Our local teaching hospital / trauma center / STEMI center / stroke center is putting on a new lecture series which focuses on STEMI and ROSC patients.  It is very similar to the trauma seminar I’ve mentioned before and has a wealth of information.

It starts with our pre-hospital radio report and continues through the balance of care for the patients.

My favorite part was when the MD leading the presentation suggested everyone in the hall go to a blog for ECG knowledge.

Mine?  Of course not, not until the seminar on fart jokes and grammar mistakes.

No, he directed us all to “Tom Boot-hill-aye” and his excellent work at EMS 12 Lead .com.

I will admit I sat a little taller in my chair when someone I know was mentioned as an expert in his field…and uses a blog to disseminate it.

Sure Tom Buothillet speaks nationwide about the importance of pre-hospital 12 lead ECGs, among other things, but also uses social media and video to make his message more powerful.

Tom recently debuted the London Ambulance Service episode of CODE:STEMI where he travels the world talking about EMS systems and their reaction to sudden cardiac chest pain and arrest.

Good work Tom, keep it up!  I think you’ll get a few more hits from today’s session!

A new site has popped up overnight (seems they’re coming fast these days) that is catering to a certain niche in our community:

The complainers.

Well, not really complainers, but those who need to vent.

I consider myself an expert on blog therapy and see this new site going one of two ways.

It will either be a tremendous hit or a disastrous flop, taking down the site owners, administrators and contributors.

It seems like a perfect idea.  Send in your EMS rant, they clean it up and post it anonymously.  Seems perfect.  Get it off your chest and move on.  They have all comments disabled, and with good reason, the troll factor would be incredible.

But, if a certain agency tries hard enough because they see something hitting a little too close to home, the entire house of rant could fall bringing every single poster into the light.

Be warned my friends, if you use this site you could walking into a delayed disaster.  But on the other hand, if you’re careful enough and can find some relief from getting your negative feelings out in a controlled environment (not at work or with a patient) who am I to stop you.

I’ll be visiting the site regularly, for the same reason I visit Fail blog, to watch the silly words and grab a smile.

EMSRants.com

Hey Motorcop, do you LEOs have anything like this?

Seems like the right time to say this too: I am not the owner or operator of that site.

Tomorrow morning (Monday) our buddy Motorcop is taking the sarg…the seargean…the saarg…well, he’s looking to promote.   In an effort to help him out I was able to pull some strings and get some of the exam questions.

I hope these help!

Vehicle 1 is parked facing south 22 feet from a stop sign in a 25MPH zone with hazard lights activated.  Vehicle 2 is traveling south at a speed of 35 MPH wit ha driver holding a cell phone to his head.  If vehicle 2 impacts vehicle 1 after applying the brake pedal for 20 feet, how far away is the Starbucks?

A male has been witnessed peeking into windows at the local yoga studio.  When you arrive on scene do you,

A) Detain the man in the london fog coat looking into the window.

B) Question the man in the london fog coat looking into the window.

C) Tazer the man in the london fog coat looking into the window.

D) Point out to the studio owner that their window faces a public street, the blinds are open and it’s daylight.

One of your patrol officers fails to report for duty.  Phoning his residence there is no answer, but he answers his cell phone.  He states he is sick and notified the night Sergeant, but in the background you hear an airport announcement.  Do you,

A) Notify him he is in violation of Dept regulations and begin suspension paperwork.

B) Accept his statement and place him off sick, then call in a cover.

C) Call the night Sgt to confirm the story.

D)  WTF guys? Am I not invited on the camping trip again this year?

CVC 21100 addresses _______________________________

A) The size and location of mud flaps on commercial vehicles.

B) The allowable length of overhang of an object protruding from a vehicle before it needs to be flagged and lighted.

C) Electric vehicles on sidewalks

D) No one is ever going to look it up, just pick something random.

And the question weighted most heavily on the exam:

Responding to a reported man down you arrive to find the local town drunk an inebriated fellow.  Do you,

A) Dismount bike in manly fashion making sure all civilians see the stripes.

B) Assess the situation after growing a bad ass mustache.

