Leaderboard

At least my duty day is over. Oktoberfest in Munich is "the largest festival of the world", yearly celebrating the anniversary of the marriage of King Ludwig I. of Bavaria to Princess Therese on 12th October 1810. Sixteen to eighteen days (depends on yearly holidays) long, starting end of each September. Fourteen large beer tents (large = approx. 4.000 to 10.000 seats) and some little ones. Around 6 million visitors in two weeks, this makes between 200 and 400 thousand visitors each day - the size of a city in it's own. Sometimes around seven persons per square meter, if tents are populated (which they are each early afternoon), dancing and chanting. They will intake more than 7 million litres of beer, half a million chickens ("Hendl"), over 100 oxen, 40 tons of fish and around 120 thousand portions of pork sausages ("Bratwurst") plus a lot more of beverages and sweets. A lot of rides and attractions will serve those who are willing to have fun outside a beer tent. Each day, 120-150 volunteer Red Cross medics, EMTs and doctors take care of the festival visitors, accompanied by the normal Munich city EMS which is reinforced by approx. 10 ambulances around the festival grounds. From 09:00 a.m til 02:00 am the next day, they staff a large central medical post, three outside medical aid stations (container) and ten mobile stretcher teams. This year, again, I was one of them. The central medical post consists of six emergency treatment cabins, one intensive care unit, two stitching cabins, a 16 place monitoring unit for drunks and two resting areas for male and female guests. There, a medic and a doctor will triage the incoming patients, more doctors and medics/EMTs will treat those in need (or monitor until getting better) and - if needed - request transport to a hospital. The stretcher teams are the ones responding on the festival grounds, by foot. At least one tactical team leader, one responsible medic and two EMTs per team take over primary care and transport to the central medical post, if applicable. Often, they will call in direct help from an ambulance, if patient conditions are worse. Medical equipment is a jump bag, oxygene and an AED, the stretcher is carried on wheels and covered with a special designed weather (and view) protection. The small outside aid stations are containers, equipped with the same as the stretcher team plus a closet full of band aids and stuff. One medic and one or two EMTs try to make their best there, assisted by called in stretcher teams or ambulances. Personally I had 61 treatments this day. My patient's nationalities (and languages) were: italian, canadian, united states, england, denmark, norway, austrian, australian, irish, spanish, german and some more (in no special order). The usual thing are blisters from shiny new lady shoes. Others involve head aches (non-alcohol related, since the other type usually comes the day after) and small flesh wounds. A young gentlemen accidentally tried to sit in a broken bottle and took a deep cut in his thigh, loosing a lot of blood, sputtering over his new pair of "Lederhosen" (and the floor of our post), needed i.v. access and a fast ambulance ride into an OR. Two girls had severe migraine pain, nearly relevant to their vitals, needing i.v. fluid and medical pain control. One cutting his finger to the bone, a lot of previously taken alcohol saved him a lot from pain. Some more straightly fell on their nose, not aware, that Munich Oktoberfest beer is stronger than usual and served in 1 liter mugs - one probably broken nose, several severe cuts and the loss off some teeth were the results. Two bee stings needed our attention, but only with local allergical reactions. A kid tried to run fast in a mirror maze, always a bad idea - resulting in a large bulge and a slight commotio. Some people just couldn't stand the wild roller costers and carousels, needing a timeout under blood pressure monitoring. One gentleman was brought by two of his friends, their diagnosis was clear: "He's drunk!". Yes, just like anybody else here, except us service workers. "But he walks funny!". Well, should I really explain to some 50 year old dudes, what alcohol can do to the human body's equilibrium sense? And that it's all OK as long as he generally knows where the sky is? "We'll take you by your word!" - yes, but take him with you, we simply don't have spare place for over 100'000 of his kind... Only one real drunk (without any additional medical condition) was to be taken care for. Just couldn't make his way home alone, constantly fell to sleep. A stretcher team eventually brought him to the monitoring unit... Then finally a nice little old lady with dementia, lost on the Oktoberfest (but not worried about) was handed over to the police. And that were only some of my patients this year, out of approx. total 700 this day - nothing but a normal shift on Oktoberfest. At least I wasn't attacked this year, no one tried to actively bleed or vomit on me and no drunk australian girl screamed name-callings in my ear at 5 centimeter distance (as last year). One day and night of sleep and all is bright again, forgetting blood and vomit, remembering only the nice talks, short lady "Dirndl" skirts, "Bratwurst" and "Hendl" smell, light shows and all the fun we had in our team. Let's see, what next year brings... Greetings to the visiting EMS fellows from the U.S., Canada and Denmark I found some minutes to talk to (actually wishing good luck to the canadian guy). And thanks to the colleagues of Italian White Cross, officially supporting us with their italian language skills, for their great help. Some links: Oktoberfest on Wikipedia official Oktoberfest homepage (english) Red Cross homepage of Oktoberfest medical coverage (german) Hope you enjoyed this report...

