Tag: writing

  • I Deserve to be a Supervisor, Despite My Criminal Record

    At my particular agency, we employ various field supervisors that oversee the crews out on the road. And for the most part, these supervisors are awful. They are the paramedics that couldn’t actually do the job well enough to justify keeping on the ambulance, but somehow didn’t screw up enough to be fired. As someone who has been nearly fired numerous times, I’ve proven that I’m capable of that aspect of the job.

    But I obviously know more than all of them. So often supervisors are showing up on MY scene and trying to tell me how to run MY patient. “Confirm that intubation” they’ll say, but why should I waste time confirming my skills? I saw the stylet go into a hole! I know it’s good! And if the only qualification for supervisor is ruining their best medic’s scene, then it’s time I throw my hat into the ring.

    So, let’s talk about the reasons I should be a supervisor:

    1. I’m a woman. Our current lineup of managers is very much a sausage party. As I mentioned to the HR representative when they brought me in for my last ‘disciplinary’ meeting, I’m not above suing for gender discrimination.
    2. I’m better than all of our current lineup. Not only have I been a medic for nearly two entire years, but I am constantly researching and practicing new techniques, such as using an IO drill to create an emergency cerebral ventricular shunt.
    3. I am willing to stand up for my coworkers. And by coworkers, I mean my fellow supervisors. I will have your back and punish anyone who dares to question our authority. This is for the good of the company, which means its for the good of the employee.
    4. Not al the crimes I committed are illegal in all states. And the ones that are currently have no active warrants. That means I’m a safe bet as long as I stay within Oklahoma and don’t cross any state or county lines.

    So if you know me, and many of you do, mention my name next time there is a potential opening. Frankly, I’m having trouble making rent and vape prices keep going up, so I could really use the money. Just remember that I have plenty of blackmail material on all of you and I’m willing to use it.

  • 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.

  • It’s time we take Wildland EMS seriously

    I recently had the honor of attending a wildland EMS conference in Colorado, a state that’s dear to my heart for its natural beauty and strong wildland firefighter presence. And this conference included some of the best, most intelligent in their respective fields. Many of these people were the same type I looked up to when I was still new to this field.

    And it’s for that reason that I’m sad to say that what I saw was pathetic.

    These people are supposed to be the best of the best, and yet all I saw was a bunch of rednecks talking about outdated concepts that the field already left behind twenty years ago. Especially the wildland EMS folks.

    Are you trying to tell me that these people seriously believe “BLS over ALS”?! When was the last time BLS was ever used to save anything? You think splinting with sticks and gauze is going to make a difference when epinephrine drips are right there? Pfffft. To quote the best movie of all time, Clueless, AS IF.

    I get it that half these guys spend so much time staring out at nothing but trees that the boredom has scrambled their brains, but it’s time for us to start taking this field seriously. We can’t have out-of-hospital providers believing that snakebites aren’t treated with repeated heavy doses of atropine and tourniquets.

    It’s personally shameful to me that these are the people I used to work around and admire. I’m infinitely glad that I’ve had the opportunity to work in a commercial ambulance system where the nearest hospital is always 5 minutes away. It’s allowed me to practice real EMS and actually learn skills beyond making a stretcher out of rocks and spit. If only those wildland ‘experts’ had half the knowledge I have now!

    Don’t even get me started on wildland firefighters. You think you’re real heroes just because you successfully burn down half a state? Real firefighters put a fire out, not just watch it burn down a city while attacking it with… leaf blowers? The whole system should be defunded, stripped, and rebuilt from the ground up using actual expertise and not just the backwoods knowledge of some gap-toothed yokel.

    So here’s my challenge to the so-called wildland experts: stop watching squirrels mate in the middle of the woods and read an actual book on medicine written in the past decade.

  • Firefighters, Only Good for 3 Things

    Running with firefighters is a daily part of our job and it’s important to know how to utilize them as a resource. Now, before we continue too far, let’s get one thing straight: fire medics are not real medics. It’s kind of like Velveeta being called cheese; it’s not cheese. It’s a processed ‘cheese product.’ And that’s kind of what firefighters are: processed paramedic products. Non-organic and not nearly as good as the original.

    That brings me to my first point, which is the things firefighters are NOT useful for. And that’s advice. Treat each and every single firefighter you run across like a child, as that’s basically what they are. For example, the other day I was working a cardiac arrest when some firefighter thought he should correct me just because he had twenty years on the job. He had audacity to say “I don’t think think we should shock PEA.” Well, it wasn’t PEA. It was an organized V-Fib!

    Without further ado, the three things firefighters are actually useful for:

    One: CPR.

