Drinking from a fire hose

I’ll begin my apologies for a week between posts. I haven’t been away from the blog, I just haven’t put out a post… What I did put out is a tutorial for medic math. Right now it’s only available on the blog, although I am working on making a downloadable .pdf out of it.

I know I looked and looked for resources to help me learn some of the things from P-school ahead of time, and had no real success- hence the tutorial. As we progress through pharmacology I will try to add a drug reference and list of the drugs they have given us to learn for future students to get a head start.

The first couple of weeks of classes were fairly mellow, rehashing old information and a very quick walk through of new procedures. We got a tour of the ambulance garage we’ll be working out of.

looking in from the outside... We'll be VERY familiar with this place by the time class is over

We stuck each other with sharp objects…

The first EJ of class...

And then it happened basic pharmacology… so much information in so little time. It lasted a week but each night of class yielded an average of 20 pages of handwritten notes… and in reality we didn’t really cover anything other than the drug math.

After a week of that we shifted gears to basic cardiology. Mostly “naming the dog” in lead II.

The reasoning behind the shift and what we are covering now is preparation for ACLS class etc. They want us to have at least a bare bones understanding of strips and drug dosages before then. Additionally, we will be able to start our phase one rotations soon, and we will be expected to know how to start and IV, administer a medication, put on ekg leads and have a clue of what kind of rhythm we are dealing with. There has been a mountain of information in the last 24 hours of classroom time, and all of it is new, and because it is a glancing blow over things we will be going way in depth to later, its been hashed over quickly. It has begun to feel like drinking from a fire hose.


I don’t mean the nice easy fire hose stream either

Drinking from the fire hose

I don't mean THIS fire hose...

Image credit

I mean this stream…

Fire hose

I mean THIS fire hose

If you’ve seen the movie “Backdraft” – there is that scene in the burning warehouse where the line is lost and its spraying and flying around all over the place… that’s the kind of hose I’m talking about.

I fully expected it, and no I’m not complaining, but there are moments when I say to myself… Damn, what did we get ourselves into it. I imagine that is something every student out there goes through, I just wonder of it happens to everyone so early.

1 week from today is our first exam… So I may be a little quiet this week…



Posted by on October 12, 2011 in Paramedic School, Personal


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Unexpected Outcomes

Have you ever had one of those periods in your life when you looked around and found the scenery wasn’t quite what you expected? After traveling a short time down the trail you stumble upon something that wasn’t listed in the guide books and far surpasses what you expected to find during the journey, and you begin to wonder how did I get HERE?

After reading “EMS social media: Why get involved?” in the summer 2011 issue of NAEMT news, I realized there was a whole world of fellow providers to connect with. I joined twitter, began reading blogs that I had never seen before and connected with providers from around the world. I had tapped into the passion of EMS providers, and I wanted in.

After a few weeks debate over whether I could add something to the treasure trove of knowledge out there, I decided to give it a go – after all we do all have a unique perspective to offer. I picked a name for my blog and I typed and I typed and when I was done with that I typed some more… I’m pretty sure Mom enjoyed those first few posts (although she is admittedly biased). Then something happened – a comment, then some feedback, now a subscriber, and another and another… wait people are actually READING my ramblings?!?

(That first comment was from Ambodriver – THANK YOU Kelly, a welcome from you meant a lot to me, and the fact that you didn’t suggest I find a dark stinky place to shove my opinions was encouraging.)

Today I look around and realize my dive into the social media world took me further than I ever expected…

Little old me- here at EMSBlogs – WOW

I wonder if this is how those people on American Idol feel… someone told me once I could sing – what the hell I’ll try out – what I’m going to Hollywood ?!? Holy crap, now what?!?

For the sake of your hearing and your sanity, I’ll avoid posting any clips of me singing – trust me you appreciate that more than you know.

So here I am standing in the middle of that big stage, spotlight firmly fixed; trying hard to make my voice come out of a glottic opening that seems way smaller than it was an hour ago.  Today the keys seem harder to press, the screen seems brighter and the blinking cursor seems way more impatient then usual – I’m sure that will slowly fade as I get more comfortable in the new house.

