Rains and Pours

One of those days...

Class 8:20 - 9:10, a bit hurried and didn't finish the topic as I wanted. That hurried feeling didn't leave me today...

9:15 or so to 11:00 - Answer e-mails, phone calls, etc. The kind of stuff you have to do but feel like nothing is getting done. I swear I deal with one and two more would come in!

Class from 11:20-12:10. Goes fine, but again, I am running a bit behind.

12:15-1:30 - Lunch with a job candidate for the position of University Librarian. Interesting.

1:30-4:10 or so: Sorting through applications, recommendations and transcripts so I can decide who to take to Australia with me in the Spring of '06. Students need to have the right personality mix, going for the right reasons, etc. PAINFUL. In the process of summarizing my thoughts and hoping to get home in time to eat before medic class...

Pager goes off: _______ rescue, _________ ambulance, three car MVA outside of the village on Route XX, south of town, reported injuries.

Decision time. I have medic class at 6:30. If the injuries are minor, all will be well. However, if this is a trauma call, I will not get from the call, to the trauma center, back home, and back up to medic class on time. Ironic part is the trauma center is within spitting distance of my class.

I pause long enough that the first rig answers up. I drive down slowly, hoping the second rig will get off without me. No such luck - They ask control to hit our tones for a driver just as the first ambulance goes by me. The medic in the first rig gets on the radio and tells our second rig that a driver is enroute.

We drive down to the scene and it is SLICK. The first rig is parked next to a t-boned car with no visible driver. The car has 2.5 feet of intrusion on the passenger side. Does not look good. The second car has all frontal damage, and doesn't look too bad (there is no one around it). I don't see a third car. We are directed to a house where our patients are at. I figure this is a good sign - Walking wounded will go to the local hospital, freeing me up to get home, eat, kiss my wife and kids, and bolt for class.

As soon as I get out of the rig our chief is standing next to me. "Can you go to the trauma center with the other rig"? Sure...

I walk down to the other rig to size up the scene - There is our paramedic, two really good EMTs, and one smashed up car. The fire folks are chopping away at the doors and working on extrication. Their deputy chief is a paramedic, and things are running smoothly. The only issue is that the patient, who was the driver, is in the backseat of the car. And she had had her seat belt on. Lots of force.

Lac over left eye. LOC for 5 min, plus anterograde amnesia. Pain in neck (literally). Severe pain in left leg/hip. No deformities. Trauma center time. Off we go.

So, after this crazy day, I ride up to the trauma center, we unload our patient, head back to home, grab my car, and drive the 45 minutes BACK up to medic class. When I get to the parking lot for class I realize I left my briefcase (with all my medic class stuff in it) in my office. I swore. Out loud.

I waltz in empty handed, an hour and fourty-five minutes late to a class with an instructor who HATES tardiness. As I come in, he gives me a look that communicates that while he wishes I were on time, he can tell by my face I don't need a lecture. Kind man.

I'm not back in my office finishing stuff up so I can have another insane day. My days would be packed with just my job, but this medic stuff is pushing me to my limits. I like it, and am glad I am doing it, but I could not keep this pace up forever. I have a new chant: May, May, May, May.

Bad Man

Forgive me for I have not blogged in forever and a day.

Classes started this week, I'm knee deep in cardiology, have had four student conduct board cases (two plagiarism, a plain old "cheating" charge, and a charge of stealing expensive equipment), writing a letter for a junior faculty member's promotion file, interviewing 40 (nope, not a typo) kids for the 2006 study abroad.... yada yada yada.

No good EMS calls.

I'll write more when things calm down.

If you like college athletics, you might find this read interesting.


DJ

Look At Me When I Am Talking To You!

S-A-T-U-R-D-A-Y, NIGHT! [sorry, Bay City Rollers outburst])

It is Saturday night and I have been in my office working on a syllabus. We had an EMS call at about 2030, and so down I went. The call was for a diabetic emergency, and things went fine, but it took a while as we were a ways from the Hospital.

By the time we got things put back together, I left the station at about 0010. I really wanted to finish the syllabus, so I drove back to my office. On the way I stopped at one of the three stoplights in town. Big intersection by our hick town standards. As I rolled to a stop I saw a collection of semi-rowdy students. There were eight of them.

