Sometimes it's real

Stay in this business long enough, and it'll happen to you. Stay in even longer, and it happens a lot. Stay in even longer, and you'll have used the phrase "are you (explicative deleted) kidding me? Just stay in until you see the judge".

That's right boys and girls, I'm talking about "incarceritis". For those unfamiliar with incarceritis, it is a condition caused by being tossed into the hoosegow. Signs and symptoms usually include chest pain, "walking seizures" and/or having "the sugar". After a few dozen of these calls, it is very easy to become jaded to the prisoner experience.

However, occasionally, a prisoner manages to surprise you, just as I was surprised recently.

My partner and I were sitting in the box when the call came in. The always exciting "... respond priority 3 to the jail for chest pain". We were sitting right next, so we scooted on over to the jail.

Inside was a male in his early 30's. He was really tall, (I'm 6' and he was well taller then me", and of average build. He said his chest was hurting on the left. Said it started the previous night, and got worse about an hour ago (which just happened to be about the same time he was arrested). The patient said he felt like someone was grabbing and squeezing that part of his chest. While talking, I noticed he was bit diaphoretic, which could have been from a medical problem or circumstances.

I briefly talked to the jailer while my partner got a base set of vitals and tossed him on the 3 lead. The jail basically told me that the patient was a regular visitor to their fine establishment "and pulled this same thing every time he came in". This is where I get on a small soap box for new EMT's and medics. Yes, once you here this it is very easy to assume your patient is faking his problem to get out of jail. Hell, I've been doing this a long time and I'll admit, the possibility ran through my mind from the minute we received the call.

About that time my parter called me over to check the monitor and I was a bit surprised by I saw. I went ahead and set up a 12 lead and informed the officer that this gentlemen would be going not only to and ER, but for safeties sake a cardiac center. Here is what we were looking at:

That's right, some big tasty trigeminy PVC's. Again, I told the jailer we were going, and informed him that there are just somethings that can't be faked.

I won't get too big into treatment, just a quick run down. My service at this time does not have a protocol for PVC's, which pretty left me with treating the pain. He vitals were stable. BP slightly elevated with pulse around 90. Went ahead with the cp protocol. O2, ASA and NTG. After the 2nd NTG pt stated pain was going away. We got caught in a little traffic on the way in. By the time we arrived at the hospital the pt had calmed, his pulse was down to around 64 and was throwing maybe 1 or 2 unifocal PVC's p/min. I actually had to show the doc all my strips because the pt's hospital EKG was so damn perfectly sinus that he had to wonder if I knew what I was doing.

As to the pt's final outcome, no idea. We stayed too busy that shift for me to back and check on him. The important moral of the story is this: Always keep your eyes open. Because the second you think you know what a scene or a patient is gonna throw at you, that 's when you get sideswiped by a saline bag.

I got a feeling this is gonna hurt

Today marks the beginning of something I like to call "Operation: Run Fat Ass Run". Why is this? Well a couple of reasons.

First this is. After years of emergent 911 response, I now find myself in the transfer business. Now, I know some people are gonna give me a big "whiskey tango foxtrot" on that one, but bare with me here. Where I live it, there are only two private services within driving distance that handle fast paced, progressive 911 service. I have worked for both in the past. One I can't go back to, nothing involving patient care, just me being me. (Hey, I was young and stupid). And the other, after taking it up the wahzo from them, I won't go back to. Aside from that, if you want emergent response where I live, you gotta be a fire fighter. I'm not gonna re fan the flames of fire medic vs non fire (that's for another story), but suffice to say it just ain't me.

So that leaves me here. But don't fret true believers. I'm not just knocking granny all day. The service I am with does a lot of ALS and critical runs, and to be honest I am learning about a lot of stuff we just didn't deal with in the 911 world. For the first time in years I have moments where I feel over my head.

