04 August 2009

The Job

I am guilty of complaining about my job. The rare occassion occurs
when I get to use the skills I spend countless hours maintaining.

Today, if you haven't heard, we had a rain event that produced wide
spread flash floods in the metro. I am a swift water rescue technician
and it is one the the more fun diciplines in technical rescue. I was
call in to assist with evacuations.

These are the days when I feel like I can make a difference. I
assisted with the evacuation some medically fragile people who were
trapped in high water. I am not a hero and no lives were directly
saved by me or the crew I was working with. Most of the day was spent
checking calls to 911 hours after the initial storm. Most of the water
in the areas had receded by the time we got to the low priority calls.

I would still do it all again. Today I love my job.

03 August 2009


I am bored with my job. I want more from my profession. I trained for two years to become highly trained in emergency medical care. Ever since obtaining my license I have been relegated to ambulance driver.

I tried to get a part-time job with a 911 service. No one in my area wants a new paramedic in their service. Yes, I said part-time job. My full time job with the fire department pays well, and there is no EMS job in this state that can come close to competing.

So I am screwed. I want to be able to make a decent living, but I also want to use my hard earned skills. I can't have both and that is sad. Do we need to let EMS in the US fail so we can have a better system? The gang over at EMS garage have another lively discussion on this very topic. Every week they get together and talk about EMS, often how bad the pay is for our workers. They never find a solution and I am not sure anyone who runs EMS wants a solution. Listen to their shows and email them with ideas. We need to all be on the same page, in the same room and stand up for decent wages.

11 June 2009

Why are YOU here?

What is the reason you got into EMS? I ask most new EMT and Paramedic students this question. I really want to know the motivation behind their entry to this profession.

Me? I wanted a career change. Like most people I thought EMS would be a 24/7 adrenaline rush. Saving lives and gathering praise from the families of the patients. I had been in the fire service as a volunteer for nine years before committing to my EMS education. Firefighter are always getting positive attention (unlike police officers), they have the public fooled, kids of all ages, races and sizes want to be a firefighter at some point in their life.

No one says "I want to work on a ambulance when I grow up". During my EMT class we all thought our future jobs would be similar to a firefighter, saving lives. My first job was with the fire department, we ran in a tiered system with third party EMS. I did not work on an ambulance until a few years later.

My paramedic friend convinced me to apply for part time work with a private service ambulance company. The government EMS service had just gone through a merger and my new job was covering trucks for the local 911 service. Just like the fire department we made only 911 calls. I learned a lot, including how to get to all the area hospitals. Eventually the city got their act together and no longer needed private service to cover for them. Being an EMT-B I was sent to a BLS transport truck. This began my true education in EMS. Gone were the days of driving with lights and sirens, rapid assessment of patients and having a paramedic to do all of the paperwork. Gomers and Chuck runs are all I saw for a few months with the occasional stint with a part-time paramedic.

I left that company, they treated EMT's like dirt and were not afraid to tell you exactly that (in fewer words). I went the second largest private ambulance service in my area and worked there part-time. I am still working for the F & B ambulance company as a part-time paramedic. I wish I could say that the EMTs and Medics are treated the same, but you know that is not the case. EMT's are still dirt and medics are a precious resource (unless there are six medics, then you are just meat in the seat). I try not to use this to my advantage or abuse my status. F & B actually fired a part-time medic recently for several reasons, but mostly he was an arrogant jerk and actually told a facility that they would never fire him, because he was a medic.

I advocate for the patient. We have older ambulances and sometimes things break. I try to return only when it is a safety issue or it would interfere with patient care (like the A/C in the patient compartment not working on hot days). I enjoy working the streets and helping new EMT's (and not so new) learn how to properly assess a patient, take vital signs, lift with their legs and improve their bedside manor. I remember being the Basic who always had to take all the runs and the medic just wanted to drive (lazy medics, we all know some) no matter the patient condition.

