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

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.

:)

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:

(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.

Infusion Pump- Wikipedia

Internal Infusion Pain Pump/Intrathecal Drug Delivery

Medtronic Fact Sheet

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.

:(

Stretcher = 2, Finger = 0



Yummy. Bloodblisters. So very tempting to pop.