C) Ensure the man down is breathing and if not, begin life saving efforts

D) Stand over him, hands on belt and shout “Stay down! The heroes are coming!” after calling for an ambulance.

Good luck MC, we’re all rooting for you!

There has been scuttle around the EMS interwebs as of late and I’ve linked to this little blog from my little blog but have been having trouble finding the right words to describe what Joe Riffe is going through.

I’ll link to his site in a minute, but he’s been in the sidebar for a few weeks.

Joe can better tell you about his past, I’m more interested in Joe’s present.

You see, Joe is recovering from the amputation of his left leg above the knee.  Had this been me, I would just curl up in a ball on the floor and ask for water occasionally.

But not Joe. Joe smiles, gives a double thumbs up and asks the Universe, “Is that all you’ve got!?”

To say that his spirit to overcome this tiny lifestyle change is an inspiration does not do justice to how I feel when reading his day by day accounts of living with and around having only one leg.

Recently a child began to ask what happened to his leg and the child’s parent whisked them away without an answer.  He’s been called a cripple.

I call him brave.  There isn’t another word to describe someone who faces this kind of setback and charges forward, guns blazing, kicking ass and taking names.

When life seems rough at HMHQ I often think back to the days before kids, or maybe when we lived in the City, perhaps even before this staff job finds me in traffic 5 of 7 days, but I can get up, walk somewhere else and change my life if I want to.

That is what Joe is teaching me as I read his accounts of life with one leg.  Sure there are awkward moments like,

How do I pee without falling down?

Do I need a wheelchair?

Will I wear shorts again?

But it makes me step back and wonder what in my life is really bothering me.  Joe didn’t set out to inspire me to reevaluate what’s important in my life, but he is.  My take on his story is a selfish one for sure, that’s just who I am, but this story has really set into my mind to make me think more about what I have, and less about what I think I want.

Joe is about to walk into a whole new chapter in his life with his head held high and I’m honored he’s letting me come along.  You should too.

Greg Friese issued a challenge of sorts to some bloggers the other day:

“Take Sean Eddy’s excellent series about famous people as Paramedics and let’s all do a Tim Tebow one.”

I imagine the idea was to see how different bloggers interpret the pop culture figure and perhaps learn more about them in the process.

So here goes:

If Tim Tebow was a Paramedic…

I would still not know who he is, nor care too much.

People get upset when he prays at the scene of a call.  That’s his right, surely, but there is a time and a place and at the scene ain’t it.

From recent accounts he would be useless at the scene of the call but wrap up the tube, the vent and the Dopamine piggyback in the time it takes to get the rig from the street to the ED entrance.  Then he’d take all the credit and point upwards.

But on the ones we lose he won’t point up.

Tim Tebow as a Paramedic would last about 3 weeks in any EMS system.  Especially when the “Roxies” get to him.  More on that soon.

One of these:

Flashlight with video recorder AND night vision?  Hells yes, MC needs this!

Alt Kilt, official kilt of Kilted to Kick Cancer and the definition of a small American business, has announced their Spring Model Contest.

You have until January 12th to email the needed information and a photo of you to them to be considered.

The thing I like about this contest is that it’s not a cattle call for beefcakes and swimsuit models, although said categories are not being excluded.  Alt Kilt is looking for everyday people of all colors, shapes and sizes.  Even amputees are being encouraged to enter, the entire point being that ANYONE looks better and feels more confident in a kilt.

I entered, mainly because the chosen few will get a free custom made kilt to model for photographers in their own area, then the photos used to promote Alt Kilt around the world.  In addition, Motorcop and I, along with interwebs coding ace Alex from Unkilted.com, have been toying with the idea of a Kilted to Kick Cancer Calendar to raise money in September.  If you have a blog, please share the contest with your readers, on twitter and facebook.  I want Alt kilt FLOODED with a wide variety of folk to chose from.

So keep an eye out for details on the calendar soon after the new launch of the improved KTKC website.

Get over to Alt Kilt, read the rules and enter!

Stay Kilted, my friends.

No, seriously.

