Saving lives with BLS

We in EMS have heard numerous times that it's BLS (basic life support) before ALS (advanced life support), and I am sure we all know medics who forget that. For those of us who are medics, I am sure we have each been guilty of that before. There is always that line of how aggressive should I be. I'm not a believer of "aggressive medicine", I am a believer of "do what the patient needs done to get them to the hospital in the same or better condition". In this field though, it's what the medic is comfortable with, and as long as you are doing a good job, then go for it. Sometimes, the pt dictates what you can do. The following pt had horrible veins and in 3 attempts, I was able to get flashback each time, a valve would be in the way. So what is one to do. BLS BLS BLS

Yesterday I was working and ran a call on a 56yo F with chest pain x3 hours. Pt also had nausea, vomiting, dull mid sternum pain radiating to the left shoulder. Pt was cool and dry to the touch with no past cardiac history. RR 22 P 48 BP 146/88 This is what presented on the monitor

I placed her on O2, gave the 324 ASA and 1 dose of nitro spray. Kept the pt talking. She had no relief of pain from the nitro. She had one more round still with no relief. So what is one to do. BP wouldn't allow for another nitro. So you run another strip.

Pulse is now 68 with RR at 18. The pain had gone to a 6 and stated she was breathing easier. I told her that I guess the medicine was working the way it was suppose to. She said, "No, it's the fact you're telling me everything you're doing and it isn't a mystery as to what was going on. I'm not as scared as I was before." All I could think was WOW. Basic skills and being myself helped this woman feel better in the middle of a massive heart attack. Sometimes the best "aggressive" medicine it making it seem that you aren't being aggressive. While I would have preferred to have hit that IV and pushed Morphine, knowing that the pt made it to the hospital slightly better than when I first saw her, tells me i was somewhat successful.

She had a 17 minute door to cath lab time.She had her procedure done with two stints placed. 3 hours after dropping her off, my partner and I were in her cardiac recovery unit room. She introduced us to her family and said "These are my two ambulance drivers". She told her daughter, who is an RN at that hospital, that she never would have guessed she was having a heart attack because the two of us were so calm. Then hearing your pt tell you thank you after that is great. You want to talk about a rare thank you. That is one of the best I've ever had.

I also want to give props to my partner Brad. He also remained calm. He understood the need for a smooth drive, while at the same time the need for a fast transport. He did an excellent job. I don't think I told him that. So Brad, thank you. I'm happy anytime I see you assigned to my truck. I'm also happy anytime you mom calls me to come over to "have some company"

America: Land of the Free, Home of the Jealous

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.~United States Declaration of Independence

So, I know of a lot of people who misread that statement all the time. It's pretty straightforward isn't it? It is to me anyway. It says that we are all created equal. To me this means race, sex, religion, sexual orientation. We are all equal, no one person better than another based on that criteria. We each have the right to live. I think that one is easy to understand. We each have the right to live in a free society, to have the liberty that so many people around the world yearn for. This is another easy one. If you are a citizen of this great question, then consider yourself blessed.

The pursuit of happiness is next. We are promised happiness. Isn't that wonderful. over 225 years ago, we were promised happiness. Our forefathers had the foresight to make sure that we stayed happy.

What, what do you mean it doesn't say that?!? It's right there in the last part of the preamble. It says we have the right to happiness. It can't be wrong, how can anyone misread or misunderstand this. It's a simple concept, WE GET TO BE HAPPY!!!

It is amazing how many people forget about the words in front of happiness. It states "the pursuit of", not the guarantee of happiness. Those 3 words change everything when it comes to that type of thinking. YET, so many people believe that happiness should be given. Not only should we help them attain the happiness, they get upset at people who have successfully pursued happiness. (Or wealth for this argument) Why do they feel this way? I don't know. During election season, you see it over and over again. This morning, I saw it again, and it just boggled my mind, not why it's happening, but that there is a party who seems to stress this feeling.

Before I go further, I do not endorse this candidate, nor am I a Republican, though I am sure there will be some people who read this and think otherwise.

This morning, I turned on the news and saw a clip from a speech that Mitt Romney was giving. After the speech there was a Q & A period. He was asked to explain why he has $1.5 millon in foreigns tax credits. He made the statement he wasn't aware of that, and that his CPA takes care of the taxes. Oh, you would have thought the world had ended the way the news ran with that statement. The political pundits came out and stated how he is out of touch with America. They kept talking about how their shouldn't be any reason why wouldn't know what were in your taxes. I just laughed.

When did it become a bad thing to be successful? When did going out and making money become evil? The campaign against the rich is puzzling to me. People talk about all the tax loopholes that are used to avoid paying taxes. Do they ever mention that when "their" party is in power, that tax laws against these loopholes are never brought up, yet when they aren't in power, it's a major talking point.

