Syndicated Columnists

A little respect

Michael Morse - Rescuing Providence - Wed, 04/04/2018 - 09:45

She spends hours at the gym, had her nails done, a pedicure, her hair is perfect and she spent a few hours getting ready for a fun night out dancing in Providence with her friends. She is beautiful, and looks fantastic, and people notice, and she doesn’t mind, as long as they are not creepy about it.

Some moron crashed into their car at two in the morning spoiling a great night. She had a few drinks, but was far from intoxicated, and wasn’t driving anyway. She was hurt in the accident, and needed to be seen at the ER for some stitches and x-rays.

Sometimes, all we can do for our patients is make them feel better during transport. The high tech equipment and highly trained EMT was reduced to performing one of the simplest, kindest and most ancient of all medical techniques.

I covered her with a blanket. Her anxiety level dropped in half. The beautiful body that she showed off earlier in the night, and did so with class and style was no longer on display.

Categories: Syndicated Columnists

“Ralph Waldo Emerson wold have been a fine medic” – Michael Morse

Michael Morse - Rescuing Providence - Tue, 04/03/2018 - 15:17

“To know one life has breathed easier because you have lived. This is to have succeeded.” —Ralph Waldo Emerson

“Engine 10 to Rescue 1, eighty year old female, respiratory distress, possible CHF.”

“Rescue 1, received.”

We turned the corner onto a narrow dead end street. The door of the last house on the left was open with frenzied activity just beyond the threshold.

“Get the chair,” I said to Adam and entered the home.

“230/115, pulsox 68%,” says Ted, as I approached the patient. She was struggling to breathe, as her lungs were full of fluid. The oxygen mask covered the bottom half of her face, and her eyes were panicked.

Adam set the chair up next to her. The guys from Engine 10 picked her up from the couch and got her ready to move. Seven or eight family members stood nearby, some worried, some afraid and some near panic.

“What is her name?” I asked.

“Auriela,” one of the women answered.

I took a nitro from the bottle I had in my pocket and had the woman tell Auriela to put it under her tongue and let it melt. She struggled for a while then understood. A minute later we were in the rescue. Ted was applying EKG leads, and Adam was starting an IV. I was preparing an albuterol treatment.

“I’ll give you a driver and an extra set of hands in back,” Frank, the officer of Engine 10 says, closing the rear doors of the rescue.

“Let’s roll.”

We began our journey toward Rhode Island Hospital with three of us in the back with the patient, a firefighter from Engine 10 driving the rescue and Frank and Paul following with the engine. Another nitro en route, 40 ml of Lasix and the albuterol treatment seemed to be effective. Auriela’s eyes stopped darting, her breathing slowed as her lungs cleared and she managed a little smile. The frantic activity in the back of the rescue slowed in rhythm with our patient’s breathing. There wasn’t much more to do but comfort her and let her know she would be all right. She didn’t speak a word of English, and we barely spoke a word of Spanish, but all of us knew she was out of the woods.

We arrived at the hospital. The rear doors of the rescue opened and there stood one of our guys, an off duty firefighter from Engine 11. I looked at him for a moment, confused.

“That’s my grandmother,” he says as he helped us wheel her in.

Twenty minutes later he shook my hand as we were preparing to leave.

“Thanks, Mike, you guys were incredible,” he says.

I can’t imagine a more satisfying job than the one I have.

How do you like them apples, Ralph Waldo Emerson.

And speaking of Ralph, here’s another;

“Every man is entitled to be valued by his best moments.”

Entitlement and reality are far different entities. While I’m in a scholarly mood, I figured I would mention William Shakespeare addressing reality in a speech from Julius Caesar;

“The evil that men do lives long after them, the good is oft interred with their bones.”

So it is in the fire and EMS business. We are only as good as our last act. Today’s hero is tomorrow’s villain, and tomorrow’s villain will still be a villain even if the day after tomorrow he becomes a hero.

It takes time to erase a major mistake. For some strange reason we love nothing more than to focus on people’s shortcomings. Perhaps we feel better about ourselves when others are exposed as having human frailties.

Just keep in mind, everybody gets a turn, and ours is coming. It’s just the way it is. So relish those moments when everything goes as planned, and savor the fleeting seconds when you can bask in your own greatness. Keep striving to do great things, and maybe you will be valued by your best moments, and the dumb things we do will be interred with our bones.

Categories: Syndicated Columnists

Rescuing Providence, by Michael Morse

Michael Morse - Rescuing Providence - Mon, 04/02/2018 - 09:32

This is the home of Rescuing Providence, written by Michael Morse. Michael is a retired Captain with the Providence, RI Fire Department. He started his career in 1991 and retired in 2016. After graduating from the 42nd training academy he was temporarily assigned to Special Hazards 1, then moved to Ladder Co. 7, Engine Co. 2, Ladder Co. 4, and  Engine Co. 9. In 2001 he was assigned to the department’s EMS division for a six month tour. In a blink, six months became 15 years. He was a rescue technician on Rescue Co. 1 for a year, them became Lieutenant of Rescue Co. 3 until transferring back to Rescue 1 as Lieutenant where he served for eight years until being promoted to Captain, Rescue Co, 5.

