ummm...yeah, i'll call.

Long time no blog. Planning a wedding and....well, being lazy. I'll try harder. I promise. Oh, and we don't need a condom, I shoot blanks. Promise.

The Stolen A/C Unit

this story happened way back when i was a student. i was doing a ride along and i was with FE and, i think, SM. we got a chest pain call at like 0400 in a horrible trailer park. we pulled up and in the darkness could see a tiny african-american woman sitting on her steps. we talked to her for a couple second and placed her on the stretcher. as we were strapping her down a man appeared out of the darkness on a bike. he had a small window a/c unit under his arm. the unit was, more than likely, recently in a window that was not his. he got off the bike and started aggressively asking us where we were taking his woman. she told him she was having chest pain and we said we were going to take her to the hospital. the guy said that he was going with her. when we told him he wasn't going with her he started to mumble to himself and got louder and louder. he was obviously a very unstable person just from his movements and the way he looked at us and the things he was mumbling. as we started to pull her towards the ambulance the bike guy pulled out a very large fillet knife and began to yell at us. we loaded the pt into the ambulance as the bike/knife guy wandered around the ambulance talking crazy talk. the three of us could have easily beat the shit out of him, he was very scrawny and malnourished, which is why he never came at us. we called for police the second he pulled the knife and they arrived shortly and took him into custody. all i had that night was a metal clip board to protect me. that was the last night i ever worked with out a weapon of some kind on me and in my bag on the truck. this city is rough and i'm not gonna let some crackhead take me out.

Adventures in Vehicle Maintenance (Part II)

about a year ago i was working with JS (the male JS) and we were driving emergency traffic and he took a corner fast. not that i was worried, i had full trust in his driving. the weird thing, that hit my mind, was the fact that he was washing the windshield at that time. i was confused at this timing, what with the high speed mixed with the wiper fluid and wiper blades. it ended up that JS was not a psychopathic nut job, it was actually radiator fluid that was flying up onto the windshield and he was trying to keep the old beast on the road. we have a lot of overheating ambulance fails in the summer down here. also, the turbo on the Fords like to pop on these hot days.

4,202...

that's how many calls we had in the month of May. we average 8 ambulances on the road at any one time (around 12 during the day and 6 at night) and only one hospital. we take people to BJ and the army hospital but that is probably only less than 10% of our calls. gonna be a warm summer and it's gonna only get worse. any medics out there need a job?

Adventures in Vehicle Maintenance

on 5/26 we were going emergency traffic to a call when our right front tire broke off and bent into the engine causing us to slide across into the on-coming lane. luckily it was late at night and there was nobody driving against us. we have a beat down fleet and are in dire need of new trucks. the Fords we have have over 200,000 miles and the suspension in all of them is a joke. it is getting embarrassing to explain to the pt's why the ride is so bumpy. you just can't run trucks like we do, hard and with no rest in a 24 hour period. something needs to change. also, my partner that night, JS, had just eaten a cupcake and that was 60% of the blame for the broken axle. junk. in. the. trunk.

I call her Blackcloud...