So they aren't in power and it's "Tax the Rich". When in power, let's never bring it up. Could it be that the powers that be are rich also and it would affect them in a negative way? Noooooo, that could never be the reason. This is a time about hope and change, they are looking after us, the American people. They would never be so selfish to think about themselves would they?

Who is it that are angry that people are successful. Is it the poor? People who think they entitled to more? Is it people who don't want to get off their ass and attempt to make a better life for themselves? Is it a party that decides to prey on the weak and those in a bad situation? You tell me.

I am working on my pursuit of further happiness. Are these people going to be angry at me because I worked overtime to purchase rental property. Are these people going to be upset because if things work out, I can retire when I'm 55 or sooner? Am I evil because I am doing what it takes to better my family's situation? According to the powers that be, I will. Pisses me off. What it boils down to is, it's the jealousy of America. If you have it, I should be given it. If it can't be given to me, you shouldn't have it.

I would love to hear what y'all think about this. To end, I'll leave with this. In the tv show Good Times, Florida Evans was a woman trying to raise her children in the projects of Chicago. A politician spoke to her and said as long as people like her kept voting for him, families like hers' would have a place in the projects. Her reply??? "That's what I'm afraid of".  Words to think about.

It Pays To Be Sick

Friday I went to the chiropractor for the first time. My wife went as well. As you all know, I am a rather large guy. I have been blessed to very healthy during my life, which in this job field is pretty amazing. So I want to be seen for preventive maintenance. I want to make sure my back can hold up another 10-15 years until I go to nursing school or another direction in life. I had a wonderful doctor who explained everything she was doing and did her best to make me comfortable, which she did. I look forward to going back actually, it was that good of an experience.

My wife has had a couple of health problems in her past and was being seen for one of those problems. She had immediate relief and also had a very good experience with the doctor as well. She had more procedures done than I and will be seen more often that I will.

As we went to settle our bills, imagine my surprise (or lack thereof) when I was told insurance wouldn't cover my visit because I ( as this is my blog, I'll word it the way I like) wanted to make sure I stayed healthy. Whereas her's was covered because she had a problem.

So it costs me more to be seen once a week and receive fewer treatment than to be seen three times a week and have more treatments. I hope I'm not the only one who see's a problem with this.

People scream from both sides of the political spectrum about Obamacare, whether they agree with it or not. I am personally tired of listening to them. As far as I'm concerned, they are all idiots. I have not heard a single one come up with any real solutions.

After a long night of hauling pt's for total bs, and knowing that Medicaid would pay for their bills just made me even more upset. I could go on and on about this, but I am sure many of us in EMS could do the same. I would just like to offer two proposals and see what yall think.

1: Offer a tax incentive to patients who regularly see a dr for preventive maintenance to make sure they stay on the road to health.

2: Eliminate Medicaid fraud by requiring all non bed ridden recipients come to a location to be interviewed and have their records reviewed. OH WAIT!!!!!! Someone already attempted that here in Mississippi and certain people said that was unfair to make them come to an office and talk. Called it discrimination.

Start doing these two things, I health care would become more affordable, I have no doubt. So maybe down the road, it won't pay so much to be sick.

Just my two cents
Gabe

It could be me

Today in the sun, I bid him farewell
A man, a hero, I never knew well
Like many before him, who answered the call
Wearing a badge, he was destined to fall

Though by choice a long life and happy old age
Would he have chosen, had he written this page
But the office he chose never promised long life
Just half of his salary, for his family and wife

He went without fear, in the darkness of night
Bringing comfort to some, to others a light
Easing their pain and calming their fears
He did his duty, never asking for cheers

A husband, a cop, he answered the call
We bid him farewell for he gave his all

author unknown

Today in Pearl, Mississippi, three police officers were shot while serving a warrant. Why they were serving it is not important. Today, two of those officers are in the hospital, while one has gone home to meet his maker. Michael Walter was an investigator for the Pearl police department. Prayers for his family, home and work, are going out as we speak.

As I watched events unfold on the news, I couldn't help but think, that could be me. No, I'm not in law enforcement, and I won't be serving any warrants, but with the job I have, it could have been me not going home to my family. I am in the EMS field along with firefighters and police officers. People don't often think of the "popo" when it comes to EMS, but I have rolled up on a scene to see a officer performing cpr, or holding pressure on a wound. They are part of my family.

Whether being an ambulance jockey, playing with hoses, or writing tickets, there isn't a single person in these fields who wake up thinking, today I'm going to die. Though, I am sure our family members worry about that every single time we clock in.

Do we think we are invincible? Do we think that we are bulletproof? Or is it, that if we think about it, it will affect the way we do our jobs? I'm not sure which category I fall into. I have never gone to work thinking about what could be the worst thing that could happen to me. Maybe it's because I am afraid to think about it.

