Ask the Paramedic II

[St.Urho]

@DogMom

Not a question, just a “thank you” to you and your fellow EMTs and Paramedics…
Back in May I broke my ankle. Badly. The guys who responded were very kind, considerate, and did a great job of keeping me, my husband and our guests (why yes, of course it was at a party :smack:) calm and getting the situation handled as efficiently as possible.
They took the time to explain all my options to me for hospitals, explained why the closest hospital probably wouldn’t be a good choice, and then gave clear directions to the person driving my husband down to the hospital we WERE going to. They kept me talking and answered all my questions, and they were SO nice. They even told the ER nurse that I was “easy to take care of” - which I disagreed with, but hey.

On behalf of all of us who are scared, in pain, and generally being seen on what could be the worst day of our lives - THANK YOU. Thank you for being there, for being patient, and for putting up with us when we’re not at our best. Thank you for doing it day after day after day, when it has to wear on you.
I, for one, appreciate it very much.

You’re welcome. It’s nice to be appreciated

[Elendil_s_Heir]

A fascinating thread. Let me add my thanks to DogMom’s, and ask some questions too.

Do you get to know cops and firefighters as individuals, or are they basically interchangeable from your perspective?

Any good pranks or practical jokes you can tell us about?

When you’ve had to call the cops about bothersome third parties, what exactly have those third parties been doing?

How often, if ever, do you have to testify in court?

Are people in your line of work more prone to alcoholism, drug abuse or PTSD?

Have you found you’ve changed personal habits in reaction to what you’ve seen (drinking less, becoming a zealot about using a seatbelt, etc.)?

Since there’s a paramedic shortage, as you mentioned, are salaries rising?

What piece of equipment would be most useful to you but hasn’t been invented/devised/deployed yet?

[St.Urho]

@trupa

Ok,. I’ll bite again. I’ve been struggling with how to ask this question, so bear with me a little here.

A fairly common meme in the paramedic blogs I read is about how everyone who goes into the profession has starry-eyed visions of “saving lives” , intubating, IVing, defibrillating and medicating like an EMS Tasmanian Devil, most of the time in an upside-down car in the ditch while waist-deep in water in the pelting rain (did I leave out any cliches?) and, that for the most part, the most valuable thing paramedics actually do is to provide transport to an ER/OR while making sure things don’t get any worse. A corollary to this is that paramedics rarely save lives, they mostly stabilize the patient to get them to where the lifesaving can actually happen.

That’s a pretty fair statement, for the most part. An exception to that rule is medical cardiac arrests- the care you get from me is identical to the care you’ll get in the emergency department- intubation, meds, defibrillation, CPR (not necessarily in that order). This is especially true in major trauma. I always stress with people I train that trauma patients don’t really need us, and don’t really need the ER, they need surgery ASAP.

I guess the question I’m struggling to formulate is: on what percentage of your calls do you feel you actually *save *a life? And the biggest problem I have is how to define " save" from a paramedics’ perspective. Sure, if you show up, patient is in asystoly, you shock them, and they convert to a normal rhythm, I think anyone would call that a save. But the collision victim with internal bleeding to whom you just apply IV, O2, and a big bolus of diesel to get them to the OR, is that a save? What about the possible MI with the inconclusive EKG whom you give O2 & aspirin and a ride?

What’s your take on the whole " lifesaving" thing, and how often do you think you’re actually doing it? If not very often, then where do you find your reward in your profession?

About the only time anyone talks about “saves” is with cardiac arrests. We all talk about the other really cool calls, but not generally in the same context. It might be because with other types of calls you have to make much more of an effort to find out what happened to the patient whereas with arrests, the outcome is pretty clear by the time we leave the hospital.

I would guesstimate that maybe 1% of my calls involve true “lifesaving.” I find it rewarding to be in a position to help people. I enjoy complex medical calls more than trauma calls. I like being able to take a complex set of symptoms and figure out what’s going on. I’d be happy to discuss it more, if you’d like.

[St.Urho]

@Elendil_s_Heir

A fascinating thread. Let me add my thanks to DogMom’s, and ask some questions too.

Do you get to know cops and firefighters as individuals, or are they basically interchangeable from your perspective?

At my old service, I knew pretty much all the cops and most of the firefighters. In Denver, there’s about 200 paramedics versus 900 firefighters and about 1400 cops, so it’s harder to get to know people. Some nights, it’s just like a nomex/blue blur…

Any good pranks or practical jokes you can tell us about?

Honestly, nothing comes to mind. I’ll come back to this if I think of anything.

When you’ve had to call the cops about bothersome third parties, what exactly have those third parties been doing?

More often than anything, it’s for being drunk and obnoxious. In particular, we’ll get people who interfere with patient care- getting in the way, or worse trying to keep us from treating or transporting someone. Happily, that doesn’t happen too often.

How often, if ever, do you have to testify in court?

So far, I’ve never had to testify in court. I’ve been subpoenaed a few times and talked to the DA once, but I’ve never seen the inside of a courtroom as a witness <knocks on wood>.

Are people in your line of work more prone to alcoholism, drug abuse or PTSD?

Yes to all of the above.

Have you found you’ve changed personal habits in reaction to what you’ve seen (drinking less, becoming a zealot about using a seatbelt, etc.)?