I have followed the “heavy hitters” of the blogosphere – Rogue, AD, and Gfriese just to name a few. They taught me how little I really know, they showed me how to become the medic I want to be when I finish school, they inspired me to challenge myself to be better, to learn more.  While I don’t consider myself to be in the same league as any of them, I hope you find something in my ramblings that challenges you to be better, that inspires you to grow on a professional level – if along the way ONE provider becomes better for having read something here – I’ll consider the effort spent a wise investment in the future of EMS.

Please come on in, pull up a seat, kick off your shoes and get comfy, there’s cold ones in the fridge. While you are here, take a moment to poke around, there’s some really good stuff hiding in the closets.

Most of all say “HI” or offer an opinion if you have one… I’m equally interested in what YOU have to say.



Posted by on October 4, 2011 in Personal

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The Pride Defense

Now that I’ve had ampule opportunity to digest my heaping portion of syllabus salad with boot camp dressing (And So It Begins…), it’s high time we take the swan dive off the high board and find out just what it is I have gotten myself into. With blind enthusiasm, I lept; landing with a thud and a huge splash in medical legal issues class.

Medico-Legal class – what else can I say. Yes, it is dull, it is boring, and it is necessary. It turns out I had prejudged the class though… this one was about to get interesting

My twisted sense of humor grew fond of the instructor (a lawyer-paramedic) telling us “unless you want your policy and procedure manual and that big ole binder with our protocols in it reconstituted in suppository form by some slimy lawyer, you will…” It would be remained funny if he hadn’t said it so often. I had a similar fascination with recto-cranial impaction for awhile so I get the draw.

After the standard misfeasance, malfeasance, abandonment, HIPPA, Good Samaritan laws, etc. Something came over him and he changed from the boring legal guy into a genuine caring paramedic.

“Look I know this stuff sucks, but it is important” Now that we have talked about the required DOT stuff let me give you MY medico-legal class. The stodgy lawyer guy was gone, as were the bad jokes and the lawyer “smell” that permeates the room sometimes when you there is an ambulance chaser attorney in the room.

There before us was a medic who genuinely cared about us as students, about his patients and EMS in general. “I’ve been doing this a long time ladies and gents, and it all comes down to three things. Three little rules that will ALWAYS have you on the right side of any encounter or treatment you render. 3 little rules that will ensure you are delivering the highest quality patient care that you each are individually capable of, and yes for those of you that worry about such things, 3 little rules that will cover your ass.

“Get out your pens and something to write with – THIS is important. In this line of work it isn’t a question of if you get sued, it’s a question of when, and in addition to making you a better medic, these 3 rules will make you as bulletproof as a medic can be. Ready…”

1 – Do what is in the best interest of your patient (this of course should be our guiding principle always)

2 – Do what your medical director would want you to do (sometimes harder to know than what is in your patient’s best interest – depending on your particular medical director and service – this one could be a sticky wicket for some of you out there.)

3- Do what you would be proud to defend. (WOW… I have never heard it put so simply and so brilliantly before.)

“Do those three things and your patients will get the treatment they need, your service will get the medic they deserve and YOU ladies and gentleman will be able to sleep at night and hold your head high when you tell people you are a Paramedic. Have a good night.”

The moment was lost on some, as they eagerly picked up their books and bolted, or began to discuss what bar they were going to meet at for beers after class. For a few of us though, we just sat there in stunned silence – jaws agape.

I felt like I had just been given the meaning of life…

Let’s be honest, if all of us could just do number three ALL the time, how much simpler would our lives as EMS providers be. Would we even need rule number 1 or 2 if we could always do 3?

Call me an idealist (you’d be right), but think about all the negative news stories you have ever heard about EMS, EMTs, Paramedics, ambulance services – public and private – How many of those stories would simply dissolve into nothingness if the individuals involved had followed rule number 3?

Do what you would be proud to defend – it’s so simple yet so eloquent.

It should be easy to remember, not most of the time, not for 98% of the calls – but for EVERY single call we run – including the “drunk” at 3 am that swears that telephone pole jumped into the road, 95 YO nana who fell down and just wants help back up when all you want to do is sleep, AND the emergent response to 7-11 – you know the one the “man down” call that proves to be a convenience store attendant is tired of looking at the homeless guy sleeping outside so he calls 911 and says “man down”.

