No it's not an actual swan but a description of a type of patient we all too frequently carry. Imagine this scene. You walk into a room. On the couch can only be described as someone going through what must be the most agonizing death possible. Arms flailing, moaning, groaning. All family and friends assembled have the look of people witnessing what must surely be an impending death. Frequently the family are crying and flailing their arms. As medical professionals we must be moved by such an exhibition of raw physical emotion. Well actually we're not (unless you are new on the job and fresh out of the wrapper). See, people that are sick, really sick, look it. They usually don't flail around, moan or groan (exceptions exist for every rule or guideline). They look sick. That "please help me I'm about to die" look.
The dying swan on the other hand doesn't look sick. They act the way they think dying people act. Like a southern belle swooning and falling to the ground, they seek attention. Usually the attention they seek is not ours, but that of their family. They refuse to talk. Pulling information from them is like being a dentist pulling an impacted molar; sweat, strength and perseverance. The family or friends try to help by answering the questions for them. We are asking the patient because that's part of the assessment, how well they can answer. When we ask the family to not answer they get defensive as they sense that we aren't grasping the gravity of the crisis. Unless we run around flailing our arms the family feels we are not taking this serious enough. Finally we get the patient loaded on the stretcher and into the ambulance. Arrival at the hospital cannot happen soon enough.
Friday, February 22, 2008
Sunday, February 10, 2008
Stories
Paramedics have stories. If you've been in this field for any length of time, you've got stories. Some are funny. Some are sad. Some just bizarre. And of course we love to tell them. A lot of the stories the average person would find offensive. We can laugh at the tragedy of others. It's not that we are laughing at them but using the humour as a defense for us. Think of the cancer patient that makes jokes about their terminal illness. They might use it as a means of diffusing the reality of the situation. Same for me. The humour seems to put a distance between me and the situation.
For example, I pick up off the ground the head of someone that has just jumped in front of a subway. I or someone else may make a joke about them losing their head. We laugh. If you were standing there watching this you would be horrified at our behaviour (actually you probably are just reading this), and rightly so. For you this is probably one of the most tragic/horrific events you will witness in your life. For me this just another day at work. If I considered how this person got to the point where the best option for them was to jump in front of a subway, it would eat away at me. I would think about the people left behind and how this event will affect them. Their children. Their parents. Their partner/spouse. All the pressures that lead to this; debts, mental illness, alcohol. This may not have been the only death I've had to deal with that day. Then there are the people that will go through life altering events. A debilitating stroke. A critical traumatic injury. There are the alcoholics that have their young children running their lives for them because they are incapable. And so it goes through my day. Black humour helps take the edge off. Then I can go home, hug the kids and try and live a normal life.
But enough of that downer. As I mentioned at the beginning some of the stories are bizarre. If you've made it this far you deserve one. Warning first, it may not be appropriate for all readers. This call didn't happen to me but one night a crew was recounting this story as we sat around a hospital chatting. They pick up a man that had inserted a dildo into his rectum. Ok, this is a large city, that kind of thing happens. I guess occasionally due to enthusiasm it goes too far as they say and it gets stuck. Fine, be a man, admit it. Yes people will laugh behind your back (when removing said object) but you are not the first to find himself in this predicament. His cover story was that he was only using the dildo to insert a suppository and ended up pushing it too far. Fair enough, try it to protect your dignity and see if people buy it. The best part was that the crew telling the story did buy it. When they had finished you could see by everyone else's face that they didn't and of course we had great fun at that crew's expense.
The one thing I have learned over the years is just when you think you've seen it all, something comes along to prove you wrong.
For example, I pick up off the ground the head of someone that has just jumped in front of a subway. I or someone else may make a joke about them losing their head. We laugh. If you were standing there watching this you would be horrified at our behaviour (actually you probably are just reading this), and rightly so. For you this is probably one of the most tragic/horrific events you will witness in your life. For me this just another day at work. If I considered how this person got to the point where the best option for them was to jump in front of a subway, it would eat away at me. I would think about the people left behind and how this event will affect them. Their children. Their parents. Their partner/spouse. All the pressures that lead to this; debts, mental illness, alcohol. This may not have been the only death I've had to deal with that day. Then there are the people that will go through life altering events. A debilitating stroke. A critical traumatic injury. There are the alcoholics that have their young children running their lives for them because they are incapable. And so it goes through my day. Black humour helps take the edge off. Then I can go home, hug the kids and try and live a normal life.
