In non-EMS news: Does anyone have 2 weeks worth of antibiotics that I could maybe permanently borrow? Pretty please?
About this whole being uninsured thing... :/
At least my partner doesn't mind that my lymph nodes have been super size tumor status for the last week and half. And that I'm sleeping every single spare second in between calls. And that I legit lost my voice today. Try giving a triage report when you can barely talk.
Between the 2400mg of ibuprofen per day, my daily otc pseudophedrine and my proventil inhaler, I should be fine.
Right?
Functioning immune systems are for losers anyways. :P
Wednesday, April 28, 2010
Friday, April 23, 2010
Abuelita
"Abuelita!" shakeshakeshake "Abuelita!" shakeshakeshake "Senora!" shakeshakeshake "Como estas?!" shakeshakeshake "Senora! Senora!"
"I'm gonna say that's a GCS of...eight. Paperwork says the fingerstick was 1213."
Could you call us before our diabetic patient's sepsis gets so bad that their glycemic level goes higher than a fingerstick can count and you have to estimate a number?
I don't like spending the entire noisy bumpy Code 1 ride to the hospital just trying to find their goshdarn carotid pulse because they're so damn thready with some crazy-bad JVD.
Maybe? Pretty please?
Because rolling into the ambulance triage and finding no nurse immediately available results in us switching our patient to the hospital stretcher and rolling right on in to the emergency department.
And the emergency department wasn't even mad at us.
...At least not after I gave a verbal report straight to the doctor and they took a good look at the EKG.
:)
"I'm gonna say that's a GCS of...eight. Paperwork says the fingerstick was 1213."
Could you call us before our diabetic patient's sepsis gets so bad that their glycemic level goes higher than a fingerstick can count and you have to estimate a number?
I don't like spending the entire noisy bumpy Code 1 ride to the hospital just trying to find their goshdarn carotid pulse because they're so damn thready with some crazy-bad JVD.
Maybe? Pretty please?
Because rolling into the ambulance triage and finding no nurse immediately available results in us switching our patient to the hospital stretcher and rolling right on in to the emergency department.
And the emergency department wasn't even mad at us.
...At least not after I gave a verbal report straight to the doctor and they took a good look at the EKG.
:)
Tuesday, April 20, 2010
Scleroderma and Implanted Infusion Pumps
Had a patient with scleroderma presenting with shortness of breath today despite their home oxygen therapy. Finding a radial pulse on super-thick skin is not the easiest thing ever. I had to go way higher up on their forearm, because the skin around all of the joints was super-bad. Also, every little thing we did was painful. Our patient took it like a champ, but they were all bones and thick skin and the beginnings of contractures. Totally alert and oriented and involved in their own care despite bed confinement.
They were just a pinch over forty years old.
There's no set explanation for causes of scleroderma, but the most common cause of death from the disorder is lung related issues.
Scleroderma - Google Health
Scleroderma - WebMD
Our scleroderma patient had an internal/implanted infusion pump for chronic pain management, so they could self-administer pain medicine as needed. It looked like a cellphone, and it had it's own little bag and everything:
But that circle bag is implanted under the skin, and it goes a little something like this:
(Compliments of kimberlygraves.tripod.com)
Infusion Pump- Wikipedia
Internal Infusion Pain Pump/Intrathecal Drug Delivery
Medtronic Fact Sheet
They were just a pinch over forty years old.
There's no set explanation for causes of scleroderma, but the most common cause of death from the disorder is lung related issues.
Scleroderma - Google Health
Scleroderma - WebMD
Our scleroderma patient had an internal/implanted infusion pump for chronic pain management, so they could self-administer pain medicine as needed. It looked like a cellphone, and it had it's own little bag and everything:
(Compliments of medtronic.com)
But that circle bag is implanted under the skin, and it goes a little something like this:
(Compliments of kimberlygraves.tripod.com)
Your doctor fills up the bag as needed. There's a little portal hole type thing in the bag, so they can just do it with a regular needle through your skin and the portal. I didn't get the name of which painkiller he was on (I wrote it in my paperwork! Just not on my hand for future reference...) The pain medicine is delivered intrathecally, kinda like an epidural.
Most often seen on late-stage cancer patients and other serious chronic-pain-inducing conditions.
Most often seen on late-stage cancer patients and other serious chronic-pain-inducing conditions.
Infusion Pump- Wikipedia
Internal Infusion Pain Pump/Intrathecal Drug Delivery
Medtronic Fact Sheet
Sunday, April 18, 2010
Apparently St. Vincent's EMS has officially started diverting. I ran into a couple of their medics in the Beth Israel ER.
WEIRD.
No longer holding my breath about my chere college. Now praying to find a bank willing to loan me $52,000.
It's so nice being told by an institution I adore more than anything that I'm not worth investing in.
:(
WEIRD.