I am here to help. The patient, my partner and the company I work for (in that order mind you). I like what I do and I wish others (general public, government officials, allied health care providers) would respect my career choice and treat us all like the professionals we are.

09 June 2009


Shift starts at 09:00. I like to arrive early, check my truck &
equipment. The adage when I worked in theater was 'early is on time,
on time is late' as it should be even for emergency services.

Dispatch supervisor greets me at the supply officer's desk. "How soon
can you go available?"

Me: "I just walked through the door, my partner is not here, I don't
know what truck I'm assigned to and I have to check my equipment &
supplies. After that I'll be available as soon as possible."

DS: "Methodist Hospital has a vent patient who is crashing and the
other medics are on runs."

Me: "Find me a partner and give me a minute to check my truck."

I am sensitive to emergent runs and meeting requirements of our
contract with the facilities. If someone needs my help, I want to meet
that need. I notice a paramedic graduate who was in my class and I
asked if she had a partner yet. The scheduler screwed up and did not have her on for the day. I told her I needed a partner immediately (get schedulers permission) for a priority 1 run. I grab the ventilator (LTV 1000) do a quick once over on my ambulance and we head towards Methodist Hospital.

The CCU unit was a flutter with activity. Nurses racing around trying to get orders. The patient's nurse told me that the patient coded last night, they got her back after 20 minutes and she is being paced TCP (trans cutaneous pacing). We are transporting the patient from Methodist to Metro Hospital CCU for pacemaker implant. Levophed drip, Epi drip, Sodium Bicarb drip ventilator and TCP. A lot going on with this patient. First trick was to switch from their pacer to our pacer. Could have been easy, but we did not have the same brand and the connections are all different. Three people helped, lift the patient, turn off their pacer, my partner slapped our pads on the patient and I started pacing again. I studied the lifepack 12, looking for signs of capture. Finally got capture. The nurses combined all the drips to one multi pump, and we transferred the patient to our stretcher. I set my LTV and transferred to my ventilator. After a minute or two of letting everything settle, and checking to see if the patient was stable, we headed for the ambulance.

Code 3 to Metro Hospital, luckily it was less then 3 miles away. We arrive, give report to their CCU nurses and reverse the procedure. The had the same brand of monitor/pacer making that transfer easier. Vital sign check BP 86/52. Very not good. At this point the patient is in the care of the nurses I offer to help in all ways I can. Unit secretary places STAT pages for the patients doctors. I am released by the nurses, I leave the room to complete paperwork. Several minutes later they get a doctor to the floor and he is not happy that the patient was transferred in this condition. My partner, after cleaning our cot & monitor, watches the activity inside the room. She comes over to me and tells me that Doc has taken the patient off the pacer four times to see the underlying rhythm. Easy guess, it's asystole (didn't take me long to figure that out). I finish writing, get my signatures and head towards the elevator. We stepped on the lift with one of the CCU nurses, going to pick up a patient from the ER, and hear "Code blue CCU, Code Blue CCU" to the same room we just left.

Preception of perfection

Only two dialysis transports do far. The A/C in the cab of the truck
was not working well, the 85 degree atmosphere was heavy. My partner was edgy, waiting to get results from the NREMT-P (National Registry of Emergency Medical Technicians) written test. She was waiting for an email, I told her to just check the website. Her eyes, widened, and she read aloud the statement of passing the test. She even made me read the results, just to be sure that she had not misinterpreted what she read.

Dispatch: "Medic 42 copy priority 1 to Farthest Nursing & Rehab for respiratory distress"

I have seen more respiratory distress patients in the months I have been working than any other kind of ALS patient. We head over to Farthest, code 3. The pager stated that the patient was to be transported to St. Other end of the County Hospital. This is mostly the patients family making these decisions in written form for the nursing home. I always keep the option to transport to Closest ER when necessary.