worked a little overtime on Friday (5/14) and got to work with Angel (AA). every time i get to work with her we run the crap out of some calls. and this day was no different. we had 10 calls in 12 hours with one cardiac arrest, a code medical and a dislocated hip. the cardiac arrest came out as a 33D, cardiac/respiratory arrest at a facility with health care providers on scene. we pulled up to a well known local doctor's office and went in to find this tiny African man (Dr. O) doing chest compressions on a tiny older lady on the floor. there was about 2 gallons of coffee ground emesis on the floor and coming out of her. there was a poorly educated "home health provider" that had brought the pt in and she told the doc that the pt was vomiting blood last night. i asked the person for the pt's history and she stated she did not know. i asked her how old the pt was and, again, she did not know. i then asked her to leave the room and she did without hesitation. AA and i worked her well, very difficult airway (very anterior) and after numerous suctioning our QRV lead medic arrived and was able to intubate her. a firefighter and i lifted her arms straight up which lifts the shoulders and hyperextendeds the neck (this was done after ruling out a fall) and has worked wonders in the past. unfortunately she was in asystole the entire time and was pronounced at the hospital. we then got a call for a 30B2, traumatic injury, where a lady had recent hip replacement and was getting out of her car and twisted wrong and it popped out as she sat into her wheelchair. we arrived to find her in her wheelchair in the heat. she did not fall so we ALSed her there, gave her fentanyl, used a KED inverted to stabilized the hip and took her to the hospital. later in the day we went to a 6D2, breathing problems, and found an elderly man with shortness of breath (SOB) and an impending sense of doom (not good, ever). did a 12-Lead in the house showing his pacemaker was firing but not producing a profusing beat. his heart rate was in the low 40s and his b/p was 80/P. placed the pacer pads on his and got him to the stretcher using a stairchair. we were only a mile away from the hospital and i told the guy that if he relaxes and stops responding to me i was going to have to "light him up" (i know, i know...but it worked. i don't like to shock or pace someone who is talking and fully awake. don't get me wrong, if his b/p was a couple ticks lower i wouldn't think twice about pacing and sedation) which worked. called a code medical and had to take him to the blue zone due to the fact that our recess room was completely full. it was like back in the old ED when we would bring a code medical or code trauma just straight past everyone and into any number of regular rooms to be worked. old school style.

Remember the Gipper?

Rudy is the poster child for the modern GOP and the Reagan-myth machine. Mr. Sully has this comparison and Greg takes it further (comment section worth a look for all your Rudy-wear).

“A nuclear-free world has been a 60-year dream of the Left, just like
socialized health-care,” - Rudy Giuliani, NRO, 2010.

“A nuclear war cannot be won and
must never be fought. And no matter how great the obstacles may seem, we must
never stop our efforts to reduce the weapons of war. We must never stop at all
until we see the day when nuclear arms have been banished from the face of this
Earth.” - Ronald Reagan, 1984, in China.

Kanye was right...

the gift that keeps giving (i.e. like herpes, but...you know, never look a gift sore in the mouth). GWB caught wiping his hands on Bill Clintons Penis (no, arm) after shaking the hand of a black man. Damn Kanye was right! that makes twice Mr. West was spot on. think i need to make a button now. (below is the second of the "twice")

Valley of Tears

while visiting my friends in Israel we decided to try and find some burnt out Syrian tanks. we had just spent the night in the northern town of Metula. we looked on the map and saw the outpost of "Oz" around the area my friend thought she had climbed on some one drunken night in the past. we drove around and after going the wrong way (i was driving the Honda in between mines fields and turned around just before reaching the Syrian border, muddin' it in Israel) we found the entrance to the Valley of Tears memorial for the 77th "Oz" Regiment. the entrance is in front of the entrance to the Kibbutz Elrom (in case you ever are in the area). it was a very chilly and windy day. we parked at the memorial and there was a lady just sitting in her car the whole time and my guess is that a family member died in battle, we were there at the end of October and the battle was on 06Oct1973 (on Yom Kippur, the Day of Atonement). we walked around the memorial and looked out over the Syrian border. the memorial is made of welded parts of tanks with the dead inscribed in the metal with torch.

we could see a fighting position to the left with a tank and we drove over to it. we walked around in the trenches and explored above ground for a while. the trenches were chest high and reinforced with corrugated metal and posts to hold their shape. you could see out over a vast flat plain and right in front of the bunker complex was a marked mine field. the girls were getting cold and they went back to the car. we followed them to get CB's iTouch with the flashlight app so we could go into the bunkers. the girls stayed in the car and CB and i walked back into the defences. we entered a trench and walked down the chute into the bunker. it was a basic concrete bunker you would see in WWII movies, cold concrete with a slit opening giving a good field of fire onto the plain below. this bunker was hit almost perfectly by either a small tank shell or, more probably, a RPG round. it entered the slit and skimmed the top of the slit causing a half-moon and hitting the left wall.

