Captain Tripps

We had a rollover MVA, female in the back seat was trapped and had no sensation/movement belly button down. After careful extrication and getting her boarded she regained some sensation and movement. By the time we arrived at the ED she had really amazing neuros, considering. We get to the ED and turn her over to the trauma team. About 5 minutes later a resident comes out and starts reaming me out for not giving Mannitol. He goes on about a five minute tirade about how incompetent I am and how Mannitol was indicated. A point I did not argue with one bit. I just stood there and took it, the attending was sitting a couple of feet away with a little smirk on his face. Finally it came to the macho point of the resident saying "so can you explain to me why you didn't give Mannitol?" My answer was short and sweet, "Dr we don't carry Mannitol on our units." The attending smiled at me, reached over the counter grabbed our protocol book (county wide protocols) gave it to the resident and sent him to the back to refresh himself on EMS protocols. Appearantly after we left there was quite a reaming. Sorry I missed it.

I was where you are after too many years as a Paramedic. You could potentially be in a very dangerous place for yourself, I know I was. What I did is take some time away from the streets, I took a lab position and it helped me regain my life. I am now back on the streets and going to Nursing school. I agree with using your EAP, and maybe think about transferring to another unit. Please feel free to E-mail if you would like to talk. Peace, Tripps

It's an acronym you are supposed to put in front of the name of someone you want called in an emergency. Stands for "In Case of Emergency." In systems I have worked family contact is PD's gig, besides with HIPAA I don't feel comfortable contacting family anymore. Sad but true.

For the past few years I've wanted to make a costume of the monster from The Village. You know "Those we do not speak of" creatures. I just haven't had the time.

You know I guess I am a little backwards on this issue. Yes pedi codes are tough. Yet somehow my heart is more broken by elderly codes, especially ones we call on scene. It is heart breaking to tell someone who has shared their life with someone for 50-60 yrs that their loved one is gone. The looks on their faces, the idea that tonite for the first time in years they are going to bed alone. Their life is gone as they knew it. It's also worse because it is usually sudden. It is even worse when it is a women who has passed. Men expect to die before their wives, many are completely lost without their wives. I was glad that my father passed before my mother. He would of had no life without her. My parents were married 53 yrs and they never spent a night apart. I often see them when I have to break it to a family member their spouse is gone. The toughest call I ever had was an elderly lady who started out aphasiac secondary to a probable CVA. She quickly crumped on me and arrested. While she was being worked in the ED I sat with her husband who had no family. I sat with him until the chaplain finally made it down, 45 minutes later. I learned how they met, and heard all kinds of stories. I have always tried to keep a distance between myself and my patients, just for this reason. I still feel for him his stories were so wonderful. Even during his loss he was the nicest and sweetest guy. To the OP, everyone is right you will never get use to it. You shouldn't though, it reminds us all we are not immortal. Peace, Tripps

Well it wasn't a hospital rule but it is probably the dumbest rule I ever fell under. When working as a Paramedic in an unnamed city we used to use the local homeless shelter as the address on our run sheets for homeless people. Well that center got tired of getting bills so they complained to the city. The city came down with this brilliant rule. We were to used the address where we FOUND the patient as their billing address. This lasted about two months until the city changed their minds. Why? About 400 local businesses did not appreciate getting bills for ambulance runs for homeless people. Gee who would have thought that? The run sheets had now way for the billing people to know this was not their address. So businesses like Quik trip, McDonalds, Citgo, The Performing Arts Center and even City Hall were getting these bills. :rotfl:

When I was doing search and rescue in my younger years we had a whitewater drowning. (Stupid mistake #1). Some kayakers decided to try and run a very violent river at flood stage. (Stupid mistake #2). One of the kayakers had no PFD and was not wearing a helmet. He gets sucked out during a roll and is last seen by his buddies shooting head first into a large rock and going under. I cannot stress just how dangerous the river and the riverbanks were that day and night. Heavy rain, flooding everywhere, banks collapsing, trees falling in other words a hell search. After about 14 hrs of searching and finding nothing I am standing with Deputy looking over the river via big floodlights that were set up. We were talking about how dangerous this search is for the teams involved. (Stupid mistake #3) I said to the Deputy "someone is going to get hurt or killed tonight trying to find a corpse." I then notice about four feet behind us was the victims dad. Doh!! I was right and later that night they suspended the search, it was just too dangerous. Yet I felt like crap for days. We found him three days later. His entire frontal skull was completely crushed, the water was moving that fast. Obviously he was killed instantly. Poor guy, if he had a helmet and PFD he might have made it. Peace, Tripps

