One day...

One day you’re gonna want that girl. that girl that knew she wasn’t perfect, but tried to be perfect for you. the girl that believed the scraps of you she was given were worth it, because something was better than nothing. that girl who wanted nothing more than to be there for you, and loving you was the only way she could. the girl who sees your flaws, but values them as much as your strengths. that girl who still can’t bring herself to hate you, even though sometimes you probably deserve it. that girl who saw past your pretty eyes and treasured parts of you that no one else has ever appreciated. the girl who realizes she may never have your heart, but will carry the image of you in hers forever. the girl that sees this and still loves you.

what would you do? interesting case...

Had an interesting call this shift. Got dispatch Class 1 for an ill person (gotta love those!) Pt wife states pt was sitting in the recliner after dinner and was fine she went outside for a little bit and came back in and found him "sleeping" in the chair and then she tried to wake him and was unable to do so, so she called 911, stating he was unconscious for 5-10 min before we got there. Upon our arrival pt was awake and sitting in chair, pt appeared to be aware of what was going on but was unable to talk. Pt had a pituitary tumor 5 yrs ago and recently the doctors found another mass this time to his left frontal lobe, took a biopsy last week, pt still has sutures in from biopsy procedure, suture site looks healthy. Pt VS are all WNL and I worked out communications with pt by asking yes/no questions and having him squeeze my hand once for yes and twice for no and again he seemed like he was aware of what was going on but just couldnt talk! Blood sugar was 143, no facial droop or arm drift, pt could stand and pivot to stairchair and then again to stretcher with a steady gait. So I took the pt 50 miles (telling my driver I wanted an easy ride, but not to fiddle faddle around either, to use lights and sirens if needed) to the hospital where his biopsy was done instead of the local hospital.
I dont know if I didnt sound sure of myself or what but the triage nurse seemed to focus on the fact that he couldnt speak and the onset time of that and immediately jumped to stroke, and she completely ignored the fact that they had drilled into this mans brain a week ago...so she called a stroke team member in who performed the same tests I had done in the field (looking for facial droop, arm drift, or weakness in extremities and checked his pupils/gaze) and stated "this is not a brain attack". Seriously? If I had compelling evidence this was a CVA I would have flown him instead of taking him an hour by ground considering he was almost an hour and half into the episode. Maybe Im in the wrong here, maybe I was being egotistical, but I did comeplete my assessment, several times, in the field and assumed this was an issue with the mass/tumor they had found recently.  Upon arrival of the hospital the pt could answer "yeah" and "no" to questions but was still unable to even state his name.

What would you all have done? Taken him an hour by ground or flew him?

weigh in #4

Weighing in at 294 this week....Im starting to slack....a lot....and to top it off Im not having a good "mental health" week either....

I was having a conversation with a long time friend of mine that I met in the very beginning of my EMS career and I have to say I got very defensive for the first time in a while. I started in EMS in a very rural, small town. My hometown consists of a town of maybe 6000 folks in the city and thousands more in BFE. The average time for a call can be anywhere from 20 min (in town) up to hours long in the country. The nearest trauma center is an hour and half from town by ground on a winding back road or 2 hours on the straighter main road (depending on where in the county you are) while the local ER has a grand total of 6 beds, the next closes hospital has a 3 bed ER...you get the picture. From there I joined the local FD where I went to college, and while the pace was a littler faster it still wasn't much, we averaged 700-800 EMS calls a year and the local hospital had up to 12 beds and the local trauma center was only 45 min by ground. Now I work for a hospital based medic truck that averages about 3000 calls a year and well, I have to say I have tested the waters with city EMS, I did practicals in school in big cities, and did some ride time with my part time job in the city and it's just not me. I enjoy having the longer transport times and spending a little extra time with my patients.

Anyways, I was on the phone with this friend and he put down the fact I worked in rural EMS. This is not the first time he has done this, he has several times and it finally got to me. I have gotten this attitude from several "big city" EMS folks, like they are better because they run 20+ calls in a 24 hour shift and I might run 5 calls or I might not turn a wheel. Just who do they think they are? It really irritated me. It does not make me any less of a medic because I work in a rural area or because I like  it.

