The following post is not about EMS, but rather about my local community. The following is my analysis of a bit of patent absurdity put out by none other than the master, Bill O'reilly. The video in question can be found on his own website, misleadingly titled "Global warming vs. christmas.":
In my opinion, there is no higher form of praise than to be directly vilified by Bill O'reilly. Our town - Great Barrington - has recently received this highest of accolades by becoming the newest front on his "war on christmas" - by limiting the town's holiday lights, which consist of two or three marquee-style banner lights stretched across downtown main street, from being lit all night. Not, mind you, from being put up at all, or lit period, but from being lit after 10:00 pm. Normally, they would run until midnight, but the town selectmen decided to turn them off for an additional two hours in order to save power. Now, O'reilly's points fell into three categories:
1. The lights are a traditional part of the "small town" asthetic of GB, which is being ruined by "rich secular elitists" from New York and elsewhere.
2. The selectmen refused to call the lights "christmas lights," instead referring to them only as "holiday lights," and
3. The lights attract people to downtown main street and are therefore good for business, and turning them off hurts these folksy, religious local shopkeepers.
4. Small attempts to save power like this are pointless and have no effect at all on global warming.
Now, point by point, these are ridiculous claims. First off,
1. The decision was made by the locally-elected selectmen and not by rich NYC insurgents. I've spoken directly to these people, and certainly believe that they adequately represent both interests. Additionally, I would say that it is in fact the rich elitists that would prefer they stay on in order to make their tourist nest that much more resemble santa's little village.
2. The selectmen preside over a town that consists of a large and growing jewish population, among others. The lights in question are festive and attractive in my opinion, and contain no religious symbols of any kind- they look like banners and snowflakes. As far as I know, Christ didn't say anything regarding snowflakes only representing his birthday. In fact, if we want to get technical, the idea of a white christmas is a distinctly non-bethlehem tradition, global warming or no.
3. We're talking about turning them off AFTER 10 PM. As anyone who has visited Great Barrington after 10 pm knows, you are not impacting the number of people shopping by dimming the lights at this point. The number is reduced from 0 to 0. All of the stores are closed, and the only places open are bar/restaurants that will get their customers lights or not. Also, this is only on downtown main street, and other parts of town are not affected at all.
4. Small attempts like this spread across multiple communities have a cumulative effect, and every step counts. Plus, it saves town money, and I'd rather have better plowed streets than festively lit ones when no one is there to see them anyhow.
The interview was full of clearly out-of-context quotes from people on the street and direct attacks on our selectmen. You can view it here and have a good laugh at the theater of it all.
http://www.foxnews.com/oreilly/#
That link may not display the story as current for too long, but for now it's easy to find.
Happy Holidays!
Simon's Rock College grad, local resident & voter, and Great Barrington volunteer EMT,
Peter Tiso
EDIT: After reading a few people's reactions to the fox news segment, including people who e-mailed the town saying that they have chosen a different holiday destination because of the fox news segment, it seems that O'reilly did more to hurt local shopkeepers than a two-hour period in which an empty downtown turns off its holiday lights ever could.
Thursday, December 20, 2007
Thursday, November 29, 2007
N&V
Last night was what I would call a perfect night of EMS. It's a hard concept to come to grips with, but as an EMT, there is a certain part of you that wants to work - you want calls, even though you know that a call means that someone else is sick or injured. You don't wish for the accident, you wish for the chance to help, and more often than not, you get it.
Last night was such a night. I came on in a good mood, although I had been tired and feeling sick all day. Dinner improved my spirits, and afterwards, we settled in for a quiet night. A little after 9 pm, we received a call, and luckily I was still dressed; an elderly individual at a local restaurant, unresponsive and projectile vomiting. We hop in the rigs quickly, the call is upgraded to code 1, the lights go on, and we page for assistance.
We arrive on scene to find a person in truly serious condition. They aren't speaking, but seem to be able to obey vocal commands; they are able to squeeze our hand, they're breathing, and they have a good pulse. So far so good. However, there are clear signs of a neurological problem of some kind; the eyes are unresponsive, and one is pointing in the wrong direction. We attempt and fail a quick on-site blood pressure reading, and decide not to wait any longer. We load the patient (with some difficulty) and move to the ambulance.
Doors close and we move right away. On route, I set to taking a blood sugar reading, which came up normal. I grab a gauze pad to cover the finger, and look up at the patient, who coughs twice before proceeding to vomit a surprising amount of barely-digested expensive dinner, a sizable portion of which ends up on my legs. I ignore this, towel the patient off a bit, and we continue to be bounced around the ambulance, suctioning the vomit from the patient and starting him on high-flow oxygen via nonrebreather mask. We arrive at the hospital, move him in quickly, transfer him to a bed, and the nurses set to him immediately. I stand back and watch it all happen, never having experienced this level of emergency before, and find that everyone's motions are practiced and smooth, while I hardly know where to stand this time; I just take it all in, remembering what to do for the next patient.