The patient's room was filled with staff members (and they even had their crash cart out), they had the patient on oxygen 8 liters per minute via a non rebreather mask (I didn't know nursing homes had these things, they always give nasal cannula). I could hear the fluid in the patients lungs from down the hall. LPN reports the patient has an axillary temperature of 103.4F bilateral Rhonchi SpO2 77%. The patient looks pale and moist. I'm told that he has become this way within a few hours. He's definitely hot to the touch and not looking well. We scoop him up, get the paperwork and head out to the truck. I like to do my work in the ambulance when I can. His pressure was 118/60 heart rate 110 (ventricular pacemaker) restorations 34 shallow lungs bilateral rales (NOT Rhonchi). First thought, I need to breath for this guy, my partner gets the BVM (bag valve mask) and begins assisting restorations. I prepare to nasally intubate the patient. I have already decided we are going to Closest Hospital, will have my dispatch notify the patients family. First attempt, sounded good, looked promising, not good (damnit). Bag the patient for a little bit, get new tube and try again. Second attempt, no good, screw it, let go I'll just bag him (we are 3 miles from ER).

We roll into the ER, give report, the nurses do their work up, get IVs, respiratory arrives. The Doc takes one look and says Aspiration Pneumonia. Patient has a PEG tube (and a foley cath that looked like mud, a PICC line that had not been flushed in days). Doc orders Etomidade, Succinylcholine and intubates the patient. Sure would be easy if I could have done that. RT suctions out the ET tube, and the contents look a lot like feeding tube goo.

08 June 2009

Minor Leagues

Today I feel like I am in the minor leagues, trying to make it to the
majors. I work for a private ambulance service as a paramedic and a
rural 911 service as an EMT-B. A former class (paramedic class) mate
of mine was recently 'upgraded' at the 911 service to medic.

I was happy to see that he got his due, he works for an ALS fire
department full time. A few people have encouraged me to speak to the
operations person at the rural service about getting upgraded myself
to medic status. I have only had my license for a few months (January)
and I'm just not sure if I'm ready for the major league.

02 June 2009

What are you reading?

I have been following a large variety of medical blogs. Most of them are related to emergency medicine, but a few are not. Here is my current list of medical blogs I follow (and so should you).

Crass-Pollination Nurse K is absolutely funny, and very sarcastic. You can follow her on Twitter also @ernursek

A Day in the life of an ambulance driver Funny and insightful, he has recently published a book called En Route .

The EMT Spot a great learning resource for all levels of prehospital medicine. You need to subscribe to this one.

Paramedicine 101 I shouldn't really need to describe this blog, it is exactly as the name states. Very useful information here. Read daily.

Street Watch: Notes of a Paramedic I really blame Mr. Canning for my interest in EMS. I read his book Paramedic back in 1999. I am also from Connecticut and I knew the areas he was writing about. You really need to read both of his books.

Rouge Medic This guy knows his science. Don't try to argue a point without your facts and the foot notes to back up your statements. Excellent use of science based medicine.

Doctor Grumpy in the House Dr. Grumpy is a neurologist. His patients are freaking hysterical. I had not idea people could be this senseless. Make a friend, bring the good Doctor a diet coke.

Random Acts of Reality a Paramedic from across the pond, Tom Reynolds has a very interesting outlook on life. His first book Blood, Sweat and Tea, was a gem. His follow up should be available any day now More Blood, More Sweat and more Tea.

On the Clock moving stories from an English major in college who also enjoys the thrill of riding in the back of the ambulance. She really is a good writer.

That's all for now. It might take you a few days to read enough of the blogs to get a feel. I'll add them to my 'Blog Roll' and more when I get a chance.

08 April 2009

Do we need Paramedics?

I was listening to the EMS garage podcast #27 the other night, when they got into a heated discussion about Columbus, OH looking to be a Basic Life Support (BLS) only service. San Antonio Fire Department in Texas has just started running six BLS only ambulances in addition to their thirty two ALS (Paramedic) ambulances.