I definitely drink less than I used to, and I’m pretty religious about safety equipment- bike helmet, seatbelts, stuff like that. Nothing too major, though.

Since there’s a paramedic shortage, as you mentioned, are salaries rising?

They seem to be starting to, but there’s nothing like parity with police/fire yet.

What piece of equipment would be most useful to you but hasn’t been invented/devised/deployed yet?

I’d like to see automated CPR devices (something like this) in wider use. It’s not something I’d use every day, but it would be really nice to have when I need it.

[St.Urho]

@Auntbeast

Come on, give us a horror story. You can change the names to protect the innocent.

I forgot I promised you a horror story… (spoilered for the weak of stomach)

A while back I ran a call for a car vs. train crash. Turns out a (rather intoxicated) guy ran full speed into train that was parked across the tracks. We was unrestrained, and ended up compressed underneath the dash. It took about 45 minutes for the fire department to extricate him. After we got him on a backboard and were taking him to the ambulance, his arm kept flopping off the side and dangling. I reached out to pick it up, and it was like picking up a bag of warm jello :eek: It turns out, he initially pinned his arm between his car and the train and basically pulverized it. Really, really gross. He had massive head injuries, including gray matter on the some of the train cars. He died after a couple weeks.

[AK84]

BUMP
Whats the most unlikely survival you have ever seen? By which I mean as a functioning human being, not a vegetable.

[St.Urho]

I had a patient a few years ago who was in a hot tub for 3-4 hours. The patient was unresponsive and face down in the hot tub when we got there, had water in her airway, had a pulse but no blood pressure, and wasn’t breathing. I intubated her and started 2 large bore IVs- after 1500 mL of fluid, the pt had a blood pressure of 60/40. Generally, you need a pressure of at least 60 systolic to perfuse the brain… In the hospital, they had a temperature of 105.5F! They spent over a week in the ICU on a ventilator, then woke up and walked out of the hospital with no permanent damage of any sort.

[BiblioCat]

As a counterpoint to St. Urho’s story, we were once called for a patient who’d been in a hot tub for 3-4 days. In the summer.
Not quite the same happy ending as his story…

[drachillix]

@BiblioCat

As a counterpoint to St. Urho’s story, we were once called for a patient who’d been in a hot tub for 3-4 days. In the summer.
Not quite the same happy ending as his story…

In a hot tub for 3-4 days?!?!?

[typical sick EMT humor]
They didnt need an ambulance, they needed carrots, potatoes, onions and a few bay leaves.
[/typical sick EMT humor]

Best unlikely survivor, motorcycle got clobbered making a left turn. The list of what was not broken was the short list. Fortunately for him, they were wrapping up 3 different procedures and 3 of the best orthopedic surgeons in town on hand when he came in. I talked to one of the orthos a couple months later when we brought a post surg pt in for follow up, he said the guy survived and was up and around walking again in a few months.

[BiblioCat]

@drachillix

In a hot tub for 3-4 days?!?!?

Apparently, he’d gotten drunk and decided a soak in the hot tub would be nice. His friends had left at some point, and when no one had heard from him for a few days, they went over to his house to see if he was okay. He wasn’t.

[typical sick EMT humor]
They didnt need an ambulance, they needed carrots, potatoes, onions and a few bay leaves.
[/typical sick EMT humor]

Good one!

[drachillix]

@Elendil_s_Heir

Do you get to know cops and firefighters as individuals, or are they basically interchangeable from your perspective?

At least around here everyone plays nice together, you learn names and faces but I only really got to know a couple of them. Generally you don’t spend enough time with them to strike up much of a conversation beyond basic hows the weather. The other EMT’s and Medics…you end up knowing WAAAAY too much about. Working 12-24 hour shifts leaves you with a lot of time to fill with idle chitchat.

Any good pranks or practical jokes you can tell us about?

There is a local company called Riggs Ambulance, we always used to tape over the leg on the R so it said Piggs.

If you ever find an ambulance unlocked it was pretty much standard to hop in, shut off the batteries, and turn on the lights and sirens, scene lights, spotlights, etc. So when they got back in and turned the batteries on, everything kicked on making for ALOT of light and noise. Hospitals HATE this.

When you’ve had to call the cops about bothersome third parties, what exactly have those third parties been doing?

I never had to do this, but heard of it being done. Mostly it was family members threatening or assaulting the crew over some percieved disrespect

How often, if ever, do you have to testify in court?

I never did

Are people in your line of work more prone to alcoholism, drug abuse or PTSD?

You have no idea

Have you found you’ve changed personal habits in reaction to what you’ve seen (drinking less, becoming a zealot about using a seatbelt, etc.)?

Not really other than I will not drive if I have had more than 1 drink in the last hour or so

[/QUOTE]

[BiblioCat]

@drachillix

If you ever find an ambulance unlocked it was pretty much standard to hop in, shut off the batteries, and turn on the lights and sirens, scene lights, spotlights, etc. So when they got back in and turned the batteries on, everything kicked on making for ALOT of light and noise. Hospitals HATE this.

We do this, too. I always lock my rig. ALWAYS.

KY on the door handles is good as well.

[St.Urho]

@BiblioCat

KY on the door handles is good as well.

Ever wonder why everybody kept carrying the conductive gel even after they switched to handsfree defibrillation?