Something I learned from my first partner was that there are times it doesn't pay to try to go back to sleep. The agency we worked for at the time, along with the one I work for now, say in their policies that crews have to be awake by 7 AM for shift change at 8. There are people that complain about this, but I'm not one of them. I live quite a distance from work, so my normal wakeup call is sometime between 5:30 and 6. I get to sleep an extra hour at work. Most of the time.
My old partner/FTO told me very early on that if you were up at 5:30, it usually didn't pay to try to go back to sleep when you returned to the station. The logic is simple. You've been up forat least an hour if it was a transport, a little less for a patient refusal. If you get back to quarters right at 5:30, you have about 10-15 minutes of paperwork to finish up (Get run times, log the call, PROOFREAD!), then if you're like me, you need to pee. Now we're up to 5:45 at best. If I try to lay down, I can rarely go right back to sleep. I usually toss and turn for a while, especially if I had a really sick patient. I tend to replay every call in my head, trying to decide if I could have done anything differently. So now we're probably looking at 6:15 or so. My alarm goes off at 6:45, so that leaves me half an hour to sleep. I firmly believe that if you can't sleep for at least an hour, you shouldn't sleep for more than 20 minutes. (Normal sleep cycles support this. Much over 20 minutes, and you drop into REM sleep, which you really don't want to interrupt if at all possible. That first sleep cycle lasts about an hour or so.) So, since less than 20 minutes isn't really worth it, and I wake up groggy if I'm inside that 20-60 minute window, I don't bother trying to sleep at all. That's what coffee is for.
Wednesday, April 25, 2012
Tuesday, April 17, 2012
Corps Curriculum
Over the past few days, I've been able to reconnect with a lot of folks from my Marine Corps days. Mostly, it's been a bunch of people I served in Desert Storm with, that I haven't seen in the last 20 years. It's funny- all it took was a couple of people on Facebook, and the cascade began. This guy knows that guy, who knows someone else, who knows a couple other people, and so on. Before you know it, the friends list is expanding rapidly.
I know that most of you reading this are mainly in the EMS community, with some innocent victims from my life outside work thrown in for good measure. I enjoy writing about my life in the wacky world of EMS immensely, but it was my time as a Marine that really shaped who I am and how I operate today. I'd really like to pass some of those lessons on, but it's all stuff that can be learned, but not taught. I'll try to pass a little of it along, though.
Lesson 1: Always remember the 6 P's.- Proper Planning Prevents Piss Poor Performance. It seems obvious, and can be summed up even more simply. Set yourself up for success. That means that you need to take stuff like checking in the ambulance seriously. Check that the laryngoscope is going to light up when you need it to. Run a test strip on the monitor EVERY MORNING. Open the nitro bottle to make sure there are some tablets in it. As you pull up to a scene, figure out your egress route. Simple stuff that can make or break your day in an instant, all preventable with a few seconds' thought.
Lesson 2: Time spent in reconnaissance is never wasted. Neither is time spent eating, sleeping, or peeing. On every scene, take a minute to look at your surroundings. Is there something that poses a threat to you? I once responded to a difficulty breathing call at an upscale residence. My partner took the paramedic student in to the patient, followed by several firefighters. they assessed and treated the patient, loaded him on the cot and were heading out to the ambulance when one of the fire guys finally saw the .357 magnum revolver next to the patient's wife on the coffee table. I saw it when I looked around the room as we entered the house, and made a point of getting between the wife and the gun, then asking if I could make sure it was unloaded. I could, and did. Nobody else had seen it.
Lesson 3: One is none, and two is one. Carry at LEAST one spare of everything. Murphy's Law dictates that if you only have one of any particular item, you will lose or break it at the exact moment you need it. Especially pens. Never buy pens in less than a 4 pack, and carry as many as possible with you at all times. We still use paper reports, so I have a banged up aluminum clipboard that rides with me. It contains at least a half dozen pens at any given time, along with a dozen reports, two dozen EKG mounting sheets, two accountability tags, and a handful of paper clips. Every time I get on an ambulance, it goes with me. I have a cheap plastic clipboard back at the station, just in case. (Irrelevant side note: My aluminum clipboard is older than my current partner.)
Lesson 4: Never eat the MRE chicken ala king. Or the sweet and sour chicken from the hospital cafeteria. Both things look, smell, and taste like someone already ate them once. And the fruitcake makes it rain. (You 9th Comm people will remember that, I'm sure.)
Lesson 5: Nobody gets left behind. If three of you go into a scene, you better make sure all three come back out before you transport. Everyone that's been in EMS any length of time can tell you horror stories of the hoarder house with the rotten floor that someone fell through and got their foot stuck, or the wreck where someone slipped and slid into a ditch, or any of a million ways you can get into bad trouble on the job. So watch out for each other. Not just physically, too. If you've been on the job a while, you're going to be seen as a mentor, and the hard learned lessons need to be passed on. I'm a firm believer that only the painful lessons stick, but it's OK to forewarn the new kids so they don't get hurt as bad as you did.