I can’t speak for anybody but me, but I know I would not be proud to have to defend every single action I have ever taken on a call. How about you? Can you look at yourself in the mirror and say that you have honestly given every patient you have ever encountered your best?

If you can say that, then either you are deluding yourself, or your best might need a little work. For those who will say I have given every single patient, every single time nothing but the absolute best I had to offer and are neither delusional nor incompetent – where do I put in my application, I would be honored to work with such an legend partner  EMS God.

For the rest of us human EMS providers, I learned something when I was in the Corps that has stuck with me to this very day “If it feels good to do or to say – you probably shouldn’t” Following this mantra has extracted me from more than one situation that could have turned out much worse then it did. I have used it in both personal and professional life; it wasn’t until sitting in a classroom full of bored paramedic students that it hit me. My mantra was indeed sound, but it didn’t go quite far enough, particularly when dealing with someone who very well may be having the worst day of their lives.

Pride is defined as “feeling pleasure or satisfaction over something regarded as highly honorable or creditable to oneself” (1)

As I continue the journey toward the glittery disco patch, the first standard of care that I intend to change from my days as a basic is to try to remember to always ask myself  “Would I be proud to defend what I am about to do ?”

Now that is a gold standard to try and live up to.



Posted by on October 1, 2011 in compassion, EMS, EMS 2.0, EMT, legal, Paramedic School, Personal

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“Well We’re Movin On Up…

…Movin on up,  to the east side, to a deluxe apartment in the skyyy…”

End cheesy “The Jefferson’s” theme song.

Seriously, there are some changes in the works behind the scenes going on right now. I am not at liberty to fully disclose them yet, but the winds of change are blowing. The blog will soon be moving to a blog network (which means someone other than my mother might read it 😉 ) If you are a subscriber I will post when the site moves, as I am not sure if your subscription will port with the rest of the site, you may need to re-subscribe after the move. Hopefully I will have a definite answer for you between now and then.

In the mean time, I have a few new stories to relay from P-school but they will have to wait until tomorrow…


Posted by on September 29, 2011 in EMS, Personal

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Endings, Beginnings and the Quest for the Disco Patch

So in less than 24 hours The Quest for the Disco Patch begins… First things first for my non EMS friends who read this blog as well as my unenlightened brethren who are sitting with a puzzled look wondering what the hell a disco patch is and why in the world would anyone want to start a quest for one… This is the disco patch

And if the old saying is true that a picture is worth a thousand words, there is no need for me to explain why it is sometimes called the disco patch. (It would be more true if you could tell that the gold thread is all glittery)

I knew as I got closer and closer to the actual start day of school my anxiety level would begin to ratchet up (and I was right 😉 ) So I decided to work as much as I could the last few days before school started… this resulted in me working 78 of 96 consecutive hours – I know it sounds crazy but it served a two-fold purpose, first it is good training for the demands and lack of sleep the upcoming year is certain to be filled with and it kept my mind from running through the imaginary scenario of the first night of class over and over again. (How I’m going to feel about an average of 2.5 hours a night of sleep over the past 4 days by the end of this weeks classes remains to be seen)

SO now you are wondering why my anxiety level was ratcheting itself up so much right… (maybe when I’m too old for EMS I’ll go into mind reading) Every single person I have ever talked to has described p-school with same word “hell” – the length of time has varied, the adjectives before hell have changed (some wholly inappropriate for our little discussion here) but the word hell has been in every description I have heard. I didn’t choose any p-school either I chose one that was competitive to get into and is renowned for its difficulty. The medics that work for the service that runs the program are the US Marines of EMS providers locally. SO in my estimation that at least doubles the challenge level of school.

I am a planner, I like to take a list of obstacles and plan for how I’m going through, over or around each of them to get to the destination, while I have a general idea of the obstacles (cardiology, pharmacology, pathophysiology and scene management) I have no idea at this point in what order or how long of a time frame I have to master them. For me that is VERY unsettling. Throw that onto the above mentioned stuff and maybe you will glean a shred of understanding into the ratcheting stress level.

