EMS NEWS

I am notorious for carrying nothing on my person except for a pen when I go to work. So many people at my job feel it’s necessary to carry trauma shears, tape, bandage scissors, a pager, a cell phone, a wallet, a stethoscope, and other garbage on calls. I can only attribute it to a lack of confidence. If your “jump bag” or whatever you want to call it doesn’t have what you need inside of it, why even bother having one?

I go through my bag each morning, so if I ever need a piece of equipment, I can reach for it, without having to carry it on me for 24 hours. I have never been in a situation where I’ve needed something that I didn’t have with me on a call an couldn’t find an alternative.

Pens seem to materialze out of nowhere when I need one. The only thing I really can’t forget on a call is my glasses, because I can’t read house numbers at all without them anymore. And I can’t afford Lasik on an EMS budget.

I’ve had the opportunity to scope out several of the ambulance/fire departments in our area (Northwest Indiana) and I would like to tell you a little bit about each of them. I’ll even rank them in order from worst to best, because I’m just that nice.

Prompt Griffith Base - This base consists of a room in the basement of a delapidated funeral home. There is an old couch, two twin mattresses, a TV, and a garage. There is no oven to cook with and the place has an odd smell to it. I’m surprised it hasn’t been condemned. Add to that the fact that you may walk upstairs and find a corpse, and you’ll see why I rated it the worst in the area.

Prompt Dyer Base - Half of an old industrial building. The ambulance is kept in a garage across the parking lot, lengthening response times. There is a small TV and lots of furniture that’s falling apart. Again, no oven to cook with. You also have to deal with the train 50 feet from the building. This would be worse than the Griffith base except for the much lighter call volume.

Prompt Munster Base - A rental in an industrial complex. Has a large garage which is nice. However, the building is infested with ants, centipedes and spiders. Has a shower, but again, no oven or kitchen of any type. Also has some horrible outdoor lighting that is hard to drown out at night.

Gary Fire Station 8 - This was probably a nice building in the 1930s when it was built. There is a kitchen, but no air conditioning downstairs. The furniture is completely destroyed.

Gary Fire Station 7 - About the same as Station 8, but with worse furniture. The furniture was this horrible crap covered in cracked vinyl revealing the foam underneath. Not sure if there was a kitchen, but I wouldn’t have wanted to eat in it regardless.

Cedar Lake EMS - The building is probably very nearly condemned. However, the garage has a drain, and there is a full kitchen, which makes up for the poor appearance and the drab bedrooms.

Crown Point Fire Rescue - Not bad, just very dull. Theres a big cafeteria style kitchen with a TV and a pool table. Two day rooms with small TVs, and an upstairs which I wasn’t allowed in.

Tri Creek EMS - Starting to get comfortable now. A big living room with comfortable couches and an older big screen TV. The kitchen is large and has an oven and 3 refrigerators and storage space for all 3 shifts. Lots of beds and a showering area. Certainly could do worse.

Portage Central station - Pretty nice. Large kitchen with several refrigerators and new appliances. The living room is big with about 8 recliners and a couch and a big screen TV. Each employee gets a private bedroom with a door. There is a gym onsite with a decent selection of equipment. I’d rate this one higher except I had a certain feeling about the place that you should never be comfortable.

Newton County North base - Very nice. Like living in a house. Bedrooms with comforters and linen. Huge shower/bathroom. Big heated garage. Kitchen with an island and a dining room table with nice lighting and comfortable couches and recliners to sleep in.

St. John Fire/EMS - Also very nice. Large dayroom with huge flatscreen TV. Gym onsite. Private bedrooms also with flatscreen TVs in each. Brand new facility with kitchen and new appliances.

Believe it or not, I used to be quite the little athlete. I was a champ at little league in the 3rd grade. I was one of the younger players, and was much smaller than the other kids, so I quit after my winning year.

I was also quite into golf. I had my own clubs and golf bags and played every Sunday for about 6 years. My problem is that they never let the kids use golf carts, and I hate walking. More than that, I hated carrying that damn bag of clubs.

My physical activity nowadays is limited to walking the dog and carrying fat people down the stairs.

I work in a town full of really old people. 3 out of every 4 calls we get are old people falling down.

That commercial really makes me cringe. The few Life Alert calls I’ve ever had are the most annoying calls I’ve ever responded to. It tends to be used just because someone needs attention rather than any pressing medical need.

Or they roll onto it in their sleep.

I wonder if they work in the shower? (Or on a shower stool, since the elderly can’t be trusted to do anything standing up.) I think it would be pretty amusing if they couldn’t get wet, because that’s primetime for falling down.

I present to you Doug Stanhope from an early failed comedy series.  The skit is Drunken Paramedic.  I cracked up when the black guy turned him in over the radio.  Give it a watch.