I work for a private ambulance service in Kentucky. I am a new paramedic with only a few months under my belt on the streets. My ambulance service does not have any 911 contracts, but we have many with nursing homes and rehabilitation centers around town. Today (like many days) was extremely slow, and the three paramedic trucks were relegated to dialysis runs and doctor appointments, all of them BLS in care level. I began to think are paramedics really needed in urban service areas?

The OPALS Major trauma study
as reviewed by Dr. Keith Wesley on JEMS.com showed that ALS intervention in major trauma patients had little to no benefit to survivability. Also it stated that when a trauma patient had a Glasgow Coma Scale (GCS) score of less then 9 and ALS intervened, the mortality rate INCREASED. Yes, this is only one study, but more and more studies are arriving showing that ALS procedures do not increase survivability for the patients. Trauma is the realm of surgeons (paramedic students are told that Trauma is a surgical disease, and the only definitive care is surgery), control the bleeding, apply oxygen and increase the diesel flow exponentially (all BLS skills by the way).

Cardiac Arrest, the American Heart Association (AHA) has been promoting more high quality CPR (cardiopulmonary resuscitation) and less time interrupting chest compressions while trying ALS interventions. Ok, I can hear the pundits (and old school medics) but we NEED an IV line and we NEED an endotracheal tube to secure the airway! Well, modern science along with a few industrious people have come up with several blind insertion airway devices, like the venerable Combitube or the King Airway. Both these devices are BLS level skills in many states (the number is growing and it should). Any decent paramedic, would not remove one of these devices as long as adequate ventilation are being performed (and you can even add capnography). What about electrical therapy? Semi-automatic External Defibrillators (SAED or AED) BLS skill. There is even a thought from Dr. Bryan Bledsoe in the recent JEMS magazine about giving too much oxygen. Summery, high quality chest compressions, not hyper oxygenation and a king airway with a bag valve mask (on room air of course), all BLS level skills.

Stroke (Cerebrovascular Accident, CVA), unless you work for a service that allows the administration of tPA (Tissue plasminogen activator) , you are just a glorified BLS transport truck trying to get the patient to a stroke center within the three hour time frame. Sure you can start and IV, but can you provide definitive care for that patient? If you could why would you be transporting them in the first place? Treat and release (yes I know this is extremely unlikely that a paramedic could EVER treat and release a CVA, but the question is still valid).

Asthma/Anaphylaxis, again modern science has given us the Epi Pen auto injector that many BLS services are now carrying. Even in the Metro are I live, BLS trucks administer albuterol nebulizer treatments. Then just transport them to hospital of choice.

Congestive Heart Failure (CHF), what about that smart ass? Again more medical directors are adopting protocols that involve less invasive treatments in the field, like CPAP (Continuous positive airway pressure). A BLS ambulance is trained to listen to lung sounds, they can identify ralse (crackles) and use the CPAP, during transport to the hospital of choice. Diuretic medications are also being studied closely, and some doctors want to stray away from excessive use of lasix in the field.

Angina and chest pain, Nitro glycerine (NTG) and asprin (ASA) along with a little oxygen and get thee to a hospital. There is talk in the EMS community of reducing the use of morphine for chest pain. Oh, you want to address the twelve lead ECG stuff also? Much of 12 lead ECG transmitting to ER's in my area is still in the pilot program stages. Yes, this can reduce door-to-balloon time but the study in my metro is still under way. If I can get a patient to the ER under 30 minutes and I did not transmit an ECG to the hospital is the door-to-balloon time really that much greater? We all act like transmitting ECGs to the ER is something new, but as I recall Johnny & Roy were doing that in the 1970's.

I believe that if your transport time is less than 30 minutes to definitive care in a hospital, then you really don't need paramedics in your service. Maybe I am just a new medic and I don't know what I am talking about, but the studies are out there. I became a medic to help people, and I find that I am just another ambulance driver. You can send your hate mail here: joelneild@gmail.com but you will only get a response if you can format a sentence correctly and use proper grammar.

