TBI

Today, I saw one of the sadder cases I've been on. 17y/o male, simply needed a transport to two doctors appointments. Took us five hours start to finish. Anyway, the reason he needed an ambulance to do this was because he had a TBI, which stands for traumatic brain injurt, two years ago. He let a friend drive his motorcycle while he was on the back, got into an accident, and now he cannot speak, have any real voluntary movement, and likely has the mental capacity of a toddler.

He is taken care of by his mom and an aid, and both seem to do a good job of it. However, he is overall pretty healthy, and therefore I have no reason to believe he won't live to old age, but he will be stuck in his current mental state for the entire time. I didn't ask if he was wearing a helmet, but based on physical exam, I doubt it. Oh, and his friend was able to walk away from the accident.

After that we transported an old Italian guy back home from the hospital, fairly uneventful except that he was a little bit crazy. We had to use a stair chair to get him into his house.

Finally, as we were heading home we get an emergency call to a dialysis center. Older guy, turned out to be moderately tachycardic (any resting heart rate over 100) and have other abnormal EKG results. Transport was uneventful, though he seemed very nervous.

Tomorrow is my last day as a ride-along. I'm on my own starting Monday, so watch out! I bet they give me transports all day until they trust me, we'll see.

First "Real" Day – Cool

I had my first ride-along today, with a shift starting at 8am. I was assigned to a bus with a medic and an EMT, but when on a BLS (basic life support) bus medics can’t do any advanced procedures.

First call was lights/sirens, which was fun, and really displays how little New Yorkers care about emergency services. Almost no one pulled to the side. We arrive to find a 78 y/o Russian male in mild respiratory distress (RR:30, HR: 93, BP: 140/70), and doesn’t speak any English. The house smells of urine. He isn’t wearing a shirt, appears wide-eyed, anxious, and has a tremor that primarily displays in his hands. After taking his vitals we tried to get him out of the house, but he wanted to take the time to put his shoes on and get his bag. Ok. Hurry up buddy.

Transported him to the hospital on a non-rebreather @ 15lpm O2 without incident. Found out he had myasthenia gravis, which is an auto-immune disorder that blocks receptors in your muscles that tell them to move, leading to weakness.

Second patient, more typical, and boring. Just a transport from the hospital to a nursing home. He had no teeth and from the time we got there to the time we dropped him off repeated “is it cold outside? It looks cold” over and over.

Third call was to a doctors office for an older lady in a-fib (the top chambers of her heart are “fluttering” and not in sync with the more powerful bottom chambers). This was considered an emergency call, lights/sirens again. Multiple drivers attempted to “beat” our ambulance while heading into oncoming traffic. Fun. We arrived, packaged the lady who had a HR of 42 (60-100 normal) and put her on O2, which she ended up refusing. Arrived at the hospital without incident, but as we get there a medic runs through the door saying a code (CPR in progress) is on the way. We shove our lady out of the way as the stretcher rolled through with an EMT doing compressions (slowly, appearing tired) on a 98 y/o woman who had been intubated. She was dead, with no shockable rhythm, before the medics got to her, and time of death was called a few minutes after they got to the ER.

Next two calls were just transports, nothing interesting.

I think it was a pretty interesting first day, and a pretty laid-back job overall. There is a fair amount of down-time, so no worries about finding lunch or snacks. There are even outlets in the back if you want to plug your laptop/cell charger in. Hopefully will have good stories to come.

EMT Day 1 and 2

I officially am now an employed EMT-B (basic life support) in NYC. I’m with a service (ambulance companies are called services) that luckily does participate in emergency calls and not just transport. A supervisor that spoke to us yesterday very much emphasized the emergency side of documentation, but I’m not sure that’s because we will get a lot of those calls or because that makes the most money. Documentation was pounded into our heads yesterday, no doubt for reimbursement purposes. That’s fine though, if the service doesn’t get paid, we can’t get paid.

Most of the last couple days has been paperwork, along with a touch of disorganization. However, we had to do a “FIT” test, which means we have a hood placed over our heads while an instructor sprays “poisonous gas” into it and makes sure we can taste it initially, and then can’t after we put on a portable respirator. We also had some “for-the-street” CPR training by a medic. This essentially just means learning to do things quickly, as well as apply defibrillation pads almost immediately to someone in cardiac arrest. We didn’t get to go on a bus (ambulance) yet, hopefully within the next day or so. Maybe I’ll have some interesting stories after that.

Water Street

I officially have a new place. Changing my borough from Brooklyn to Manhattan, but ironically I am living steps away from the Brooklyn Bridge (I just found out that the order of bridges between Brooklyn and Manhattan is BMW – Brooklyn, Manhattan, Williamsburg – awesome).

If I want, I can pretend that I am in San Diego for a brief period of time by walking a few minutes to South Seaport, which is on the water and has some resemblance to Seaport Village in downtown, San Diego. Of course, this illusion will only work for another few months, when it begins to snow.