Afterwards, we begin on the lengthy cleanup process. Every tool we used gets wiped down thoroughly, and I change into a set of scrubs, feeling for all the world that although I've been an EMT for a year now, this was my first real call.
Last night was such a night. I came on in a good mood, although I had been tired and feeling sick all day. Dinner improved my spirits, and afterwards, we settled in for a quiet night. A little after 9 pm, we received a call, and luckily I was still dressed; an elderly individual at a local restaurant, unresponsive and projectile vomiting. We hop in the rigs quickly, the call is upgraded to code 1, the lights go on, and we page for assistance.
We arrive on scene to find a person in truly serious condition. They aren't speaking, but seem to be able to obey vocal commands; they are able to squeeze our hand, they're breathing, and they have a good pulse. So far so good. However, there are clear signs of a neurological problem of some kind; the eyes are unresponsive, and one is pointing in the wrong direction. We attempt and fail a quick on-site blood pressure reading, and decide not to wait any longer. We load the patient (with some difficulty) and move to the ambulance.
Doors close and we move right away. On route, I set to taking a blood sugar reading, which came up normal. I grab a gauze pad to cover the finger, and look up at the patient, who coughs twice before proceeding to vomit a surprising amount of barely-digested expensive dinner, a sizable portion of which ends up on my legs. I ignore this, towel the patient off a bit, and we continue to be bounced around the ambulance, suctioning the vomit from the patient and starting him on high-flow oxygen via nonrebreather mask. We arrive at the hospital, move him in quickly, transfer him to a bed, and the nurses set to him immediately. I stand back and watch it all happen, never having experienced this level of emergency before, and find that everyone's motions are practiced and smooth, while I hardly know where to stand this time; I just take it all in, remembering what to do for the next patient.
Afterwards, we begin on the lengthy cleanup process. Every tool we used gets wiped down thoroughly, and I change into a set of scrubs, feeling for all the world that although I've been an EMT for a year now, this was my first real call.
Thursday, November 1, 2007
Happy Halloween
I went as an emergency services worker for halloween last night, and definitely got to go out trick-or-treating. A number of bizarre incidents, some of which directly related to the holiday, kept my team and I running around all evening. Sadly, I treated two patients who had very minor injuries as the result of violence perpetrated by themselves and others, and one patient with a more serious injury caused by her desire to not let the unfinished state of her front steps stop her from giving out candy to local kids.
The first and most notable incident was well in progress when my shift started. An assault took place at the local convenience store, and the guy proceeded to run off into the woods, where he "tripped on some bittersweet vines and twisted his knees and ankles." He then proceeded to climb onto the roof of the bowling alley, which is perhaps the most exposed yet least escapable location I can think of in town. Following a brief scuffle with officers (which I believe caused the laceration to his forehead) he was arrested. He seemed to be much calmer when we took him to the hospital later, and this leads me to wonder what he may have been thinking (or on) when he committed the crime. Witnesses say he "threw the clerk five feet through the air," but that scarcely seems possible from looking at him.
The second incident was a simple fight victim found in a parking lot. 19, a shiner, and drunk enough to write his date of birth on the "today's date" line beside the signature on his refusal form (the form that says we think you should go to the hospital but you don't want to and it's your choice.)
Third was a woman whose house was under construction who broke one ankle and sprained the other while running out to give candy to local kids. It was good to deal with a patient not handcuffed to something, but the downside was that her house was like an obstacle course. we had to traverse around a hanging wire, through a muddy dirt front yard, over a very steep makeshift step and through a doorway that didn't allow the stretcher to turn through without lifting it a couple feet over the stairway. Generally, having a hydraulic stretcher (the Power Pro on this list) is a huge advantage, but when you have to carry the whole thing, patient included, the extra weight is not helpful.
Long story short? Halloween is one of my favorite holidays. It's an incredible cultural event, and it was interesting to see it from this perspective. However, there's no question that any emergency department is going to be spread thin with unfortunate incidents when there's a combination of children in the streets and drinking, all while the spirits are free for the evening to walk the earth.
The first and most notable incident was well in progress when my shift started. An assault took place at the local convenience store, and the guy proceeded to run off into the woods, where he "tripped on some bittersweet vines and twisted his knees and ankles." He then proceeded to climb onto the roof of the bowling alley, which is perhaps the most exposed yet least escapable location I can think of in town. Following a brief scuffle with officers (which I believe caused the laceration to his forehead) he was arrested. He seemed to be much calmer when we took him to the hospital later, and this leads me to wonder what he may have been thinking (or on) when he committed the crime. Witnesses say he "threw the clerk five feet through the air," but that scarcely seems possible from looking at him.