I'm sure there are more, but I have a short attention span tonight, so I'll stop there for now. Stay crazy, my friends.
I know that most of you reading this are mainly in the EMS community, with some innocent victims from my life outside work thrown in for good measure. I enjoy writing about my life in the wacky world of EMS immensely, but it was my time as a Marine that really shaped who I am and how I operate today. I'd really like to pass some of those lessons on, but it's all stuff that can be learned, but not taught. I'll try to pass a little of it along, though.
Lesson 1: Always remember the 6 P's.- Proper Planning Prevents Piss Poor Performance. It seems obvious, and can be summed up even more simply. Set yourself up for success. That means that you need to take stuff like checking in the ambulance seriously. Check that the laryngoscope is going to light up when you need it to. Run a test strip on the monitor EVERY MORNING. Open the nitro bottle to make sure there are some tablets in it. As you pull up to a scene, figure out your egress route. Simple stuff that can make or break your day in an instant, all preventable with a few seconds' thought.
Lesson 2: Time spent in reconnaissance is never wasted. Neither is time spent eating, sleeping, or peeing. On every scene, take a minute to look at your surroundings. Is there something that poses a threat to you? I once responded to a difficulty breathing call at an upscale residence. My partner took the paramedic student in to the patient, followed by several firefighters. they assessed and treated the patient, loaded him on the cot and were heading out to the ambulance when one of the fire guys finally saw the .357 magnum revolver next to the patient's wife on the coffee table. I saw it when I looked around the room as we entered the house, and made a point of getting between the wife and the gun, then asking if I could make sure it was unloaded. I could, and did. Nobody else had seen it.
Lesson 3: One is none, and two is one. Carry at LEAST one spare of everything. Murphy's Law dictates that if you only have one of any particular item, you will lose or break it at the exact moment you need it. Especially pens. Never buy pens in less than a 4 pack, and carry as many as possible with you at all times. We still use paper reports, so I have a banged up aluminum clipboard that rides with me. It contains at least a half dozen pens at any given time, along with a dozen reports, two dozen EKG mounting sheets, two accountability tags, and a handful of paper clips. Every time I get on an ambulance, it goes with me. I have a cheap plastic clipboard back at the station, just in case. (Irrelevant side note: My aluminum clipboard is older than my current partner.)
Lesson 4: Never eat the MRE chicken ala king. Or the sweet and sour chicken from the hospital cafeteria. Both things look, smell, and taste like someone already ate them once. And the fruitcake makes it rain. (You 9th Comm people will remember that, I'm sure.)
Lesson 5: Nobody gets left behind. If three of you go into a scene, you better make sure all three come back out before you transport. Everyone that's been in EMS any length of time can tell you horror stories of the hoarder house with the rotten floor that someone fell through and got their foot stuck, or the wreck where someone slipped and slid into a ditch, or any of a million ways you can get into bad trouble on the job. So watch out for each other. Not just physically, too. If you've been on the job a while, you're going to be seen as a mentor, and the hard learned lessons need to be passed on. I'm a firm believer that only the painful lessons stick, but it's OK to forewarn the new kids so they don't get hurt as bad as you did.
I'm sure there are more, but I have a short attention span tonight, so I'll stop there for now. Stay crazy, my friends.
Wednesday, April 11, 2012
Sick Day
My daughter stayed home from school today, sick. Nothing major, she puked a couple times last night, barely slept, and still felt bad this morning. Nobody else was sick, so my son went to school, my wife went to work, and I'm on days off, so I stayed home with her.
Now, I take care of sick people for a living, so why is taking care of a kid with a mild virus such an undertaking? It's not like she needed a lot of care. She spent most of the day sleeping, after all. When she was awake, she was kind of whiny, but she didn't feel good, so I expected that. I warmed up some chicken noodle soup for her lunch, but that's pretty much all the care she needed today. So WHY did I feel like I spent the day trying to keep up with her?
She's better this afternoon. No fever, no puking, and she told me she's hungry. Back to school in the morning.
And can someone tell me, has kids' TV always sucked this bad, or is that something new?
Now, I take care of sick people for a living, so why is taking care of a kid with a mild virus such an undertaking? It's not like she needed a lot of care. She spent most of the day sleeping, after all. When she was awake, she was kind of whiny, but she didn't feel good, so I expected that. I warmed up some chicken noodle soup for her lunch, but that's pretty much all the care she needed today. So WHY did I feel like I spent the day trying to keep up with her?
She's better this afternoon. No fever, no puking, and she told me she's hungry. Back to school in the morning.
And can someone tell me, has kids' TV always sucked this bad, or is that something new?
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