Some good did come out of it though, I had a very interesting discussion with one of the firefighter medics in the station I worked in this weekend. She pointed out what in her opinion were some of the “weaknesses” an EMT who works in a system like mine are likely to have going into to P-school and strategies to overcome said weaknesses. This was all helpful information, the particular department my service is quartered with are among the best fire medics I have ever worked with so her advice was both appreciated and respected.

A friend pointed out to me as well today “You do realize that today is the last day you will ever be “JUST” a basic (emphasis hers not mine)” While that thought hadn’t actually crossed my mind I suppose they were right, starting tomorrow “I am Paramedic student” not that that isn’t still “just” a basic, but they were right somehow it is different (in my mind at least)

The text is sitting on the desk – the first 4 assigned chapters (due the first night of class) have been read (for those interested below is our main text and work book)

Let the quest for the Disco Patch begin…


Posted by on September 18, 2011 in Anxiety, EMS, Paramedic School, Personal

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Dry spell

It started with working 64 out of 72 hours, and in one of the funny EMS twists it was for all intents and purposes a stand up 64. After some MUCH needed sleep, I sat down here and stared at the cursor’s impatient blink in the vast white space I am typing in now. Funny how our perception of things can change, at that moment the screen was this huge empty vacuum that demanded I put something into it. The screen was way too bright, way too needy, and the blog was crying out for sustenance, just a morsel of a thought was all it wanted. To my mind though it was starving, it needed a meal and simply put my mental cupboard was bare.

A few days passed, each one of them whispered into my ear – hey dude that blog thing you started… how bout pecking out some words… I heard the whisper, but something inside chose to ignore it. At those moments while it nagged persistently in my ear, a root canal seemed more enjoyable than the prospect of logging on here and finding something to talk about with some semblance of intelligence.

It wasn’t until today that it dawned on me, that I have been subconsciously taking a character inventory, as well as a performing a mental remodel of sorts.  It sounds like something I would have been rather conscious of, but the truth is it was rather insidious, dwelling just below the consciousness of my psyche.

It wasn’t until today when I read Kelly Grayson’s blog post containing a letter for EMT students on their first day of class that it dawned on me what was happening just below my parietal bones. You can read Kelly’s letter here

In all honesty by the time I reached the end of the letter I was choked up, not quite crying, but as close as I can remember being to tears in a long time. For the record – I am a 41-year-old former Marine and anyone who knows me will tell you I am not the crying king of guy. Why then did Kelly’s letter move me in such a profound way? I spent the day trying to answer that very question after a few hours the fog in my head parted and I saw what had been going on.

I had been examining the reasons I wanted to make the leap from basic to medic, trying to find what need inside myself becoming a medic would fill that wasn’t being filled now. I have heard more “horror” stories about the difficulties of completing paramedic school than I can count, how difficult it would be, how little I would sleep in the coming year, how I would never be around anyone but my preceptors, how when I was around I would be grumpy, stressed and exhausted.

Undaunted by all these stories, I submitted my application the very first day that I met the criteria, having now been officially accepted I thought I better make sure I was doing it for all the right reasons. Yes I did perform this mental inventory of sorts before applying, but now that I have a letter in my hand that says I am accepted, somehow it’s different. I suppose it’s my minds way of giving me one last out… nice of it to be so considerate, but totally unnecessary.

While taking that inventory, I have been trying hard to change my attitude from the extremely confident basic (did I mention I was a former Marine… I’m pretty sure the last time I truly lacked confidence when I got off the bus at Parris Island – the instilled enough in me after that to last a couple of lifetimes) to the I know absolutely nothing paramedic student. That has been quite the paradigm shift for me, I spent all this time getting comfortable in my own EMS skin, growing comfortable in my skills, expanding my knowledge etc, and now I was working to “undo” all of that. Yes, I do realize that I’m still going to need to know this stuff when I arrive for p-school, however, I don’t want to be the arrogant ass that the instructors are always trying to show how little they actually know. On top of that, I know me… If i think I know it already, I won’t work as hard to master the concepts as I will going in with the attitude of “I don’t know shit”.

As the icing on my cake, anything that has happened at work over the last week or so that didn’t go absolutely perfectly, anytime I perceived anything on a call could have gone better, I questioned myself – are you sure you are really ready for p-school?

