My latest Remember Two Things video is up over at EMS1. At EMS World last year I gave a 90 minute presentation about sepsis for EMS providers. This video answers the most essential question from that lecture in about four minutes.
The question: What can EMS providers really do to reduce mortality rates in sepsis patients?
The answer is here:
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Chances are, you’ve probably heard about the new trend in synthetic cannabis products either 
from your local news media or from your ongoing EMS education. Over the past few years, these products have been increasing in prevalence around the US and in Europe. But what are these products anyway? Are they cannabis or not? Are they legal to posses? Are the effects similar to traditional marijuana?
Here’s a quick rundown of what EMS folks should know about this new and growing trend in street pharmacology.
Synthetic cannabis products have a variety of street names including Spice, K2, Herbal Incense, Potpourri, Barely Legal and Kronic. It is frequently sold under the classification of an “herbal smoking blend” and some head shops and online retailers have attempted to skirt the ongoing tide of new regulations by selling the products as legitimate potpourri or plant food with the warning, “Not for human consumption.”
What is it really?
These products are all various dried organic (plant) compounds that are laced with a synthetic cannabinoid chemical that is designed to mimic the effects of cannabis in the body. Many of the products claim that they are a natural blend of legal herbs and spices that combine to give the user a legal and cannabis free high. Investigations into the contents of the products reveal that most of the herbs listed on the product packaging are not truly present in the product and that the often unidentified organic material in the product is laced with one of five common synthetic cannabinoids. (While there are over a hundred known synthetic chemical cannabinoids, these products tend to contain cannabicyclohexanol, JWH-018, JWH-073, CP-47,497 or HU-210.)
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The breezes taste of apple peel. The air is full of smells to feel – Ripe fruit, old footballs, burning brush, new books, erasers, chalk and stuff.
Like Plates washed clean with suds, the days are polished with a morning haze.
- John Updike, September
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I haven’t yet tasted apple peel on the breeze across the Colorado front range, but fall has definitely come to The EMT Spot. The October chill has arrived and my Bi-annual tropical vacation is calling once again. September was consumed with silent remembrances of 9/11 and furious preparations for EMS Expo. With that grand event behind us, I look forward to cultivating the new partnerships created under the Dallas sun and posting some great content. Now, we’ll continue our tradition of beginning by looking back at the month that was.
We started off with a discussion about moving past medical mistakes and a guest post by Sally Davidson about coping with victims emotions. It’s always nice to get an outside perspective; thanks Sally. Then I stirred a bit of controversy by asking if you’d saved any lives today before asking you to meet me at EMS Expo. To finish it all off I told you the ten things I was most looking forward to at the event.
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The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent.
Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety.
He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled through a list of questions. What caused it? Could it damage her vision? Could she lose her eye? Could she go blind?
I cleared the engine to go back in service and sat down next to him. Over the next ten minutes we both explained what pink-eye was and how to take care of it. We talked about hot-compresses and how contagious the bacteria was going to be. We reviewed the typical course for such and infection. How to prevent it in the other kids. How likely it was that one of them already had it. And we discussed his plan for morning. (It involved asking a neighbor to drive them to a near-by clinic.)
Alan called 911 for pink-eye. And…(This part is bound to be controversial, depending on what kind of system you work in.) I never offered to take him to the emergency room. And he never asked.
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“In Germany they first came for the communists, and I didn’t speak up because I wasn’t a communist. Then they came for the Jews, and I didn’t speak up because I wasn’t a Jew. Then they came for the trade unionists, and I didn’t speak up because I wasn’t a trade unionist. Then they came for the Catholics, and I didn’t speak up because I was a Protestant. Then they came for me – and by that time no one was left to speak up.”
