21 November 2009

Well now, is this a sign of things to come?

Well now, is this a sign of things to come?

For years I have heard that women ought to get annual PAP tests, annual mammograms, etc. The idea was to catch various situations early and thereby ‘fixing the problem’. Now I know that sometimes there are things that we have ‘always done’ that are really what we should not be doing, i.e. a lot of stuff we do in EMS.

But I have always thought (and still believe, by the way) that we need to have regular check-ups and get those tests (are they really that expensive?) so that we can catch various diseases early rather than later. Cancer comes to mind.

We have had a lot of experience in my family of late with cancer. Doodlebug’s mother-in-law just recently passed away from it. A few years ago Mrs. 9-ECHO-1 had a close call with breast cancer.

At age 50.

Just had turned 50. Her mammogram at age 49 was clear.

So what would have happened had these new ‘guidelines’ that just came out about mammograms been in effect then? Since they say that they should not worry about getting regular mammograms ‘until age 50’, and then every other year after that, would Mrs. 9-ECHO-1 had been able to get a mammogram done in time enough to catch this? Would she have been able to get in for a ‘gram right after birthday #50? And what would the results (and consequences) have been in waiting another year?

What if she had been put on a ‘waiting list’?

I shudder to think about the consequences. You see, I come across as a pretty bad dude from time to time, and for some people, I have a real reputation of being an ass when I need to. But the prospect of life without Mrs. 9E1, well, I don’t mind saying, I was scared.

And then I heard this morning that apparently the ‘task force’ that came up with this ‘recommendation’ was basing it most on a ‘cost-benefit’ analysis.

I understand that.

I understand that in this country the health care system is in trouble. It costs waaaay too much.

I understand that.

But is this just a foreshadowing of things to come in the way of rationing if Obama, Pelosi, Reid, and others get their way?

Our own cancer scare in the 9-ECHO-1 household could have come out in two different ways. Which one do you think I prefer?

19 November 2009

I have a request...

As I read a lot of EMS articles and such, I seem to be noticing something that has caught my attention. Actually, I noticed it a while back, but I have been following it, and well, I have a request.

For all of you authors out there that write about EMS please find another word to use while referring to our profession rather than industry.

Industry. To me it suggests a trade ro vocation.

I know, how about using the word 'profession'. Instead of 'industry standards' how about 'profession standards'?

I know it is a small thing.

But then again, if we don't even refer to ourselves as a profession, how can we expect anyone else to?

02 November 2009

I have given in...

Yes, I fought it. I really did. I don't mind changes. Some of them are really good. But sometimes, well, I just dig my heels in and fight.

But I had to give up. Mrs 9-ECHO-1 told me I had to.

Seems that the battery for my trusty NEXTEL i560 had become, well, defective. After charging all night it would last for, oh, 30 minutes.

So I went to the i560 store and inquired about a battery. A $57.65 battery.

And new phone only costs $50.00. A Blackberry phone, at that.

Alas, they did not have one in stock, but it will be here this week. And of course I had to order some cool accessories with it. Armored Otterbox case. Car charger. Total cost? $104.00.

Me? I thought it was kind of expensive. But Mrs. 9E1 is the financial brains in our household. And with the new plan (we are saving $150.00 per month), she said go for it. Something about all of the hours I work and deserving it. Who am I to argue?

So, the Blackberry will be here this week.

See? I can keep up with the times. But I STILL want my Cadillac ambulance back.

9E1

Because Nice Matters…

Changes are afoot in the 9-ECHO-1 family. First, my (step) son Brad’s beloved Heather  (H2) is “with child”. Let me clarify something. Brad is technically my step son. But basically, Mrs. 9-ECHO-1 and I have gone on the premise that they are our kids. She treats Doodlebug and Booger Bear (my names for my daughters when they were growing up) as though they were her own. And I view Brad as my own (no, I have not come up with a name for him yet). Our relationship has been tenuous at best up until the past few weeks, but he is still my son. And I will do for him as I would do for my daughters.

Anyway, H2 is with child, so that makes me a…wait for it…grandfather in the making.

So what does that have to do with the title of this entry? Well, nothing. I just thought I would share that.

Now, back to the subject at hand. You see, H2 was in a car wreck this past Saturday. Everyone is alright (thanks for asking). But the whole experience, was, well, not what it should have been. Seems like the friendliest person in the entire prehospital experience was probably the cop who gave her a ticket.

You know, our job as EMSers is trying at times. It really is. I long ago gave up on all of the traumas, cardiac arrests, baby birthings, and all that I envisioned my EMS career to be. As it turns out, the biggest part of my job is being nice, holding hands, etc.