No longer holding my breath about my chere college. Now praying to find a bank willing to loan me $52,000.
It's so nice being told by an institution I adore more than anything that I'm not worth investing in.
:(
Friday, April 16, 2010
Wednesday, April 14, 2010
Monday, April 12, 2010
CUTEST. PATIENT. EVER.
Because really, watching a seventeen-month-old sleep for an hour and a half is enough to make anyone happy.
Totally makes up for how sore I am from that three flight carry-down via spiral staircase this morning.
Also, prettiest location for a children's rehab ever. It looked like my summer camp. And while I have to wonder what they do in emergency medical situations, since they're out in the sticks, it's totally somewhere I would recommend for long-term care. And I like the nurses. As soon as we showed in the readmission office, the staff picked our patient up and wouldn't put them down. As if all of them knowing our patient by name wasn't impressive enough. :) That is most definitely patient care I can support.
See also: Panhypopituitarism and its relation to Traumatic Brain Injuries.
Because really, watching a seventeen-month-old sleep for an hour and a half is enough to make anyone happy.
Totally makes up for how sore I am from that three flight carry-down via spiral staircase this morning.
Also, prettiest location for a children's rehab ever. It looked like my summer camp. And while I have to wonder what they do in emergency medical situations, since they're out in the sticks, it's totally somewhere I would recommend for long-term care. And I like the nurses. As soon as we showed in the readmission office, the staff picked our patient up and wouldn't put them down. As if all of them knowing our patient by name wasn't impressive enough. :) That is most definitely patient care I can support.
See also: Panhypopituitarism and its relation to Traumatic Brain Injuries.
Thursday, April 8, 2010
Accomplished the following today:
1. Eating an entire pint of Ben and Jerry's Peanut Butter Cup ice cream.
2. Seriously grossing out my partner.
3. Following it up with a large quantity of pizza.
4. Doing five calls with a stretcher that's 1.5 x my body weight.
5. And not calling for a lift assist on any of them.
6. Who loves bariatric stretchers?
7. ME.
8. :)
(Image compliments of blog.syracuse.com. They also have a neat article on Rural/Metro Ambulance Service in Syracuse and some of the Stryker gear they've outfitted their bariatric buses with.)
1. Eating an entire pint of Ben and Jerry's Peanut Butter Cup ice cream.
2. Seriously grossing out my partner.
3. Following it up with a large quantity of pizza.
4. Doing five calls with a stretcher that's 1.5 x my body weight.
5. And not calling for a lift assist on any of them.
6. Who loves bariatric stretchers?
7. ME.
8. :)
(Image compliments of blog.syracuse.com. They also have a neat article on Rural/Metro Ambulance Service in Syracuse and some of the Stryker gear they've outfitted their bariatric buses with.)
Wednesday, April 7, 2010
St. Vincent's
Now, ladies and gents, for something near and dear to my heart.
St. Vincent's Hospital Manhattan To Close - NYT
A little over twenty-one years ago, I was born in that hospital. I spent twenty seven hours torturing my parents by deciding I didn't particularly want to come out on their schedule, and the doctors finally concluded I was just too damn big and would have to be cut out. I spent the first three days of my life terrorizing the nurses, demonstrating my superior lung capabilities while the rest of the nursery was sleeping, and being so big and fuzzy that I was repeatedly mistaken for a boy.* My parents were actually asked on one occasion if they needed their son circumcised.
That's right, I was a nine pound twenty one inch monstrosity with a full head of hair. And I knew exactly what I wanted and when I wanted it. I suppose I was enjoying the only moment in my life during which I would tower over my peers. I would proceed to be the smallest person in my class for decades to come. Same temperament, though. And the lungs still work, though I have some crazy asthmatic issues from growing up in a filthy apartment above a pair of drug dealers who always were smoking something illegal.
But back to St. Vincent's.
They're shutting down a Level 1 trauma center in the middle of lower Manhattan. St. Vincent's even had their own totally awesome ambulance unit. Yes, NYU and Bellevue are both Level 1 trauma centers, and they're only a couple of minutes away. The world's not going to end. It's just going to be missing a hospital that's been around for one hundred and sixty something years. You know, one of the hospitals that treated Titanic survivors. More importantly, the place where I was born. (You think they'd want to keep it around, so they can make it a landmark when I become famous. Seriously, think ahead, people.)
I guess not even big donors could fix years of mismanagement and $700 million in debt. There's not much profit in charity work.
Dear healthcare system, you can has be fix now?
*Note: This has no relation to the fact that I secretly am a twelve year old boy. Particularly around super-gross stuff. :)
St. Vincent's Hospital Manhattan To Close - NYT
A little over twenty-one years ago, I was born in that hospital. I spent twenty seven hours torturing my parents by deciding I didn't particularly want to come out on their schedule, and the doctors finally concluded I was just too damn big and would have to be cut out. I spent the first three days of my life terrorizing the nurses, demonstrating my superior lung capabilities while the rest of the nursery was sleeping, and being so big and fuzzy that I was repeatedly mistaken for a boy.* My parents were actually asked on one occasion if they needed their son circumcised.