04 April 2009

Speak to me

Stop what you are doing. Read this story from Ambulance Driver blog. Don't come back until you have read the whole story. I'll wait for you.

While listening to the EMS Educast episode 6, Dr. Joseph Weiner, a psycologist was talking about how to teach EMTs compassion. He had a few really good ideas, including just simply talking to the patient. Ask the patient about their life, inquire about what interests them.

During my induction to transport medicine (chuck runs), the goal was to finish all your paperwork prior to arriving at your destination. Rarely did I engage the patient in conversation (save for the few talkers we would transport, then I usually faked listening while completing paperwork). I did not consider myself as the dispationate burnt out EMT, I was just trying to get my work done. After a while I would engage the patients, try to brighten their day, or just pass the time (although I would try to multi task and I would write while talking).

Now, I find that I either don't have the time to do paperwork, or (especially after listening to the show) I just try to show a little more compassion towards my patients. Most of the people are from nursing homes and rarely do they get to talk to new people outside their circle.

I have always been interested in sociology (albiet from a distance) and the history of the individual people who live through historic times. I have been transporting these people for years now and I have only just begun to truely listen to them, and learn what I can. There are some very depressing stories. A few patients don't get to talk to anyone, until the ambulance picks them up for their dialysis appointment, and after they return to a house, void of human interaction, they turn on the TV and wait until we return.

A few stories have left me sadder for the day, but I hope that the patients gain from our short interaction.

03 April 2009

Twitter Log

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  • 06:06 Working @ OCEMS for 12 hrs.
  • 06:07 OC is next to @buckman hollar. With any luck we won't meet today.
  • 10:29 BTW I am playing BLS today. I can't be ALS at OC. They don't hire new medics. We just took a possible MI to the ER ( ALS onboard)
  • 10:36 Just FYI - use of a whizinator is a class A misdemeanor. (via @dancanon)
  • 10:39 #followfriday @weebeefire is my major at the firehouse. He's new to Twitter
  • 12:05 On the move. We're rotating back to the center of the county.
  • 12:07 Any one in Louisville taking part in the Humana Festival? Wondering which plays I should see.
  • 12:28 4 people have been shot and up to 41 people have been taken hostage at the American Civic Association in Binghamton, NY. (via @BreakingNews)
  • 14:12 RT @gfriese: welcome EMS magazine editor @NancyEPerry #followfriday (via @dengerin)
  • 14:18 URGENT: Jumping out of moving cars on the highway is not a good idea. Carry on with your day
  • 17:07 The Walt Disney Co. says it has cut 1,900 positions at its U.S. theme parks due to the slumping economy. (via @BreakingNews)
  • 17:13 That last tweet is true. Many managers lost their jobs at Disney World. Luckily my friends survived the cuts.
  • 17:18 Returning from BLS transfer from urgent care to hospital.
  • 17:28 Shameless #followfriday plug for @medic_ray he's a good read, and inventive. No power failure stops him!
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02 April 2009

Twitter Log

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  • 04:24 Awake. 5 hrs sleep. Entire crew going to gym @ 5am. Maybe an aftenoon nap in my future!
  • 05:50 Finished workout. Waiting for the rest of the crew. Basketball last night wasn't good on my knee. It's not happy today
  • 10:39 At the sound of the tone the time will be 10:39 EDT. I've been awake for 7 hours. I get to nap now.
  • 10:42 @funambulator
  • 10:42 Nice use of negative space . @funambulator.
  • 11:03 Ok, maybe no nap just yet. Rain is coming and I need to mow the yard. I hate grass, the way it grows continuously. It's evil incarnate.
  • 12:23 RT @funambulator: If you remember or have a story about the '74 tornado, we want to hear from you today around 1:20 502-814-TALK or @soatalk
  • 12:32 RT @toddmundt: Cutting the Coax: an update bit.ly/iP6Ll (I like the concept, and we thought of dumping cable but we would miss UK BB)
  • 14:39 Watching Bottle Shock. Knee still hurts, I knew I shouldn't have played basketball last night
  • 16:23 Everyone says I'm a wise ass. I'm waching Talidega Nights, I feel my IQ lowering already.
  • 20:24 Going to sleep. Have to get up @ 4am for a shift at OCEMS
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01 April 2009

