Tuesday, July 31, 2007

For this, we double our taxes?

Government Health care. I keep hearing people bleat on about how the government should pay for our health care, and these people frequently point to the (formerly) Great Britain as an example. These people complain that the rich get the best care, while the poor get poor care. To those people, I give you this story. That is right. This lady has to wait 18 months for a hearing aid.

A hearing aid. That isn't all. Apparently, this is more than common. According to the article:

A spokesman for the Royal National Institute for the Deaf said: "I am afraid this is a common problem. In some parts of the country there are over two year waiting lists, which is shocking."

Digital hearing aids can be had on the open market for as little as $1500. With no wait.

Free health care isn't free. The US spends 15% of the GDP on health care. That means that "free" health care would mean increasing taxes by a corresponding amount.

So, the rich still get the care they can afford, the poor still get crappy care, and we all get to pay higher taxes, especially the rich. We sure punished those rich guys with those higher taxes, which I suppose was the point. Or was it just another vote buying tactic? I can't remember.

Monday, July 30, 2007

Scene Safety

When we teach new paramedic and EMT students, we frequently have them role play to improve their patient interview skills. Every student learns that the first thing to come out of their mouth better be "scene safety" or it means an automatic failure of the scenario. This is done to make sure that they are always watching out for safety. The safety of themselves, their crew, and their patient.

Some years ago, I was involved in a discussion about this subject, because a man whose mother was living with him called 911. When the paramedics arrived, they noted some firearms sitting nearby, and had a law enforcement officer take control of the weapons for the duration of their visit. The weapons were returned to him as soon as the call was concluded.

This gentleman wanted to know under what authority the EMS crew confiscated his firearms. I tried to point out to him that his guns were not "confiscated," but merely held temporarily for the safety of the crew operating there. The gentleman told me that if EMS crews were THAT afraid, perhaps we should find another line of work. He then called me a "jack booted thug." When I tried to point out that this is standard procedure nationwide, he got really angry.

When EMS responds to a call, they do not know what they are going to be facing when they get there. I personally have stumbled upon numerous scenes that included rape, robbery, murder, and suicide. If I do not know you, I am going to have someone hold your weapon for a little bit, until we get the scene under control.

Not only are there people who want to kill, but people who are REALLY sick tend to experience an altered level of consciousness. Part of that altered LOC is a tendency to become combative. A head injury, seizure, stroke, low blood sugar, poor perfusion, any one of these problems can cause combativeness. When an EMS crew holds on to your weapons, it isn't because they are trying to be a JBT. It is because they want to see another sunrise. Just because you are not dangerous when you are healthy does not mean you will remain so when injured. I have news for you- we even disarm cops when they are hurt. ( I have seen a cop with a head injury repeatedly try to draw his weapon)

Since many EMS personnel are not trained to handle weapons, this procedure is usually left to a LEO. You still get your firearm back- as soon as the call is over. 30 minutes, tops.

Sunday, July 29, 2007

The other world

I am flying over an alien landscape. Gliding effortlessly with the current, I steer towards a small, rocky outcropping with small movements of my feet. The sand and rocks of the surface slide by only 7 or 8 feet below. I feel like Superman.

Just ahead, I see another creature approach.



The largest shark I have ever seen glides silently by. He is longer than I am from the top of my head to the tip of my fins- at least 8 feet.

Same planet, different world.

Saturday, July 28, 2007

Tale of two drownings

1996

I am breaking in a new partner. He has been an EMT for about a month, and he is still gung ho. It has been a slow day so far, and we are only an hour away from going home. I can smell dinner already.

It has been a typical hot summer day here in Florida. The kind of day where it feels like you are 6 inches away from the sun, the air so thick with humidity that it takes effort to breathe.

When we got the call for a possible drowning, we were just a few blocks away, and it seemed to me that we arrived almost instantly. A sheriff's deputy arrived at the same time. He ran through the house, and beat us by a good minute or so, as we had to grab bags and gear.

I arrive in the backyard and take in the scene. The pool is half filled with a green liquid, the color of pea soup. The deputy is standing in the water, and reaching down, he pulls a lifeless form from the pool and throws him onto the deck.

The child is grey and lifeless. It isn't long before the helicopter arrives to take him away. Just after they depart, I notice that there is a little girl of about 8 years standing next to me. She says, "Is my brother dead?"

