Overheard at ITLS

I took this excellent course last weekend, after a feverish three days of reading as much of the textbook as I could in 72 hours while still sleeping and giving a full time job due diligence. It was a great weekend, having practical time alongside Paramedics and RNs as well as EMTs from other stations was an excellent opportunity to sharpen skills, learn new things, and share what works with people from other departments. Even through I didn’t ‘get a weekend’ rest-wise, I came back Monday morning with my Patient Care batteries recharged. Hearing one of my former EMT instructors say how proud she was of her ‘graduated students’ reminded me what I like about doing this ‘free job’ I’ve got.

As usual, there were occasions for a few laughs.

During a lecture on ‘Patients Under the Influence’ our instructor told us a lot of things about what is going on in schools that convince me that I made the right decision limiting my children to the four legged, fur bearing variety. Apparently the ‘new and improved kegstand’ involves inverting oneself while beer is inserted into the anus. It would seem the alcohol crosses into the bloodstream faster and one can get drunk more quickly on less beer. Good grief, people. I feel like I’m taking a walk on the wild side when I eat a sleeve of Sprees and drink a Pepsi. Many questions spring to mind, as well, including but not limited to:

What about the carbonation?
Is there a separate keg for people who want their beer the old fashioned way?
Is there a surefire way to differentiate same that doesn’t involve sniffing the tap?
If you can actually stand on your hands and let someone do that without falling over (or, even more compelling, do it YOURSELF) is there a better outlet for your talents that might be in some way financially lucrative? Oughtn’t you check this out?

We’re all shooting the breeze during lunch on day 3 of class, discussing other training opportunities. A student (who is frequently an instructor) was telling us about Wilderness EMS, and I said we should have that this summer. I volunteered to be the ‘S’Mores Officer’ for the weekend.

(I realize the last couple of anecdotes seem unrelated. Bear with me.)

Said student went on to say that when he took Wilderness EMS the ‘patient’ he had to ‘keep alive’ in his scenario was hypoglycemic and unconscious, and that they had considered ‘putting chocolate up his butt’ as a possible solution.

There was a moment of silence while this was considered. Then I said,
"I guess that would be like a ‘S’mores Stand’. Though I don’t recommend using the graham crackers." (general laughter)

Aaaand…..scene.

Oh, and I passed. Not as high a grade as I’d like but I’m obsessive about such things. So if you wreck in the 'Boro on a Wednesday night, if you'd keep your injuries around a B+, I'd appreciate it.

Its paid for, but please don't......

I finally got to ride in our sweet new ambulance Tuesday night. After countless bone jarring ambulance transfers in a 4WD vehicle that would have eventually resulted in breasts I could kneel on, we got a 2WD that offered a smooth ride and steps you can negotiate with a wide butt and short legs without looking like you just fell off a Mardi Gras float. Yaay for me!

It still has that 'new ambulance' smell, which is kind of like the 'new car' smell, if new cars came with extrication tools and the smell cost about $160,000 extra. Everything is shiny and unused.

We set off with a patient onboard who had difficulties that were not of the elimination variety, so I was alarmed when she had a whispered conversation with the nurse on board that ended with said nurse saying, "You have to POOP?" This was followed with a reassuring explanation of how very close we were to our destination, a place where she could do what needed done, possibly even without three onlookers in close quarters. This reassurance lasted exactly 45 seconds. I was at the head of the cot so I couldn't hear much of what was being said, only "Right NOW? Are you sure?"

A bedpan (which I prayed to the Patron Saint of Inopportune Defecation was actually IN the storage bin) was located, and we pawed through the layers of straps, tubing, non washable and very vulnerable-looking wool blankets, and ether blanketing to get to the patient and slip it in place.

Have you ever gotten on an elevator and experienced that awkward silence that settles in after the doors close? Or been witness to the 'party lull' where everyone stops talking at the same time for no particular reason? I would submit to you that these experiences run a distant seventy-third to dropping trou so you can poop in front of strangers in a moving vehicle.

We got the patient sorted out, then field tested something called the 'Power Vent'. (Ambulance manufacturers, whoever thought of a ceiling-mounted fan that sucks smells out of the back so they can hover malevolently over random municipalities, THANK YOU. It works like a champ.)

And nothing cheers up the staff of my favorite ER like walking in with a big red biohazard bag and saying, "Do you have someplace I can put this?" I wish I had one for them every day.

Simple Gifts

It is the day after Christmas. Our house is decorated with enthusiasm if not style, the living room cluttered with wrapping paper. We came home from Christmas with the in-laws to find a large package on our porch, and after quick work with a pocketknife on the many layers of tape, we opened more gifts.

Its quiet. Just the hiss and swish of iron on fabric.

Getting the pleats just right takes skill. First, I take off the badge, take off the nametag, take off the tack pin that came from that first aviation assist, a shiny unexpected gift from the BDU pocket of a pilot that afforded that instant of sheer childlike delight; a tiny enameled helicopter. I take off the Hazmat certification and follow the creases that came in the shirt, iron around the patches. Promise myself I will sew them down better, another time. The pins go back on; the tiny silver angel from my mother goes back on my shoulder. The badge wrapped in black ribbon. I eye it all critically, making sure all is straight and even.

It is the day after Christmas.

The pants are easy; lint roller and a razor sharp pleat front and back. I hang it all together on the outside of the closet door, ready for the morning.