Morse began writing about his experiences in 2004, and started this blog in 2006. His first book, Rescuing Providence was published by Paladin Press in 2007. Since then he has written four more books, Rescue 1 Responding, which is the sequel to Rescuing Providence, City Life, a collection of short stories, Rescue 911, another collection and Mr. Wilson Makes it Home which tells the story of Morse moving into the next chapter of life after the fire service.

He is currently a columnist with EMS1, Fire Engineering and The Providence Journal.

Michael and his family live in Rhode Island, travel a little, work a little and live a lot.

Categories: Syndicated Columnists

Horror (bringing bedbugs home)

Michael Morse - Rescuing Providence - Mon, 04/02/2018 - 09:13

Call to 911 for flu-like symptoms?

.25 cents

Rapid response by rescue 5?

$300.00

Expert EMS treatment and transport?

$425.00

The look on the EMT’s face when he sees a bedbug in the middle of the stretcher after transporting?

Priceless.

Returning to quarters with bedbugs and infesting the firehouse?

Beyond priceless!

 

https://www.tipsbulletin.com/home-remedies-to-get-rid-of-bed-bugs/

Categories: Syndicated Columnists

Being There

Michael Morse - Rescuing Providence - Mon, 04/02/2018 - 07:16

By Michael Morse

When I see images from a disaster,

    Photo credit Eric Norberg

terrorist attack, or mass shooting flash across my screen, my eyes are drawn to the rescuers, not the victims. I focus on the job at hand and the people doing it. I wonder what they are thinking, how they are managing, what emotions they are ignoring, and how they will cope.

I think of the people behind the uniforms and the mass of chemicals that are accumulating in their bodies; the adrenaline, cortisone, dopamine, and others I do not remember that give them the fortitude to perform in horrific conditions. I remember stepping over bodies of obviously dead people to get to the living, how sometimes I had to lie across a body to get to a victim, and waiting for the hydraulic rescue tools to free us. I remember thinking I was okay, it was part of the job, we all do it, we all survive, and we all do it again.

Little did I know I would never forget.

If who we become is a direct result of what we have done, it is imperative that we focus on the lives we saved, not the ones we stepped over. I do not see the face of the guy dead in the driver’s seat anymore; I see the girl in the passenger seat who survived. I even remember her name. The body is just that, in my mind anyway; I cannot think of him, I don’t think of him, he is gone, and we are not.

If there is one thing I know better than everything else, it is this; what we do may not define us, but it certainly shapes who we become. Our personalities are fluid; we never stop changing. Life experience changes us subtly; we do not notice those gradual shifts in perception. It is only when looking back, often through the eyes of the people who are actively responding to emergencies, that everything becomes clear:

We are not hard; we are not machines; we are not tools to be used, put away, and used again until there is no more life left and a replacement is needed. We are human beings, made exactly like the people who need us.

It is human beings who have to be there when things get ugly. And if not us, then who?

Who will they call when the bullets are hitting their targets?

When they are hunkered down, bleeding, dying.

When sirens in the distance are the only thing they have to hold on to.

When all is lost.

Who will they call?

They call us. First Responders. The Army isn’t coming, the Marines either. It’s their neighbors who respond, their fathers, their sisters, their friends. It’s the people they see at the market in their street clothes, the ones standing in line with them at the coffee shop, and the ones on duty, in uniform and prepared for the unimaginable. When their world descends to madness and nothing makes sense, we respond.

We are everywhere we are needed, nestled in neighborhoods, patrolling the streets, sitting on corners in our ambulances waiting for the call. We are in the crowd that comes under attack, never really off duty, once trained and experienced it matters not when we are needed, only that we are.

Most of us will never be called to a mass casualty or be present when tragedy strikes. All of us carry with us the know-how and presence of mind to act in an emergency. None of us wants our training, experience, and demeanor to be needed.

Every time tragedy hits home it’s the police, the firefighters, and the EMTs running toward the gunfire. Somehow we make careers out of it and walk among our families, friends, and neighbors as if we are just like everybody else. But deep down I think every one of us knows that we are different. And if we don’t know it now, we will definitely find out.

