Something to Care About

I had the day off. The second Tuesday of every month I go to the regional council education and medical advisory meetings. I sleep till I get up, drink a diet coke and read the news on the internet, go to the gym, shower, change, then go to Quiznos and get a mesquite chicken sub, which I eat at the meeting -- everyone eats their lunch at the meeting.

I am the paramedic representative on committees made up largely of clinical coordinators and physicians. I generally hate meetings, but we get work done. I am involved in many projects, most particuarly rewriting the old protocols and coming up with new ones. I feel like the committee members listen to me and the work we do makes a difference.

In May, we will change the standing order dose for morpine from 5mg to .1mg/kg, which means a 220 pound man with a broken femur can get 10 mg before we have to call medical control rather than just 5mg. We're introducing the bougie as an aid to intubation and CPAP for pulmonary edema for services who chose to use it, permitting medics to give narcan intranasally, lowering the minimium BP to give NTG from 120 to 100, permiting reglan or phenergan to be given on standard orders for nausea/vomiting, and starting a data collection project on intubations.

A few years ago, we couldn't even give morphine without calling to talk to a doctor. We're able to cease resucitations in the field if the person, who must meet certain criteria, hasn't responded to ACLS interventions and we have a spinal immobilization algorithm that enables us to decide which patient should be c-spined instead of having to c-spine everyone.

I'm most proud of the work I have done to make giving pain medicince easier. A number of years ago I helped change the state law that had required on-line medical control to give controlled substances. I did the background research that was presented to the legislature and I testified before them.

When I go to a scene where a man has fallen and his bone is sticking through his leg, I can grab a quick BP and then if he isn't allergic, get some morphine on board right away, and not have to go back down to the ambulance, get on the radio, and call the hospital and wait for a doctor to come to the phone. I can help his pain right there.

I love clinical medicine and hate missing a day of work, but sometimes you can help your patients more by going to meeting.

Maybe when I'm too old or injuried to work the streets I'll have a job where I can help people, where I can champion a worthy cause, something I care about.

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I'm off the next two days -- going to Fenway Park. Go Sawx!