This really happened

April 29, 2013 by 7 Comments

Some urgent care center called us to transfer a lady to the hospital for observation. “Rule out chest pain” were the notes on the call. Which means someone was dumb enough to say that to a call-taker, and the call-taker was dumb enough to actually type it into the notes of the call.

“Do you have chest pain? Yes?” There. Chest pain has now been ruled in. Fixed it for you.

I digress.

Nurse hands me an envelope sealed tighter than an evidence packet. She walks away. Interested in what findings this dipshit nurse may have found, I follow her out to the desk.

“Can I get a report on the patient in B?” I ask her as politely as humanly possible.

“Everything the hospital needs is in that envelope, and I already called report to them.”

“Oh, okay. But I could use a report, just so I know what is going on.”

“I can’t tell you that. That would be a HIPAA violation.”

—–

Now this is where the old CCC would have said something along the lines of “Come on, lady. It’s a HIPAA violation for you not to give me a report. This is 2013, and you can’t give me a report on a patient you expect me to take care of for the next half-hour? Oh, that’s right. I just ride in the back of my ambulance, twiddling my thumbs. I didn’t spend 3 years in school or nothing.”

But nice CCC says: “Oh, okay. Have a nice day.” As he opens the envelope and begins reading the notes.

Just another miracle of modern medicine. Better living through pharmacology, I say.

 

Filed Under: Customer Service, Lame, Stupid

Silly bird

April 25, 2013 by Leave a Comment

I’m no ornithologist, but I like birds. Springtime is great for birds.

There is a cardinal that has taken up residence in a tree in my backyard. I’m sure he is a nice bird. Probably a good bird-father, a loving bird-husband, and he makes sure he brings the highest quality materials so his bird-wife can make a good nest.

I named him Ozzie, after my favorite St. Louis Cardinal.

But this Ozzie isn’t too smart. I certainly wouldn’t call him a wizard.

Ozzie keeps flying into my windows downstairs. I have a sliding glass door, and he stopped flying into it when I moved the screen. Then he started flying into the other side of the glass, the side that slides.

He flew into that for a little while until I hung some stuff on the inside of the glass. Then he started attacking the window over the sink.

There are three other windows on the same side of my house, in the family room. I think Ozzie has attacked every one of those as well.

Earlier, while I was in the shower, he attacked the window there, too. And that’s upstairs.

All in all, there are are ten windows on the side of my house where Ozzie’s tree is. And he routinely attacks each one of them. Repeatedly. All day. Until the sun goes down.

I kind of feel bad for him, but then, his wife probably thinks he is a stud since he is always fighting off so many other cardinals.

 

Filed Under: Uncategorized

I can’t watch TV anymore

April 22, 2013 by 8 Comments

Watching Royal Pains, one of the main characters is taking care of a person injured at the frequently-occurring explosion in the Hamptons. I don’t know what is wrong with the injured person. There is a firefighter-looking person helping the main character, Dr. Hank Lawson.

Doctor Lawson puts a tourniquet on someone’s leg.

“Good, we have homeostasis, let’s get to the hospital.”

I swear, if I ever heard that on scene, my natural reflex would be a backhand slap to the face.

I recently tried watching this new series on TNT, Monday Mornings. It seems like a cool concept, centered around the weekly meetings that some teaching hospitals have. In the last episode I saw, a drug seeking guy assaults two doctors in a parking garage, causing the prettier one to fall to the ground, obviously sustaining a head injury. I say obviously because of the blood coming from the lady’s ear, and the Battle’s sign that was present before her head hit the ground.

The neurosurgeon with the bedside manner of a rotten cucumber performs a craniotomy that seems to take about 40 minutes. Then the patient wakes up several hours later and begins speaking. She looks ready to go cut someone open again, albeit bald.

No ICU bed. No ventilator. I’m willing to bet the nasal cannula wasn’t even plugged into oxygen.

But the show was based on a book by Sanjay Gupta, so I shouldn’t have expected much.