there was also bullet holes in the concrete on the right hand wall. i have been in combat and was lucky enough to be above ground and with a light infantry unit. i could not imagine the strength it would take to stand your ground in a cold coffin like these bunkers. knowing that at one point in the battle only 40 Israeli tanks were holding off 500 Syrian tanks (and if i remember right, there were also Iraqi tanks mixed in) it really shows how a few heroes can save a whole country. we were walking around and came across another bunker but it was too dark in it. we deduced that the slit must be caved in so we searched out another. we tried to enter the bunker in the rear, obviously a command and supply bunker since it didn't open up to the battle field. as we entered it both CB and i got the willies and decided to get the hell out fast. we both were laughing, nervously, as we left the bunker. we had both got that creepy feeling and both our arms had goose bumps. we were still laughing when we came around the command bunker and saw the girls in the car. but they looked a bit shaken and started talking before we could even sit in the car.

they were sitting in the car and were reading and talking when suddenly the door locks on the car started to go up and down. they got startled and then my girl said it was us guys screwing with them. then a little later it happened again, the locks went up and down fast a number of times and then stopped. my girl said that us guys were using the key chain to lock and unlock the doors but then they said they remembered i had left the keys with them. and sure enough, they were just sitting there on the console. just as they noticed that, we came around the corner after getting spooked ourselves. we sat in the car for a bit and i talked about what i knew about the battle (from reading The Yom Kippur War). i didn't feel scared at all and the others were not upset at all. to know what happened there, and the history it made and produced, i can see why spirits would inhabit the area. it was the one and only time in my life i really truly believe that kind of thinking. that something "other" could reach out and communicate with living persons.

I can smell the popcorn but i can't see it...

engineers have recently started the long march towards invisibility. a team at Duke University's Pratt School of Engineering have made a device (pictured) that can make an object invisible to microwaves. even though microwaves have a longer wavelength than light, this is a great start. they are only able to do it in a 2 dimensional form but 3D is probably not too far off. this article will lead you to the basic how's-and-what's involved.

...and I drove too fast.

this is part two of the last post. when last you read us CC and i just had our first cardiac arrest together and CC got his intubation. well, the next day was a busy day and by the end of it we came to the conclusion that we were douches. we were supposed to be done at 7 pm. around 1700 we got a 27D, GSW. some crack head/heroin addict was walking down the street and some peeps drove by and shot her in the ass and back of the legs with a shotgun. it was my call and we got her fat ass off the scene and to the hospital in nice time. we were on top of our game that day, after having such a good day the day before. so we check out of the hospital and right at 1825 we get another call. ok, no big deal i guess. yeah, it sucks but what can we do. so we go and pick up this old guy and take him to the hospital on base (he's retired military and gets a choice between the two in our county). we check out of that hospital at 1945 (45 minutes over our scheduled time) and now we get to go back to base with no chance of getting another call. unless, of course, a bad call comes out and we are the closest. BAM! 9E1, cardiac arrest comes out. we are kinda far from it but when we hear the only truck available for it is coming from base we have a choice to make. i look at CC and he goes "ok, let's do this" and i get on the radio and tell the other truck, medic 13, to keep going and we'll MEET them there. fully thinking (wishing) they will get there a couple minutes before us and CC will get another tube and then we can just help out until they take off for the hospital. but what does my dumb ass do? i drive to fucking fast and smoke the other ambulance. now WE are the first on scene and this is now our call. i couldn't believe it when i came around the corner in the neighborhood and saw just a fire truck. and on top of it all the firefighters placed a BIAD/King airway! so we load the guy up because he was outside in his car at the time. the fire dept had him on the ground and it was cold out so, without thinking, we put him in our ambulance. WRONG. he was in asystole at our first contact and according to our protocols we can work him for another 30 or so minutes (with numerous other caveats on top) and call it there on the scene if he doesn't improve (even getting him into a VTach/VFib i consider an "improvement"). but now we have him in the truck and we aren't just going to stop and take him back out after 30 minutes and lay him in the grass in front of the neighbors. so we take off for the hospital (after setting him up) and en route the King airway is sliding around in the guys mouth due to all the puke. CC notices the SPO2 dropping and d/c's the King and intubates the guy. so it all worked out in the end. at least until it was 2245 and we were still at base writing up the report into emscharts. we both were so tired and we could only laugh at how stupid we were.