Seven of the aforementioned students were in a circle goofing around. Number eight had his back to them. Facing me. The kid was literally twenty feet away and facing me. He was clearly intoxicated. I don't know if he saw me. I saw him. And his penis. For the man (boy? Dude? Asshat?) whipped his stuff out and peed right there. I tried to avert my eyes. I did. But it was, I must confess, captivating. Not the penis. Not the urine. No, what made me not be able to let go of the situation was the fact that one of the women in the group must have said something to the young man in question. Always the gentleman, he decided it made sense to turn to face the person speaking to him, urine still flowing as it does from a beer filled male with a 20-year old prostate. The entire group jumped back fast enough that I think they must have been more sober than the perpetrator. Based on the reactions of two of the people, it seems they were not fast enough.

The light turned green, and I drove off, planning to poke my head into Campus Safety to give them a heads up (my office is very close to theirs). Turns out this wasn't needed, as one of their rigs flew past me headed to the intersection in question.

I am still at work, wondering if this young man will be sitting in my office in a few weeks. I won't forget his face. I am trying to forget the rest of the scene.

Deflation Due to Lack of Information

Blah.

My day started OK. A full day to finish two syllabi and get copies made for my 0800 class on Monday. I had a plan. I was focused. Nothing could get in my way...

Interruption #1: EMS call for 94 female with injuries from a fall (maybe syncopal episode secondary to dehydration?). The students are starting to be around, so I had mentally been prepared for the day to be covered by them (it has been a long five weeks with them gone). Just me and a medic (our driver didn’t even show), so I had to go and I drove. Hour gone.

Interruption #2: I got a curt e-mail from the Associate Dean who was upset that an adjunct faculty member teaching a class in my program was just now coming to her attention (the person gave her a ring asking where his hiring letter and pay information was). The Dean made it clear that in the future I need to run any “teaching for cash” people in my program past her first. We sometimes use adjunct faculty to teach a class here or there, and the funds come from her office. A reasonable request, to be sure.

The problem, from my perspective, was that I had no idea I had hired someone from the outside. It turns out that I did, but purely due to my ignorance and some lack of communication and oversight.

Ignorance: In planning classes for this semester, I took course projections that had been made before I was appointed and had an administrative assistant contact those people and ask them if they still planned on teaching in the program. Turns out one of the people on the projection list had been a regular faculty member but now isn’t. It just never occurred to me that I should check to make sure people saying “yes, I plan to teach” are indeed employed by us. I just assumed (ouch!) that someone who no longer works for the institution would mention that fact when asked if they still plan to teach their class. I would. Most people I know would. I am still ignorant when it comes to how wide a variety of behavior you can see from people.

Lack of Communication: The person who is no longer faculty could have let me know this fact. I could have told the administrative assistant that she should double check the list against the full-time faculty list. I could have been told when I took this position that this is an issue. The person whose place I took could have told me that this guy was an adjunct now.

Lack of Oversight: My list of proposed courses went to my division director in late September and the Associate Dean’s office in early October. The all signed off on my list and didn’t catch that this guy wasn’t a regular employee. They have been doing this for considerably longer than I have, and they clearly didn’t check. If I am expected to check, maybe I could have been told this was one of my duties? I suspect it officially isn’t, as this just can’t happen by accident (though it did, damn it).

I’ve got a pit in my stomach. I hate when preventable mistakes are made. Sure, we have the money to pay the guy. Sure, other people could have kept this from happening. But in the end, I could have kept this from happening and did not. I really respect and like the associate dean, and now she has a data point suggesting I am not doing my job as well as it could be done.

I’d have a beer, but the students still are not on the board so I am the EMT from 1800 to 0600 (and again tomorrow).

Blah

Classes Start Monday...

Calm before the storm.

Monday I will face:

150+ students in a large introductory class. This is a small lecture class at some institutions, but for us it is the largest on campus.

40+ students who want to be in a class limited (in theory) to 18 students.

Seniors nervous about finishing up their senior research projects.