Over the years, I have read a lot of cards and letters addressed to my various agencies from our patients and their families. I have also fielded a few phone calls. I have even been the subject of a few of them. But not once has anyone ever praised me on my ability, as AD puts it so eloquently, to “intubate five people while falling down a flight of stairs, with one eye closed and a broken arm”, or read a 12-lead ECG at 50 yards and determine axis deviation by laying hands on the patient (actually, I can’t do that, but it sounded good). They have never praised me on my impressive scene management skills. They have never praised me on my pretty doggone good IV skills, assessment skills, etc.

What they have praised me and each of my coworkers for is being nice. Being polite. Being compassionate. That’s what they understand. Because basically, you can be as dumb as a bag of hair, but if you were nice, polite, and made them believe you cared, then they will naturally believe that you can actually do all that other stuff above.

But if you were an ass to them, well, all of the clinical competence and ability and knowledge in the world will not convince them that you are nothing more than, well, an ass.

And I know sometimes it is really hard to be nice. Some people, well, you just cannot be nice to. And it is really hard, sometimes, at 0230, to be nice when someone calls you for an acute case of athlete’s foot or a bad dream and wants to go to the farthest hospital. But we have to. That’s our job. You have to make the patient believe that you really do want to be there to take care of their crisis. And if you cannot do that, I will pick you up some applications from the DMV, the IRS, and WalMart.

You also have to explain what we are doing. You have to explain that the ambulance does not ride well (What? You did not know that the average American ambulance rides like a sheet of plywood with little wheels on it?), and you are not going to fall off of the stretcher/cot/bench because we have you secured with some pretty good straps. You have to explain that IVs do hurt. And you have to explain what all of those wires and such you are hooking up to them are for.

You have to explain that the neck torture device cervical collar and the long plastic torture back board is uncomfortable but "necessary" to prevent further potential injury (yes, I know they are not, but old habits for some are hard to break).

And I know we have to get billing forms signed, but there is a way to do that. You have to explain what the form says (have you read one lately? Do you really know what it says?). And don’t get upset when the patient wants to read it. And if they do not have their glasses, then maybe you are out of luck. But don’t get pushy. If they sign it, fine. If they don’t? Well, fine. As I recall the Medicare/Medicaid regulations (And I could be wrong. It happens occasionally), a face sheet from the hospital is sufficient. And if they do not want to sign, well, that is their right. They don’t have to, and we can’t make them.

I know we have to try to get information from them. But guess what? Sometimes they do not know that information we so desperately crave. What if they just moved here? Are they going to know their ZIP code? And I never cease to be amazed at the number of people who do not know a lot of the phone numbers they use, since they are all stored in ‘speed dial’ on the Blackberry. Don’t get upset if they do not know the numbers.

How about the people that do not know what medications they are taking? Or they are taking them “because their doctor told them to”. And maybe they have “a bad heart”, or “high blood”, or “sugar”, or “bad lungs”. That may really be all they know. Their spouse or children may look after this for them. There are real people out there that this is all of the information you are going to get.

Adapt and overcome. If you cannot get the information, whether it is past medical history, phone numbers, or other information, move on. Ask once, Maybe twice. After that, move on. Don't get pushy, and for God's sake, don't act like an ass when they can't provide you with that little tidbit of information. I have entered into many call reports terms like “numerous- patient does not know specifically” or “spouse has information” or something like that. And no one has ever called me on it. Well, once they did. Only once. They knew better after that.

Enough for now.

Be nice. Because nice matters. A lot.

And until next time- be safe, be well, and be careful.

9E1

29 October 2009

My Safety, Pt II


This is why I want a fire truck on scene when I am working on a highway. This car was traveling at 45-55 mph when it struck the fire truck. Imagine what that would have done to a human body or the back of my ambulance as I am trying to load a patient.

Was the driver distracted or just not paying attention? It doesn't matter what the reason was. And with a car traveling at that speed how much warning would we have?


And don't tell me about your car being the blocker with your flashing lights on. An impact at that speed could push your car forward. Into me.

If the fire truck is not there when I get there, I will call them. And I will verify that they are en route while I am responding. And I will NOT take no for an answer!

As I said earlier, my safety is a paramount concern of mine, as well as that of my partner and my patient.

Mindless entertainment is always a good thing...

Enjoy...

26 October 2009

Funeral Arrangements for Paul Boyer, EMT-P

Sisters and Brothers;

Funeral arrangements for Paul Boyer, EMT-P, of Womack Army Medical Center/Fort Bragg EMS are as follows-

The family will receive friends from 5 to 8 pm Thursday evening, October 29, at Bryan-Lee Funeral Home in Raleigh. The family wishes to inter Paul in York, Pennsylvania where he is from. The interment will be at Mount Rose Cemetery; date and time undecided at this point.

Memorial service will held later in November.

Bryan-Lee Funeral Home
138 Wake Forest Road
Raleigh, NC 27604
(919) 832-8225

Mount Rose Cemetery
1502 Mt Rose Ave
York, PA 17403
(717) 845-6618