Chuck got his tube...

i have been training CC since 12/23 and we have seen just about everything in the entire protocol book (CPAP, SVT, Afib w/ RVR, STEMI, etc.) but we couldn't buy him an intubation. we would try and jump cardiac arrests and someone would be closer or we would get there and the dude would be dead for days. we tried switching up stupid things, trying to drum up a cardiac arrest. and finally on 2/17 CC finally got one. we were at base and a 6D, respiratory distress, came out for medic 10 and the dispatcher stated possible cardiac arrest. CC and i were very close so we advised dispatch we were going to it too. we figured that we would pull up a minute after medic 10 and CC could still intubate (and we would just steal the call from them and run it in). the two units met at an intersection and CC was on the phone with medic 10. we were at the exact same intersection near the call and they stopped their lights and siren and gave it to us. we rolled up on scene and the fire dept. was already there (it happened to be one of the guys mother-in-law). she was on the floor with CPR going and we took over. she was in asystole on the monitor and after the next rhythm check she was still in asystole. we had IV access and intubated her and cardiac drugs on board. our QRV was there, as well, and had pulled the family into the kitchen and explained that we were going to work her for another 25 minutes and if she didn't get out of asystole we were going to call it here in the house. the family was ok with that and were very understanding. the pt just was released from the hospital with pneumonia and when we tubed her thick, white phlegm was all in the tube. she was altered and short of breath (SOB) for most of the day and she just collapsed on the floor. 24 and a half minutes into it she gets a strong femoral pulse and we scooped her up and took off to the hosptial. 24 1/2 minutes exactly. asystole to pulse. strange, very strange. she stayed alive for most of the day and CC went into the room to see the family (they had already signed a DNR for her and were sitting by the bedside all day) and CC literally saw her go into PEA and he called for the doc to come in to the room. CC brought her back and was there the second she died, again. strange day. the next day was even stranger....

And I...

jizzed in my pants. ;)

Spanish for dummies...

was on a SWAT raid recently, i'm a medic on two separate SWAT teams locally, and they were joking around when we were in the truck on the way to the scene. they were talking about another guy, who wasn't with us that day. i'm paraphrasing but here's the jist of the story. they hit a house and there was a spanish dude in the house and the SWAT officer came at him, gun up and fully kitted up, and wanted the spanish dude to put his hands up. so he started yelling "Como te llamas!!" and the dude said "Juan". so he kept moving forward and yelling "Como te llamas!!" and the dude yelled back "Juan!" with his hands still by his side. "I'll shot you motherfucker!! Como te llamas!!!" and the dude screamed back "JUAN!!". hahahahahaha. finally someone corrected him before he shot the dude. i'm not sure what exactly they are taught in SWAT school, i finnaly get to go this summer, but "Manos arriba" will probably work just fine. reminds me of when we were in Iraq. we were in the invasion so our cultural knowledge was very primitive and the universal American sign for stop (hand palm forward and arm up) is actually a greeting and sign of "come over here" for the Iraqis....oops. within a day or two my platoon noticed it was different (both hands over your head and arms crossed). luckily we hadn't killed any civilians by then. ah, but understanding cultural diversity is such a dirty fucking hippie (DFH) way to approach the world, isn't it. too bad most people who get into the infantry and police work are, for the most part, not the sharpest tools in the shed.

Solar flares and the shuttle...

go to spaceweather and search for today in the archive in the top right (02/08/2010) and check out some wonderful pics of the space shuttle Endeavour lifting off. it is bringing a new section of the space station so the astronauts can see in a 360 degree space. how f-in cool would that be?!? and then right below that part you can listen, by links, to massive solar flares screaming by the Earth. it sounds like being in a tent during a strong rain storm... i guess that is a pretty good analogy of us and our planet. such a great website on a daily basis.

