Monday, March 22, 2010

Someone asked my opinion....

I will not deny that healthcare costs are out of control and access to health *insurance* is difficult to come by, however...

1.) The provision of healthcare is not a human right. Life, Liberty, Pursuit of Happiness- nothing in there about quality of life.
2.) We already live in too large of a welfare state. The Founding Fathers did not intend for those with to pay the way for those without. Can't afford healthcare? Not my problem.
3.) This "plan" could, in all likelihood, lead to the complete financial collapse of this nation. But then again, Obama spent more money in the first eight months in office than Bush did in eight years- including what has been spent in Iraq and Afghanistan, so I'm pretty sure he doesn't give a damn about the financial security of, well, anyone.
4.) There has been zero transparency in the creation of this program, despite campaign promises of increased transparency in government.
5.) It is simply out & out unconstitutional in the way that it is structured- a provision that prevents the law from being repealed!

Spend time in a healthcare institution and witness the blatant abuse from the entitlement mentality sputtering "I can't afford no co-pays!" These are people bitching about three dollar Medicaid co-payments that they "can't afford" while they're yapping on their cell phone or fishing through their pockets looking for a pack of cigarettes.

And that's not to mention the ER abuse. People using ER's in place of primary care. Calling 911 for an ambulance for pain that they've had for seven years (no lie!) and saying "oh, well I didn't have nothin' to do tonight so I figured I'd get it checked" at two in the morning. Or how about the four people who walked into the ER one night a few years back demanding STD screenings because they all hooked up with the one woman among them and now it burns to take a piss. My personal favorite is when a woman comes in for a two dollar pregnancy test because Medicaid won't pay for prenatal care until there's a confirmation of pregnancy by a physician but they won't cover the cost of an office visit for a pregnancy test. Thanks to current law they cannot be denied at the very least a medical screening, but no physician out there will deny them what they want out of fear of litigation and pressure from administration. These people are a drain on the system and it will only get worse when more and more people are allowed to participate in the system. Witness all of this then sit in my ambulance some day and try to not let your head explode when someone from the Department of Not Fucking Getting It says to you "Just take me to the fuckin' hospital. I pay your salary!" when in the next breath they sputter "I can afford it, I got the 'Caid, you're payin' for it."

A real, workable solution would involve welfare reform and reform of healthcare costs to make healthcare more affordable instead of providing yet another handout to people who contribute nothing to society yet demand that the government provide them with everything.

I have worked in multiple municipalities in multiple counties in multiple states. The *majority* of patients served by the areas I have worked in are on Medicaid. The minority of the people cannot support the majority for very long before complete collapse. We the working class We The People, are being forced to support the majority while Congress members have exempted themselves from this healthcare bill and will collect their pensions for life without having to pay in to Social Security. Unfortunately the damage has already been done, so someone please pass the lube, because we're all about to get fucked with something hard and sand-papery.

Sunday, March 14, 2010

Why Do We Do This Job?

I was going to leave a comment on a post put up by Ambulance Driver, but it is long enough to be its own post.

It was a beautiful spring day, probably right about this time of year. The sun was shining, not a cloud in the sky, perfect for some parasailing on a Sunday morning. The view must have really been impressive, and I'm sure he could see for miles and miles.

While he was in the air he started to feel ill, so he brought the parasail down in a field where his adult son was waiting for him. They began to package the gear when it happened. He clutched his chest and his heart likely stopped beating before he even hit the ground. His son called 911 from his cell phone and immediately started performing CPR. An ambulance was dispatched along with the local first responders. There happened to be a sheriffs deputy near by who just also happened to have an AED in his cruiser. How that Crown Vic with its low ground clearance made it down that muddy, rutted road to the field we'll never know, but the deputy made it there and applied the AED and delivered two shocks. After just a couple of minutes the local first responders arrived on scene and took over CPR, they suctioned his airway and placed an oropharyngeal airway and provided oxygen via BVM, minutes after the first responders arrived two ambulances made their way down that rutted muddy road.

The first responders in this town can be hit or miss, it all depends on who is in town and available, on this day there were plenty of them, but not knowing that, both ambulances responded. As we made our way down that muddy road I took the radio "Gini, you're on airway. Brett, get history from the bystanders, Abbie will get a line. The EMT student can do compressions. I'll take the monitor & drugs."

The first responder who was bagging the patient was one of our full timers, he quickly made room for Gini, the ink not yet dry on her EMT-Intermediate license, to get in position for her first field tube. As the eager EMT-B student got into position to start compressions I told him "push hard, push fast, only stop when I tell you to." The deputy's AED wasn't compatible with our monitor and so I peeled his pads off and placed ours on the patients chest- asystole. Fuck.

The student continued the picture perfect compressions that the son had started. Gini placed an 8.0 ET tube into the patient's trachea and we confirmed its placement via condensation, colorimetric CO2 detector, good, clear bilateral lung sounds and waveform capnography. Abbie had an 18 at the left A/C and so I tossed her the epi & atropine. Brett gave us a report on the history and I had the EMT pause compressions. V-tach. "He's already had two AED shocks, I'm charging to 360. Stop compressions, everyone clear!" Sinus tach at 120. "Son of a bitch, he's got a pulse! lets get into the truck and check a BP." One of the first responders came over to use with a longboard & straps & C-collar & blocks. We got him onto the board and secured to the stretcher and into the truck.

The patient's son followed me to the curb door of the rig and I told him that he was welcome to ride up front. "I'm not leaving my father! I've been with him through everything this morning, I'm not leaving him!" I learned long ago to pick your battles carefully. He had a point, he was the one who started CPR, he was already committed, who was I to deny him that.

I sat on the bench, the son to my left, the student across from me, ready to start CPR again if necessary, Abbie at the head to maintain airway. On the way in to the hospital I got on the radio "Podunk General, this is Medic 8, we're about five minutes out with a male patient, 50's, status post asystole arrest. After one round of ACLS drugs he's in a sinus rhythm now at 80, I've got a lido drip running, 12 lead shows an anterolateral infarct, he's got a pressure of 130/70, I'll see you in five, might want to start LifeFlight now."

Every link in the chain of survival was there that day. His son provided early CPR. The deputy provided early defibrillation. The first responders were able to provide good BLS airway control. My crew and I provided early ACLS and rapid transport. The ED staff was on top of their game that day as well. Just over an hour passed from the time he went into arrest until he was back up in the air, this time in an Agusta helicopter on his way to a cath lab. Several days later he walked out of the hospital under his own power. His only deficit- he doesn't remember landing the parasail.

And that is why I do my job. Because I was a part of the team that saved his life.

Monday, March 8, 2010

I don't know his name, but he was my brother.

I don't know why he got into EMS. I don't know how long he has been in EMS, I don't know what his life's experience was. But the simple fact is he was an EMS provider, he chose a life of dedication to others and one patient, in an instant, took that away from him. His name has not yet been released but we do know that he was 37 years old, married and had two children who expected their daddy to come home in the morning after his shift.

Resquiat in pacem, brother.

Wednesday, March 3, 2010


Second Annual AD NE Bloggershoot AAR to follow later.
I left the Harvard Sportsmen's Club to go directly to a friend's birthday party. Shooty Goodness + darn good company + 150+ mile drive + revelry with drunken fools (only one drink for me) + another 30 miles to home = direct to bed, then off to work this morning and now getting ready for bed again. Just like last  year's event I had a darn good time.

I also need to revamp my blogroll, the format I'm using currently takes up too much space, I need to shorten it and add a new list of Bloggers I've met. But that will be done in the not so distant future.

g'night all