December 1, 2009

Holiday lights


You can always tell when you've arrived at Ambulance Driver's house during Christmas.

:)

November 9, 2009

The weekend that was

I had been on the road for work all week, and after an exhausting time on the job, I came home Saturday morning. As per the norm, Casey met me at the door with a wet tongue and a tail that could have broken a tibia, had it struck the wrong angle.

We spent the past couple days walking more miles than most people do in a month, watched a couple sunsets, took naps beside the fireplace, and ate like Kings (me: grilled brats and baked beans, washed down with beer; her: a beef femur bone and a handful of gizzards and hearts mixed in with her kibble.)

Reminded me of this:

"I talk to him when I'm lonesome like; and I'm sure he understands.
"When he looks at me so attentively, and gently licks my hands;
"Then he rubs his nose on my tailored clothes, but I never say naught thereat.
"For the good Lord knows I can buy more clothes, but never a friend like that."

~ W. Dayton Wedgefarth

October 27, 2009

It's been a while

But I simply haven't had time to write anything.

However, I do have a random observation to make:

If you think watching children trying to catch snowflakes on their tongue is cute, you haven't seen an mutt dog raised in the Arizona desert try to do the same thing.

That is all. For now.

September 5, 2009

For aspiring IT folks

There is more to creating a back up of a SQL Database than simply copying a bunch of .ldf and .mdf files.

That method of a "back up" will only ensure great pain, frustration, and difficulty for your software vendor's rep when he comes out to install a SQL based software program. It may even drive him to drink.

That is all.

August 29, 2009

Advice to new Medics

My two pals, AD and TOTWTYTR both have excellent posts up that offer sound advice to new medics. And, to be honest, I can't believe AD remembered our conversation all those years ago in Austin. I'm honored.

Frankly, there's little more I could add, but I'm going to anyway.

*****

The Good Lord gave you two ears and one mouth in that ratio for a reason.

Spend more time listening than talking.

Listen to your patients. When possible, ask them a question that can't be answered with a "Yes" or "No." Get them talking. Then listen to what they have to say. A wise Physician Assistant I once worked with told me "The patient's history and physical exam will give you the diagnosis most of the time. Fancy tests and x-rays and such just confirm it." That's a truism I've kept in my pocket over the past decade as I've worked in EMS.

Listen to the doctors. They're better educated than you, and underneath the skin of every physician is a frustrated teacher yearning to breathe free. If you get a patient that doesn't quite meet the "text book picture" of a disease or injury -- and trust me, most of your patients will fail to meet the text book picture -- get the doctor talking, and listen. You'll learn something.

Listen to the nurses. Like the NCO in the military, it's the nurse that really keeps things running in the hospital. A wise physician will listen to the nurse, and if the doctor is smart enough to do that, you should too. Nurses have a different outlook on patient care, and broadening your view will help you become a better paramedic.

No single text book contains all the knowledge you need to do your job.

I really wish those public service announcements on TV that implore parents to read to their kids would expand to include paramedic students. Read! Get your paws on every book you can find about medicine, and read. Dr. Bryan Bledsoe has a 5 volume set of texts that cover a veritable cornucopia of information about prehospital care, and even those don't cover it all. Read! Get yourself a copy of Tintinalli's or Rosen's guide to emergency medicine. Then read it. When you come to a term you don't understand, go look it up. Have a copy of Taber's on the back of the toilet tank. Find a library that has various journals -- Annals of Emergency Medicine, Prehospital Emergency Care, Journal of Trauma, Heart -- and sit down to read.

Read! Read a diverse selection. I have texts on cardiology, medical-surgical nursing, critical care paramedicine, air medical transport, wilderness and remote medicine, orthopedic trauma, renal disease, critical care nursing, pediatrics, and internal medicine. I've given away twice that many to other folks.

Read!

You always have time to think.