I must be dreaming...

this was a couple years back. i was working a shift with SA and we were in line to get breakfast at Bojangles and a 10D, chest pain, came out and we both got out of line and set off to it. usually when interrupted from breakfast a crew may make snarky remarks about the pt we are going to (of course, once on scene that all goes away) but this time i remember we didn't say anything we just took off. we got on scene and the first responders were already there with the pt. this was in a bad area of town on one of our worst streets for drugs and violence. we walked into the house and the pt was a black male about 42 years old, he looked younger. he was wild eyed and clutching frequently at his chest. right away we could tell there was something going on and we placed him on the stretcher. as we were pulling the stretcher out of his house, he was only 2-3 minutes from the hospital and we decided to do everything in the truck, he said something about "spiders". his house was dirty and i started to look at my shoulders and arms and get that feeling like stuff was crawling all over me. as we loaded him into the ambulance he said it again "is it the spider?" and i crawled into the truck looking at my clothes for spiders. SA placed him on the monitor and right away, i think without even a 12-Lead she just said "let's go, i'll do everything en route". the pt was very anxious and had that text book "impending sense of doom" going on, looking back in hindsight. i took off for the hospital and i could hear him asking SA "is it the spider" and finally she asked him what he was meaning. he started to say he was watching a hospital-type show the other night and heard about a spider. SA asked him "you mean a widow maker?" and he goes "yeah, that. is it that?" and i just mashed the pedal a little further into the floor. as i pulled up on the ramp of the old ED i could see SA in the rear view mirror start yelling at the guy and she pulled the head of the stretcher down, moving him from sitting to supine. i ran around to the back and pulled open the doors and jumped up and the pt looked to be having a seizure. SA was at the monitor and she had placed the pads on him earlier and the monitor was showing V-tach. but the pt was shaking so violently i told her to hold on and i checked for a pulse quickly and after 5-10 seconds of not finding one she gave him a nice shock at 200J. as i was pulling him out someone came out and i yelled to them to tell the ED our pt coded on the ramp. we ran him in and i was doing CPR and SA was pushing the stretcher and we got him into the old orange zone and the nurses and MD were there and i moved around to lower the head of the stretcher and the doc yelled out shock him again. the monitor was in between the pt's legs and the doc could see the V-tach plain as day once i stopped doing compressions. BAM! we hit him again and began to move him to the bed. within a minute of his first shock on the ramp the pt was shocked a second time and he was on the hospital bed, biting a female ED tech in the hand and screaming "i'm dreaming!!! i'm dreaming!!!". hell yeah he was dreaming. and sure enough he WAS having a widow maker. we later found out he had an extensive cardiac history from abusing cocaine and had had a mild MI in the past. "i'm dreaming!!! i'm dreaming!!!" crazy town.

Words to the wise...

As I Develop The Awakening Mind I Praise The Buddha As They Shine
I Bow Before You As I Travel My Path To Join Your Ranks,
I Make My Full Time Task
For The Sake Of All Beings I Seek
The Enlighted Mind That I Know I'll Reap
Respect To Shantideva And All The Others
Who Brought Down The Darma For Sisters And Brothers
I Give Thanks For This World As A Place To Learn
And For This Human Body That I'm Glad To Have Earned
And My Deepest Thanks To All Sentient Beings
For Without Them There Would Be No Place To Learn What I'm Seeing
There's Nothing Here That's Not Been Said Before
But I Put It Down Now So I'll Be Sure
To Solidify My Own Views And I'll Be Glad If It Helps
Anyone Else Out Too
If Others Disrespect Me Or Give Me Flack
I'll Stop And Think Before I React =
Knowing That They're Going Through Insecure Stages
I'll Take The Opportunity To Exercise Patience
I'll See It As A Chance To Help The Other Person
Nip It In The Bud Before It Can Worsen
A Change For Me To Be Strong And Sure
As I Think On The Buddhas Who Have Come Before
As I Praise And Respect The Good They've Done
Knowing Only Love Can Conquer In Every Situation
We Need Other People In Order To Create
The Circumstances For The Learning That We're Here To Generate
Situations That Bring Up Our Deepest Fears
So We Can Work To Release Them Until They're Cleared
Therefore, It Only Makes Sense
To Thank Our Enemies Despite Their Intent
The Bodhisattva Path Is One Of Power And Strength
A Strength From Within To Go The Length
Seeing Others Are As Important As Myself
I Strive For A Happiness Of Mental Wealth
With The Interconnectedness That We Share As One
Every Action That We Take Affects Everyone
So In Deciding For What A Situation Calls
There Is A Path For The Good For All
I Try To Make My Every Action For That Highest Good
With The Altruistic Wish To Achive Buddhahood
So I Pledge Here Before Everyone Who's Listening
To Try To Make My Every Action For The Good Of All Beings
For The Rest Of My Lifetimes And Even Beyond
I Vow To Do My Best To Do No Harm
And In Times Of Doubt I Can Think On The Dharma
And The Enlightened Ones Who've Graduated Samsara