Last night I was trying to fall asleep, and flipped the television to a showing of John Q. What do I see? This kid on a ventilator, with a tube coming out the right corner of his mouth. He wakes up when Denzel calls his name.

“I can’t talk” he says. While being ventilated. And intubated. Apparently without sedation, either.

—–

And on a similar note, every single time I see an EMS crew on TV moving a patient, they are always going backwards. When is the last time you took a patient on a gurney head-first? And why are the EMS stretchers in cinema never made up with a sheet? Am I the odd man out, since I put a sheet on my stretcher?

I’m sticking to baseball games from now on.

Filed Under: Lame

The Attack of the Nonsensical Policy

April 19, 2013 by 3 Comments

Another stupid motor vehicle collision.

No, it’s not an accident. Accidents aren’t preventable.

4 cars, with damage to their cars that is considerably less than the damage on my daily driver. One dumbass wasn’t paying attention and smacked into the back of a perfectly delightful lady who was sitting at a red light, waiting to turn left. Then two additional dumbasses caused the other damage.

Nobody has any injuries. The first dumbass says her neck hurts. Probably not as much as the tattoo on her neck. She doesn’t want to go.

She signs a refusal. Nobody else has complaints.

“Hey guys, we’re gonna leave it with you.” I say to the fire crew.

“Who all did you get refusals on?”

“Just her. She was the only one with a complaint” I say, indicating the pillar of society on the phone with her lawyer.

“Oh, you didn’t get any more refusals? We have to get refusals on anyone in a wreck.”

I survey the scene, and my quick, rudimentary math counts 4 drivers and 7 passengers. Honestly, I ran out of fingers to count on.

“So you have to get a refusal on everybody in every car that is involved in an accident?”

“Yeah. It’s our policy”

“So if I climb in to one of the cars and sit there, you have to get a refusal on me, too?”

“I guess so.”

“Interesting. See ya later.”

Filed Under: Lame, Politics

Grumpy Geriatric German

April 19, 2013 by 1 Comment

It was obvious the family didn’t want this old lady in the house. She’s had a stroke, and now she is basically trapped in her power wheelchair. They take good care of her, but it seems like they don’t want to. She apparently was “dazed” for a few minutes so they want us to run her across town in rush hour traffic to “get checked out.”

Whatever.

She strikes me as grumpy. Not to us, but to her family members who seem to be completely ignoring her.

We’ve got a long way to go, and I’m curious about where she is from, with her thick German accent.

“What part of Germany are you from?”

“Nuremberg”

“Neat. My family came from Schwabach.*” She is not impressed. “When did you move to the States?”

“1947”

Holy shit.

It dawns on me. She’s 84, and lived in Nuremberg in the 1940s. She was 19 when she moved from Germany.

We spent the next hour talking about what it was like growing up as a teenager in Nazi Germany.

She had incredible, heart-wrenching stories.

She smiled at me when I left and I said “auf weidersehen.” I wonder when the last time she smiled was. I wonder when the last time someone talked to her. I wonder when the last time someone listened to her.

 

*Essentially a suburb of Nuremberg.**

**I can do geography, too.

 

Filed Under: Customer Service, Patients

Disaster averted

March 13, 2013 by 2 Comments

Admittedly, the portion of paramedic school that covered the care of the newborn was short. We didn’t learn much aside from managing either a perfectly normal baby, or a baby that was terribly abnormal.

A friend of mine was relating a story recently. He was telling me about a call he ran that morning in which a mother delivered a baby at home. Apparently the mother wanted a home birth, but the HMO’s obstetrician insisted the baby be transported to the hospital after delivery, going so far as calling 911 for the new parents.

My friend Jeff* was explaining that he arrived a few minutes after the local first responders, and walked into the house about 5 minutes after they did. The first responders apparently cheated by having a station less than half a block away from the house, and also cheated by having their vehicle parked outside, doing their morning truck check-off when the call came in.