Twitter Log

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  • 06:24 When everything is wrong... I'm trying to just move along. Need mental health day off work.
  • 08:12 This day is proving to be a worthy adversary but I have won the battle thus far. The war is still being waged. More reports from the front
  • 08:36 I have to take my V02 max test again today. This FD doesn't understand that you can't really change a VO2 max number in 3 months.
  • 08:38 Technically it's not a real test. It's a mathematical estimate of what my VO2 max should be given BMI & max heart rate over time.
  • 09:34 Got 29 and change on m VO2 max test. Dept. Standard is 38. Ask me if I care.
  • 09:37 Anyone want to hire a medic full time? Prospects need good health plan and pay.
  • 09:40 I lie to the public when they ask if my job is exciting. It's not, and I wish we had more fires to fight. I'm bored
  • 10:12 I am feeling Verbose today, and this is Tweet 3000 for me. Thanks for putting up with me ;)
  • 11:09 What's worse than killing a patient? Trying to hide it: is.gd/pWUy (via @kevinmd)
  • 13:00 Training at Nortons Commons. Preplan strategies & tactics. Yawn.
  • 16:57 Back from gym. Truck washed. Last shift left us with nothing to dry the engine so it will hang on the line for an hour or more.
  • 17:05 Congradulations on the new Class. Who did you get for lead instructor?
  • 17:23 Dear Facebook iPhone App, Why can't I share links? Easy, simple add to next update. Ok, thanks.
  • 18:11 Why the Monkey? 091/365 Nortons Commons tinyurl.com/d7ef3d
  • 18:38 I have determined that the Submaximal VO2 max test is a joke. Tried to convince department to get a real VO2 Max test. No takers yet
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31 March 2009

Twitter Log

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  • 14:04 Very busy day on the ambulance. Finally got to eat lunch.
  • 14:12 Nursing home to ER all day long. We're now posting.
  • 14:26 I need to improve my IV stats. All the BLS runs are making me rusty. Missed twice today :(
  • 16:06 Driving past down town. Sky doesn't look so good. Maybe rain soon twitpic.com/2nh14
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30 March 2009

Twitter Log

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  • 09:12 Waiting for my partner to Show (he's late). 1 of 3 medics on the street today
  • 11:11 Waiting in radiology. Our truck has no power to the box. We are OOS.
  • 14:25 At least they gave us 10 minutes to eat lunch before sending on another chuck run.
  • 15:17 Posting. Beautiful sunny day - bkite.com/061Fn
  • 16:03 Run volume has slowed this afternoon. One ALS truck has gone home. Only two medic left on the street. We're posting still.
  • 19:36 Why the Monkey? 089/365 Vulcan tinyurl.com/c82jnu
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29 March 2009

Twitter Log

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  • 09:38 24 hours of firehouse love. Teaching Hazmat to the recruits.
  • 14:50 I'm getting dragged into a legal case from an EMS run more than 3 years ago.
  • 14:53 The 2 Louisville fans I work with are yelling at the TV. Sloppy play all around.
  • 15:45 Watching Louisville MIST game at the station - bkite.com/05ZTn
  • 17:28 Sitting on the side of I-71 SB waiting to clear from an MVC
  • 17:55 Finally clearing the highway. What's for dinner?
  • 20:34 Everything is all cleaned up at the station (finally). Washing clothes, working Rural Metro tomorrow
  • 20:41 Been on my feet since 7am. My knee does not like me at the moment.
  • 21:00 A friend of mine is doing a photo project fo her masters in education tinyurl.com/d48jjv
  • 21:06 Why the Monkey? 087/365 Thai iced tea tinyurl.com/carehe
  • 21:07 Why the Monkey? 088/365 MVC tinyurl.com/devufn
  • 21:30 My first Medical Neccessity blog: Dispatch - tinyurl.com/cqwyrs
  • 21:33 Don't know if I can keep up two blogs, but I am going to try to write. Too many things to say about Prehospital medical care.
  • 22:25 Listening to EMS educast. Yes, I'm a junkie. I live with my issues.
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28 March 2009