I read everyday about an ambulance crash, or a firefighter being injured in a fire, or a police officer being killed. I've never personally known anyone to die in the line of duty. I hope I never do. What happened today keeps me thinking. What if??? What if something happens to me while I am on a call. Have I told my family what they mean to me? Have I shown them how much they have guided me? Have I been a good example to my children? Have I said "This is what I want if this happens"?

 There are so many questions with so few answers. Things keep spinning in my head. All I can do is wake up, put on my uniform, kiss my family good bye and be the best paramedic that I can.

I know some of my EMS friends will read this. I am wondering how many of you could have typed this same blog, with the same feelings?. I know I'm not alone with these thoughts tonight. I know I'm not the only one with these questions. I wonder if I'm not the only one who thinks, It Could Have Me? How do handle the thoughts that keep going through my head toni.....will have to think about this later, time to run another call.

Gabe

This is a touchy subject

There are few things that get people going more than politics. If you are an elephant, then you are evil. If you are a donkey, then you are going to hell. This is the reality of our country today. The amazing thing is that so few of us fit into the Republican or Democrat parties. Oh, make no mistake, that most people state they are one or the other, just like I use to do. Forever, I was a GOPer. Breathed, lived, died with whoever the GOP choice was. I'm not sure when that changed, but I am glad it did.

Today I view myself as a Libertarian. The funny thing about this party is how it is viewed by the big two. Republicans call us far left wing, while Democrats call us ultra conservative.Ok, how can you be far left wing AND far right wing at the same time??? That's right, when the big two feel that you are a free thinker. They seem to be scared when you don't fall into one of the convenient categories they have set up. When you express yourself, their people tell you that your views and vote are wasted on someone who can't possibly win. I say, why can't they. If enough people "wasted" their vote this cycle, their candidate may not win, but their voice would be heard. In the next election, if even more people "wasted" their vote, the voice would be louder. Come the next election, is their vote wasted, or has it become a powerful voice where one didn't exist before.

We speak of how we want to leave of children a better future. Yet, when it comes to a better future in directing our country, we ask, which is the lesser of two evils, instead of who represents my beliefs the most. I am proud to say that when primary season came around, I voted that way. He may have received very few votes, but it was what I believed in. I wish more people would do this.

Let me touch on something here, on why I wont be welcomed by the big two.

Why I can't be a Democrat:
I am fiscally conservative
I don't believe in entitlements
Welfare should have a time limit on it
I am anti abortion
I am a believer in the free market system
I don't believe the rich should be taxed more, just because they have made the most of the American dream
I believe Social Security should be privatized
I believe in a strong military
I believe the United Nations is a waste
I believe that homosexuality is a sin

Why I can't be a Republican
I believe Marijuana should be legalized
I believe no court should tell a woman what to do with her body
I believe that the only soldiers overseas should be one guarding the embassies
I believe in war only if we are attacked first or evidence that a forthcoming attack is about to happen
I believe in civil unions, no matter the sex of the partners

These are just some of my beliefs. Some seem to contradict each other and some can argue that point, but I am more than willing to argue mine. I am not ashamed of any of the things I just listed. These are me.

All this being said, you do have a choice. You don't have to wait to November to make that choice. I want to encourage each of you to check out www.americanselect.org  This is a website where you determine who the candidate for their party is. Every state is important, because every state carries the same weight. One vote=One voice. I won't ask you to support a particular person. Just because you support them, doesn't mean you have to vote for them come election time, BUT it may help you find someone who believes as you do. There is no such thing as a wasted vote unless of course, you are voting for the lesser of two evils.

Gabe

Stories, Snakes and Family

Do you have that family member, or group of them, that you don't see very often? The ones that if you run into them at the family reunion, you are able to sit down and just talk the day away, while at the same time, not knowing much about them at all? Yeah, that's what I thought, we all do. Well, a family reunion is one thing, but three days with them is something totally different.

A little about my family. I come from a blended family. Two divorcee's who already had children of their own. My father had myself and two other sons. My stepmother had three sons and one girl. There really has never been a "this is my step-...." mentality. These are my brothers and sister.These people are our family. I love each of them, mainly for the uniqueness that each has. We each have different view points on life, and we have learned to embrace what differences that we have. A little about each....

J: 40 yo brother who is an RN, but at one point was an EMT and firefighter. He has a wife and three children, two girls, one boy. He is a great father who has helped raise some awesome kids.

J: 38 yo brother who helps run a national communications company. He has a wife and three kids as well. Two girls and one boy. I've looked up to him for many years. He is quick with a laugh and a wonderful listener who doesn't judge and offers great insight from an outsiders view

A: 34 yo sister. Her and her husband own their own big rig mechanic business. She is married to my favorite brother in law and have one boy and one girl. We had differences when growing up. We raised our voice a time or two at each other without a doubt. She is someone I love. Christine and I have discussed that if anything happened to us and to my sister in law Dawn, that we would want A to take care of our girls. She is that good.

