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. ;)