MOLST (pt. 1)

Dear Healthcare Proxy (child over age 18),

When I'm transporting your parent for a dislodged PEG tube for the third time this month, I want you to know that this is not normal. I want you to sit down and discuss things with your parent. Deciding to set up a MOLST form (the NY State version of DNR/DNI) is not an easy conversation.

I am aware that your parent has expressive aphasia and hemiparesis from the stroke. But I want you to know that your parent is completely alert and oriented, and that we have very pleasant discussions (even if I do most of the talking and they make faces and squeeze my hand in reply).

I know you may not want to hear this. The MOLST form probably wasn't set up earlier because you had no reason to expect the stroke.

But I also know that transporting your parent to and from the hospital nearly every week is not a fun experience for anyone. Your parent is perfectly aware of their actions. Your parent is perfectly aware of their quality of life in a nursing home. And your parent has taken the situation into their own hands.

You can't change that reality by upping their dosage of anti-depressants.

Put on your grown-up pants and do your parent the biggest favor they'll ever ask from you.

Updates:

I made the blog a little purtier. Still loving the basic layout, it matches my EMT patch. :)

My house is full of strange couch surfers. Again.

I have an awesome sunburn. Note to self: apply sunscreen prior to ingesting alcohol. Also, still loving the Cyclone, but this new Luna Park has nothing on Astroland. And fun fact for you NYC EMS (and potential tourists): Bring your license to the Coney Island freak show and you get a discount.

More to come...

Lifting

Lifting is one of those basics we all learned in EMT class or at our first job in EMS. Squat, get a firm grip, and lift up with the legs.




We get lectured and lectured and lectured. Body mechanics, and injury prevention, and asking for lift assists when needed. You never ever bend your back to lift, and it's all because of the discs between the vertebrae in your spine. They cushion the weight across their full surface so long as your back is straight. When you bend your back, you're putting pressure on just a small portion or edge of the disc. Add a bunch of extra weight to a spine that isn't cushioning properly and your back isn't going to work the way you want it too.

These are discs. Be nice to them, because they can herniate, too. And no one likes hernias.



We all do stupid things. Particularly when it comes to putting our patients before our own safety. Because when you've got a bariatric patient in severe respiratory distress, sometimes you lift wrong to get the job done. As in, when your legs can't compensate for the additional weight and you have to throw your back and arms into it.

And then... you will be sore. You will be very, very sore, and you will have to take a sick day.

For those quiet times when you can consider things, like your sanity, here's some reading:

Lifting and Moving - hopperinsitute.com

Watch Your Back - emsresponder.com

Bariatric Lifting and Moving - emsresponder.com

Also, can I get one of these? As an early birthday present? Pretty please?

At some point in time I might separate my EMS related posts from my rest-of-my-life related posts. But as of right now, they're the sum of a whole. :)

And I should be less cranky now that school looks slightly realistic again.

And I can't drive for 3 weeks because I scratched the side of my ambulance pulling out of an ER bay.

Oops.

In the last 34 hrs I accomplished the following:

1 ten hour afternoon tour (that became eleven and a half hours)

followed by

1 eight hour overnight tour

followed by

getting home in time for a shower and change of clothes

before

getting back on the train to open the bookstore

followed by

working another eight hours

then finally getting back home

and doing a load of laundry so that I have something resembling clean uniforms...

...And discovering that my loan application for next year's full tuition at my chere college was approved.

So yes, the last 34 hrs without sleep were worth it. Completely and entirely worth it.

Dear EMS powers-that-be: STOP CHANGING MY EFFING SCHEDULED PARTNERS. I don't like working with a new person every single shift. I like coming in brain dead and half-done with my caffeinated beverage and having someone who already knows that I'm not fit for human interaction for at least three hours, and that I love to tech, and that I like bottom on stretcher, and that I take my second set of vitals in the bus before we leave the scene. I like predictable routine, ladies and gentlemen. Having a good relationship with your partner makes for better patient care. Building a new one every effing morning when I'm already grumpy and sarcastic as hell? Not ideal. I'm just saying.

In other news, I got promoted to manager at the bookstore. Yes, pay raise. Yes, staying part time.

Because standing in one place all day is starting to become a foreign concept...

Things I like:

Rubberbands shaped like sea animals.

Fruit bowls with just kiwi, strawberries and blueberries.

Movies about babies.

Ginger lemon white chocolate from Dylan's Candy Bar.

First firefly of the summer.

Also, my friends.

<3

Driving Code 3 (Or Code 1, for us Non-911 EMS)

This is why you alwaysalwaysalways STOP and LOOK before proceeding through intersections. Even if the light is green, there might be another emergency vehicle coming against the regular traffic rules. Props to these drivers. :)

Glucose Measuring Tattoo?

Can we just appreciate how awesome this is? Because this is AWESOME.

Nano Ink Tattoo Could Monitor Diabetes - DiscoveryNews

Who doesn't want a tattoo that changes colors depending on the glucose levels in their skin?

Wind Shear. Also Known As: Why I HATE Bridges

The New York Metro Area has 2,027 bridges and tunnels. Tunnels are easy. Make sure you've got enough clearance for your ambulance and don't change lanes.

Bridges are a whole other story. Single level suspension bridges have minor wind shear to begin with. Keep both hands steady on the wheel and stay in your lane.

Now, when you're in the ambulance that drives like a poor abused dog because it's been in too many accidents, this is a little more difficult. Every little bump and dip will send you drifting into your neighboring lane.

When you're in the aforementioned ambulance crossing a long suspension bridge in a spontaneous monsoon on an emergency call...

...you will be honked at. Repeatedly.

Safety suggestions, according to my partner:
1. Slow down
2. Open front windows of vehicle
3. Change to middle lane (the left lane is not your friend, that divider makes the situation worse)

Safety suggestions, according to the American Red Cross:
1. Keep both hands on the wheel and slow down.
2. Watch for objects blowing across the roadway and into your path.
3. Keep a safe distance from cars in adjacent lanes as strong gusts could push a car outside its lane of travel.
4. Take extra care in a high-profile vehicle such as a truck, van, SUV, or when towing a trailer, as these are more prone to be pushed or even flipped by high wind gusts.
5. If winds are severe enough to prevent safe driving, get onto the shoulder of the road and stop, making sure you are away from trees or other tall objects that could fall onto your vehicle. Stay in the car and turn on the hazard lights until the wind subsides.

So here's some information on wind shear and suspension bridges. (Don't read stuff about the Tacoma Bridge. It's not reassuring.)

Suspension Bridges - bukisa.com

Wind Shear - Wikipedia.com

High Wind Safety Tips - American Red Cross

Driving In High Winds - Midas