J: 34 yo brother. He is a SFC in the national guard and works as a recruiter. I hope sometimes, that I am one of the reasons he joined the service. You know, the whole following big brother thing. I wish i had been a 1/4 of the soldier that he is. He has done several tours overseas. He is single and has two beautiful girls. We don't see each other much, but when we do, it seems like only a day has passed when we last talked. Best storyteller I have ever met.

D: 33yo brother. New Orleans police officer. He is engaged with four boys. Yep four. D was injured during a police pursuit two yeas ago when the suspect T-boned his cruiser. He was named officer of the month three times in one calendar year. He was good at what he did. He is no longer able to serve due to his injuries. He is the asshole of the family. He comes up with one liners and zingers that are truly awesome.

M: 33yo brother. He is a produce manager at a supermarket. He is married and has four kids, two and two. My brother is a unique individual. He is a wonderful dad. He is the one family member you just have to meet, because words can't express him.

These are my brothers and sister. We know each other. We hang with each other. We laugh, play, pray, cry and love each other. This is the life, the family we are use to.

Then there is my cousin B. He is 34yo and lives in Boston. He works with computer and is a non meat eater. He hasn't fired a weapon since he was five years old. He has never picked food from a country sized garden. He grew up an hour outside of Houston, TX and an hour outside of San Fransisco. It is safe to say he is a city boy. This weekend, he brought along his girlfriend (a Harvard educated lawyer and fellow city girl) to the family farm near Brookhaven. This was a weekend that I think may have changed the way he looked at family. He has one brother who is the total opposite of him. His father is a very matter of fact person. His mom is a wonderful woman who fits in well with us and we are happy she is part of this family. B though, well Im not sure any of us were sure where he fit in, him included. I am very happy to say I learned quite a few things about him over the last few days. He is a great storyteller, which is a trait in this family. While he didn't know our grandfather as well as we did, he admired him greatly. He enjoys being part of something bigger than just his parents and brother. 

This weekend, was a time of laughs and fun. Anytime you can gather with your family, it should be a joyous time. (I wish Christine could have been there all three days, but she was off seeing South Pacific on stage) This weekend, it was different, but in a very good way. While B has been our cousin, I believe it was these last few days, that he became family. He is a welcomed addition to our family, and I hope we showed him that. If B is reading this, I hope you know that any of us are here if you ever need help with anything. We may not be the wealthiest of people, but you are us, and if its the shirt off of our back that you need, then it is  yours. I hope you felt welcome being around us. I know we can be crazy sometimes, but that is the wonderful part about family, you can be crazy and loved none the less.

I hope we didn't scare him away with our crazy ways. I hope he will consider making this a yearly excursion. I know he would be more than welcome any time.

Its great to have a family as wonderful as mine. My wife, my children. My parents and my brothers and sisters. I am blessed.

Gabe

P.S. The part about snakes....you see, B's gf M isn't the biggest fan of snakes. Sooooooooooo we were asked not to mention that a 5 ft rattler had been killed a couple of days before they arrived. As a gift to M, my brother M had cut the rattles off and presented it to her right before she left. Well, thats how it happened in life, but we are hoping she shares with her friends how she stared down that rattlesnake and took a Kaiser blade too it.

As the Waffle House turns....

It amazes me the type of people who call us for their "emergencies". You would think that after 7 years of doing this, I would be use to it, but tonight was a first. Tonight, someone was arrested for the abuse of the 911 system. Yep, you read that right, someone in the state of Mississippi was arrested for 911 abuse. I couldn't believe it either.

Its sorta sad what this girl is doing, but at the same time, you just want to smack her and say snap out of it. She had been making false abuse reports against her mother throughout the day for assault against her. The patient (and I use this term very very loosely) lost custody of her 5 month old due to drug use and her mother took custody of her. This woman doesn't have a pot to piss in, and yet she is taking in her grandchild to make sure it is raised in somewhat stable structure. This apparently pisses the patient off. I transported her earlier in the day,which was very interesting. She wouldn't let me do any examination, she just talked on the phone. Spoke about how,despite being 14 weeks preggers, she was surprised to have passed her drug test. Continued on about how the cops are out to get her and her boyfriend just because he led the police on a pursuit chase that led to the bf crashing and breaking both his legs.

After speaking to a med control dr, he said to have her arrested. I gave her a shot and said if she called back she would be arrested. The deputy said that wouldn't be needed, as he was handling it right now. This person could not grasp the concept of what she did wrong, with calling 911 or making false claims against someone. These are the people you aren't sure whether to pat on the back or have committed. Well, I know we wont have to deal with her again tonight.....until she gets to jail and starts complaining about chest pain that is.