Divemedic: "We are doing everything we can to help him."

LG: "Why aren't you still with him then?"

DM: "The people in the helicopter are helping him now."

LG: "I killed him."

DM: "What?"

LG: "I threw him the ball, and when he tried to catch it, he fell in the pool. Now he is dead, and it is my fault."

Ten minutes later, after talking to the parents of these two children, my partner found me. I was sitting in the rig, tears in my eyes. My new partner tells me, "You have to learn to shut it out. Don't take these calls so personally, look at me. I am not bothered by it."

I threw him out of my truck, and I refused to ever ride with him again.


2003

Three minutes after the initial call to 911, we arrived at the front of a small, well-kept house, a typical one for the area. There are toys scattered about the yard, undoubtedly left there by a small child.

The first through the door, I arrive in a rush and take in the scene. Even now, four years later, that image is burned into my memory as clearly as if it were yesterday. There is a small child lying on the couch in the living room, a small pitiful figure, his skin is a mottled gray. He is covered in water and appears lifeless.

An adult male is standing next to the couch. He is soaked from the waist down, his clothing disheveled; his eyes red-rimmed, he looks like a wild man. I will not find out that this man was the child’s uncle for another fifteen minutes.

I pick up the child, and he is cold. He does not stir, even when I harshly pinch his arm. I move to the door, to the safety and privacy of the truck.

On the way out to my ambulance, I quickly look him over. He is about three years old, 12 kilos or so. Lying lifeless in my arms, he doesn't appear to be doing very well. He isn't breathing and has no pulse. My mind already computing drug dosages and accessing protocols, I reach for my radio and called in a “code” to the dispatch center.

I place my lips over the child's mouth, and give gentle breaths. Chest compressions. Breaths.

We arrive at the truck, and I select the proper sized ET tube, and slide it down his throat. My partner begins squeezing the bag, and I start an IV.

I place him on the monitor, and I note that he is in asystole. Not good.

I knew then that we had already lost the battle.

As the helicopter flew away, taking with it the small, pitiful body once so full of life, so precious to all who knew him, his Uncle approached and asked me what he should tell his brother. He wanted to know how to tell a man that his baby boy drowned in a backyard pool while his Uncle took a shower.

I keep hoping that maybe next time, if we are lucky enough, if we are good enough, we’ll be able to say just this once, an Uncle isn’t going to have to tell his brother that his little boy is dead, or a little girl won't have to think she killed her brother.

Friday, July 27, 2007

Hello, Nurse

This post is for those of you that remember the old show, Emergency. I tell you, when I was a young lad, I had the lunch box with scenes from the show on it. I loved that show!

Here is some vintage music from Gayle Peck. That, of course, was her real name. Her stage name was Julie London.

She was easy on the eyes, and had a fine, fine singing voice.


We all knew her as Dixie McCall.

Tuesday, July 24, 2007

Speeders

I just got done watching an episode of the show "Speeders." For those unfamiliar with the show, it is one of those "follow along with the cops while they write traffic citations" shows, sort of like "Cops," but without the trailers.

The first person to be pulled over was pulled over by a Cop wearing the handle of "The Hammer." The sequence starts with the officer stating that he was looking for drunk drivers, and that he would use traffic violations as his probable cause to stop an unwary drunk. He soon spots a gentleman driving 60 in a 40 without his headlights on.

In the course of the traffic stop, the driver admits to one drink hours before, and smoking marijuana hours before. The Breathalyzer shows a blood alcohol of .06, which is below the limit of .08. "The Hammer" cites the driver for speeding, and then tells the driver that he is "not allowed to drive," and that he must find someone to come get him.

My question here is: Why? Since he is not legally drunk, on what authority does this officer tell the driver that he cannot drive? Since he is not legally intoxicated, he is not breaking the law by driving. If he is not breaking the law, then what power does this cop have to tell a person (whose only crimes were minor traffic offenses) that he cannot operate his vehicle?

Any police officers out there who would care to weigh in, please help me out here...

Sunday, July 22, 2007

Light posting

Posting has been lacking these last few days because I was at the ClinCon EMS convention, sucking up as much free stuff as I could get.

Tuesday, July 17, 2007

Reflections on Katrina

I was just reading the news, and happened to reflect on the liberties taken when certain journalists report the news. I immediately began to think back a couple of years, to my deployment into the Hurricane Katrina disaster area.