- Rev. Martin Niemoller
Yesterday an Action Care ambulance covered my station while I was at a training. Action Care is the local private ambulance service. I know, the name always seemed a little silly to me. If a super hero ever created an ambulance service, he would most certainly call it Action Care. I joke about the name, but they’re the real deal. If you’re going to work as a private service EMT, you could do worse than Action Care. And if that doesn’t work out, there’s always the medical billing and coding field.
I’m glad we have Action Care. They help cover our district when we are low on resources. They are always professional and polite on scene. They give good care.
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Call it a curiosity. I wanted to know how the EMT Spot readers would finish the sentence, “Behind every great EMT…” So I asked.
I asked on twitter. I asked on Facebook. I even asked right here at the blog. And the answers poured in. Your responses represented the full spectrum of personalities that inhabit our workplace. There were poignant responses, cynical responses and a bunch of funny ones. The responses made me smile and frown and think.
Within this list of answers you’ll find feedback from 30+ year EMS veterans and newbies just getting their EMS feet wet. Everyone is represented. And the responses are telling.
I’m rather proud of how this little experiment turned out. I hope you find these responses as enjoyable and thought provoking as I did. Thanks for all your contributions. Aside from categorizing these contributions, I’ve made no further editorial additions. This post will become part of the guest posts category, because it was written by you.
Complete the sentence, “Behind every great EMT…”
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In Greek tragedies, the hero typically displays some form of hamarita, also known as a “tragic flaw.” Hamlet was brooding, Othello was jealous, Macbeth was ambitious. For the most part, it is their tragic flaw that is usually the key to their undoing. When the hero ultimately falls, they tend to sow the seeds of their own demise with their respective tragic flaws.
People often use the word hero when they refer to EMS caregivers. EMT’s, paramedics, firefighters, we all get the hero moniker pinned on us from time to time. I cringe at the term. Most of us are uncomfortable with it to different degrees. And, if there is any truth to our hero title, it is certainly closer to the heroes of Greek tragedy that the comic book heroes we grew up with.
In other words, we all have our tragic flaws. Yes, all of us.
Here are eight of the most common tragic flaws of the EMS hero persona. I have, at one time or another in my career, embodied each and every one of these flaws to one degree or another. I’ve lived each one of them. I would guess that most of us do.
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“In June, as many as a dozen species may burst their buds on a single day. No man can heed all of these anniversaries; no man can ignore all of them.”
-Aldo Leopold
So many anniversaries. So many happenings in the EMS world. Regardless of how many of them you attempted to heed, you were bound to miss a few. Here’s to the stuff you may have inadvertently ignored.
I started the month with a webinar on how to pass the national registry cognitive exam and quickly moved on to the name the chronicles contest and part three of the very popular ultimate guide to EMT vital signs. I asked you two telling questions with “Where do you put the fear?” and “Are you an EMS nonconformist?” before asking you to consider what will happen on the day that your career clock strikes midnight. Then we talked about what really motivates us and wrapped up with ten reasons why I work in EMS.
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Our department recently offered an early retirement buy-out option. I understand a half-dozen or so people took it. So next month, 6 or so of my colleagues will run their last call and close the door on their career. Six people will write the final chapter and be done.
It makes me wonder. I wonder what that’s like, to hear the tones go off and say, “Yup, this is probably it, the last call of my career.”
What will people say about your EMS career when you’re all done? For many of the readers here at the spot, retirement is a long way away. It’s hard to imagine what is will one day be like to not be in EMS anymore. Yet, it’s worth considering, because you never really know when your last call will be.
Consider Elizabeth Ann Mitchell.
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I once thought that part of the goal of being a competent paramedic was getting to the point where I no longer felt any fear or anxiety about running calls. After all, most of the folks I worked with appeared to be absolutely
fearless. At least the competent ones did. They never go flustered or rushed. They smiled. They remained calm in the face of very real emergencies. I needed to be like that.
Eventually I figured out how to act like they acted, but I never really mastered the whole not-feeling-any-fear thing. It nagged at me for a long time. It took me almost a decade to figure out the secret.
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