Click that big image. LIKE Magnum Boots on Facebook (why haven’t you already?), then LIKE their status update about the 12th Day of Christmas. Total time: less than 30 seconds. Impact: $1 to a worthy charity.

After you LIKE it I expect you to share it on facebook and twitter. They should reach this goal by lunch.

Merry Christmas from HMHQ!

EMS blogs pop up all the time, write a few posts, then suddenly nothing.  Maybe they got caught, maybe they got bored, maybe they forgot.  One day I read a post from a new blogger calling their site Captain Chair Confessions.  The style was right up my alley and the stories were so familiar I felt an immediate connection with the author.

The frustration, the angst, the sheer hair pulling insanity that can only come from being in EMS for more than 20 minutes in a system or with a partner or in a place that just doesn’t get it.  It’s there.

Also there, if you read carefully, is the withdrawing of a burn out in progress.

I think CCC, as they call themselves for short, has been saved by this amazing therapy experiment called blogging.  Even though the political stuff can get heavy from time to time, it is CCC’s forum and I can skip a post from time to time, but rarely do.

CCC, thanks for making me smile this year and good luck in the future!  I’ll be reading!

Rogue Medic is in a great mood as of late and this article about the complete joke that is Mechanism of Injury (MOI) hits the nail on the head.  I recently had to triage a car over a patient because of strict trauma guidelines, luckily finding the always available “Paramedic Judgement” to wiggle my way out of it.

The simple point is this: Mechanism needs to be a symbol on a map, not the destination.  With cars designed to crumple around our patients, what if it does take 30 minutes to get them out but they are unharmed?  And the pedestrian clipped by the mirror on the arm by a passing car at 40MPH?  Why are they on a board and in a collar?

Because 30 years ago when this Profession was still trying to figure itself out we bought into some crazy ideas, that’s why.  Now that we’re actually starting to study some of these ideas and finding them hurting more patients than they are supposed to help, we need to start revamping a number of our “standards of care” which actually should read “That’s what everyone else does…”

Whenever I have to document damage to a vehicle (mainly for my recollection of the run later on, just in case) I try to use some basic terms that at least remain consistent in my own description of vehicles.  Those are:

Light truck, truck, large truck, coupe, sedan, wagon, van and commercial vehicle.

Then I go and describe the damage using 3 terms, light, moderate and considerable.

Those are mine and can be widely interpreted.  Maybe I’ll get Motorcop to jump in on this but…A coupe hitting a brick wall at 40MPH will look differently than a van that hits another van at 25MPH.  One is a trauma, the other not by protocol, even though one may indeed have carried far more force.

And even if I do mention light damage to the front of the vehicle, what does that mean? What kind of car? What kind of impact? Against what? Did the vehicle’s protection systems discharge properly?  If the driver was able to self extricate and has no chief complaint, why am I chasing him down with a C-Collar? Because the folks who wrote the policy are in a committee long ago and far away.

MOI is important as far as it gives us an idea of POSSIBLE injuries to consider.  I consider it as a part of the Past Medical History and weigh it just as heavily.  If it does not apply to the patient’s presentation it will be considered, but not relied upon.

One rollover will have a 17 year old girl sitting on the curb completely unharmed while a minor damage collision could yield significant injuries to the passengers.  We won’t know until we assess them.

I remember long ago in far off new Mexico, some medics would launch the helicopter just based on dispatch information of the reported damage.  And we’re back to the telephone game of one person’s “Oh my God! They’re trapped!” and another’s “She’s just not getting out, but looks fine.”

Assess.  Use MOI as a tool, not a guide.  We always look inside the passenger compartment for deformity, blood, marks, bent steering column etc, but we should not be basing a transport on the vehicle.

Then again, try documenting that you let a driver refuse transport who had moderate damage after a head on collision into a guardrail, deploying front airbags with a non-complete recollection of events.

Now if I tell you they hit the guardrail head on after sideswiping another vehicle at 40MPH and spinning around, coming to rest in the slow lane and is avoiding telling the police they cut across 6 lanes of traffic to make an exit…now can I let them go home?  Or should I be chasing him down with a collar?  We all know the answer to that one.

Looking forward to more, Rogue!