Stuck

Earlier in the morning a car wiped out a telephone pole, bisecting it , and blowing out the powerlines exploding transformers all the way down the street, leaving half the town without power.

We get called for a lift assist. We find a 91-year-old woman sitting in an electric chair with her feet up. "I'm stuck," she says. "The electricity is out."

We consider calling the fire department to bring in a generator to power up the chair. Naw! We lift her out, and set her in a smaller chair. She tanks us kindly and we are on our way.

***

What do you do when someone you work with has unremitting BO? I'm not saying it happened today. I'm just asking what do you do? Do you say something? It is not an everytime occurance. Or do you roll down the window and stick your head out in the rain? That bad.

***

A 25 year old who had no breakfast feels dizzy in a store. Refusal.

A woman at a health fair has sudden onset chest pain. It hurts more when she breathes and moves. Her skin is warm and dry. There is no dsypnea. The first responders had a nonrebreather on. I put her down to a cannula. The doctor on scene questions my decision asking if it is wise given her chest pain, wouldn't the mask be better? No, I'm confident the cannula is fine, I say. That's good enough for me. She looks well oxygenated. He says nothing. I didn't slam him and he wasn't impolite in his suggestion. The lady is discharged two hours later.

I read an interesting article about too much oxygen.

Giving Oxygen May Do More Harm Than Good

The AHA says a cannula is fine. That's good enough for me.

Oxygen
Administer oxygen to all patients complaining of ischemic-type chest discomfort. Also administer oxygen, usually by nasal cannula, to all patients with suspected ACS.
-AHA ECC Guidelines 2000

***

A motor vehicle. Two big big patients. Fortunately no neck or back pain. They both go in for evaluation.

***

Got an interesting link on an email group that I have been watching tonight. It is a lecture that challenges many dogmas about EMS -- dogmas that many of us feel need to be changed.

A>C>L>S> -- What's USEFUL, WHAT's USELESS

The lecture given by an Emergency Physician is anti-working dead people, anti-lights and sirens, anti-helicopter, anti-ACLS drugs, anti-politics, anti-baloney.

***

Pouring rain tonight. Go to a difficulty breathing that turns into a refusal. Man has been drinking and throws up, but feels better.

Then we do a man with vertigo. He pukes all the way to the hospital.

***

The rain keeps coming down. Hard and cold.

Oh, I hope I get off on time.