During my deployment, I didn't see any of the violence or mayhem that was being reported on the news. Most of the people were thankful for our assistance, many even cooked us dinner with whatever meager supplies survived the damage. That damage was restricted to within a mile of the coast, and a 5 mile drive to the north got you completely away from the disaster area. Sure, this wasn't New Orleans, but the damage in the Gulfport area was actually worse.

Of course, the reporters had a little to do with that. When we were there, a group of reporters were busy talking on camera about how it was four days since the storm, and no one had seen any assistance from the gubmint yet. They were breathlessly explaining how the people were starving, with no help on the horizon, all the while blaming the President, FEMA, and anyone else they could think of.

We were standing less than 300 feet away, giving out food, water, diapers, and vaccinations against diphtheria and tetanus. What was funny was that they had to shoot it twice, because one of the people that we had just given food to walked behind the on camera reporter with a sandwich in one hand, and a coke in the other.

I know how truthful the journalism is in this country, and that is why I am not a consumer of what passes for news nowadays.

Saturday, July 14, 2007

Firehouse Recipe

cooking time: 15 minutes

1 pound ground beef
1 packet taco meat seasoning
tortillas
medium salsa
8 oz half and half
8 oz mexican cheese blend
sour cream
1 small can sliced black olives, if desired

Preheat oven to 350 degF
Brown meat, drain.
Push meat to one side of the pan, mix taco seasoning with half and half, stir to get rid of lumps, stir into meat. (add black olives if desired)
Line the bottom of an 8x8 baking pan with tortillas.
Spoon half of the meat mixture onto the tortillas, and top with a third of the cheese.
Repeat for a second layer, top with another layer of tortillas and the remaining cheese.
Place in oven, bake until cheese melts (about 10 minutes)
Serve with a topping of salsa and sour cream (if desired)

Serves 4 (or two firefighters)

Friday, July 13, 2007

Government healthcare

Just yesterday, I had a discussion with a coworker about "free" health care. His position was that a .gov run health care system was needed, because some people could not afford to get the health care they wanted.

My position on this is threefold:

1 Practicality- the .gov is not going to make health care cheaper, it will simply spread the costs of the care, in addition to the government's costs in administering the system, around. This means that health care will be more expensive, and the people who need less health care will subsidize those who need more. The only way for the government to keep costs affordable is to either tell doctors what they can charge, or ration out the care. (or both)

2 "Fairness" - The other argument for government health care is that the poor do not get the same care as those with more money, and only way to make this "fair" is for the government to run it. I guess the government NEVER shows favorites. Not only that, the rich will still get better care, they just will be paying higher taxes at the same time, because they are busy paying for the care of others.

3 The moral reason I oppose this plan, is that I have a hard time seeing how you can call a system "fair" when you are charging me a mandatory tax (read as taking my money by force) to pay for something that someone else wants. I EARN my money, and just because you work in a menial, unskilled job that pays poorly and offers no insurance because you smoked pot and slept instead of paying attention in school is not my problem.

/rant

Wednesday, July 11, 2007

How did that get in there?

I once read that you can tell when you have worked too long in emergency medicine when you have ever had a patient look you in the eye and say, "I don't know how that got in there." The thing is, that sort of thing happens all the time.

We were lounging at the station one fine morning, when we were dispatched to an "unknown medical." As we climbed into the trucks, I noticed that several crew members were reading the dispatch information on the computers and laughing. A lot. I was sure that something evil was waiting for us, and it turned out that I was not to be disappointed.

When we arrived on scene, the ensuing conversation was absolutely hysterical.

Lieutenant: "What is his problem?"

Female Medic: "He has a cock ring stuck on his penis."

Rest of crew present: "Snicker."

Patient: "It is NOT a cock ring, it is a key ring."

Lieutenant: "I think she's right, I don't see any keys on it."

Rest of crew present: "Bwahahahahahaha."

Patient: "I don't see what is so funny. Is someone gonna take a look at this?"

Female medic: "I'm not. I'd rather stare at the sun."

Lieutenant: "I'm not, either. The new guy can do it."

New guy (while thoughtfully looking at impaled key ring): "Oh, you definitely need to go to the hospital for that one."

For nearly a year, that key ring occupied a place of honor, in a specimen jar in the office at the station. To this day, the patient doesn't know how it got in there...