In the mean time, I have been trying to pound out syllabi, handle some administrative crap, and imagine what it would look like if my office were clean.

EMS stuff has been quiet. We started cardiac this week. Cardiac A&P on Monday and the beginning of EKG last night. So far, so good. I hate route memorization, so I am hoping that I can learn what I need to know using logic and an understanding of the systems, but the instructors make it sound like you are stuck having to memorize some stuff. So be it.

Ego boost of the day… My daughter, out of now where, exclaims (with a bright smile on her face like this is a good thing): “Daddy, you must need a lot of toilet paper because your bottom is so big!” Indeed.

What Would You Do?

---- I have been on several conduct boards where something like the following happened. What follows is a general version of these cases and is not meant to (and doesn't) reveal anything about any particular case ----

While driving a car from the bars to campus (a 20 min walk or so if you decide to not take the free shuttle bus), an underage college student is pulled over for crossing a double yellow line on "main" street. Let's call the student "Mary".

A Law Enforcement Officer (LEO) asks Mary if she has been drinking. "I had a few beers", she says.

The LEO asks Mary to take a field sobriety test. She agrees. Mary begins, misses her nose with her finger, and refuses to continue.

The LEO asks Mary to take a breathalyzer. She refuses.

Mary is given a Miranda warning, and informed of the law regarding failure to take a breathalyzer. She is given a chance to reconsider. She still refuses.

Mary is taken to the police station, where she is asked to submit to a breathalyzer and a blood test. She again refuses.

She gets another set of Miranda warnings, is again told of the laws related to DWI and failure to submit to BAC tests, and again refuses to cooperate.

Mary is booked for DWI.


- -

Assume the above happens while Mary is a student at a private liberal arts college that claims to be grooming future leaders. Do you think the college should also discipline her? If so, how?

Did ya hear?

Oh my, how this changes things…

Odds of DJ hooking up with JA before the above: 0.00000000

Odds of DJ hooking up with JA after the above: 0.00000000

(note to any statisticians out there: The above are, of course, rounded)

Hmmm, never mind. I now return you to your regularly scheduled programming…

Recipe for "It Could Have Been Worse" Trauma

Take:

6 young adults (use 18-21 year olds without helmets)
3 Modern Snowmobiles
5 inches of powdery snow with a layer of ice on top
1 Very Dark Night
1 Very Hilly Piece of Property with lots of obstacles.
Ethanol
1 HEAPING serving of luck.

---

To make tonight’s dish, combine all of the above, and don’t skimp on the luck!

Just got back. Call comes in for a 20 y/o with head injuries from a snowmobile accident. On the board is our chief (as driver), a medic (actually, the medic while our other one is out of town), and me as EMT. I rolled out of bed, did some “stuff” (you know, pry the sleep out of my eyes, get dressed, etc.), and started high-tailing it into town and toward the station. I’m on the road for about 90 sec when the medic tells control he is on his way. 30 sec after that the chief calls in and says he is going directly to the scene. Makes sense as the scene is within a minute of his house. Another EMT showed up for the call, so we have a decent crew even without the chief. The medic drives and off we go.

Arrive at a nice house out of town. The house is on a Christmas tree farm and there are evergreens at various stages of development. I hate to say it, but my first look at the scene was one of beauty. The accident wasn’t visible, so the view was one of snow covered evergreens, with a layer of ice on them, reflecting the flashing lights of all the rescue vehicles (the fire-rescue boys [and girls] beat us to the scene). You know how some people put foil “icicles” on their Christmas tree? This must be what they are trying to imitate.

There is ice on top of everything, and it is very slippery. We walk/trot/slide down a hill to see the scene itself. On our way, we see snowmobile tracks everywhere. Very erratic in nature, some headed toward natural “jumps” where it is clear the machines, if going fast enough, could get air. Given the nature of the tracks, it is clear they have being getting air. A lot of it.

Five young adults in various stages of hysteria, standing in the middle of some 8” to 20” trees. Rescue standing around in a circle and our chief and his wife (a RN and an EMT) working on the patient. As I walk past the young adults I smell what I take to be metabolizing ethanol. A lot of it. One of the bystanders goes to light a cigarette, and before I can say anything, someone from rescue points out the fact that O2 is flowing.