Jeff was saying he walked into the house to find a first responder putting the finishing touches on an IV that they had established on the baby. The IV that was established before any vitals were obtained. With the exception of a heelstick glucose.

He mentioned that the baby appeared “completely normal and content.” The parents had already given the baby a cursory bath, and clamped and cut the umbilical cord. The baby was born about 15 minutes before Jeff walked in. The baby was full-term, but had not begun feeding yet.

He didn’t say what the cord was clamped with, and I should have asked.

Another first responder on scene was holding an ampule of dextrose. Not D5 or D10. Not even D25.

D50.

The baby’s heelstick glucose was 49.

They were about to administer, according to Jeff, “half an amp of D50 through a 24 gauge IV of saline.” Until they were stopped by my friend.

The first responder who was about to administer the dextrose had recently finished paramedic school. One would think he would know better, but he wasn’t taught.

Who is responsible for errors when the paramedics that we put on the street ‘don’t know what they don’t know?’

 

*Not his real name, of course.

Filed Under: Case studies, Education, Patients

I don’t like to take riders

March 10, 2013 by 12 Comments

I don’t like to take passengers in the ambulance with us to the hospital. They are a distraction to me in the back, the patient, and to my partner, who theoretically could be referred to as an “ambulance driver.”

Gasp. I said it.

But yeah, I prefer not to take riders. I don’t really mind if a husband or wife wants to ride along, or a parent of a young child wants to ride along, but that’s pretty much where I draw the line.

So we get called to an office tower for a “female in her 20s with difficulty breathing.” I know what you are thinking, and no, it was not a panic attack. Turns out the office was painted or something, and the fumes triggered her asthma.

Poor girl. (She is better now.)

Her boss approaches, wearing an ill-fitting pantsuit with an air of attitude about her.

“I’m going to ride to the hospital with her in the ambulance.”

“Actually, we only take riders if they are family. You are welcome to follow in your car if you would like. Maybe you could give her a ride back to her car when she gets discharged?”

“No. I’m going to ride in the ambulance with her.”

Now, in general, I don’t appreciate when people tell me what they are going to do, I prefer that they ask me. Unless it’s vomit related. Then a person is free to tell me they are going to vomit.

“Well, actually, we have a policy that says only family members can ride to the hospital in the ambulance, I’m really sorry.” I catch the eyes of the patient during this conversation and I can see her trepidation. Something is on her mind, and I have the feeling that I am doing the right thing for the patient.

“I want your supervisor’s phone number!” she yells at me.

“No problem” I say, handing over a business card with the requested phone numbers.

After loading the patient in the ambulance and giving her some medications to start fixing her situation, I ask the patient about her the medications she takes aside from the asthma. She is a healthy appearing woman, so I don’t expect too much.

She starts rattling off medications that sound familiar, but that I don’t hear often. I stop writing, and look at her as her office building begins disappearing from the rear windows.

“So what kind of medical problems do you have?” I ask her.

“I have asthma.”

“What else?”

She hangs her head a bit and her voice cracks. “HIV.”

“How long have you known?”

“Only a few months” she replies, and her eyes begin to water.

We spend the next twenty minutes checking vital signs, talking about what she does at work, and (seriously) the sequestration crisis.

As we pull onto the hospital ramp, she looks at me, her eyes asking the question.

“You aren’t going to tell my boss, are you?” she asks.

“I wouldn’t tell your boss, even if I was allowed to. Nobody here will tell her anything, and they will keep her out of your room if you want.”

She seems relieved, and I am glad that I could comfort her in some way.

—

Somebody tell me that she would have felt comfortable telling me such private information with her overbearing boss ten feet away.

It wouldn’t have happened.

So only family rides.

 

Filed Under: Co-workers, Customer Service, Patients

House vs. Car

February 27, 2013 by 2 Comments

Dispatch tells us the call is for a “car into a house.” In a neighborhood. How this happens, I don’t know, but will eventually find out.

I mean, houses are like, so…big, and kinda easy to miss. But the ability of the general public to do strange things never ceases to amaze me.

