emtannie

I haven't been around in forever. I have to admit, I was cleaning up my email account that I rarely use anymore, and saw a notification for this post. I'm so sorry. Leaving EMS is hard. It's not just a job - it's a part of your personality. I have no words of wisdom, except take time for you. You'll figure out where you want and need to be. And if you end up travelling in western Canada, give me a shout! Take care.

Wow - that is terrible news. I had lost track of her... and Don... I hope he is holding up ok. Thank you for posting this, and the GoFundMe.

"I am so sorry" and "Condolences" just never seems to be quite enough. Barb was a woman who was so much more than could ever be put into words. Sending big hugs to Dwayne and Dylan.

I haven't been here in ages! But, this thread kept showing up in my feed, so I am succumbing to peer pressure and responding.

Medicgirl, when I read your post, part of me thought "you are reading my mind!" I have been in EMS for 16 years, sometimes part time, sometimes full time. I have had a number of personal struggles the past two years, and many times I have seriously considered leaving EMS altogether. I still wake up a lot of mornings and ask myself if this is where I should be. I don't have my answer yet... but I know that where I am now, is better than where I was before. The career I was in before EMS, the last while I was there, I would wake up in the morning and think "damn, I am not sick, so I can't call in sick to work." I don't feel like that here, but I am working through some things that are pretty big hurdles in my career right now. Are you feeling like you aren't in the right place at the right time, because you feel you don't know enough? Because that one call that went bad is still haunting you? Are you doubting that you are making a difference? Because you feel like you have too much to do? Because you always have a student and are getting burnt out? Because your partner drives you crazy? Because your boss drives you crazy? I think once you have narrowed down why you feel the way you do, then you can move forward to figure out how to solve that why... it might mean just changing something in your workplace... or it may mean changing careers... I don't think you are in the wrong field. I think you take your work seriously, and you do your best on every call (which is a lot more than some medics do!). I suspect that you are hitting a bit of a wall.. the "is this all there is" kind of wall... maybe you are ready for a challenge just to change your perspective a little bit... maybe teaching, maybe mentoring, maybe working on a research project for your boss... I am just throwing out ideas, and hoping one sticks. Don't be quick to leave EMS.

The death of Sally Ride is a sad occasion. I sincerely hope that those feminists who spent more time in front of the camera (the Jane Fondas of the world) will put their time to better use by sending well wishes to the family and friends of Ms Ride, than using her death as another excuse to get a few more minutes of camera time. I have read several articles about her life today, and she was truly an accomplished woman. One of the most striking things about her life, was that she did not attempt to glorify herself or her accomplishments as "feminist" but that she chose to use her skills to encourage others through her company and her teaching. How many students was she mentor to? What a difference she must have made in their lives! How sad that there were those who chose to make childish comments about bathroom privacy, and "what will she wear" when she was the first US female astronaut to go into space, rather than take the opportunity to encourage more women to look at that field of science. Unfortunately that mentality is still alive and well today in too many workplaces. I hope that the legacy of Sally Ride is that those students that she taught and mentored can bring the same enthusiasm and passion for science that she had, and pass it on to others.

Hey send me a pm with your email address.... I will dig through my stuff - I am positive I have some med math review assignments...

I had always considered myself on the side of those who oppose physician-assisted suicide, until I cared for my father when he was in end stage cancer. I wouldn't wish what he went through on my worst enemy, and if he could have moved to take his own life, he would have. The pain he endured was horrible. The stress it put on my mother, and my sisters and brother, were horrible. He hated every second that he stayed alive the last few days. It was all I could do, to not fill him full of every med I had at my disposal, to put him into a deep sleep that would allow his escape from his pain-filled life. He was very adamant that he did not want any life-saving interventions but it was unfortunate that he was not allowed to make the decision to end his life how he chose once the pain and suffering became unbearable. Some of the posts here express concern about ending one's life like this becoming a casual event, that patients and doctors will make this decision like they decide whether they want an extra shot of cream in their coffee. It has to be the decision of the person who is ill, not the family, not the doctor. I don't believe that it will ever be a casual event, or that we have to worry about doctors using it as a regular form of treatment. With proper education, most people are smart enough to make their own decisions. We try to educate our patients on the treatment options that they have. Why can we not do the same in this situation? People with debilitating diseases are generally informed about the progression of their disease, the signs and symptoms that will appear, and the deterioration of their quality of life. With that information, why do we not allow them to make the decision that will allow them to escape that pain and suffering in the way they see fit? My personal opinion is that by withdrawing treatments eg feeding tubes or medications, and then allowing the person to starve, or allow a slow organ failure, and accepting that as a more appropriate treatment than the person deciding to have a quick, less painful death through some other means, is merely a way of splitting hairs to distance ourselves from the negative connotation of "suicide." By allowing the slower, more painful, less dignified death, we can comfort ourselves that the person "died naturally" rather than "suicide." But who did this truly benefit? Definitely not the patient. And in the grand scheme of things, isn't the patient our first priority? Isn't patient comfort supposed to be one of our basic treatments? If or when that day comes that I have such a debilitating illness that I cannot care for myself, that I am a burden to others, and that there is no quality of life, I will do my very best to take those steps to ensure that I do not linger.