In regards to cheating, especially "serial" cheating, it is almost invariably a distraction from the real issues. By that I mean, problems with your marriage and problems with yourself. The amazing thing about being in a marriage is that sooner or later, all the weaknesses in your own personal character are exposed; whether these are issues of self esteem, dishonorable ways of dealing with others, addiction issues, etc. etc. As we all struggle with these issues, we use a myriad of methods to avoid exposing ourselves in those dark secret places where we are the most vulnerable. People fight tooth and nail over the placement of the furniture, whats for dinner and other seemingly insignificant issues that are representative of the deeper issues between the couple. As a serial monogamist, ;-}, I have learned that the personal and relationship problems of one marriage tend to follow me into the next. The excitement, ego stroking and initial gratification of an affair are a great way to avoid dealing with what needs to be dealt with. At the conclusion of the affair, and there always is a conclusion, you are left with the same shit you were avoiding in the first place, as well as the inevitable and complex fallout of the affair. Pretty stupid I think.

OK, you seem to bring a unique perspective on things (I mean that in a good way) and that would explain it.

Seriously, do yourself a favour; wait. Give yourself a year minimum in the field, maybe even two to gain some perspective. You can dump a tonne of money into this stuff unnecessarily. Truly consider how you can best help someone off-duty and you'll realize the most useful things you can provide are a good 911 call, a calm presence, a blanket and nothing more complicated than you'd find in the average first aid kit.

Don't get hung up on buying equipment or the great stethoscope debate. Learn your priorities now and it'll help prevent burn-out. Priority one: yourself. Long before you go nuts with gear for scenes and patient care, consider your working environment and how to make the best of it. Look at your boots, socks, underwear; are they going to keep you comfortable and dry during the shift? Beyond that, get a good water bottle and keep it filled. Pick some healthy snacks for the truck and if you don't have a station where you can cook, make sure you get in the habit of packing a good lunch now before you start hitting the junk while on the road. If you don't have a base, toss a good neck pillow in your bag to help you rest in the truck when you can. Pack reading materials, some work related to keep current, and others just for fun so you can relax. Consider an ipod or portable dvd player. Toss some advil or aleve in your bag along with non-drowsy cough/cold medication for the aches and pains. You also can't go wrong with some travel toiletries (your partners will thank you for reapplying deodorant when necessary). Once you've done all that, then maybe look at a stethoscope that'll suit your needs and any other toys that will let you enjoy the new eager phase. Don't be put off by those that would call it being a "whacker"; as long as it's within reason, this is just the natural enthusiasm of a new job. Though do yourself a favour, no EMS tatoos until you're at least 15 years in.

You really want a Nurse to decide what you can and can not do ? Your State EMS Office and Medical Director should clearly define what you can and can not do, it is not the job of any ER or ER Nurse to be knowlegable about your scope of practice. Are you a practicing EMT ?