Also, “One to two inch incision” instead of “1/2 inch incision” is pure gold.

I don’t get many crackheads at work.  I can only think of one within the last few months.  Crack isn’t really prominent in suburban white America (where I work.)  What IS prominent in suburban white America, is falling down, breaking a hip, drinking over the age of 80, and heroin.

We currently have one repeat overdoser.  This varies, sometimes we have 3 or 4, then they die, get locked up, or get kicked out of mommy’s house.  This particular kid is 23 and his parents only real concern is the amount of money the ambulance charges everytime we get called to pump him full of Narcan.  (They could have paid for a few stays at a drug treatment center from the number of times we’ve been there.)

We also had a doozy a few shifts ago.  A 50-ish caretaker of an old man decided to sneak a few of the old man’s Oxycontin and then no one could figure out why he couldn’t wake up.

Today was one of the most stressful days of my life.  I took my paramedic practicals for the national registry.  I’m not big on studying.  I probably studied a whole 2 hours total. 

AND I PASSED EVERYTHING ON THE FIRST TRY!

After nearly 4 years of continuous EMS education, I am down to 2 more days of class and just a handful of clinical hours left.

While this year has gone by quickly, I also feel like I have done nothing.  (Except getting married, of course.)  We took some nice vacations, but in between vacations has just been a blur of disgusting elderly people wanting me to carry them around.

Here’s hoping 2008 will be my year to par-tay.

Here is a non-comprehensive list of places that I have dragged an old person out of.

1. Wedged between a wall and a toilet.

2. Wedged between a wall and the bed.

3. Wedged between a wall and an easy chair.

4. Sitting directly in front of an easy chair.

5. In the tub, naked.

6. On a toilet, naked.

7. On shower chairs, naked.

8. In the kitchen, naked.

9. In the driveway covered in snow.

10. Under a van.

I think it’s a prerequisite that old people be naked when we pick them up.  If they aren’t naked when they call 911, their relatives strip them down right before we get there.  It’s a mystery. 

About once or twice a month we get a call asking us to locate some piece of clothing or an ID card or jewelry that a patient lost.  99.99% of the time we don’t have it.  Do you know why we don’t have it?  Because our ambulance is a very very small box and anything that is out of place in it is immediately noticed.  A gold chain is going to stand out among the blue vinyl or diamond plate flooring.  There just isn’t anywhere for these things to go because an ambulance is made to be easy to clean, so there aren’t many nooks and crevices. 

My theory on this is simple.  The hospital lost this stuff, and the nurses don’t want the patients to get nasty with them, so they blame us, because we aren’t there to defend ourselves.  (Or the patients never had it to begin with, which is also common.)  They have been in the hospital for a week, but the item just HAS to have been lost in the ambulance.

So please keep this in mind next time you are asked to locate an item from a patient you took in a week ago. 

Tonight marks the second time I’ve taken PHTLS and I’m pretty sure that nothing has changed in the past few years.  The class was pretty useful the first time around.  I learned a lot about kinetics and transfer of energy.  I also learned about the three impacts of a car crash, and cavitation, and the types of injuries associated with different types of accidents.

The thing that gets me is that our treatment isn’t going to change one bit depending on any of this.  I mean, it would be great to know if I was a surgeon, or an emergency department doctor looking at a CT scan.  In the field, all I can do is immobilize what I can see, start an IV, and drive fast.  Whether they have hollow organ injuries, a C-3 fracture, or a subdural bleed, I can’t do anything but immobilize and give fluids.

One of the more common reasons we are called to someone’s house is old age.  Old age is not an emergency, but when you’ve got 2 old people living together and they can’t do things for one another, we have to step in and drag someone to the hospital.  These calls almost always come in first thing in the morning or late afternoon, which is fine. 

Of course, no one is going to say “my husband is old” when I ask what the problem is, so we usually hear something like he’s “going downhill”, or “I can’t get him to the bathroom”.  (at least half our calls start with someone on the toilet.)

Anyhow, last shift we got a “going downhill” call.  I looked at my Blancpain watch and saw that it was 1:00am.  Who decides at 1 in the morning that their 90 year old husband is suddenly too much to handle?  Surely he was a handful at 7, or at noon, or probably anytime in the past 30 years.

FNG’s are ever-present at my job.  If you don’t know what an FNG is, think “new guy”.  Because I’m stuck at a private service for the next few months, we get brand new EMT’s every month, usually 5 or more.  We have huge turnover because hauling around dialysis and hospital discharge patients is degrading, thankless, stressful, and torture on your body.  For a lot of people this is their first EMS job, and most of them have a really idealistic view of the job.  What we like to call an amby baby.

“I’m gonna save the world, and people are gonna love me for it!”