Twitter Log

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  • 09:32 RT @craigdurling: Here's one way to clean your monitor: is.gd/5msS
  • 09:39 RT @gbullard: This seems pretty smart tinyurl.com/ck35fn (I can't even get Fire Chiefs to work one 24hr shift to see what it's like)
  • 10:01 Morning World. Welcome to my one day off, until Thursday.
  • 10:02 I get 100% chance of severe storms today. Thanks NWS. At least I am not working.,would be very busy.
  • 10:03 Actually I turned down two offers to work today from the two ambulance services I work for. I needed a day off.
  • 10:04 Many people around here may not voluntarily participate in @EarthHourUS but mother nature will force our hand ;)
  • 20:43 Line of thunder storms approaching the metro. Tornado watch for Louisville.
  • 20:49 Welcome to spring weather metro Louisville!
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27 March 2009
Another day on the bus. The previous day was extremely busy for my service, so I thought that this one would be busy also. I was wrong, at least for the first six hours of my eight hour tour. The day began as most days in private service EMS, dialysis transports and return trips to the nursing home. The service I work for has been increasing the number of trucks on the street recently, today we had seven medics on the street for a total of nineteen transport ambulances. With so many paramedics I knew that I would be busy with the 'chuck' run all day long. I am not bothered by chucking people.

After the fourth run for my truck (which I teched so my partner could get a brake) we went back to a posting location. We did not stay long, we finally had the chace to make a priority 1 (code 3) run. Dispatch sends us the info, elderly female with difficulty breathing, a nursing home clear across the county. My partner is driving and we hit the road, lights and siren blaring. Five minutes pass and they send another truck to a priority 1 run right near where we had been. I have not knowledge of where this ALS truck cleared from but I thought they might be west of our location. I thought about trying to swap runs with them, but I decided that dispatch would know best. As it happenes so often in private ambulance service, we passed the other ALS truck, going opposite directions on the highway.

Surely the dispatcher could have seen this error? Why do they spend so much time crossing trucks, wasting fuel and time? Most of our dispatch staff have never been on the street, however they do have CAD to assist them, and they hear us enough to know where the facilities are located. I make it a point to tell them my exact location when they call my number. I am hoping they will use their brain and send me to the closest available run, not across town, when there is a closer truck.

My patient required a breathing treatment and a trip to the ER (non emergency). When we arrived on scene the nursing home staff told us she had a SpO2 of 50% on 3 lpm by nasal cannula and she had an irregular heart beat. The PT was laying supine in bed. I removed the nasal cannula, listened to her lungs and administered a breathing treatment before getting her on our cot. When will nursing homes get their act together and stop placing 2 miles of oxygen tubing connected to a concentrator at 2-3 liters per minute. This does your patient no good if they are having a hard time breathing, seriously people. LPN's are useless, if they cannot understand the concept.

27 March 2009

Twitter Log

Follow me on Twitter
  • 09:14 Back on the paramedic band wagon. R/M was busy yesterday. Slow morning so far, we shall see!
  • 09:44 Posting downtown. A BLS crew is here with us. - bkite.com/05VfX
  • 09:46 I'm at Waterfront Park - bkite.com/05Vg6
  • 09:51 #followfriday @geekymedic for all your EMS podcast needs.
  • 14:12 Posted in the Audobon area. Waiting for the next run - bkite.com/05VHr
  • 14:16 bit.ly/bYlv explains, FINALLY, what this "#followfriday" thing is. (Thanks, @jankabili!) (via @Pogue)
  • 15:45 Billy Gillispie gone from Kentucky. Press conference @ 4:30edt.
  • 18:25 Clearing from lift assist. Missed IV on last run. Only ALS PT of the day.
  • 19:18 Americanized Chinese food! Yumm! - bkite.com/05WeM
  • 20:35 Arizona forgot to show up to the game. Louisville is klling them 65-34
  • 21:02 Going to bed. Both games are a blow out. No point watching anymore. Need sleep
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26 March 2009

