Tag: health

  • White People Don’t Deserve 911

    I know that’s a shocking title, but I have a right to make these decisions. After all, I’m white. And I’m proud of being white. Anybody who knows me knows about my undeniable Irish heritage, and they’re the whitest of all people. If you combine that with my allergy to the sun, I’m the foremost white amongst the American population.

    911 services shouldn’t be allowed to the white population, and that includes fire, police, and ambulances. Especially ambulances, as we’re the most important first responders. If you do respond to a white household, you have a moral obligation to deny that person service or transport. And for the record, I consider white households to be any place that has two or more contains of sunscreen.

    Ambulances should go to people who actually need them, not the latest Karen complaining of a minor cough and insisting it’s Ebola because she saw that on last week’s rerun of Grey’s Anatomy. And nobody needs them more than minorities. After all, America has a history of crushing minority populations underfoot and leaving them with increased risk of diseases and less access to healthcare. It’s time for reparations, and it begins with their actual health.

    Besides, they need all the help they can get. Minorities are not, statistically, good at making decisions. They tend to be uneducated, operate on outdated beliefs, and are highly superstitious. They can’t be trusted to make decisions for themselves and ought to be treated like a dog being brought to the vet. If that needs an ambulance to accomplish, then so be it.

    Meanwhile, white people are extremely capable, intelligent, and diligent. If a white person gets to the point where they need help from an ambulance, then it’s their own fault. Minorities are often victims of their own decisions and should not be judged for their naturally poor reasoning. It’s very likely they’ll have a medical emergency for just this reason.

    So, this is a plea to all my medical homies: if you’re in a house and the dog isn’t a pitbull or Chihuahua, then you’re wasting your time. It’s time we remove the bias in the industry and this can only be accomplished one call at a time.

  • Intubation: We’ve Been Doing It Wrong

    We’ve all been there. A 56 year old female, chief complaint of chest pain, with a history of anxiety and diabetes. Her skin is warm and pink with rapid respirations in the range of 38. Irregular and shallow ventilations and with clear lung sounds. If you’re a decent medic (and if you’re reading this, you are) then you can tell one thing just from what I’ve mentioned above: this patient in unable to control her own airway and is a candidate for rapid sequence intubation.

    Here’s the problem with the scene: time is limited. One thing other fields of medicine don’t understand about paramedicine is that our scene time, legally and morally, cannot be more than ten minutes. So taking time to push sedatives like ketamine or etomidate ()both of which are incredibly lethal drugs even in small doses) is a waste of time and resources. But for too long we’ve tried to accommodate the opinions of so-called ‘doctors’ and ‘medical experts’ and ‘the court of law’ just because they’re the ones in charge. But it’s not their patient. And it’s not their life to save.

    I think it’s time us paramedics really buckle down and focus on what we are: life-saving heroes. And life saving heroes don’t have time for Delayed Sequence Intubation (an oxymoron if I’ve ever heard one). Instead, it’s paralytic time.

    In the above scenario, the patient shows all the traditional signs of imminent respiratory collapse: rapid respirations, an inability to stop crying, and a recent breakup with her boyfriend of three years. (His name was Marko and he had shaggy blonde hair and a smile like a sunrise.) The traditional way would say to administer a sedative like versed or etomidate first. That’s wrong. If we waste anymore time, the patient could crash on us. Not to mention all the dangerous side effects we could be introducting. So, what’s the correct way?

    We skip straight to the Succs.

    A proper dosing of Suchsinocholine (.3 – 5mg/kg) will have the desired effect of controlling the patients airway and decreasing their respirations while we prepare for ventilation. By reducing their respiratory rate, we allow a proper build of carbon dioxide to help reset their respiratory drive. We can even supply 4 ppm of O2 via a non-rebreather to help support ventilation efforts in this time.

    After preparing for intubation (remember to forego the flex-guide or stylet as these will damage the airway 70% of the time), we immediately intubate the patient. We’ve now controlled the respirations and ventilations and have saved yet another life. This is the new way we should be operating and the which that modern science actually teaches us.

    So next time you go out into the field and run that chest pain call that turns into respiratory distress? Remember this simple phrase: intubation before relaxation.