The patient is supine in the snow, in a row of young trees. The patient is alert, but is laying on what looks like a mosaic made out of circular tiles ranging in color from light pink to deep red. Our patient was the passenger on a snowmobile and fell off the back (no helmet). The laceration on his head was at least five inches in length. HUGE. I don’t really know if it came from hitting the ground itself or if it was a cut from the ice on top of the snow (if you’ve never felt it, if you break through ice on top of snow the edge can be very sharp).

There are more than enough hands near the patient, and I decide to turn the rig around as it is about 60 feet from the road down a driveway that is barely wide enough to fit it. I figured it would be better to turn it around instead of trying to back out if we got in a hurry. I haven’t been driving much lately, and it got my heart rate up having to back the rig up hill, in the snow, with a few feet drop off on either side. If I had gotten stuck I would have not only impaired patient care but I would have trapped the fire/rescue truck and the chief’s truck. Just as I finished turning around the back doors fly open, our patient is loaded, and we head to the local hospital per his request and with the medic’s blessing.


Oh, I almost forgot. State police got there as we were leaving. In my state it is against the law to operate a snowmobile when you are intoxicated. It is also against the law to drink alcohol if you are under the age of 21. Hmmm. I wonder if the five people remaining on scene will “forget” who was driving?

Deja?

Just got back from medic class and had to post this real quick. We took a quiz, got yelled at, and then did some lab work on respiratory emergencies. As I have mentioned, I love this stuff and had a good time (but for the yelling…).

Last March I was taking an EMT-B class and posted on getting the riot act read to us because some people were not performing to the best of their ability. Tonight in medic class a similar situation happened.

First some background. We had the Module 3 Exam (trauma) right before break. It was 100 questions, and I thought it was challenging but fair (I scored a 95 so it was very “doable”). Monday we didn’t talk about the exam and started new material. We were told that tonight’s class would start with a quiz. Tonight’s quiz was again fair and was almost directly out of the notes from Monday (there were 20 short answer questions with answers like: Larynx, cor pulmonale, sympathomimetic, 0.3 mg, 125 mg, Beta 2, course rales, prolonged inactivity and birth control pills, visceral, steroid, edema, right-to-left shunting, barrel chest, COPD, etc. – I’ll let you guess the questions). I handed my quiz in and waited patiently for class to start. As quizzes came in, the instructor started to look more and more agitated. After the last quiz came in, off he went on a very well formed tirade, which was certainly less degrading but somehow more forceful than the one from my basic course (and 10 minutes shorter). However, some SCARED faces in the crowd. After class I asked the instructor what was up. He said the exam scores were low (mine was the only one in the 90’s, with many in the 70s). Given the exam was new, he had wondered whether he made the exam too hard. When he saw that on tonight’s quizzes people were again missing a lot of questions (the guy next to me got a 90 and I got a 100, so it wasn’t the quizzes fault..), he decided he had to say something.

I know this got hashed out last time so I’ll save my commentary on why I don’t care if you are a slacker if you work in fast food, but if you want to come to my house and take care of my kids in an emergency I want you to be someone who CARES about the material. In any event, someone once wrote to me that these conversations take place in most EMS classes and in my experience it is two for two.

May the individuals in my county breath easy tonight, because I despite doing well on the assessments I need a LOT of practical experience before I will be able to make differential diagnoses between various respiratory disorders in the field. At least our ONE ALS provider in town is around tonight…

DJ

Happy New Year

Happy New Year everyone.

Things have been relatively quiet of late. Been on a few EMS calls, but mostly glorified taxi runs. Work is quiet as the students are gone, but I need to generate some syllabi soon and have a job search meeting this week.

Medic class started back up this week. We started respiratory emergencies Monday and will continue on the subject tonight. I really like the topic and am looking forward to cardiac starting next week.

We had a driver's training last night at my corps (Coaching the Emergency Vehicle Operator II: Ambulance) and it was pretty good though a scary reminder of the moral and legal implications of driving an ambulance.

DJ