Wow I wish I could say I have never heard that before but I would be lying. I sometimes worry about some of the GP's still practicing out there. I had a patient who had to pull over and call 911 after his Doc sent him POV to the ER. I have also arrived at an MD's office to be told by the secretary the patients in room whatever. Find the patient pale, diaphoretic, moderate dyspnea and complaining of 8/10 CP. All alone in the room, no O2, no ASA, no NTG, no EKG, no IV not even someone to monitor him besides his wife. Sad really. Tripps

I have never broken teeth or caused any injury to my patients over the years and I have had to "reef" on many to visualize. I would suggest a little more practice with the heads to build up your self confidence. It is very hard to injure a patient during intubation so calm down on your next attempt. A couple of things might help... 1. Remember once you get your blade in lift straight up. It helps some people to put their thumb parallel on the handle (pointing up) and just pull it towards the ceiling. You cannot injure the teeth if your pulling straight up. Injury comes when you try to pull the handle back and up not just up. 2. On non trauma patients it is easier to tilt the head back, which I am sure you know. But a little trick for difficult patients is to let their head hang off the end of the bed with someone supporting their head. I have gotten really anterior patients this way. 3. Don't be ashamed to ask for cricoid pressure, it helps sometimes. 4. Finally, a real human is MUCH easier than the practice heads. If you can tube a head you can tube a person. I have a feeling that once you get your first tube you'll be fine. Good luck, Tripps

I just love how the warning (that appears on every Craig's List posting) works out with the last line of this post. Peace, Tripps

I love compounding pharmacies because of lollipops. When I had my tonsils and adenoids removed my MD prescribed tetracaine lollipops (as well as various other liquid meds) that made my pain bearable for two weeks. My brother had the same surgery and had multiple infections secondary to not being able to drink his antibiotics due to the pain, no lollipops. I never knew what a compounding pharm was either until then, once again, thank god for them.

As a burned out old Medic let me throw in my two cents. #1. I agree with Diana, R/O pregnancy right off the bat. You never know and syncope is pretty common for pregnancy. #2. I know this is going to sound weird but, you might have held your breath to the point of passing out. I have seen students and others do this, they get so wired they hold their breath while watching something and actually pass out from hypoxia. #3. Most importantly make sure it's not a medical issue and then forget about it. You just might have found your 'thing'. Every Paramedic, EMT and even Nurses I have ever worked with has one thing that gets to them. For some it's lots of blood, or puke, or some other vile body fluid. For me it's always been stool from a lower GI bleed, for some reason the smell makes me want yack. Don't get discouraged it happens to a lot of people, maybe even the ones who made the snide comments. Peace, Tripps

See this is where my quick, and usually rather mean, sense of humor gets me in trouble. I would have looked right at her and said, "Wow, you do that too? I looked you up the other day just for fun, so how are the outbreaks? Is the Valtrex working for ya?? Peace, Tripps

I agree there is a bond but (there's always a but), does it have less to do with shared feelings and more to do with constant contact. As an adult almost every relationship I have had was either a Nurse, Nursing student, EMT student or a fellow EMS worker. My wife and I met when she was an EMT-Basic student on my ambulance. Also if you were like I was and worked a lot of overtime and had no life, then your co-workers are all that you see. So to quote Silence of the Lambs "we covet what we see everyday." So maybe it's because we just don't have the opportunities to meet people who aren't flat on their back. Peace, Tripps

I have a helicopter wife! :uhoh21: Not defending the situation but there are communities that have their own pseudo health care system outside of the hospitals. Some people in the Asian community in Portland never go to the hospital (or be transported by EMS) they go to such caregivers. It could be she never plans on taking care of English speaking patients. Just a thought. Peace, Marty

Ok, where to start? G.W. is my president, just like the womanizing, lying, impeached, bloated, gas bag was my president, or the stuttering no new taxes guy, the jelly bean Iran Contra guy, peanut boy, the I am not a crook guy and even I pick my nose in public LBJ. If your faith in the country is decided by who is president then I suggest you move to a dictatorship like, umm... I don't know CUBA maybe. They have great healthcare! This country has been around for 231 years, we've had good and bad presidents yet we're still here. So step away from the kool aid, the end of the world is not nigh. I have compared the U.S. health care with other countries. One of the major differences between us and them is what medical professionals are payed. U.S. Doctors & Nurses are making mint, what other job can you get a two year degree and walk out of school making $30/hr? Not many. Are you willing to drop your salary to CNA wages to help others get healthcare?? Another issue is the cost of medications in the U.S. and the excessive costs of emerging technology. It cost my mothers insurance $3500 a dose for her chemo!! Doesn't that seems a little excessive?? The problems with the U.S. system far outweighs anything a single president has done. Drop the George Soros talking points and look at the real problems. Peace, Tripps

