Sunday, June 29, 2008

When the Levee Breaks...

... heavy rains and an 18th century infrastructure- and the Mid-West is underwater.
2000 years ago the Romans built with stone and mortar- today we build dams out of mud and blame the muskrat when they fall down.
Not much different than our health care system.

Stay safe- Pedro loves you.

Friday, June 27, 2008

EMS Scheduling...

... to continue with the fatigue factor in EMS, let us examine the EMS schedule as a contributing factor- a factor that leads to dangerous performance levels and a loss of quality of life. Below I've typed out my actual schedule for the upcoming two weeks - I'm sure that EMS personnel will see nothing unique about it- that is just the way it is- schedules made with no rhyme, reason or consideration for the health and welfare of the Paramedic (or EMT)...

M-1100-2300 T-1100-2300 W-1500-2300 TH-0700-1500 F-off Sat-2300-0700 Su-off

M-0700-1500 T-off W-1100-2300 TH-1100-2300 F-off Sat-0700-1500 Su-off

* Note week one- evening, daytime, overnight and back bright and early the next Monday!
* But at least we're off the 12 on, 12 off schedule!

Thursday, June 26, 2008

Fatigue Is A Factor...

... If the average EMS customer, the sick guy on the street- or his/ her family, was aware of the fatigue level that the average Paramedic is working at they would be terrified. Terrified.
The question becomes- well, I'm too tired to drive, am I too tired to attend to the patient? Or- should I just suck it up, wake myself up and try to drive this damn thing through town to the ER?

As an aside- I have fallen asleep in the cab of the ambulance- at a light, with a critical ALS patient in the back.
My partner and I repeated this at another light on the way back- we both dozed off. Slept through at least one cycle of lights...

... who should have been in back then?

12 on, 12 off- Kill yer staff, cover yer schedule.
12 on, 12 off.

Sunday, June 22, 2008

Junkies Always Lie...

... The truth is the first thing junkies give up- junkies always lie. Always. Let me repeat that- and if you are a parent, grandparent or otherwise close to a doper please take heed- JUNKIES ALWAYS LIE!
Everything that comes out of their mouths is a lie- if you talk to them long enough, they will begin to lie about their lies.
Because junkies always lie.

Wednesday, June 18, 2008

The Way of the Dinosaur

I am pretty sure that most of the people in EMS who know what they're doing are already gone- feel free to correct tense and grammar if you must but- you know it's true.
Let's get rid of the Star of Life and make the new National EMS symbol a Dinosaur eating an ice cream cone... sound right? Sure it does... it's not that the old folks are taking over EMS, it's that the old thinkers are staying in- and pushing every one else out or away- everyone except a future generation of slow moving, slow witted Dinosaurs.
So, you tell your good friend Pedro what is your service doing about retention in this time of Paramedic and EMT shortage... probably like mine, nothing other than- treating staff like crap, putting out schedules that don't support a healthy lifestyle and then, crying when only seven people in a major metropolitan area answer the call and test for (in the case of my service) 32 open positions. Oh, no no no- Pedro did not make a typo- that is 32 open positions- and seven applicants- just think what the smaller services are going through. Some of the EMS managers may have to curtail whining, stealing, embezzling and call dodging long enough to confront the issue. Nope- let the plunder continue, the EMS provider shortage get ... shorter, and when there is no one else left in EMS but the Dinosaurs they can all sit around in a meeting somewhere and lament the fact that "they were all assholes- the hell with them- it's just a cycle- they'll all come crawling back."
Yup, it is a cycle all right- every one is leaving EMS- everyone except the Dinosaurs...

Things we've overheard...
"ahh, umm, well, I just drive..."

Sunday, June 15, 2008

Day of the Doper (Again)

... shifts seem to have themes- car crash day, cardiac arrest, breathing etc, etc, etc... Today it's been dopers with problems- a crack user who got beat up by her Grannie for stealing money, a pill junkie with- what else, a sore back, and a nice couple we had contact with at the bus station- they wanted to get their teeth checked and "Can you give us sumpin' for the pain?"... nope...
... So I felt pretty good when I took a little break, called my Dad and told him I loved him- hope you got to do the same...