The second incident was a simple fight victim found in a parking lot. 19, a shiner, and drunk enough to write his date of birth on the "today's date" line beside the signature on his refusal form (the form that says we think you should go to the hospital but you don't want to and it's your choice.)
Third was a woman whose house was under construction who broke one ankle and sprained the other while running out to give candy to local kids. It was good to deal with a patient not handcuffed to something, but the downside was that her house was like an obstacle course. we had to traverse around a hanging wire, through a muddy dirt front yard, over a very steep makeshift step and through a doorway that didn't allow the stretcher to turn through without lifting it a couple feet over the stairway. Generally, having a hydraulic stretcher (the Power Pro on this list) is a huge advantage, but when you have to carry the whole thing, patient included, the extra weight is not helpful.
Long story short? Halloween is one of my favorite holidays. It's an incredible cultural event, and it was interesting to see it from this perspective. However, there's no question that any emergency department is going to be spread thin with unfortunate incidents when there's a combination of children in the streets and drinking, all while the spirits are free for the evening to walk the earth.
Sunday, October 28, 2007
A Sense of Urgency
It's been a relatively quiet night. My usual partner has switched off, dinner is long past, and all that remains is to read a bit and try to fall asleep, always a difficult task while on call. However, it's a nice, cool night, and I'm tired, so I manage it relatively quickly tonight.
At exactly 0300, I'm awoken by the familiar sound of the pager buzzing angrily on the desk beside my head. The dispatcher chimes in with a common, and uniformly unhelpful, "please respond to [one of the local nursing facilities], 66 year old male patient." No further information. This is a relatively common call, and with the usual lethargy I haul myself out of bed and into my boots. My partner for the night similarly takes his time; we know that at the nursing home, nurses are on hand, and conditions are generally good. We weren't given a code 1 or other information that would lead us to hurry.
However, upon arrival we find nurses that look unusually concerned. Our patient, an elderly man, was breathing at an unbelievable 60-80 times per minute, and was shockingly unresponsive. I had taken this man back to this facility the week before, and found him to be a good patient. Now, he was breathing fast, loud, and with a rough noise that made me think of the training I've recieved concerning agonal respirations , which of course these were not. Our sense of urgency increased. A weak, thready pulse, low blood oxygen saturation , and a complete inability to control his muscles in any way didn't make me feel any better. We got him started on Oxygen, and started driving.
Things went uphill from there - his breathing normalized a bit, his sweating relaxed, and while he didn't regain what I'd exactly call consciousness his vitals approached normal again. How he fared in the long term I don't know, but from the episode I've certainly come to know that a call to the nursing home can be as much of an emergency as a call anywhere else, no matter how little the dispatcher tells you.
At exactly 0300, I'm awoken by the familiar sound of the pager buzzing angrily on the desk beside my head. The dispatcher chimes in with a common, and uniformly unhelpful, "please respond to [one of the local nursing facilities], 66 year old male patient." No further information. This is a relatively common call, and with the usual lethargy I haul myself out of bed and into my boots. My partner for the night similarly takes his time; we know that at the nursing home, nurses are on hand, and conditions are generally good. We weren't given a code 1 or other information that would lead us to hurry.
However, upon arrival we find nurses that look unusually concerned. Our patient, an elderly man, was breathing at an unbelievable 60-80 times per minute, and was shockingly unresponsive. I had taken this man back to this facility the week before, and found him to be a good patient. Now, he was breathing fast, loud, and with a rough noise that made me think of the training I've recieved concerning agonal respirations , which of course these were not. Our sense of urgency increased. A weak, thready pulse, low blood oxygen saturation , and a complete inability to control his muscles in any way didn't make me feel any better. We got him started on Oxygen, and started driving.
Things went uphill from there - his breathing normalized a bit, his sweating relaxed, and while he didn't regain what I'd exactly call consciousness his vitals approached normal again. How he fared in the long term I don't know, but from the episode I've certainly come to know that a call to the nursing home can be as much of an emergency as a call anywhere else, no matter how little the dispatcher tells you.
Wednesday, July 25, 2007
I'll only be looking 40% of the time
I've just finished a job application for a private Ambulance service.
The job description itemized by use of my senses by percentage of time worked.
I will be using my sense of touch 15% of the time.
My Touch ability must be "high."
I do not believe I will pursue this particular position much further.
The job description itemized by use of my senses by percentage of time worked.
I will be using my sense of touch 15% of the time.
My Touch ability must be "high."
I do not believe I will pursue this particular position much further.
Monday, July 23, 2007
Busy Night
I apologize for a long lack of posts, but to put it simply, nothing much has happened that I would consider blogworthy. This changed last Wednesday, however.
