Wednesday, May 9, 2012

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"

Monday, May 7, 2012

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.

Sunday, May 6, 2012

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

Tuesday, May 1, 2012

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