Tuesday, July 31

What is a Paramedic?

I have often been asked this question in so many words. Sometimes it's "what do you do?" or "What's the difference between an EMT and a Paramedic?" or "do you just drive fast?" I have even had the occasional "hey, are you an idiot" question threw at me especially after explaining the crazy schedule an average paramedic works.

I would wager that some of you reading this can't even explain the role of a paramedic in todays healthcare system.

Lucky for you. I have decided to begin a series of post on the true nature of a paramedic. This isn't going to be a rambling journey through war stories but a true attempt to explain the profession I am currently in and also some conjecture on where I would like to see this profession progress.

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Monday, July 23

Not Worth a Title


I find it very difficult, most if not all of the time, to control my cravings for food. I am not an obese person but I do eat things that I shouldn't. Not only is this bad for my body but it is bad for our bottom line too. It is nearly impossible to eat out for Supper, or even lunch for that matter, under ten dollars a person. This is a very bad thing when I kind of have the money but kind of don't and a craving for Mu-Shu-Vegetables or a fish sandwich take complete control over my brain. What am I supposed to do? I just can't control the urge.

I don't consider myself a weak person by no means but this is certainly my vice. I guess I will wonder through life forever afraid of my overwhelming cravings.

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Thursday, July 19

Just Fucking Stop

Got your attention?

I do not understand what motivates someone to call 911 while driving down a residential street to explain that a person "seems to be having a heat stroke" but doesn't stop and speak to that person. Is it that hard to pull over and say "Hey, what's your problem?" Are you afraid that the person will ask for help or does the simple call to 911 make you feel like a good Samaritan. Because if it does you are badly mistaken! Badly. Mind your own business or actually help. Don't be a half-ass just to stroke your ego.

On another note. The past week or so has been stressful. I have changed partners, not by choice, and we get along well enough but there is still a learning curve. My previous partner and I worked together for a year. When we were taking care of patient's most of the time we didn't have to even speak. During emergencies it is important to bring order to chaos and it's much easier when you can predict the actions of the person that you are working with. I am having a hard time predicting this guy. I know the more we work together the better it will go but this week we have been thrown to the fire.

About an hour before shift change ( I was still asleep) the tones blared and we responded to a possible DOA. We arrived and soon found out that the patient had not died long ago and we made a futile attempt at resuscitation. Unfortunately, the area we working doesn't have very effective first responders especially in the mornings. Basically, we ended up working the entire code by ourselves.

Other than that I have been putting way to many hours in at my part-time job. I am probably averaging 80 hour work weeks. This alone can be very stressful. One year left.

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Saturday, July 7

One Year

By the way. Happy one year anniversary to this blog.

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Blogsphere Sample

Not much going on today so I thought I would amass some samples from various blogs, so here goes.

  • Creating the God Complex answers some questions from his readers on his installment of Questionable Admit.
  • The Surgeonsblog, which happens to be one of my favorites, crawls onto a large box of soap and delves into health care reform on More Solutions, Long Post
  • For a little airier read check out Sara in Israel. She's tackling some interesting things from the viewpoint of a helicopter and it does sound like Sometimes, its cool to be me.
  • Midwife With A Knife conjures up some OB wisdom on a regular basis. A New Approach to Call affords a sneak peek into the dreaded delivery room and beyond.
  • P4P, the new buzz term. You'll just have to read it.
Ok, that's enough for now.

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Friday, July 6

Road Bike

I am buying a road bike. A Caloi to be exact. It's the model that was built for the Motorola bike team in the mid 1990's. Some of you may recognize the team probably because Lance Armstrong began his racing career with them during the time this bike was used. triathlons here I come!

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Wednesday, July 4

Little Old Lady

The computer screen shows an ekg. The phone rings and a woman answers. She sounds frail, old and intimidated. The technology she holds and wears is unfamiliar and the technician who is on the other end of the line is indifferent.

Earlier today she felt a "flutter" in her chest while riding a crowded bus and it scared her. She lives by herself and she couldn't help but wonder what she would do if this happened when she was home.  She finds herself afraid much more often now since her husband of 50 years died.

She called her doctor's office and they made an appointment for her immediately. Everyone on the bus said she should go straight to he ER because they were scared for her but she wanter to see HER doctor not a stranger in an overcrowded ER.