I arrived at the garage about an hour early for my shift in order to do some work on the company's website. However, right after I settled in and got my uniform out of the car, the on-call team's pagers went off for a car accident with four passengers involved. I immediately went ahead and put on my uniform as well, since it was probable that a backup team would be called. It was called a moment later, and by luck my team Capitan that night (who is a Paramedic, another good thing) walked in, and I told her that we may as well head straight over to a rig.
The ride over was fast, and I barely had time to lace up my boots and gather equipment before we got on-scene. The scene was well organized, and maneuvering the ambulance in didn't prove difficult. The cars were badly damaged - it had been a head-on collision at about forty miles an hour - and at least one of the passengers was badly enough injured to require a fast ride to a better trauma center than we have locally.
My own involvement was very specific. Passengers had been triaged and tended to when I arrived, and I simply helped to apply straps to a patient on a backboard and get her into our ambulance. We then staged for a moment in order to get vital signs and prepare for the trip, and headed off for the ER.
This was perhaps the most intense part of the experience for me. It was my first time driving an ambulance with a trauma patient in it with all the lights on. It's a little surreal - you can never be sure what other drivers are going to do - but I quickly became comfortable with maneuvering traffic and was incredibly focused throughout the experience. I also remembered to communicate with my partner, and slowed down through turns and helped to make sure the ride was smooth while she attempted to start IV's on the patient.
This case was a remarkable demonstration for me in vehicle safety features. Three patients wearing seatbelts in a minivan suffered little worse than bruising, while one patient, unrestrained, driving a Jeep suffered life-threatening head injuries from the same incident. The rest of the night proved trying - we had calls almost back-to-back until three A.M., and I had to drive to Pittsfield (about 45 minutes each way) twice, in heavy rain and thick fog.
On the other hand, I'm getting to know my squad better and increasingly feel competent in the day-to-day running of an Ambulance. This is what I'm here for, isn't it?
I arrived at the garage about an hour early for my shift in order to do some work on the company's website. However, right after I settled in and got my uniform out of the car, the on-call team's pagers went off for a car accident with four passengers involved. I immediately went ahead and put on my uniform as well, since it was probable that a backup team would be called. It was called a moment later, and by luck my team Capitan that night (who is a Paramedic, another good thing) walked in, and I told her that we may as well head straight over to a rig.
The ride over was fast, and I barely had time to lace up my boots and gather equipment before we got on-scene. The scene was well organized, and maneuvering the ambulance in didn't prove difficult. The cars were badly damaged - it had been a head-on collision at about forty miles an hour - and at least one of the passengers was badly enough injured to require a fast ride to a better trauma center than we have locally.
My own involvement was very specific. Passengers had been triaged and tended to when I arrived, and I simply helped to apply straps to a patient on a backboard and get her into our ambulance. We then staged for a moment in order to get vital signs and prepare for the trip, and headed off for the ER.
This was perhaps the most intense part of the experience for me. It was my first time driving an ambulance with a trauma patient in it with all the lights on. It's a little surreal - you can never be sure what other drivers are going to do - but I quickly became comfortable with maneuvering traffic and was incredibly focused throughout the experience. I also remembered to communicate with my partner, and slowed down through turns and helped to make sure the ride was smooth while she attempted to start IV's on the patient.
This case was a remarkable demonstration for me in vehicle safety features. Three patients wearing seatbelts in a minivan suffered little worse than bruising, while one patient, unrestrained, driving a Jeep suffered life-threatening head injuries from the same incident. The rest of the night proved trying - we had calls almost back-to-back until three A.M., and I had to drive to Pittsfield (about 45 minutes each way) twice, in heavy rain and thick fog.
On the other hand, I'm getting to know my squad better and increasingly feel competent in the day-to-day running of an Ambulance. This is what I'm here for, isn't it?
Friday, May 4, 2007
Recognition
When I started this blog, it was with the intent of letting others in on the absolutely surreal quality that my first foray into Emergency Medicine had been taking on. Lately, as I've been working nights that have taken on a more familiar quality, this has been perhaps subsiding a bit, but yesterday the feeling came back in full force.
I was out at dinner and saw someone on the street. I did a double take, as they looked very familiar, and after a minute it dawned on me that it was a patient that I had transported, and that was where I had seen them. It completely knocked me off my feet for a few minutes, as this was the first time it had happened. I don't know if they saw or recognized me, and I wouldn't have been able to communicate at the time if they had - it was too odd seeing them in such a wildly different context.
I'd better get used to it.
I was out at dinner and saw someone on the street. I did a double take, as they looked very familiar, and after a minute it dawned on me that it was a patient that I had transported, and that was where I had seen them. It completely knocked me off my feet for a few minutes, as this was the first time it had happened. I don't know if they saw or recognized me, and I wouldn't have been able to communicate at the time if they had - it was too odd seeing them in such a wildly different context.
I'd better get used to it.
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