Romeo y Juliet

went to see my first ballet and what a perfect show and perfect venue to pop my cherry. my lovely fiance used to dance as a little girl and for her birthday i got us tickets to see the American Ballet Theatre (ABT) on their winter tour at the Kennedy Center in DC. we checked into the Renaissance M St. Hotel (a beautiful place, i used Priceline and bid $75 on a 4-star and they took it, next time i'll try a touch lower) and got dressed up just in time for our friends in DC to show up for an early dinner. we went to the Blue Duck Tavern on 24th St. and got lucky getting a table. the wait staff and host were incredible and very funny. great place to eat if you go to DC. we then said our goodbyes and jumped into a cab and got dropped off at the front of the Kennedy Center. the performance was in the Opera House, we were seated in box 4 and had a perfect view. a father and his daughter had the front row on the rail and we talked to them after the first act. they left half way through and gave us their seats for the rest of the show. ABT did Romeo and Juliet (it was nice for my first ballet to know the play). Juliet was played by Julie Kent (see above photo and video below) she was very tiny and graceful and did a great job, she had me laughing at parts and holding my breath at others. Romeo was played by Marcelo Gomes (see video below) he was unbelievable. he is a very muscular Brazilian who made a smooth dancer by himself and such a strong base for Miss Kent, she was like a feather in is arms. he was on his knees at one time, Act III, Scene 1, and had her in the air above him and was sitting back on his legs and then kneeling up again. he did this 3 times and it was flawless. the Kennedy Center is a wonderful place and the Opera House is one of the most beautiful places i've ever stepped into. a wonderful experience, but it was DC and that is what always happens in DC. great food, great friends, great show, great people, great cabbies, great city.
Julie Kent

M. Gomes

New York state...

the new Jay-Z song about NYC (Empire State of Mind) has really grown on me. smooth raps by Z and that hook by Miss Keys just flow to make a really great song about the best city in the world. to sit and wonder what it must be like to have the city in the palm of my hands like Jay...damn. so i started to think about some of the other NYC songs that i have liked and i can only think of a couple. maybe if some day traffic to this site increases (why it would, i have no idea) then if you have a personal fav throw it into the comments and i'll put it front and center in some "updates". here's the Jay-Z video:

the next song i love about NYC was on Big Pun's album "Yeeeah Baby". track #5 New York Giants. i have just an ok stock Honda system in my car but this song sounds unbelieveable in it, i can only guess how mind blowing it must sound in a major system. on top of it the song is a great team song (unlike the lame ass Vikings fight song by Prince. love the Prince, but sometimes i'm not on the same page. oh, and lets not even talk about The Super Bowl Suffle). give it a try and buy it and pump it in the car, a must.

the last, but not least, is the Beastie Boys on their album "To the 5 Boroughs". it is track #12 An Open Letter to NYC. New York City, the Beasie Boys....that's all you need to know.

so there you go. no damn "new york state of mind" Sinatra bullshit. NYC and hip hop. East coast.

lesson in common sense #36...

we are going through some changes over the last year and a half in our system. our new boss, appearing at first to be a big talker, has has come through with some very needed changes. but occasionally there are a few knee-jerk reactions to ANY type of "bad press", no matter how poorly sourced and one-sided the editor of the Cheers and Jeers section happens to be. the inability to attack weak local journalism is a shame for such a politically oriented boss.
today i wish to examine a lack of common sense by the Yes-Men he has surrounded himself with. according to our new state protocols we need a blind insertion device (BIAD) for adults AND pediatric pts. a quick explanation of the use of a BIAD:

in case we are unable to perform an intubation via laryngoscope, after 2 attempts we have the choice to throw in a Combitube and go from there. easy to do and has worked perfectly everytime i have used one. it is so easy to use i can show some 18 year old country hick first responder just once, and he can do it right everytime. the majority of times i have seen failed airways is on TALL, heavy black guys who naturally have large tongues (see: Mallampati airway classification)and no necks.