Despite what the television drama shows or paramedic instructors tell you, there are very few times where you must act immediately! Damn few. I can think of two calls in 10+ years where I had less than 30 seconds to make a decision, and one of those was an easy decision to make. When things don't make sense, and you're not sure what the right course of action is, your best bet is to stop, step back, and think. Obviously, some of the basic stuff is a good idea, and comforting measures go farther than you think, but overall, you should engage the gray matter 'tween your ears and think.

One of my pet peeves, and the answer I give when people ask me in interviews "What's your weakest area?" is that I have absolutely no tolerance or patience for people who don't think. You've been entrusted with the care of another person's life and health. That's not a burden to take lightly, and it requires that you think. If you stop and think, and your thinking is awry, I'm OK with that, and most experienced and quality paramedics are, too. We don't mind if you make a mistake in your thinking. That's easy to fix: Sit down with some coffee, talk it over, and find out where your thought process was flawed. Simple, takes about 45 minutes. But if you tell me "I wasn't thinking," then I don't have any use for you, and would rather you sit your rump in the front seat and stay out of my way.

When it doesn't make sense, stop and think.

It's never a bad idea to put the patient in the ambulance and go to the hospital.

Along with the thinking bit above, don't forget that your job, ultimately, is to take the patient to the big building where the doctors and nurses work. You're not curing disease out there... you're helping people feel better in the short term, providing them some peace of mind, and applying temporary care until you get them to the hospital. If you can think of nothing else to do, put the patient in the ambulance and go to the hospital. This was the first thing my paramedic instructor told us on the first day of class: "If you remember nothing else after the next 14 months, remember that it's never a bad idea to take the sick person to the Emergency Room."

August 20, 2009

Giggle*snort

You've seen that picture of the squirrel that popped up in the vacation picture of the couple in Banff National Park?

It seems he's been around.


Beverage alert in effect.

August 16, 2009

Whole Foods

Via Ann Althouse...

TMV has a guest post
up regarding the op-ed piece by Whole Food's CEO John Mackey in the WSJ this week.

In brief:

With a single op-ed in an uber conservative national newspaper, this wholesome image has been blown to bits. In the course of writing 1,165 words, CEO Mackey has caused more potential damage to the Whole Foods corporate image than an e-coli outbreak in the meat room.

In calling for support of the boycott of Whole Foods, I’m making an educated guess that their average customer is very politically progressive in nature. And that is why, if liberals and progressives quit shopping at Whole Foods, the impact would be quickly apparent to the company’s Board of Directors. By quickly, I mean by this coming Monday morning when the weekend receipts are tallied.

I am all for freedom of speech. Mr. Mackey had every right to express his views on health care in the WSJ, even as anathema as those views might be to progressives. Similarly, we progressives have every right to decide whether or not we want to spend our food dollars in a store whose CEO clearly doesn’t support the most important progressive cause of the moment.

So, if you are a Whole Foods shopper, please consider honoring the boycott, at least for a short period of time. The impact will be very evident, and almost immediate.

There are several factors and dynamics to this, and it's kinda fun to read. I'll ignore the knee-jerk reaction of liberals to automatically label anything or anyone that disagrees with them as "uber-conservative." I'm modestly surprised they didn't call Mr. Mackey a "neo-con."

TMV's piece does call Mackey's op-ed "anti-health care," which is indicative that Mr. Blair lacks reading comprehension... the entire op-ed was giving suggestions and examples of how we can improve and increase health care for all Americans.

Further, Whole Foods pays 100% of health insurance for employees that work more than 30 hours. This is significant, since most companies require that the employee pay at least part of their premiums. Second, Whole Foods also gives their employees $1800 in donations to their Health Savings Accounts.

Keeping that in mind, can you imagine the sweet irony should the boycott by these "progressive" voices causes Whole Foods to enact layoffs, thus removing the health care benefits of laid-off employees? Whole Foods does what the liberals want everyone to do: Provide "free" health care to their employees. They should be applauded for their acts. Instead, they're going to be boycotted because their CEO has the temerity to make suggestions other than "Tax the rich, and enact a single payer system."

If you've got a Whole Foods in your neck of the words, consider dropping in and spending a couple dollars. You can also drop an e-mail of support by clicking here.