In the morning we will present ourselves in our best, out of respect. We will present ourselves to confront the unimaginable, to say to a family, he was one of us and we loved him too. To say, we cannot know your pain, but in this place where there are no words, and only tears between heartbeats, we will stand with you. We will always stand with you.


Chief Timothy R. Martin
Goodyear Hose Company
October 4, 1976- December 21, 2008

Quiescat in Pace

Not just a job, but an adventure

Ah, the station. I probably spend more time here than I should. In fact, I'm writing this here. Mostly because we have a big flatscreen monitor on the computer and the keyboard isn't full of crumbs like the one at home. (I'm not to blame. I'll leave it at that.)
Anyway, the station is a little like college. You sometimes share close quarters with other people of whom you have a certain fondness. A certain camaraderie. Okay, you tolerate them. Sometimes.

We don't have a live-in program or anything, so there isn't a full kitchen, though we do have a bunkroom that has been used now and again. I camp here myself in inclement weather, since I have a car that isn't the best handler in snow and ice. I'd rather be here already if its really bad out.

Some time ago it was decided that someone should be cleaning this place on a regular basis. I won't get into why. Just trust me. It was necessary. A price was negotiated, and the job fell to myself. I don't really mind it. Twice a week I chase away the cobwebs, wipe up the smudges, and clean the bathroom. This is a pretty uneventful experience about 98% of the time. Today was a two-percenter. I performed an intervention. Then left this note.

Some Thoughts to Ponder


1. The throne on which
you are sitting delivers water at the rate of 1.6 gallons per flush.
2. Despite the impressive WHOOSH it makes when you pull the handle, it
is a LOW FLOW TOILET.
3. If you, in the course of business here,
believe that the payload you are delivering will not be sufficiently moved into
the sewage system of Our Fine Borough by 1.6 gallons of water, a mid-transaction
courtesy flush is in order.
4. The average human anus is approximately
the size of a dime. It does not require FIFTEEN YARDS OF PAPER to clean.
5. Should you experience a plumbing emergency worthy of intervention,
a plunger can be found across the street (in the firehouse) in the ladies
room. Knock first; it’s a one-seater.
6. Should I ever have to clear a
plumbing emergency like the one I found tonight, and the perpetrator does not
make an effort to solve the problem, and leaves it to me, and said perpetrator
can be positively identified, they might find what they left behind in the
pockets of their turnouts.

Brothers and sisters, this holiday season, if you stop at the station for a little 'You Time'....just make sure all systems are clear before you go about your day. That's all I'm sayin'.

Physics is Not Your Friend

I have no kids. Some might say I have no business dispensing advice to kids. I'm going to anyway. Its not particularly loving or kind. Too bad.


List of Realities For A Seventeen Year Old Male

1. You are too young to drink.
2. Anywhere. Anytime. Four more years to go. Wait.
3. Drinking anyway makes you a lawbreaker.
4. Drinking and driving makes you a selfish dickhead lawbreaker.
5. Such decisions are expensive. No one is impressed, least of all your parents, or the person whose rather new sportscar you totalled.
6. See #4 re: selfish dickhead
7. That body you are walking around in is essentially an animated bag of meat. It is fairly easy to break and poke holes in, particularly when you are too stupid to wear a seatbelt.
8. We all know that you know better. Since you aren't dead you get a chance to prove it. Don't screw it up.

Training

I'm sure that at some point you've knelt on the floor in some firehouse annex or church basement learning the fundamentals of rescue breathing with one of these.



And when you take EMT class, you are invariably faced with the Bag 'o Babies:


If you are especially lucky, you have the model for 'emergency childbirth' demos, complete with a rubberized vagina and a palpable fetus and a removable placenta that looks just like a grape fruit roll-up. I had the good fortune of sitting directly in front of the training pelvis for one whole evening while it was parked on the table in front of my regular seat. You'll just have to take my word for it; it was creepy. I can't find a picture and to be honest I am scared to try harder.

All I can say is, if Pennsylvania EMS protocols ever necessitate the use of THIS training item, I quit.

LIfting Assistance

Friday night I took a four hour piece of the duty section for a couple who were on their way back from somewhere. I was folding laundry and making some sort of point about something or other when my pager went off. Difficulty breathing call. I went to the station and arrived pretty much at the same time as the rest of the pinch-hitting crew and we responded quickly. The driver asks me as I go to jump out whether the patient is a man or a woman.

"A woman. Why?"

He cuts his eyes sideways. "You'll see. Just go inside."

I go inside and it doesn't take too awful long to figure out what he was talking about. Before I can even say it the call goes out for lifting assistance and pickups start pulling into the driveway.

I'm not good at eyeballing such things but I'd say my patient is somewhere in the region of 400-500 pounds and all day she has felt like she hasn't been able to catch her breath. We help her stand, turn, and sit on the stretcher, and when we try to pull her up the blanket rips in half. I suddenly feel very grateful I've been spending five days a week at the gym because lifting one of her legs onto the stretcher takes pretty much all I've got.

Anyone who knows me is probably wondering why I'm even writing about this; I'm not a small person. I guess that's the point. This lady scared the holy hell out of me. She couldn't move. Her body wasn't just betraying her; it was suffocating her. It made me think of what it means to live in a prison of your own making, and how much further I still need to go to break out.

You hear a lot of still, small voices in the ambulance. One of the most chilling and persistent is 'This can happen to you'.