Medic Students say the darndest things.

So in class tonight, we learned some new descriptive phrases – this is meant mostly as humor, and also evidence and reminder for the T-shirt or “remember this” list that we’ll be coming up with eventually.

Pulmonary function is now summed up in one word: Flowability. “Doc, the patient has bad flowability and we're CPAP'ing 'em"

And 12-lead interpretation got easier… if the ST segment looks like a smile from a smilieface… that is good. If it is a frown, it’s bad. So from now on, when we call a certain doc on the command line, we can say “I’ve got smiles on the ST segments and good flowability… I’ll see you in 10. Of course, if we get any other doc… this could be really bad.

And Miles to go before I sleep.

So we use this program called FISDAP to track all of our clinical hours for school. We have 72 hours to enter in all our data, and we also need to turn in a paper form with our clinical preceptor's signature, etc. I was up until 0300 taking care of school paperwork. Today starts at 0500, working 0600-1400, then clinicals 1800-0000.

As I was typing last night, I thought back to a poem I once read... Robert Frost's "Stopping by the Woods on a Snowy Evening". I can appreacate some poetry, and I remember this one from middle school englis

The line that kept running through my head was "And miles to go before I sleep." Given my current schedule, sleep has become the "optional" part of my scheducle. So When I got to work this monring, I took several shorter naps, and probably slept for close to an hour.

Anyway.... I need more sleep.

Whose woods these are I think I know,
His house is in the village though.
He will not see me stopping here,
To watch his woods fill up with snow.

My little horse must think it queer,
To stop without a farmhouse near,
Between the woods and frozen lake,
The darkest evening of the year.

He gives his harness bells a shake,
To ask if there is some mistake.
The only other sound's the sweep,
Of easy wind and downy flake.

The woods are lovely, dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
~Robert Frost

Monday again

So, I'm at work again.

Last night I had to fuel my car, and it was refreshing that a full tank of gas was less than $50! I remember cringing when I was payin $80+ for a full tank, so it is nice that the price is a little better.

I was just watching on TV that it's the Marine Corps birthday today, and Veteran's Day tomorrow. THANK YOU to everyone who is serving, or has served our great country!


Check this video out on YouTube:

Wow.

I woke up this morning, hoping that last night was a bad dream. Nope. Obama won, it seems.


Anyway - yesterday was busy at work... Cardiac Arrest at the local "Skilled" Nursing facility... came in as "Unresponsive Person".... and we walk in and the CNA is doing compressions. It don't get any more unresponsive than that!

The arrest was wittnessed. We worked it into the ED and got ROSC on the way in... guy coded twice more in the ED before it was finially called an hour or two later.

We then got our butts kicked with 5 calls between 2 BLS trucks and the medic... and we had another BLS cover us for a 3rd call.

Daylight Savings Time

So... is Daylight Savings time really worth it? The inconvience of changing your body schedule an hour, twice a year isn't that much, in fact, to anyone used to rotating shifts (Read: most EMS, Fire, and Law Enforcement folks) it really isn't anything at all.

But why do we do it? I don't care if the sun comes out at 7:30 or 8:30... I've got to start work at 0600... so it is going to be dark when I get to work - all the time.

Then there is the inconvience of having to change all your clocks. And we have clocks on everything - Phones, radios, microwaves, DVD/VCR's, computers.

Then the government goes and changes the program... and screws up the time on any electrical device that is programmed to automatically change the time.

PVC Challenge

Clinicals continue to entertain.

I'm way behind in my clinical paperwork... as soon as I finish posting, I've got to work on my charts for my ED shift last week, as well as my prehospital shift on Sunday. If I get all caught up, there is paperwork from the L&D rotation to do, too.


Anyway... the other night was a pretty busy shift. Started off with a major trauma after an MVA. BLS onscene called for us to assist. Patient had a femur fracture and signs of a head injury... so he got himself a ticket for a helicopter ride to the nearest trauma center.

I had a few other calls, but the last one was the most serious:

Dispatched for a CVA (Stroke). On arrival, the usually calm cop was a little panicked. PD said that the patient had just gone unresponsive on him after exhibitng sudden-onset, stroke-like symptoms.

The patient wasn't breathing well... fast, shallow, irregular respirations. We laid the patient down and he wasn't moving air and had signs of a brain injury, so we went for the airway.

After ventilations with a BVM, the patient started to look better. Gag reflex was intact, so I intubated nasally. I'd always head how easy it was... but I didn't really believe it. I had a little trouble at first, because I had to remember to push the tube BACK, not up. I was using a BAAM (a whistle that fits over the end of the ET tube), and all of a sudden, it started whistling. I checked lung sounds and secred the tube.

I was a little protective of the tube... because I didn't want to lose the tube.
Part of that reason was that I'd pulled a medic's tube out on my last prehospital shift... the tube just popped out... and I wanted to make SURE it didn't happen to me.

So... I got another first in the class. Someone else got the first oral tube... but I'm the only one with a nasal tube.

Tuesday - Post 1

So... I'm sitting at work. Working 2 hours overtime to cover a hole in the schedule. I'll take the money.

I'm about a month into medic school - and we've got some form of mid-term tonight. There is a study group gathering before class... and I might stop by.

I've been running myself ragged between work and school. I need sleep. I need a day off. I'm also sick - had a sore throat start last night during clinical, runny nose today, and I feel miserable.

I had 3 calls so far today at work - 2 were cancelled before getting to the scene, and the third was a moderate MVA - high speeds, limited injury.


Last night at clinicals was cool. I had the first shift of the class in Labor and Delivery. That meant that I was the guinea pig. I stood around looking a little out of place (6'3" big guy in gray shirt and blue pants surrounded by female RN's in green scrubs. Then they realized that I needed to get into scrubs - which I did.

I don't like wearing scrubs - at least not in public. My scrubs at home are reserved for around the house and use as pajamas. I'm used to having pockets, and thicker fabric. I feel so out of my element in scrubs. No trauma shears, no key ring, no glove pocket.

I got to observe a C-section last night. C-sections are WAY out of the paramedic scope of practice, but it is intresting to watch. Because I went through a different paramedic program already, but now get to start over from scratch, I'd actually already done a few shifts through L&D, but at a different hosptial, in the City. So I actually had seen one before... but it is still intreesting to see. I also spent a lot of time talking with a medical student doing his mandatory OB rotation. I learned some from him... and even more from watching the attending teaching him. I also spoke with a PA in the OR.

I've been in OR's before. I understood what was sterile, and what wasn't. I had to ask where I would be able to stand out of the way... but otherwise, stayed back and watched. The procedure seemed to go without any trouble, and the NICU folks were there to resusitate the baby, but didn't have to do much. Initial APGAR was 9. I had a discussion about that, too. Although the perfect score would be 10, they only usually get 9, loosing a point on color.


Anyway - it was a good experience. But I really hope to keep my rig "life-neutral"... no one dies in my truck, and no one is born in my truck. I've done pretty good on the second half, lately. OB was a great change for me - in my previous 2 clinical shifts, I'd worked 3 codes... 2/3 were unsuccessful. The 3rd one we actually got ROSC (Return of Spontanious Circulation)... AFTER we started working the code, the nursing home gave my preceptor the patient's living will, which called for no heroic measures. By the time we got this, we were transporting - so we kept going, consulting with the hospital staff. So we walked in the door and got a pulse back - but the patient didn't want to be there... now what? I'm not sure if the ED staff continued mechanical ventialtion, as the patient had no spontanous respirations. I'm going to guess that that patient died, too... making me 3/3.