Self Defense...

... self defense and EMS- almost always focuses on avoidance... and it should. Learning to avoid trouble or run from it intelligently, well that's just good common sense. Stuff that could save your life.
What if you can't run- you're trapped, caught, cornered and fighting for your life... take the following with a grain of salt- it's from a man who grew up in a tough part of town and makes his living on the streets...

  • No matter what-always look for a way out
  • keep cool- call for help
  • Facing a gun? Take cover- even a couch or other barrier sets up a psychological barrier to a shooter... call for help, get out!
  • A knife? Run man... can't run? You need a weapon- O2 bottle, House bag, kitchen chair... rule of thumb- fight a blade and you will get cut... and you will bleed. Don't stop trying to get away and don't stop fighting
  • Hand to hand? Number One- do not go to the ground with your assailant- never, don't go in low and get trapped. Remember- eyes, nose, throat and testicles. Multiple strikes at a sensitive area are better than a wheel house swing and a miss. If your finger ends up in an eye- push it in, all the way- and then run like hell.
  • In the wrong hands anything becomes a weapon- do not forget that.
  • You are important- your family needs you- do not go soft in the face of a struggle you are not allowed to escape.
I'm just a working guy like you- seek qualified professional help in this- might save your life...
... or mine...

Pedro loves ya'

Sunday, June 8, 2008

The American Health Care System Revisited...

... 1407, dispatched for a cardiac arrest- about two blocks from the scene we spotted the local police (and their AED) parked up a side street- waiting for us to turn the corner and then, on come the red lights, the siren and the "You guys alright here?"... Yup, take off, don't need you. Some of those guys are more useless than the volunteer EMT's on our Citizens Advisory Board- stay out of the way... Oops, Dispatch- get the PD back, Pedro's callin' the arrest and we need the coppers to babysit the body...
... Later that shift we stopped for food, the local Veterans Group had a booth set up outside- they're taking donations for one of the younger members, Iraq vet with uncovered medical bills and procedures that still need to be done- and they're selling tickets to the obligatory Oldies Dance/ Spaghetti Dinner- eat up folks, Danny Boy needs a new kidney and gots no insurance...
1722, MVC- about six people involved from two cars- all the folks from one car stood around holding their necks, while everyone from the other car cried, I mean really sobbed... No one hurt...
1901, called for a guy having an asthma attack- works a forty hour week at the local Garden Center- no insurance. Usually shares an inhaler with his girlfriends Mom- and I guess it was her turn to have it today... gave him a breathing treatment and got him to the ER...
... not much to say about the rest of the shift- an intox, a guy in jeans and a flannel shirt who thought he was going to pass out- hey dude- it's 92 degrees out, skip the layers today...

Tuesday, June 3, 2008

Observations On American Culture

... I'm still on the Response Truck, the QRS... can't say I'm unhappy about the assignment- it's a pretty good detail.
Today I was sent into a lower middle class, urban area for a call at a doctors office- called off enroute so I pulled to the curb about 100 feet from a bus stop to catch up my call log before heading back.
What caught my eye was the group waiting for the bus- two dudes about 25 to 30 years old, a Mom with a 3 year old and an old guy, 75, maybe 80- still in good shape, kind of reminded me of Popeye.
Now what made this a micro-cosmic bit of Americana? Well, the bus pulled up- the two young guys pushed past Popeye and the young Mommie and her child- but Popeye, he quietly, with a gracefulness practiced over a lifetime, stood aside to let moms and child get on the bus first. His generation would never have shoved aside a woman, child or anyone else to get through a doorway, off an elevator- or onto a bus. Popeye grew up holding doors open- it was considered rude and disgraceful to push past. Now, the ignorant go first, texting and cell phoning. ( "yeah, I'm getting on the bus, where are you... uh huh, yeah, I know... right, I'm on the bus, you know...uh huh")
And, that is what's wrong with you people- you have lost your grace, your civility. Surrendered it to lard rage and ignorance ( wha? She wha? Huh? Wha?)
Mmmm, lard- now that's good eatin'...

Sleep well America... Pedro the Paramedic loves you.