as for a pediatric BIAD, no big deal there. King Airways makes a wonderful product (see above photo) easy enough, just purchase a size #3 and done. keep our tried and true Combitube and add the King #3. but Sadly, No. our system (and now all the city fire stations) go and throw out the Combitube and buy King #3 and #4. the #3 is for persons 4-5 feet tall and the #4 (our NEW adult BIAD) is for persons 5-6 feet tall. notice anything? of, course you did as did every fire fighter i have talked to....what about a person over 6 feet tall?!?! as medics this is sorta a moot point, we now have numerous other choices in case of a failed or difficult airway (Bougie, AirTrack, surgical, etc.) but the first responders now have to bag (using an OPA/NPA, of course) and try and keep a person oxygenated while they wait for us to get to the scene to intubate. a lack of common sense can result in death in a busy system like we run. and it is funny how the people who make a lot of the major decisions in our system are the people farthest from running on an actual truck. not that i think the regular paramedics have the time to sit in all these meetings, but at least try and get their opinion occasionally about product use and need. oh, and to just show how easy it is to place a Combitube in an adult i'll let this crazy German doctor show you....

old dogs and new tricks...

hey, i guess i have to give props to GW. you can teach an old dog new tricks. bush and clinton have joined forces to help the people of haiti. if you haven't given just google them and donate (even if you are just reading this many many moons later i'm sure the people of haiti still need your help). the above image was taken on Jan. 16th, four days after the first earthquake hit the island. now lets see how GW reacted with Katrina....

the hurricane made landfall at 7am on monday Aug. 29. this photo was taken at 11 am. GW was with the man he destroyed in the 2000 race by sending out mailers to the people of South Carolina. the mailers said that McCain had fathered an illegitimate "black baby" when the truth was that McCain and his wife adopted a child. i love how the idea of The Blacks can turn SC into crazy town (yet another reason to NEVER visit SC).

this photo was taken at 2 pm tuesday Aug. 30. GW plays guitar with some douche bag named mark willis. the levees had already failed over 24 hours prior to this photo op. GW then flys back to the fake ranch/staged prop of Crawford to finish his vacation (if you google bush's vacation days you will see he set a record, as of March 11, 2008 GW had spent 879 days in Crawford)

this photo is from wednesday Aug. 31st. GW does a 35 minute fly-by. FEMA's response is still floundering but the 24 hour news keeps the nation informed (one of the only bright spots by the MSM during GW's days in office). later this night Condi would go to a Broadway show, remember by this time she is Sec. of State (Hillary's job now) and gets booed, she went to see "Spamalot".....i can go on for days (what with Condi shoe shopping, "Heckava job Brownie", GW claiming that no one could have predicted the levees would break, GW's mom talking about the refugees in Houston, etc, etc, etc.) but just go to this link to see the national shame that was Katrina.
so i gotta give props to GW today for linking up with The Clenis to be the faces of the US aid effort. but i'll never forget this picture and everything that happened after...NEVER EVER FORGET.

1/2 a baby...

i have delivered one and a half babies in the field (so far). this is the story of my 1/2 baby. i think i was with JH at the time and we got sent to a 24D, baby on the way. we pull up on scene at like 3 am and walk into a back bedroom and there is a lady with a newborn baby on her belly, umbilical cord still attached. we missed it by seconds. the lady's 18 year old sister delivered it and tied off the cord with shoelace per EMD (EMD are the people you talk to on the phone if you call 911). the baby was great, a little tiny naked little baby. mom was fine and sister did a great job. the baby had its first crap and my partner was helping mom clean up some of that oily messy stuff while i clamped the cord closer to the belly button. i noticed him at first but now i had the time to take it in. the mom's 5 year old son was on the bed with her and by the shock-and-awed look on his face he was there for EVERY THING. he had these wide eyes and was just silent and taking every thing in. i finished clamping off the cord and took out the scalpel and looked up at the boy and said "come around here". he jumped down and ran around to me and i put the scalpel in his little hands with the blade up and told him to hold tight. i slid the cord in a sawing motion across the blade and he got to cut his little sibling's cord. as i got the last of it over the scalpel a burst of blood spurted onto his hand and he looked at it, looked at me and threw down the scalpel and ran into the bathroom and i could here him washing his hands. he came back out and we cleaned up mom and the baby, mom hadn't passed the placenta yet, and we loaded them both onto the stretcher and into the ambulance and off to the hospital we went. the lady had gone to L and D earlier in the night with labor pains but they sent her home at midnight with some percocets...oops. the mom was joking with us in the ambulance and was in a good mood right up until we walked into L and D and she got the greatest pissed-off-black-lady face i ever saw. the nurse saw her and said "did we just see..." she trailed off as she looked down at the baby. that was a funny site.