Uppity neighborhood. Half-million dollar homes. Three car garages. Manicured lawns. Sidewalks and junk.

We find the home. One of the garage doors is destroyed. With a Hummer H3 amidst the rubble.

Except…the Hummer doesn’t look like it ran into the house. It looks like it smashed out of the house.

Crying and walking around is a young, high-school age girl. She’s on the phone with someone. She doesn’t appear physically injured, so we let her finish the phone call.

Then we find out what happened.

Her parents are out of town for the weekend, and she was late going to meet some of her friends. The garage door wouldn’t open. Neither her remote nor the button on the wall would work.

She thought the best course of action was to drive through the door, so she wouldn’t be late.

I mean, who would have thought to manually open a garage door?

One of the firemen installs garage doors on his days off. He says this is a custom job, and an insulated door. Basically, it’s fancy.

He says some words like “custom” and “carriage house” and “wooden” and stuff.

Ten grand worth of damage to the door alone.

It would be nice to have a rich daddy.

Filed Under: Oops, Patients

The student and the hurt feelings

February 24, 2013 by 10 Comments

I hurt that poor paramedic student’s feelings today. Poor guy. I’m always cordial with students, and nice as I can be. But I was apparently very mean today.

First, I hurt his feelings when I suggested he get some real-world experience as an EMT before even thinking about taking the National Registry exam for paramedic. I know the commercials on late-night TV make this job look easy, and they tell you that you won’t get judged for not working on an ambulance until you have “P” on your patch, but that’s not true.

Then I hurt his feelings when I wrote in his evaluation something along the lines of “there is a lot that happens in the back of the ambulance, but this student wouldn’t know, since he spent the entire 12 hours napping, playing on Facebook, or staring out the back of the ambulance with his hands in his pockets. I guess my suggestion that he spend his time asking questions or reading his book didn’t go over too well.

I hurt his feelings once more when I suggested that he could start an IV if he wanted to, but he had to actually want to try and that it would be his responsibility if (God help us, when) he becomes a paramedic.

And lastly, I hurt his feelings when I suggested his bedside manor was more in line with someone who made a living selling used clothes on eBay.

This ain’t no Sadie Hawkins dance. I’m not going to grab your hand and tell you what to do.

Poor guy. I guess his complaint was warranted, after all.

Filed Under: Education, Lame, Students, Things that bother me

Stop the charade

February 20, 2013 by 3 Comments

Look, I don’t want to be at work either. I come to this place at least twice a week, most frequently on Mondays, and it is always the same thing: a female feeling faint, or with chest pain, or with difficulty breathing.

I understand your boss is a really, really big meany-head, and doesn’t like it when you call out to work because you were hung over the whole weekend, I really do. I get it. I promise.

But every time you call for something like “feeling faint” or “chest pain” or with “difficulty breathing,” we send a fire truck, an rescue truck, and an ambulance to this place.

Ten people, eight EMTs and two paramedics, in 3 vehicles, for one person who just doesn’t want to be at work.

And when you call with one of those complaints, we have to send all those people to this place because it might actually be an ALS call. Then we have to start lines, do 12-leads, give aspirin and nitro, and the hospital has to waste their time doing the same thing.

And I know there isn’t anything wrong with any of you. I’ve been coming here weekly for years. Literally, years. I could drive here in my sleep. It’s like a giant room full of women crying wolf.

So I propose a deal: I will continue being the jovial paramedic who is genuinely concerned for your well-being, and you stop complaining of these things. How about “back pain from a kidney stone” or “nausea” or “pregnancy problem” or something that is BLS, but sick enough for your boss to believe your story.

I will still bring the stretcher to you, because we all know you can’t walk. I’ll still take you to the hospital, and they will still give you a work excuse, and your friend can also get off of work to come pick you up from the hospital, and you can both be back at your house in time to catch Judge Judy.

Stop the charade.

Filed Under: Customer Service, Lame, Patients, Things that bother me
«Older Posts
Newer Posts»