It’s been an interesting awakening and a rather insightful look under my own hood, I am happy to see me again when I look in the mirror and to see words in the vast empty white space in front of the little blinky cursor.

I almost forgot to answer the question I’m sure you are asking… why did Kelly’s letter choke me up… That’s another days post

Til next time…





Posted by on August 11, 2011 in Anxiety, Paramedic School, Personal


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Running on empty

Despite my best efforts today simply put – I got nothing.  I’ve been trying to find something to say all day, some witticism, some insight, hell I would have settled for some smart ass comment; I’ve opened all kinds of boxes in the filing cabinets of my mind, each and every one of them stared blankly back at me as if asking what I wanted.

The only thing echoing through the corridors inside my head is that ’70’s Jackson Browne song “Running On Empty”. Rather than try to BS my way through a post – I’d rather just say I don’t have it in me today.

I’m sure tomorrow will be a more productive blogosphere day…

Til then…


Posted by on August 3, 2011 in Personal

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Endings, beginnings and limbo

A couple of days ago I found out that I was in fact accepted into the paramedic program I have been working so hard to get into.  5 days later, after considering where I had been, where I wanted to go and where I am right now, I realized with that single phone call I reached an end, a new beginning and found myself in a sort of limbo.

It isn’t often that a single event can bring about all those paradigm shifts, life tends to reserve such a substantial change in perspective for equally substantial events. I can hear some of you saying it’s just paramedic school man, get over it; and yes, on the most basic of levels, you are right it is “just” paramedic school. Of course when you take into consideration that I have wanted to be a medic for over 20 years now, that I was away from EMS for over 15 years, and that I walked away from owning a successful construction company to return to the field I love, it takes on more meaning, If you factor in that I took a SUBSTANTIAL cut in salary to return to EMS, and that every decision I have made in my professional career over the last two years had led up to that phone call, well you might then begin to understand how important that phone call was to me.

Now I found myself wondering whats next – it’s no longer I want to go to p school this fall, it’s I am going to paramedic school this fall. It’s no longer have to do x,y,z to impress the selection committee, it’s I have to do x,y,z because it’ll make me a better paramedic student and ultimately a better paramedic. The pre-requisite classes are now all officially over and it feels as if this stage is coming to a close. I didn’t get to this stage by myself, it took a lot of support from people who care, it took a gentle kick in the kiester (or two) and someone to believe in me and tell me I could do it.

Now that p-school is no longer something that I am working towards, it is something I will be in. I find that all the anxiety about not getting in has now shifted to “oh my God, I got in… now I have to do more than just talk about it.” The whole new set of challenges, the new base of knowledge, even the physical demands of paramedic school all bring a renewed set of challenges, new obstacles to overcome. A new beginning to an old dream, needless to say, I am more than a little excited about it. So excited I find myself having to stifle the urge to start right this very minute… to not to dive into pharmacology, cardiology and patho phys. Not to say that I won’t prepare and try to get a head start, but I have some time for that still. Hell, I haven’t even received the new student packet yet.

That brings me to now and the “limbo” – school doesn’t start until September – and I can’t say what day in September yet – (see new student packet above) I’ve been so focused on getting in that now that I am in and until it starts I feel sort of lost, like I don’t know what I should be working on. The fun-loving side of my brain says take some time for yourself now – plan a trip up to the mountains and try to get as much “fun” in outside of work as you can because once school starts opportunities for that kind of recreation will be very few and very far between. The practical, professional, driven side of me says start studying now, because I can’t seem to suppress that drive to be the best (frankly, I don’t really want to either).

For the moment I think I will dwell in the satisfaction of a job well done, I will plan a trip to mountains before school starts and I will take a moment (or two) to breathe, before I start the early studying.

Til next time…


Posted by on August 2, 2011 in Paramedic School, Personal

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T minus 5 days and counting

As many of you already know, I am anxiously awaiting a decision letter regarding acceptance status into paramedic school, I had my interview back on the 6th and was told to expect a decision before the 1st. Though always lingering in the recesses of my mind, thus far it has been fairly easy to stave off any anxiety regarding that decision with the calendar, it’s simply been to far away to dwell on. Then this week started and since Monday I have been checking my e-mail every 5  minutes, not because I really expect an answer yet, instead more because I just can’t help myself.