That is all...thanks for the steam blowing!

weigh in #3

Weighed in last night at 292lbs....but I also cheated a bit this week... :/   Im gonna do better this week...heck I even walked to work 3 of my 5 days this week!

weigh in #2

Finished week 3 of the new meal plan and an happy to announce I am weighing in at 293 today! This makes a grand total of 23 pounds since Christmas and 7 lbs in the last 3 weeks.  Now if I could only motivate myself to start doing some physical exercise I know I could lose more weight and maybe even build up some strength and stamina...

weigh in #1

Ok, its been 2 weeks since I started this new healthy lifestyle eating plan. I am weiging in today at 295. Thats a 5 pound loss. Not too shabby if I do say so myself..... I have been doing pretty good on this plan, only had one or two occasions where my will power lost, but I didn't go crazy with it. Now if I can just motivate myself to get more exercise in this new lifestyle...I need an exercise buddy that will call me out and make me accountable, Id be happy with just a walking buddy 3 days a week....I simply need to get off my lazy butt.....

frustration

Sorry its been so long.

My roommate/best friend has been sick for the last 5-6 weeks, something to do with her GI system, they are thinking gastroparesis. Meanwhile since she has been sick she has been unable to work. We have been dealing but its getting to the point that Im not sure what we are going to do. She has not worked in a month. She knew that no working=no income. She is working on getting a temporary disability which will include rent assistance and such. I talked to her tonight and asked what our landlord said when she talked to them. Guess what...she hasnt yet! Rent is due in 4 days. I knew she had been waiting to hear from the assistance office, but our landlord is expecting rent, paid in full on the 1st. I am not mad that she is sick and can not work. I am mad that she hasnt taken the initiative to straighten things like this out. It leaves a lot of pressure on me. I have been working a lot of hours in hopes of putting some funds away in savings for emergencies and for vacation. She is my best friend, she is like a sister to me. I know she is frustrated, but this doesnt affect only her. I am trying to be as supportive as I can, trying to keep her from getting depressed, but I cant do it anymore. Im too tired. Physically tired, emotionally drained....I dont know what to do...

no regrets

"Eat that damn chocolate cake, get your hair wet, love someone, dance in those muddy puddles, tell someone off, draw a picture with crayons like you’re still 6 years old and then give it to someone who is very important to you. Take a nap, go on vacation, do a cartwheel, make your own recipe, dance like no one sees you, paint each nail a different color, take a bubble bath, laugh at a corny joke. Get on that table and dance, pick strawberries, take a jog, plant a garden, make an ugly shirt and wear it all day, learn a new language, write a song, date someone you wouldn’t usually go for, make a scrap book, go on a picnic, relax in the sun, make your own home video, kiss the un-kissed, hug the un-hugged, love the unloved, and live your life to the fullest. So when you’re standing in front of heaven’s gate that chosen day, you’ll have no regrets, no sorrows, no disappointments."


THIS (found this at "and it's love" tumblr)

oxygen, harmful or not?

Im pretty sure oxygen is a good thing, in the majority of cases anyways. In the last 24 hours I have had 2 encounters where I thought a bit more O2 would definitely be a good thing, but was contradicted by providers with more schooling than me.

event #1:  severe asthmatic comes in to the ER and we take them straight to a bed, I pull out a duoneb treatment (cause it takes respiratory a few min to get downstairs after someone calls them) and give the pt a neb via mask on oxygen when the RN tells me "no, use the medical air"...what?? When she sees my confused look she says they normally use medical air, and I inform her we (the medics) use oxygen, pt got the neb via oxygen in the end....

event #2: 20 something y/o male, intoxicated, took a swan dive head first 6-7 feet into a cement trench. Pt unconscious and unresponsive, lac to right temporal, no active bleeding, pupils round, equal, but non reactive to light, pt breathing 12 times a min but shallow with snoring resps, lung sounds clear and equal, O2 sats at 02%, pt resps assisted via BVM, when OPA was attempted pt clenched down. 2 large bore IVs established,  24 min from on scene time to completing extrication of pt from the trench via stokes basket. Upon arrival of flight crew I asked if they wanted to RSI and they replied "no, he's breathing on his own".

I dont know if they were concerned with increasing the ICP, but found it interesting they opted not to intubate. Follow up of the pt was pt had an open fx to right temporal area, several closed fx, an epidural bleed to right temporal lobe and a parenchymal hemorrhage.  Pt was intubated at trauma center upon arrival. Pt was extubated approx 8-10 hrs later and is now alert and oriented but still in ICU at trauma center.

What do you all think?