She changed her plans and continued on the bus until she arrived at her doctor's office. As she walked into the non-assuming building she felt much calmer and she even looked forward to seeing someone she new would listen.

The receptionist seen her coming and rolled her eyes as she spoke under her breath "I don't have time for this."

As the glass door opened the lady behind the counter curtly explained that she should sign in and because she was a "call in" it would be a while before anyone could see her.

The frail lady stepped into a crowded waiting room and sat down. An obese lady sitting next to her coughs and looks uncomfortable in the small seat. A small child walks by wiping his nose on his shirt while his mother grabs him by the arm and scolds him for not "acting sick."

The needy continue to file through the door and briefly pass the sliding glass window and continue to their seat, to wait.

"Ms Big Pants" the nurse calls and the obese lady stands, coughs loudly, and slowly makes her way through another door where she expects to feel better.

"I've never waited this long before" the little lady thinks but she still is confident in the fact that her doctor will be there to comfort her and tell her she is going to be ok.

Finally, a nurse steps out and calls her name. She stands, shaky, and walks through the door into a white, quiet hall that has several generic wooden doors. The nurse stops, opens a door, and ask her to have a seat on the table. The nurse takes her blood pressure and pulse then walks out. No one has spoken.

A nurse practitioner opens the door and begins to speak. She takes a history and asks questions while she types on her laptop. Little old lady tells her story and the NP leaves the room while the lady waits for her doctor.

A technician enters the white room with a picture of a beach hanging on the wall. The tech puts one of a thousand heart monitors on the old lady and explains that she should call the number written on the front of the monitor and ask them what to do next.

He turns and shows the lady the way out. "Don't forget to stop and pay your co-pay on the way out" he instructs and opens another generic wooden door disappearing into the white.

Fifty dollars later she steps out into the street with no purpose. Luckily, it is only  July 3rd and she has a few more dollars in her pocket to get her home. She takes the bus because there is no one to call.

The monitor she is wearing begins to beep and she remembered that she was supposed to call the number on the front of it and decides to as soon as she gets home.

"I wonder where my doctor was today" she thought. Disappointed and looking for someone to speak with, she begins to look forward to calling this number in hopes of speaking with someone that will explain why she couldn't see her doctor today.

The bus drops her off and she steps onto her yard and into her home.

she picks up the phone and calls the number and begins to ask the person on the other end why she didn't she HER doctor today. Before she can finish the question the technician explains that they don't work for her doctor and they don't have a clue why?

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Sunday, July 1

Rated R

What's your rating? Check out this website and rate your blog.

I got the big R and I am proud of it.

Online Dating

Mingle2 - Online Dating

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It's Not My Problem

I had the opportunity to shadow an ER physician the other day. Before shadowing him I was always impressed by his ability to quickly identify and prioritize emergencies and care for them appropriately. I even liked him personally. Don't get me wrong I still like and respect him because he is a good person as well as an excellent EM doc. However, I did see something that made me question not only his thought processes but EM in general.

"It's not really my problem, it's not an emergency."

The patient was in his mid-thirties complaining of severe groin pain that hasd smoldered over the past couple of days and peaked earlier today prompting this ED visit. Dr. Cool explained that the emergent condition, the one he could treat, was a testicular torsion, however his gut feeling told him that it was Epididymitis.

In this case, luckily for the patient, it was not a torsion. He would get an antibiotic and be on his way. In and out, that's the goal.

In the mean time Dr. C ordered some blood test and an ultrasound of the guys nuts. We wandered around and seen a couple of other patient's. Finally, after the blood test and the ultra sound returned everything was reviewed and a dx was made. It was in fact epididymitis, the testicle wasn't injured and it also had unimpeded blood flow. However, the patient's creatine was threw the roof. Dr. Cool looked back at the patient's past history and noted that the patient was not having problems urinating and never had.

He then discharged the patient without mentioning the fact that his blood test were not normal.

Is this a big deal?

I personally trust this doctor and believe that he would not do something to harm someone. What bothers me is the fact that we all know that even the best doctors can become indifferent when so much pressure is put on them to move people in  and out like cattle.

From someone looking in from the outside it almost felt like Dr. Cool was ignoring something because it may increase his workload just because it may not have been an emergency.

On one hand I completely understand why this happens and the patient's health beyond a life threatening condition is their problem. However, I do think the test results should have been relayed to the patient with hopes that the patient would follow-up with their primary care provider.

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