Dwayne.... please please PLEASE delete my browser history if I die... Why fold a fittes sheet anyways? No one will see it. #10: Bad decisions make good stories.. AND KEEP ME EMPLOYED... I think another one to add to your list is: does anyone know what that blue screen of death on the computer really is? We all know it is bad, but then what?

I have been following this thread for a couple days... and it is bothering me... I feel like there is something I am missing when I read the thread... The patient is wheezing, but has no history to support it, and vital signs show no distress... I get that the event could precipitate an asthma attack, and I can see where a neb could be justified. But, I can also see why comfort only is ok, since patient has good sats and is not complaining of any breathing distress. I want to dig a lot deeper into his history... is there anything.. ANYTHING.. that this wheezing can be attributed to? He may not think that something is pertinent until we ask the right question. Where does he work? Any possible exposure to chemical inhalant, asbestos, silicone? Chlorine from a swimming pool? Was there anything leaking from the vehicle that could have been an irritant? I just want to question this guy to the point where I am annoying... And turnip - I am fully in favor of the therapeutic head slap for texting while driving...

A KED is only to be used on a stable patient not requiring rapid extrication. That should be considered before "is my patient pregnant." I don't see where pregnancy would be an issue. If the situation warranted it, I would use a KED on that patient. Having the patient lying supine is an issue, but you will most likely be placing this patient on a board once they are out of the vehicle, and just put a blanket or pillow under the one side of the board so they are lying left lateral recumbant. I think practitioners who have not had a lot of experience or exposure to pregnant women tend to think of pregnancy as an illness or a disease, something to be worried about right away, when, unless there are signs and symptoms to tell us there is a problem, we shouldn't make that our first priority. I'm not saying there aren't special considerations when dealing with pregnant patients... but remember that we also have special considerations for patients with physical disabilities, mental illness, head injuries, allergies... any number of things. Take a deep breath, remember what the chief complaint is, do your full assessment and history, complete your differential diagnosis, and figure out the best treatment.

1, Do any of you guys consider pregnant patients with any level of trauma as a risk for miscarriage? All pregnancy carries some risk of miscarriage – it is a fact of life. The trauma may precipitate a miscarriage. Now, that being said, even the most minor of trauma incidents, I recommend the patient go to the ER or to their doc for follow-up. They may feel fine, but going to see a doc will put any fears to rest that there is any risk to the baby. Sometimes the treatment is just directing them in the right direction so they get peace of mind. 2. Do you start IVs on all pregnant trauma patients? As others have said – “any level” is vague. It depends on the trauma. Do they need fluids? Am I giving pain meds? Are there any health issues I need to be concerned about? 3. If not why? Giving an IV just because they are pregnant isn’t a good enough reason. What is the reason for the IV? If we don’t need to give fluids, medications, draw blood, or are starting it so we have a patent line for hospital use or when the patient deteriorates, why are we starting it? Katiebug, I always thought that hep locks were contraindicated on pregnant patients. I realize that some pregnant patients are prescribed hep due to certain medical conditions, but as a general rule, although it is a very small amount of heparin, why not just go with a saline lock instead? Please correct me and enlighten me if I am wrong.

I am definitely not well read enough to argue the efficacy of vaccines with you... but I do know that I wish the chicken pox vaccine had been available for me as a kid, and as a young adult (yeah, I am showing my age)... I had chicken pox twice - the first time when I was 12, and I had pneumonia at the same time. From what I am told, I was near death for many days. I only really remember a bit of that time, and missing a lot of school. The second time, I was in my last semester of university, which then turned out not to be my last semester, as missing 3 weeks of school during midterms isn't condusive to graduating. My symptoms were severe enough that I have permanent hearing loss from it. In that case, to me, the benefits of the vaccine outweighed the risks... I wish I could have had it... So now I am going to thank you for giving me a project on my next night shift (which is tomorrow).. I am going to read up on the efficacy of vaccinations, because I don't know enough about it. I was never able to have children, so I cannot relate to having a "normal" child (what the heck is normal?) or one who has difficulties. My husband is a teacher, and used to work with teens with special problems. Now he teaches Grade 6. He always says "Every child is gifted. Just because they may not be gifted in math, or science, doesn't mean they aren't gifted at something else. I have had students who couldn't count to 10, but put a musical instrument in their hands, and they work magic; or put them on a stage, and they are Hamlet. Too many times we only consider a child's gifts as being academic." To all who have children... count your blessings.. although they may be trying, they are still a precious gift to you. To those who have children with difficulties... you have been given special challenges, and I don't know what I would do in the same situation. Dwayne, I consider you and Babs dear friends, and Dylan could not have gotten better parents than you. OK, now that I have derailed this thread enough.... I should probably head to sleep....

Some good responses here, and some good questions so we can get more information. BoCat, you stated that this was "the first cardiac arrest I ran as a lone medic." Do not, do not, do not beat yourself up over this call! Of course you will ask yourself if there is anything you could have done better, or different. Of course you want to learn from this call, so that you will do something different or better next time. That is what a good medic does. But, if you are using this thread to prove to yourself that you did poorly, or did something wrong, that is a BAD BAD thing. There are details missing that would enable us to give more input (several have asked about signs and symptions of anaphylaxis). I hope that you get the chance to add more informaiton here, so we can all think on it a little more. Remember, this thread is a learning opportunity for all of us, not just you - so I hope you won't use the responses to beat up on yourself, or bring yourself down.