This attitude usually dies in the first month or two when they realize we are an abused taxi service for people on government aid.  Our company ran about 50,000 transports last year, you just can’t keep up the level of optimism when you encounter that many people.

We get a company newsletter every 2 weeks, and they include little writeups from new employees.  They are usually short blurbs.  ’I'm Joe Somebody and I’ve been an EMT for 2 days and I’m looking forward to working with you all’, or something along those lines. 

This last edition of the newsletter had an epic FNG letter.  It is a full half page of optimism and vigor which will be crushed soon, eventually leading to a failed EMS career and a story to his children about how “It just wasn’t what I thought it would be”. 

I will now transcribe it for you.  Names have been changed.

My first shift ever as a Medic began with Stacy Smith training me in Unit 920 on December 10, 2007.  As I made the 10-41 call to dispatch, Stacy assured and guided me.  throughout my OJT, Stacy did her very best for me, and I did my very best also.  Since that moment, I, like you, have been 10-76, with a helpful partner, “On Schedule”, and I know now that I am in the right place, at the right time.  Thanks, Stacy, and thanks to all of you that I have worked with (Bob, Tom, Mary) and the others who I have simply met, for welcoming me, for your guidance, and for helping to make my first month a success!

As an introduction, please let me tell you why I’m here and, at the same time, thank you for your partnership.  I’m 42 years old - and I’ve had a lot of past experiences, a lot of past successes.  I know about my own personal responsibility and that only I am responsible for taking the actions necessary for my success, my happiness - and I know that my happiness is a result of taking action on my values.  I relish this time in my life, this new phase, because I am definitely taking action on my values.  Those values include helping others - our patients, partnership, leadership, flexibility, time-off to enjoy other pursuits, opportunity for more responsibility - its all here.  I’m in the right place, at the right time.   

A few moments have been super-rewarding.  It’s been great to give our patients comfort.  Their response has been extremely rewarding!  The look in their eyes when they realize I really do care very much has been hugely, hugely rewarding!  I’ve had a couple opportunities to make good decisions under pressure during Code 3’s.  What a great rush!  I can’t wait to begin paramedic school and continue with this pursuit.

Thanks for my first month, partners.  I look forward to partnering with you next.  When we work together, we’ll share our stories and learn more about each other.  I look forward to that.  When we meet, you can ask me about my post 9/11 anti-terrorism work or about Nathan, my unbelievably beautiful 7-year-old son.  And I look forward to hearing about you, Partner.  Until then, I’ll be 10-76 or 10-8, in the right place, at the right time.  Thanks!  I’m 10-8.

First of all, if you are 42, you are too old to start new in this line of work.  You’ll never get onto a fire department because of age limits, so you’ll be stuck in private services.  There is no chance for advancement or saving lives or being a hero.  Second, if you’re so successful, why are you working on a basic ambulance for $10 an hour at age 42? 

Third, could you be any creepier with your talking of your “partners” and wanting to partner with everyone and share stories and be all Kum-Bay-Ah?  Seriously.  Partners are an arbitrary assignment based on whose availability matches your own.  No one wants to sit in an ambulance for 12 hours and hear stories about your life and play 20 questions.  Especially not a new EMT whose stories will be as exciting as dried mud.

Also Code 3’s are not exciting.  Code 3 is any response that is lights and sirens.  If someone calls with the flu, that’s a lights and sirens response.  Wowee sockem, that’s thrilling.  All of my responses are code 3, and I can’t remember the last time I got excited about turning the lights on. 

In conclusion, this guy is either trying to get into a management position, hopelessly lost, or trying to convince himself that he didn’t just make a HUGE mistake in his career move.  I’m guessing the latter, but the whole “PARTNER!!!” talk makes me think he’s just an excited pervert who will be caught molesting a patient in the back of the ambulance on a midnight shift.

While you are comfortable in your bed, someone is driving an ambulance in a desperate attempt to get back to their bed after a call.  Some might say the world is more interesting at 4 A.M.

At least once a night we have to sector at the border of 2 towns.  Once there, there’s nothing to do but sit and wait.

After an hour, more or less, the call will come in, which results in a furious race towards the base so that we might get back to base before we are wide awake again.

So our company just acquired a 5th town’s 911 EMS contract.  While our previous 911 contracts have been for towns that are all neighboringeach other, this new town is quite far from our main office, and they average over 3,500 transports per year.  I know I’m not an expert in business performance management, but things just really don’t look good for this.  We won’t be able to rush a crew into town for quick coverage, so the town will need to be overstaffed. 

On top of that, the town had a municipal, unionized service prior to our company taking over, so I’m pretty sure the Fire Dept. is going to be gunning for us, as well as the cops.  Nothing like working EMS when your backup is hostile towards you.

Did I mention we are short staffed right now, as well?