baby octopus and the surgical site...

im with CC lately, he's "bluedotting" with me, and we get a call, 26A, a lady is having problems with her surgery site. i had just ate way too much food. i went to a Chinese food buffet place that is one of the best in town and got a to-go box. i put a lot of baby octopus in it and some fried sweet plantains. my stomach was full. we walk in to her house and she was easily 400 lbs, sitting on the couch. she had a bowel obstruction on 12/12/09 (she went to the ED that day vomiting feces) and over the last month she has been in the ED 4 times having "electrolyte problems". about 30 minutes prior to calling 911 her surgical site on her belly, which was cleared a couple days prior by the surgeon, burst open at one end and massive amounts of puss flowed out. i noticed her pants were wet in her crotch area and just assumed she pissed herself. CC said "let me look at it" so he began to pull her pants down to look and i could see right away from how tight her pants were, she was presenting with a distended abdomen. her belly was very tight and rigid. as CC pulled her pants down to expose her scar/site there was a towel there. he pulled the towel down and immediately a sound like "blub, blub" occurred and bubbling puss flowed up and over the top of the towel. i'm not kidding, a crap load of puss came out, that was what had wetted her pants in the front. i spun around and stepped right outside. luckily the puss didn't smell but i was way to full to even attempt to stay in that room. i stood out in the carport and called for Engine 12 to come and give us some "lifting assistance". as we were waiting for them i just stood outside and talked through the door asking her name, history, meds, allergies, family doctor, etc. and then i just walked out to the truck and typed in all the stuff until E12 showed up. CC stayed with her in the house and got a set of vitals, he could tell i was fighting to keep my food down. i'm usually very good with smells and sights but i was just too full at that specific time. the only thing that makes me dry heave at work is smelly vagina, the kind that is so rotten the smell is seeping through the persons jeans. i have never puked on scene or in front of a patient....yet. we loaded her onto the stretcher and took her to the ambulance and took her to the hospital. i told the doc what was going on and we both agreed we may have found the source of her "electrolyte problems". CC was all gung-ho about seeing the puss again so when the doc looked at it he helped her but i stood outside the room, behind the glass door and watched. it didn't come out like it did at the house and her belly looked less distended. i would have loved to see what her CT-scan would have looked like had anyone in her previous visits done one. lesson learned for when i become and PA in an ED, if someone comes in with a recent surgery and they have electrolyte problems maybe i should take a peek under the scar.

Grand Ol' Party

the modern GOP (1980-present) can be best understood by first fully understanding this recent quote i saw by the General...

...for nearly two hundred years until the Reagan Revolution triumphantly destroyed the Middle Class in the War of Wage Suppression, a war that so far has lasted just over three decades.

the fact that middle class wages have not grown since the 1970's (read the article "Is Our Tax System Helping Us Create Wealth?" by David Cay Johnston) but prices continue to go up. the drum beat of consumerism keeps steady and credit debt climbs per family. the disparity between "haves" and the "have nots" is as great as it was in the 20's and 30's. the modern GOP can still get dirt poor folks to not only vote Republican, but do it with a smile. they can get poor elderly folks to not only fight against health care reform, but scream about social security "privatisation". these people who live and breath by every word Rush/Beck/Hannity sputter into a mic. these people who vote for anything these multi-millionaire talking heads trick them into supporting. and why do they do it? simple. they all have delusions of grandeur, each one thinks "one day i will/can/could be rich too" and that is all they need. is that the key to eternal bliss? a daydream and a powerball ticket. some days i wish i could just shut off and float in the ignorance with them.