As I sit here 0212 synching the IPhone and Ipad wishing "E" was home I c
an't help but think what a twisted place this is. On one hand new doors open everyday on the other hand God slams one in your face to wake you up. Just when you think you have it down you realize you don't. After a certain amount of time working the streets as a paramedic you realize that you will make very little difference regardless of how hard you work. The reality of EMS now is 50% to 60% of your pt load is transients, drunks, street drug addicts and seekers. We all know this is nothing new. What is new is the change in attitude regarding these pt's. Yes I called them pt's. I know deep philosophical breath............. The trend now in the ER's as well as pre hospital is to just medicate, transport and get them back out the door as quickly as possible. It's a process as complicated yet simple as the Ocean conveyer belt. Without it the system dies. Critically ill pt's don't get the expedient care they need due to congestion. Don't get me wrong they get care but it's not what it could be. The reality is we focus on expediting the drunks etc. so we can just do our jobs. We call it customer service. Keep these people happy and quiet and they make less of a scene and can be moved quicker. Standing orders for dilaudid for ANYONE if they request pain med's. Ativan to keep the drunks from seizing call em clinically sober (They can walk at 300) and ship em to detox. Detox discharges them the next day, they self medicate to stop the withdraw and call 911 from the pay phone outside Mrs. Fields cookies! No shit that's the phone of choice right after just lying down on the sidewalk and telling some well meaning dolt with a cell phone they have chest pain. It's a constant cycle that's been going on for years. On one hand ya can't blame a guy who is going through withdraws for self medicating with booze. It's a horrible experience. One I wouldn't wish on anyone. Something I could never have understood until this weekend. I was admitted to the hospital with a respiratory infection that was causing hypertension at a biblical level. 200+ systolic pressures (140 mean) and SaO2's in the mid 80's. Having all kinds of issues being the dysfunctional paramedic that I am they decided to smoke my bags with Solu Medrol and Ativan. They did this non stop for 36 hours. Don't get me wrong I was going ape shit and told them to please sedate me. What I didn't need was 2mg of Ativan q 4 on top of 125 of Solu Medrol Q 4 with a little MS thrown in for good measure! HOLY F&CK!!!!!!! Well two days later things are looking up from a respiratory standpoint and it's time to thing about sending Scott home. Now common sense would state that you wean the poor bastard that you've just done this to off of this stuff. Not so much. Packed me up in a daze and sent me home after my wife had begged them to start cutting the dosing and been ignored. By the time the half life of the Ativan came into play I was climbing the fuc*ing walls. I can honestly say that it was one of the worst experiences of my life. 20 + hours of hell. Keep in mind Iv'e never withdrawn from ANYTHING! Not really a drinker and don't do any kind of recreational drugs at all. I have a whole new understanding of the hell those people are in. Regardless of wether it's self inflicted or not it's still a living hell. I guess thats what it took for God (or whatever imaginary man you prey to) to get me to open my eye's.
Now that aside I still laugh my ass off at how stupid people think we actually are. So this dip shit and his buddy are driving down the street when his crank enabling partner starts to no shit seize! Being the socially responsible citizen he is, he pulls over and calls 911. Drags his buddy out onto the side of the road and closes the car door. Less chance of anyone seeing the meth in the car that way or ending up with a corpse in the passenger seat that's going to be a trifle hard to explain. Enter the paramedics. Get out of the bus and here's this guy that's actually postictal, incontinent and has chewed the hell out of his tongue (not some fibro frump pseudo seizure attention getting bull shit). So while starting to work on getting this guy going I look at his "friend" and ask "what were you guy's doing when this started.....any kind of recreational drugs etc?" Now if you're in the business so to speak you get this. I don't give a shit what you've done just tell me so I can figure out how to try to fix it. "Oh no sir we don't do that stuff" through his grey rotting grill someone might mistake for dentation. This guy's D stick is 101......well shit thats not it. Go fishing through the guys pockets and find the bottle in the picture above. He's has the nerve to look me in the eye and say "I did't know". REALLY! So as the pt is beginning to come around and we begin to get some actual history this guy's absolutely denying doing any kind of drugs. When confronted with the bottle his response was (no shit I love this) I cut my aspirin up with a razor and snort it. Refused to cop to the crank regardless of the fact. What a jack wagon. Oh well get on the conveyer belt ya douche bag thats a violation of rule one and two in the same sentence.
