may go their entire career without drawing their gun in the field.

EMS is very much the same. we are educated, trained and equipped for the worst. Even though most calls meet BLS criteria, or less. But for that 10% who are legitimately critical ,we still need ALS. So how do prepare for the worst? By completing 48hrs of continuing education every two years…… Really? Kinda embarrassing when you think about.   Go look in the back of your ambulance and consider how many things we carry, and how many are actually used on a daily basis.  Then consider how many things you remember how to use (Properly)

We as individual providers and as a profession can not just wait for the National Registry or our local agencies to require more from us, because they won’t. We need to be responsible and proactive for our industry and require more from them, and from our selves.

As individuals we can educate our selves and practice skills on our own or in small groups. As a profession we can raise the bar for all of us  by increasing the minimum standards for employment. Individual schools can increase the required hours (or years) of education, and begin asking for more prerequisites. The industry standards will not change for us, we must change the industry. And it starts today with you.

If you are interested more on the importance of good BLS care, Steve Whitehead has a great post on the subject. Also   Rescue Monkey brings a different perspective, and adds a good dove tail to the issue.

08
Feb
10

Diseases of the Nation

By Jeramedic 4 Comments
Categories: Rants
Tags: , , , , , , ,

What is the desease of the nation?

Is it Heart disease?

Is it Diabetes?

Really I think if any disease can get so common somewhere that it can become a part of the culture, then we have a problem. The disease I’m thinking about at this moment is a little different. The problem with this disease is that it can’t be prevented with diet and exercise, or prescribed an inhaler. The problem with this diseases, is that it’s us. And we can’t just start killing each other off with some social antibiotics to fix it, because killing each other is the problem.

I’m talking about violence.  And it’s not so  much a disease of the nation as it is a diseases of humanity. I don’t know why this is on my mind today. But it is related to a conversation I had with an old friend and crew mate last week. We were sharing memories and stories as EMS people tend to do. He was telling me about how things had changed at the station since I had left.

There was the usual news. New crew, different vibe, same patients…well almost.  We were talking about some of our frequent customers, some old favorites, and some not so favorite. He was telling me that some of our frequents had died, sadly for some it was expected. The ones that were elderly and chronically ill, I knew sooner or later I’d get the bad news (or be the one giving it)

Whats not so expected is when the 23y/o girl with asthma dies, the one who lives on 135th street. The one who you’ve ran on more times then you can count. The one who even through a nebulizer and two to three word sentences could still tell you a joke. That one.

“What happened?” I asked, expecting something respiratory. “She was Shot” he said. I didn’t believe him at first. “It’s true” he said, “It was a drive by. She was hit a couple times in the back.”

Some of you my know that I tend to work in the more “interesting” neighborhoods of the city. Stories like this are some what common, it could have been anyone. But that doesn’t make it any better. It just bothers me that this happened. It just doesn’t make sense  to me. I mean in some ways it does. I can figure out what probably happened. Maybe it was a case of wrong place at the wrong  time. Maybe she was involved with a dangerous group of people. I think it was a little of both.

It’s difficult for me to even pretend whats it’s like to want to kill someone. Maybe I’m biased on the issue? After all I work towards the preservation of life, not destruction. To think that someone could put that much time and effort into something so horrible is beyond me.

I have many opinions about violence, but no solutions. And there are many things I want to do, but don’t know where to start.  I’m just tired of it is all.

We are all in this together folks.

Play nice.

17
Jan
10

Do These Gloves Make Me Look Fat?

By Jeramedic 4 Comments
Categories: Rants
Tags: , , , , , ,

A Nurse puts on a pair of exam gloves and then rips the fingers off. Then cleans an IV site, then touches the vein to be punctured with ungloved fingers.

A Doctor (not wearing face or eye protection) sutures a lacerated lip of an intoxicated man who spits bloody saliva into the air. The Doctor shouts at the patient “don’t spit I’m trying to help you!” The patient spits again, this time hitting the Doctor in the face.

A EMT puts on gloves while en route to a call. He runs the entire call in that same pair of gloves, Then he  drives half way to the hospital in the same dirty, contaminated, sweaty, had on for the last twenty minutes gloves.

What do these three scenarios have in common? They are all incorrect uses ass backwards uses of protective equipment that I have witnessed.

In a study preformed at the Hospital of Kaunas University of Medicine from January to June of 2006, they found that of the workers surveyed ( the number of participants are not given ) 62.1% reported exposure to biological fluids. Exposure of healthy skin and eyes to biological fluids occurred in 63%. 60% of the exposures were due to “blood splashes”. And it was found that No personal protective equipment was used by 14.5% of the respondents during sharps injuries and 5% during exposures. This study was preformed only on surgical staff, but it reinforces the fact that the world of medicine is a filthy dangerous place. I know that most of you (I hope) take BSI very seriously. I would not be bringing all this up just to state the obvious, but something happened to me recently.

There was this patient. Mid 30′s, male,  and he was trouble. When I got to him he was very altered and very combative. He was restrained to the gurney and was covered in sweat and blood. He caused one paramedic to be exposed by spiting and getting blood on his arms and chest after fighting and pulling out three IV’s. The patient had received 2mg of Ativan IM and was ever so slightly starting to calming down. I was to take over care, and before I approached the patient I pulled out of my pocket a pair of very well fitted and good looking 3M goggles and put them on. I was Laughed at by the others on scene. “Dude are those goggles? are you actually going to wear those?” I don’t believe it. Are you serious? Do I actually need to defend the fact that I Don’t Want Sh*t in my eye?………yes.  Since when did it become a party foul to be safe? When did being smart go out of fashion? Did I miss something? I have had colleagues both in and out of hospital say that with “intact skin and proper hand washing you should be fine” and yes that is sort of  true to a point, but come on. Really? Is that how you want to play?

Look folks, “BSI Scene Safety” doesn’t just pass tests, it also increases the odds of you coming home at the end of your shift. It increases the odds of you having a long healthy career. It keeps your family healthy. And BSI isn’t just for us, it helps keep our patients healthy too. In the beginning, education can do better to teach new providers. Along the way preceptors, FTO’s and crew mates can help to reinforce good habits. But at the end of the day, personal safety falls on you.

Be good.  Play nice.  And stay safe out there.

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