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As anyone working in a big city in paramedicine knows, we often get sent to “unconscious” patients that end up being a drunk that decided to catch some Z’s in the middle of the street. We had one such call today, at 4pm in the afternoon.

We picked up and onto our stretcher and into the truck. After enjoying a nice sternal rub he woke up. Of course he denied drinking, and then the following exchange:

Intox: “why am I here?”
Me: “you were sleeping in the street”
Intox: “what are you talking about, I was at home” (he’s homeless, so maybe a true statement)
Me: “you can’t sleep in the street, someone called 911, and now you’re going to [insert name of a not-so-highly-respected hospital]”
Intox: “nooo!!! please don’t take me there, let me out, last time I was there they didn’t get me no foooood man, how am I supposed to get my Chinese food?”
Me: “you’re going there”
Intox: “man, you guys are the worst, why you always be picking me up?”
Me: “probably should stop getting drunk and sleeping in the street, enjoy your stay at not-so-good hospital.”

Oh, and he couldn’t tell us his social security number, but could remember his Medicaid number and tried to chide us by saying it would cover his visit, which was weird because last night a homeless guy asked for money, which I denied him, and then yelled at me that maybe he would just go to the ER and complain of chest pain and they would feed him. Thanks for contributing to society.

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The middle-aged Hispanic male that presented to the ER today after cutting his hand open with a circular saw unnecessarily reminded me that power tools are indeed sharp, and probably should not be used when your hand is in the line of fire. Yes, you may have your morphine. Ow.

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January 14, 2010 Leave a comment

Transporting a man born in 1919 back from radiation treatment and I overhear him mumble to himself “I feel soo disabled.” I’m not sure why, but at that moment, that was one of the saddest things I’ve heard one of my patient’s say. I wonder whose decision it was to have this 90-year-old man undergo radiation treatment when apparently he doesn’t feel he has much quality of life as is, not to mention the stage III ulcer he has on his back that causes him 10/10 pain anytime he is moved the least bit.

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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.

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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.
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What a homeopathic ER would be like.

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Turkish Show Tries to "Convert" Atheists

Hahahahaha…. hahaha… hah.

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.
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