It’s on a cobble-stone street in the Financial District (or “FiDi”), which is kind of cool. The apartment itself is in a renovated industrial building, with the whole floor to ourselves, which means a huge common space by New York standards. Three roommates around my age, hopefully all normal. After meeting a very abnormal potential roommate in a tenement who told me I would brush my teeth in the kitchen sink, shower in a closet, and use the toilet in his room, I began to realize why so many people on Craigslist state: “looking for a NORMAL roommate for our apartment” — Oh.

What a homeopathic ER would be like.

Turkish Show Tries to "Convert" Atheists

Hahahahaha…. hahaha… hah.

TV gameshow offers atheists ‘salvation’

The show, called “Tovbekarlar Yarisiyor,” or “Penitents Compete,” features a Muslim imam, a Catholic priest, a Jewish rabbi and a Buddhist monk attempting to persuade 10 atheists of the merits of their religion, according to CNN Turk.

Disregarding how wrong it is for different religions to compete with each other for someone’s faith, I don’t see how any atheist whom has given real though to his/her lack of belief would ever be convinced otherwise through words. For an atheist, I’m fairly confident it would take an act of God to believe in God. More than likely, if someone is converted, they will simply be good actors. Either they were always theists and hid their feelings from the start, or they are atheists who will hide them at the end.

And, let’s say an atheist changes their mind. Ok. So now they have to choose out of four religious belief systems on national television, and if they pick the “wrong” one, they go to hell. Now that’s pressure.

Sarah Palin

Sarah Palin is what I would call a “serious joke”. A joke in that she seems mildly crazy, but serious because there are actually people that take her seriously, and that’s scary. She is quitting as governor? Wow. So, either she plans to run for president or something else came up that we don’t know about yet. It remains to be seen if there are enough dummies out there that will consider voting for her if she does run. I wish there were a system of preventing dummies from voting, but I guess that wouldn’t exactly be fair. Still, I think the idea that “the people” as a hive mind will come up with the best solution to a problem is flawed.

How Smart People Turn Stupid

I had my first experience of moving in NYC yesterday.

There were thunderstorms, six flights of stairs, and back-breaking boxes. But, possibly most salient was the driving.

New York City drivers have to be, by far, the WORST drivers I have ever encountered. It’s not just the taxi drivers that are the problem, which you would expect since the majority come from countries where the

primary form of transportation is by foot or maybe a bike. The crazy part is that even the people in brand new cars, luxury vehicles — thus, they are likely to be hard-working/intelligent/lucky to afford to have and park a car in Manhattan — are just as bad.

I’m pretty sure I was the only person that uses a turn-signal. The standard train-of-thought for New Yorker’s is “aggressive driving”, not “defensive driving”. I’ve heard multiple natives suggest the best method is to be aggressive. I’m guessing this becomes a mob-behavior, because typically the way people change lanes here is by simply drifting into the other lane regardless of if there is a car occupying the space. I lost track of the number of times I was minding my own business as some idiot is near my front bumper and started moving into my lane.

Also, on several occasions I was trying to turn and drivers would go around me and attempt to turn in front of me, even though there is no place to go because I was blocked by traffic.

That reminds me of another piece of madness in terms of New York driving. In California, and every other state I’ve driven, when you are at an intersection with a green light that indicates left turns yield to oncoming traffic, and there is another car across from you also trying to turn left, as you are making the turn you pass in front of the other car so that it will be on your right as you pass. Well, the crazies in New York will often drive into the intersection, become side-by-side with the oncoming car on your LEFT, cross paths and then turn AROUND each other. This works if there i

s only two cars and they time it properly. However, once you get multiple cars then paths start to intersect. I cannot understand how this method is at all logical.

Abuse of Lights/Sirens

For some reason I’m also reminded of something I saw a few days ago. I was about to cross Eastern Parkway as I hear sirens blaring and see a van hurtling towards the intersection. Problem is, people were already beginning to cross as the light had just turned red. At first the van changed its siren tone to try to get people to notice (changing tones literally every few seconds is very common in NYC due to most drivers simply ignoring emergency service vehicles), but no cars got out of the way and the pedest

rians kept walking, so it came to a stop at the intersection and simply turned its lights/siren off. Hm.

If this were a true emergency, they would have kept everything on and went around the car and the pedestrian and sped off. However, the fact it just stopped everything and was fine continuing with the rest of traffic just confirmed my suspicions that there are plenty of people with sirens that abuse them. In NYC there is a lot more leeway about who can install these in their personal vehicles. Technically, as an EMT I could purchase concealed lights/sirens and install them in my car legally. So, as such, I feel plenty of people that have no real need for them will install them (likely even legally) and use them to simply avoid traffic. Walking through the highly Haredi/Hasidic Jewish area of Williamsburg, Brooklyn there is probably a 50% chance I will see a private car barreling down narrow streets with sirens. I highly doubt Jewish people have this many emergencies.