Every decision I have made with regard to my career has led up to this decision. I have passed all the tests, sat through the interview process and have completed the pre-reqs all with a 4.0 GPA, but now I am in this state of limbo where there is nothing further I can do to positively influence whether or not I am going to be a paramedic student in September or if I will have to wait another year. It plays with my head a little to be involved in such an important decision and have it totally out of my hands.

I made the decision on which school I wanted to attend early in my career here and made no effort to even apply anywhere else, I would rather wait another year then attend another program. Knowing that letter SHOULD arrive at some point this week, has led to a bit of anxiety. While working the box it’s pretty easy to push the thoughts off – there are simply more important things to focus on at that moment, but I just finished a 48 and I have the next 4 days off… I anticipate that the send/receive buttons on both my phone and the computer are in for a workout.

I will announce the decision here when I find out… in the mean time maybe one of you will do the math for me and figure out how many times I will press the get mail button in the next 5 days…


Posted by on July 27, 2011 in Anxiety, EMS, Paramedic School, Personal

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19 hours in 29 to go…

I’ll apologize ahead of time for this post as it may make little sense to anyone but me, and after a few hours of sleep, I may not even know what I was trying to say. Today was simply put one of those EMS days where everything is stacked against you from the beginning. We’ve all had them so I’m pretty sure you know what I mean.

My day started with me oversleeping, something I never do, I woke up 5 minutes past the time I needed to leave for my 48 hour shift in an outlying station… an hours drive from the house  on a good day minimum. With an “OH SHIT!!!” I flew out of bed and grabbed my phone to call my partner and let him know I was running late.

Luckily, I prepared my bag and gear ahead of time. 7 minutes later with a full mug of coffee in one hand, a duffel, sleeping bag and pillow in the other I ran out to the truck and hit the road. Being a “professional driver” I firmly planted my foot in the carburetor doing 90-95 all the way to work cursing myself between sips of morning go-go juice. I arrived only 10 minutes late which was pretty damn impressive to me, but drove me nuts all the same… I am not one of those EMT’s who shows up late EVER. I prefer to be early and actually thoroughly check out my rig for my own peace of mind… SO now I am late AND i have no peace of mind that my rig is stocked as it should be. Then I find we have an EMT student third rider – which normally I really enjoy, but knowing I just was the example to this impressionable young lady of exactly the type of  provider I get so pissed at that didn’t help my day any either.

Then the EMS Gods wreaked their vengeance on us, the tones went off NON stop all day… several times we were called out before actually clearing the hospital. SO much for students being “white clouds” or so I thought at the time. The calls today have been mentally challenging medical calls all of them except the last one anyway. I swear syncopal episodes were on sale at the dispatch shack today. Each call was an investigation, a series of asking questions, not just questions but the right questions to figure out why our otherwise completely healthy patient is lying on the floor with a bump on the head. After 10 hours our student left and then all hell really broke loose, we didn’t see the station at all for the next 7 hours – considering that the average transport time here is about 7 minutes – well you get the picture.

So now here I sit, bone weary, mentally spent a little drop of drool cascading down from the corner of my lip 19 hours into a 48… and after the day I had today all I can think is…

How lucky I am to do what I do. Yes, it was a tough day, challenging in every way shape and form. It was both mentally and physically exhausting and yet I still told every single patient I met today that it was my pleasure to be allowed the privilege of taking care of them in their time of need. I don’t need nor want their thanks… I want them to focus on getting well. For me its enough to know that someone needed help today bad enough to pick up the phone and call 911 – My partner and I answered… and together we made what could easily have been the worst day in that person’s life better just by being there and by showing them we cared. Who can ask for better rewards than that?

The drool on my chin is slowly inching towards the keyboard…and my pillow and sleeping bag are starting to bellow for me. Hopefully tomorrow will be a better day – fewer people who need us, more people enjoying their lives – but if the call should come in… 2124 will be there and it will be our pleasure to have the honor of taking care of the person on the other end of the phone.

Till tomorrow – well technically later today – stay safe out there

PS Thank God for spell check 😉


Posted by on July 26, 2011 in EMS, Personal

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