So, what does this have to do with Operation: Run Fat Ass Run (ORFAR)? Well, this service is also the largest aeromedical response (emergent chopper and fixed wing) in my area. I have the qualifications to fly, but as of right now I'm over their flight weight. Yeah, a few years of overnights eating burgers and chicken legs will pack it on. I'll roughly 6 months until I can even apply for transfer. So I have at least that long to get to weight.

Aside from that, there is another reason.

True story, funny story. A friend of mine(best friend, known him probably 20 years) comes up to me and says "Hey John, I got this event you should do with me. Yeah it's a run, but hey, free beer after"! And if you know me, you know free beer is like my kryptonite. I'm weak to its temptations. So I sure, and promise to do it. It was then that I found out that this little even was actually: The Warrior Dash

So yeah, I'm f*cked.

But I made a promise to give it a run, plus the time of the race coincides with my 6 months. Everything has seemed to of fallen into place, and the cosmos has given me a reason to get myself right.

So... just pray I don't keel over and stroke out in the process.

Those damn TV shows.

So, for my first actual post on here, lets get the fire started tv style, with a new little show called Trauma. A show that the EMS community despised so much that letters were written to the heads of NBC, and boycotts were threatened.

So first off... what the hell? Really? It's a tv show, find something better to do with your time.

I mean, I get it, "it portrays EMS professionals in a negative light". Once again, lighten up, it's TV. Not to mention, it sure is a good thing nobody decided to boycott FX over a couple of small shows called "The Shield" and "Rescue Me" Both amazing shows. Neither celebrating the "we are holiness" of the FD or PD. Hell, I know fire crews who never miss an episode of Rescue Me.

And why is this? Because they don't take themselves so damn seriously. We in EMS are so used to being the step children, so used to having to defend ourselves all the damn time, that we can't even relax for an hour.

Now don't get me wrong, as my following comments will show, the first episode was EFFING horrible. But hey, it got a little better.

What follows in my response on a message board about this very subject. If any lonely soul comes across this page... I enjoy a heated discussion.


Ya know, when the show first came on, I hate it. I hated the premier. I felt it an assault to every fiber of my being, both as a medic and a tv viewer. As a medic, I hated the way the job was portrayed professionally. I felt as though the show has zero technical advisement. And as tv viewer, it just seemed to try to hard for it's own damn good. The writing and dialogue of the premier were horrible. And the actors were stiff like cardboard.

Now, as to how the crews were portrayed on a personal level (the part that most of the EMS over achievers took issue with) didn't bother. Yes, most of the characters came across as being totally morally bankrupt. But the fact of the matter is, if you've worked in this business long enough, in busy enough systems, you've met each one of those people, and probably have some stuff in common with a few of them.

So like I said, at first I hated. But, after recently learning it was going to be cancelled, I decided to give it another chance. I figured I was bored, and it would at least give me something to laugh at.

Second episode... a little better. Third... a little better. Yes, I still laughed at the stupid mistakes they made. Even contemplated making a drinking game where you take shots when the crews go "full-on Rain Man". But a funny thing happened while i was laughing, I started to enjoy the damn show. As a few episodes went by, you started learning a little more about the characters. By the time I was a few episodes in, the show seemed to manage to make the switch from "an action packed adrenalin shot to the heart" (btw NBC...that tag line was 100% grade A cheese), to being a really decent, action filled, character driven show.

And while I am sure I'll catch shit from my somewhat more uptight brothers and sisters in the field, I'm actually sad it's to be cancelled. Do I think it would be one of the greatest shows on television? Not in any way. But if nothing else, with the way it's improving, it could be a good 3-4 season show.

A New World

Well, not so much a new world. But the view of it through my slightly off centered eyes. After more then seven years in the business, I finally decided to stop fighting it, and hop on the blogwagon. Most of what you'll read here will pertain to EMS. Whether it is about in field issues, behind the scenes issues, or the politics of it all. What ever gives my synapses a "whiskey tango foxtrot" moment.

Besides that you'll probably see the occasion post from my other interests; music, RBSD, my kiddo and being the commissioner of a fantasy football league in which my team is dropping like a turd from heaven.

So sit back, relax, and lets have a little fun.