But enough of that downer. As I mentioned at the beginning some of the stories are bizarre. If you've made it this far you deserve one. Warning first, it may not be appropriate for all readers. This call didn't happen to me but one night a crew was recounting this story as we sat around a hospital chatting. They pick up a man that had inserted a dildo into his rectum. Ok, this is a large city, that kind of thing happens. I guess occasionally due to enthusiasm it goes too far as they say and it gets stuck. Fine, be a man, admit it. Yes people will laugh behind your back (when removing said object) but you are not the first to find himself in this predicament. His cover story was that he was only using the dildo to insert a suppository and ended up pushing it too far. Fair enough, try it to protect your dignity and see if people buy it. The best part was that the crew telling the story did buy it. When they had finished you could see by everyone else's face that they didn't and of course we had great fun at that crew's expense.
The one thing I have learned over the years is just when you think you've seen it all, something comes along to prove you wrong.
Friday, February 8, 2008
Patients Dying in 'Hall of Shame'
http://www.torontosun.com/News/TorontoAndGTA/2008/02/07/4831979-sun.html
The link leads to an interesting article on "off load delay". If you didn't know, that is when you have to sit with your patient on your stretcher, waiting for a bed in the emerg. Apparently the average time is around an hour, but frequently it can be 2-4 hours, and upwards of 10. That's right, 10 hours lying on an ambulance stretcher. Not good for the patient, the medics, or the citizens waiting for an ambulance because medics are sitting around the emerg, doing the hospital's job. Sometimes it's the hospital's fault, sometimes it is the system's fault. Lots of politics involved.
The article states that no patient died on an EMS stretcher or in the waiting room. Of course not because once they go into cardiac arrest they will be moved to a hospital bed, worked on and if they die, it's after they have been "admitted". So technically no one dies in the waiting room or on an ambulance stretcher.
Patients suffer due to off load delay. It is hard to quantify but in-hospital tests and treatments are delayed which has to negatively affect some patients. Response times in Toronto have climbed which delays arrival of the medics. Again in some cases this has to have a detrimental affect on the patient.
From a paramedic's view Etobicoke is one of the worst for off load delay.
The link leads to an interesting article on "off load delay". If you didn't know, that is when you have to sit with your patient on your stretcher, waiting for a bed in the emerg. Apparently the average time is around an hour, but frequently it can be 2-4 hours, and upwards of 10. That's right, 10 hours lying on an ambulance stretcher. Not good for the patient, the medics, or the citizens waiting for an ambulance because medics are sitting around the emerg, doing the hospital's job. Sometimes it's the hospital's fault, sometimes it is the system's fault. Lots of politics involved.
The article states that no patient died on an EMS stretcher or in the waiting room. Of course not because once they go into cardiac arrest they will be moved to a hospital bed, worked on and if they die, it's after they have been "admitted". So technically no one dies in the waiting room or on an ambulance stretcher.
Patients suffer due to off load delay. It is hard to quantify but in-hospital tests and treatments are delayed which has to negatively affect some patients. Response times in Toronto have climbed which delays arrival of the medics. Again in some cases this has to have a detrimental affect on the patient.
From a paramedic's view Etobicoke is one of the worst for off load delay.
Wednesday, January 30, 2008
The Beginning
This is something I've pondered doing for a while now. As paramedics we get to see a side of life that few do. The good and the bad. From the birth of a new life to the final moments of another. From the sudden accidental death of a child to the horrors that people can commit against one another. Not many people have such a wide range of experiences. I hope to bring some of their stories to life.
You'll also see the irreverence that paramedics can bring to any situation. Hopefully you won't find it offensive but you might. "Black humour" is always available to us as a defense mechanism against what we see; a combination of MASH, ER, and Animal House. Really though, it's not like anything on TV or in the movies. It's not near as dramatic. I guess the closest I've seen is "Bringing Out The Dead". It was over the top in some ways but captured the interplay between paramedics and some of the humour better than most.
I hope that you find this entertaining and educational.
You'll also see the irreverence that paramedics can bring to any situation. Hopefully you won't find it offensive but you might. "Black humour" is always available to us as a defense mechanism against what we see; a combination of MASH, ER, and Animal House. Really though, it's not like anything on TV or in the movies. It's not near as dramatic. I guess the closest I've seen is "Bringing Out The Dead". It was over the top in some ways but captured the interplay between paramedics and some of the humour better than most.
I hope that you find this entertaining and educational.
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