That's right, I was a nine pound twenty one inch monstrosity with a full head of hair. And I knew exactly what I wanted and when I wanted it. I suppose I was enjoying the only moment in my life during which I would tower over my peers. I would proceed to be the smallest person in my class for decades to come. Same temperament, though. And the lungs still work, though I have some crazy asthmatic issues from growing up in a filthy apartment above a pair of drug dealers who always were smoking something illegal.
But back to St. Vincent's.
They're shutting down a Level 1 trauma center in the middle of lower Manhattan. St. Vincent's even had their own totally awesome ambulance unit. Yes, NYU and Bellevue are both Level 1 trauma centers, and they're only a couple of minutes away. The world's not going to end. It's just going to be missing a hospital that's been around for one hundred and sixty something years. You know, one of the hospitals that treated Titanic survivors. More importantly, the place where I was born. (You think they'd want to keep it around, so they can make it a landmark when I become famous. Seriously, think ahead, people.)
I guess not even big donors could fix years of mismanagement and $700 million in debt. There's not much profit in charity work.
Dear healthcare system, you can has be fix now?
*Note: This has no relation to the fact that I secretly am a twelve year old boy. Particularly around super-gross stuff. :)
Traumatic Brain Injuries
The ABC's of TBI
Compliments of JEMS. :)
I know most of you have already read it, but between the trainee EMT and a head cold, I've been booked. I've got some good ones coming, I promise.
And if you need a laugh, picture this: The projects, a 300 lbs paralyzed dialysis patient on the stretcher, and five steps to go up to get in to the building. Stair chair is not an option (also, would be just as inconvenient). Me, 5'3" tall 105 lbs white girl, crouching down, sticking my butt out and using my entire body weight as leverage to weigh down the front end of the stretcher, and then wiggling backwards so my partner could lift up the back end and roll it forward.
My patient and her HHA were laughing all the way up to their apartment, because apparently I was the funniest one yet. And it got the job done. Double win.
Compliments of JEMS. :)
I know most of you have already read it, but between the trainee EMT and a head cold, I've been booked. I've got some good ones coming, I promise.
And if you need a laugh, picture this: The projects, a 300 lbs paralyzed dialysis patient on the stretcher, and five steps to go up to get in to the building. Stair chair is not an option (also, would be just as inconvenient). Me, 5'3" tall 105 lbs white girl, crouching down, sticking my butt out and using my entire body weight as leverage to weigh down the front end of the stretcher, and then wiggling backwards so my partner could lift up the back end and roll it forward.
My patient and her HHA were laughing all the way up to their apartment, because apparently I was the funniest one yet. And it got the job done. Double win.
Thursday, April 1, 2010
Thirteen
If you were transporting your thirteen-year-old self, what would you say? If you went to take vitals on a wrist etched with scabs, and shifting to look at your watch, saw the layers of scar tissue lining the inside of your arm. If you could turn back time eight years, what would you want to hear?
If you could lay hands on your thirteen-year-old self's significantly older significant other, for leading them down a road lined with weed and cocaine, leading them to a place in life where they completely disappeared for months at a time, for disrespecting and selling their body, for leaving them in the pediatric emergency room with wounds that antibiotics won't cure...
...would you?
And when you're giving your report to the triage nurse, would you be internally raging when she gave your thirteen-year-old self the dirtiest look-over and then refused to sign your PCR?
Because if my thirteen-year-old self's aunt and my own trainee EMT hadn't been with me, I would have said much, much more than I did.
When really, I just want to take my thirteen-year-old self in my arms and hold tight until all the bad goes away.
Take care of yourself, love. No one's going to do it for you, and if you want this life to be good, you're going to have to fight for it every step of the way. No one can make that decision for you.
If you could lay hands on your thirteen-year-old self's significantly older significant other, for leading them down a road lined with weed and cocaine, leading them to a place in life where they completely disappeared for months at a time, for disrespecting and selling their body, for leaving them in the pediatric emergency room with wounds that antibiotics won't cure...
...would you?
And when you're giving your report to the triage nurse, would you be internally raging when she gave your thirteen-year-old self the dirtiest look-over and then refused to sign your PCR?
Because if my thirteen-year-old self's aunt and my own trainee EMT hadn't been with me, I would have said much, much more than I did.
When really, I just want to take my thirteen-year-old self in my arms and hold tight until all the bad goes away.
Take care of yourself, love. No one's going to do it for you, and if you want this life to be good, you're going to have to fight for it every step of the way. No one can make that decision for you.
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