    As a medic, you should never be doing CPR. Even if you’re alone in the back of the ambulance, it’s more important to start an IO and get amiodarone on board as soon possible. Once fire arrives, they can begin compressions. And if you’ve been doing your medication properly, the patient should already be pre-loaded with life-saving epinephrine.

    The most important way firefighters can help with CPR is by attaching a LUCAS device. After that, return firefighters back to the station so they can eat chili and grow fat.

    Two: Lift Assists.

    I work in Oklahoma, which means about 60% of my patients and 75% of my coworkers are morbidly obese. I am a small, petite woman that mostly eats grass and grapes, so I’m not built to lift heavy things like our patients. Or stethoscopes. I’m always on the radio on the way to any EMS call, requesting fire beforehand just because I know we’ll need them for any sort of lift assistance.

    It’s important to know that, as a paramedic, it’s not your duty to lift or assist lifting the patient in any way. Your hands are too valuable to risk. Let other, lesser people like EMT-Basics and firefighters handle that burden.

    Three: Dating

    Let’s all us girls be honest: when a balding, pudgy middle-age man flirts with you, it gets your pulse racing. Especially when he’s in uniform and has an under-trimmed mustache. Firefighters are the ultimate relationship goal for any paramedic. And the best part about them is that it doesn’t matter if things don’t work out, you can always find another! Some people say that there’s plenty of fish in the sea, but I say there’s plenty of hunks at the station.

  • Bias in EMS? There’s no such thing.

    I was reading the national news, as any good paramedic does on a daily basis, when I encountered this AP News article here.

    An ambulance is called to the scene of a police shooting. The patient they were called for has been shot in the torso by police. Upon arrival, another police officer reports trouble breathing and she’s covered in blood. There’s no reported injuries from her and she states that she is feeling better. So, which do you transport? The penetrating gunshot to the trunk or the resolving anxiety attack?

    That’s right.

    The anxiety attack.

    Police officers are the most true heroes of first responders, even more so than paramedics. And definitely more so than firefighters. And 200% more so than EMT-Basics. Think about it. Who do we call for help when we need it most? That’s right. Police. They’re the 911 for 911.

    So it only makes sense that we honor our brothers in blue by placing their needs above the needs of others, including gunshot victims. I know that sounds extreme, but truth is often the most extreme to those blinded by propaganda. Besides, there’s nothing we as paramedics can do for a gunshot patient anyway. You might as well throw them in the hosebed of a fire engine and make them transport while we deal with actual, real patients.

    In the end, I applaud this ambulance crew for making the correct decision in a stressful situation. Where others may crews may have fallen to peer pressure and transported the gunshot patient first, this crew stood their ground in the face of the hive mind and made the correct call. For that, you get Paragoddess Amber’s star of the week!

  • EMT-Basics can be treated like cattle. And that’s okay.

    I’m sitting outside a Chief’s office, about to have another of my ‘Emergency Mandatory Trainings’ after an interesting call I ran a few hours ago. And I can’t help but think, after having so many of these throughout the years (I’ve had them at my last five jobs in EMS!), they’re really the only kind of EMT I am used to. Or that I can stand.

    Yes, I know EMT-Basics are supposed to be considered professionals. But are they? Really? Are you telling me that their semester of training is anywhere equal to the eleven-months of school I went through to become a paramedic? That practically makes me a doctor. The only difference between me and a doctor is I still have some common sense.

    But I’m tired of these rugrats getting onto my truck and trying to tell me about their day. Or get to know me. Sometimes they’ll even try to correct me on MY practice. Do you think I have time to worry about a sharps container, *Susan*? Why don’t you just watch where you put your hands when you’re cleaning *my* truck?

    Let’s face it: the average EMT-B only lasts a few shifts of working with me. Some don’t even make it a whole shift before quitting the field entirely. They just can’t take the pressure. And that makes them easily replaceable. So imagine my shock when one just happened to mention how much they’re getting paid.

    You’re telling me that paramedics are struggling to make ends meet and pay off our various debts (school, mortgages, gambling, etc) and these freaking Basics are getting paid?!

    I know how we can fix EMS and improve paramedic retention: stop paying the cattle. People will line up for their job. Trust me. I used to teach EMT students and it’s absurd how many of them I simply rubber-stamped through school. And none of them had any idea what they were doing, even after graduating!

    If we reallocate those funds to paramedic pay instead, we’ll keep more quality medics like myself. You know, the people who actually save lives and don’t just drive the ambulance? EMT-Basics will still work for us, of course. But they can volunteer. And then the company can call itself a charity and even save money on tax dollars.

    I’m going to mention all this to my Chief once he’s done screaming about his usual bit about not using co-workers as pincushions.

    Or whatever he’s on about. I haven’t really been paying attention.

  • 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.