Michael Moore is a self promoting douchebag who uses the suffering of others to pay for his million dollar apartment and his vaction homes. Do not believe for a minute that he gives a damn about anyone but himself. Having said that, yes our health system is screwed up. No doubt about that, but to believe in universal healthcare provided by the government is naive. Just look at the current state of medicare and medicaid, do you really think our government can provide effective healthcare? Canada has universal healthcare, yet Canadians DO come across the borders to get care here rather than wait for months to get it there. Cuba?? Friggin Cuba?? You have got to be kidding me, they probably used up all their medical supplies to take care of these patients for the cameras. If you think Cuba is great I suggest you study your history or better yet talk to an ex-pat in Miami. Their system is so great people risk there lives to leave and come here, 50 to a boat that supposed to hold 10. Instead of the U.S. government taking over healthcare and wasting away trillions I have an idea. Why not have the U.S. government pay the PREMIUMS to private healthcare companies for people who cannot afford health insurance. This would make the insurance companies happy and fat and get people healthcare. Even if the premiums were a $2000 a month that is still only one ER visit. Simple idea so of course they will never even think about that. Now please continue with the praises of Michael Moore; go see his movie; he needs another vacation home, maybe Aspen this time. Peace, Tripps

My sig says it all. Former Paramedic, before that EMT-Basic, before that high schooler working at a grocery store. Peace, Tripps

Hmm, I was always curious what became of my ex. Seriously though does your facility not have a policy regarding gifts from patients or patients families. I mean this goes way beyond flowers, a card or cookies. This seems to be the reason those policies are written. As far as what comes around, what would be appropriate for this woman? Ebola? Fishing with Scott Peterson? The T Virus? (video game reference) An interview with Geraldo? Peace, Tripps

You know they have medication for that now. Peace, Tripps

My worst experience was after surgery. I was in PACU, drugged out of my mind and in some pretty severe pain despite the meds/anesthesia. Someone (I cant remember who) drew an ABG and left the RN to hold pressure on the draw. Me being ever helpful told the Nurse I would hold pressure for her. Since she knew me she thought that was OK. Did I mention I was drugged out of my mind? I am sure I held good pressure for at least 5 seconds and then I don't remember anything since one of the meds kicked in. After a stint in ICU secondary to complications/reactions a full day had elapsed since I remembered anything. The first thing I noticed was pain in my arm, I looked down to see a bruise that ran from the most of my left hand and ran almost to the elbow. Apparently the Nurse had left to do something after I said I would hold pressure. I guess I bleed an impressive amount and was left with one nasty painful hemtoma. I don't blame the nurse and I still think it was kind of funny. The complications were not related to the ABG incident by the way. Best experience with a Nurse was in the ER and had nothing to do with medicine. Peace, Tripps

They sell these little dropper bottles of breath freshener, minty fresh or something like that. Just a drop above your lip, works like Vick's without the horrible smell. Peace, Tripps

Damn sounds a little high schoolish to me, I'm pretty sure "titty twister" is not in the medical literature anymore. It amazes me to see what was at one time a normal practice that seems so barbaric now. I once saw an RN use hemostats to squeeze the nail bed on a patients toe, she said she learned that years ago in nursing school. OUCH!! Peace, Tripps

I live in Longview which is basically becoming a bedroom community for Portland/Vancouver. We call it the "Banana Belt" here, the Coast Range Mountains get the brunt of the rain and we live in the "shadow". We get less rain than Portland and sometimes it will be nice here and rainy in the Portland metro area. Longview is a nice little city, about 30,000, some meth issues, 1 hospital, some meth issues, housing is $$$, and we have a bit of a meth problem. Peace, Tripps

Look I am not a big fan of wiping my own butt, it's gross and kind of degrading. The only thing worse would be if someone had to do it for me. Patient care is about the patient not about the caregivers feeling toward certain body functions. Now a quick story from the streets to lighten the mood. We had a very pleasant elderly lady at home who was in some mild medical distress. She was non ambulatory and needed to go from the bedroom to the living down a hall we could not fit the cot down. So we did an underarm/leg carry to move her which unfortunately left her bum exposed. After the move down the hall to the cot, I notice a large BM lying in the hall with a boot print in the middle of it. I do the mandatory quick look of my boots and find nothing, I then point it out to my partner. She does the quick look turns pale white and asks the patient if she has a cat or dog to which the patient says no. My partner, who is now extremely pale and near vomiting discreetly limps out of the house and cleans her boot off in the grass. My partner who was very clean and fastidious ended up throwing the boots away. Peace, Tripps