Photo credit; Eric Norberg

Categories: Syndicated Columnists

Research Analysis: Check and Inject program is safe and cost effective

Syndicated Columnists - Thu, 03/29/2018 - 16:17
Inspired by the rising costs of epinephrine auto-injectors, King County Emergency Medical Services decided to implement a “Check and Inject” program in 2014. Recently published research in Prehospital Emergency Care has shown that this switch was not only safe for patients but saved the region at least $1 million over a three-year period. This research was also presented at the 2018 National ...
Categories: Syndicated Columnists

Quiz: Test your knowledge on anatomy and physiology

Syndicated Columnists - Thu, 03/29/2018 - 15:40
Even the most skilled EMTs are ineffective if they can’t communicate and document basic anatomic principles to other healthcare providers. This quiz will test your knowledge on anatomy and physiology basics and terms of direction.
Categories: Syndicated Columnists

I’m as free as a bird now…

Michael Morse - Rescuing Providence - Wed, 03/28/2018 - 09:50

It’s not all heroic rescues, trauma codes, waving to kids and CPR, it’s so much more. It’s really all about people, and trying to do what is right, or at the very least, what you hope is right. . .

Nothing on the floor but dirt, roaches and him. The carpet was stained beyond repair; food, beer, piss and shit mostly. That would have to be replaced in a few weeks when they finally got rid of the tennant. Three weeks at the most, probably one or two, it wouldn’t be long, now.

“Jake” stood guard. The smell that nearly knocked me over didn’t bother him, he circled his master, protecting him from the intruders.

“Easy Jake,” said Richard from the floor. Eighty pounds, bald, yellow and brown underwear and nothing else, no blanket or sheet to cover him, no pillows or other comforts, spilled warm cheap beer next to him, some old smokes in an overflowing ashtray, Lynyard Skynard cranking from the Sylvania Hi-Fi in the corner.

“I got cancer,” he said.

“A lot of people have cancer, sir.”

“Poor souls.”

“We have to get you to a hospital.”

“Been there, ain’t going back. Me and Jake till the end,” he grinned from his spot on the floor. Jake wagged his tail and enjoyed the massage from the bony hand between his ears.

He wanted to get back in bed, where the remote was, and the piss bucket, and the warm 12-pack.

“If shit didn’t stink I wouldn’t bother to get out of bed.”

“I’m not leaving you here.”

“The fuck you ain’t”

Jake eyeballed me suspiciously when I moved toward him. The dirty little terrier had some heart, I’ll give him that.

“What am I going to do then, let you die on the floor?”

“Put me back in bed and let me die there.”

I got him onto the bed, gathered some pillows and blankets, put his beer in arms reach, moved the piss bucket closer and fed the dog.

“Turn that up!”  he said when Freebird came on. “I love that song!”

I lifted the cover to the console, saw the eight-track in it’s place next to the turntable, found the volume knob and turned it up.

Categories: Syndicated Columnists

EMS and Health Experts

EMScapades Cartoon - Tue, 03/27/2018 - 11:25
Categories: EMS, Syndicated Columnists

Applying Your EMS Knowledge

EMS Office Hours Podcast - Tue, 03/27/2018 - 10:11

You have heard the saying “Knowledge is Power”. In EMS you have to be able to apply that knowledge and know when and how. Especially within the pre hospital environment.

Anyone can memorize big words and sound smart around the water cooler. But that won’t change what you can do as a paramedic or EMT.

Be good in EMS so you can be great for your patients.

Listen to this weeks podcast to see what I mean and how your knowledge focus may need to change.

Be sure to visit iTunes and leave a quick rating or review.

Get your EMS PHD. Seven powerful modules that will build your knowledge base and be a go to resource in your EMS library. See all seven modules and get 2GB of additional storage all in one small device. Go here for all details. 

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Does your EMS agency have protocols for deceased patients in public?

Syndicated Columnists - Mon, 03/26/2018 - 09:43
Recently, a county EMS agency was taken to task by local media when a crew left the body of a deceased individual outside in public view after an unsuccessful resuscitation. According to local news accounts, it took nearly three hours for a funeral home to retrieve the body. The patient’s wife was sitting with the body for much of that time. Not having spoken to anyone directly involved with the ...
Categories: Syndicated Columnists

EPIC: An EMS-centered approach to head injuries

Syndicated Columnists - Mon, 03/26/2018 - 08:31
Traumatic head injuries account for 2.5 million emergency department visits annually in the United States. More than 10 percent of these head injuries are hospitalized, from which nearly 53,000 die. This is more than one-third of all injury-related deaths. In the past, it was thought that there was little that prehospital care providers could do for patients with head injuries, but new research and ...
Categories: Syndicated Columnists

Moving beyond the 'standard' 12-lead ECG

Syndicated Columnists - Mon, 03/26/2018 - 08:19
Acquiring a 12-lead ECG has become the standard practice for paramedics when encountering a variety of patient presentations. Aside from the basics of assessing a rhythm strip for the purpose of rhythm identification, your 12-lead gets you into the realm of diagnostic information and actual rhythm interpretation. In many EMS systems, 12-lead acquisition has even become a standard part of basic life ...
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