Twitter Log

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  • 07:32 Back at the firehouse. Hope all my friends @ WDW survive the axe!
  • 08:12 On the way to USAR team training. First one for me. Just got on the team last December
  • 08:38 I'm at Louisville - bkite.com/05TfI
  • 12:42 On the way back from training. Nothing exciting, keep moving.
  • 16:08 I'm riding as officer until 10pm EDT. Be afraid. Seriously.
  • 17:35 EMS is busy. All private svcs. are out of trucks. LMEMS are holding code 1 runs. And it's sunny & dry out! WTF?
  • 18:18 Dinner, yum! Night cleaning finished. I've got a few admin. duties to finish then I get to rest!
  • 20:57 Finally finished with the administrative duties. No wonder my Major never gets to sleep before 1am!
  • 21:07 Why the Monkey? 085/365 Tender 1869 tinyurl.com/dasqs5
  • 21:18 Waiting for laundry in washer. Bored and tired.
  • 21:24 Anyone ever actually try to read Legeslative bills in House or Senate? Ridiculously convoluted or what?
  • 22:08 According to WHAS 11 news Billy Gillispie may not be back for a third season. tinyurl.com/cwq4r9
  • 22:11 WHAS 11 implied that Billy G. is mostly fired. No official word yet.
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25 March 2009

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  • 07:56 Just added myself to the wefollow.com twitter directory under: ##Paramedic ##Photographer ##Firefighter
  • 07:57 Morning Twits. Warm and rainy here in the metro. Probably going to be busy on the ambulance
  • 11:25 1st run difficulty breathing. PT was very warm. I'm thinking Pneumonia exacerbated COPD.
  • 12:50 On the way to the Suburban Hosp. Area for posting. - bkite.com/05RLk
  • 14:42 Clearing VA hospital. Back to our posting location.
  • 14:46 Bright Kite is a neat idea but not very useful in my area. Not many users, and some haven't updated in 7-10 months #britekite
  • 14:49 When will we finally have enough social media websites? Twitter, Brite kite, FB, Socialscope, plaxo, linked in. I'm going to pare down my
  • 14:49 Social media web presence. Too freaking many.
  • 20:36 Why the Monkey? 083/365 Lines & Knots tinyurl.com/cwl4xh
  • 20:36 Why the Monkey? 084/365 Executive Inn tinyurl.com/cmu5b6
  • 20:50 Kentucky proves why they never made the NCAA tourny. They can't get the little ball in the basket. #NIT
  • 20:55 Horrible performance Kentucky. Lost 67-77 to ND. Please come back next year with some freaking heart and desire to play the game
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24 March 2009

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  • 07:59 Home. No runs last night. Maybe I'll take an early morning nap.
  • 22:26 That was easy - Funny video - Twouble with Twitter. tinyurl.com/cjrujf (via @MedblogAddict)
  • 22:29 Let the dogs out, going to bed. Back on ambulance tomorrow morning.
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23 March 2009

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  • 07:10 Welcome to 24 more hours at the firehouse. Hopefully stupidity will stay home
  • 07:50 Live fire training this morning. Four departments will be there. Oh joy!
  • 12:11 Back from training. Lunch finished. Need to repair door on the engine & refill bottles.
  • 14:27 Stopped by station 2; now for some area awareness - bkite.com/05OlF
  • 15:15 Listening to EMS garage podcast.
  • 15:42 Back at station 3. Getting sleepy. - bkite.com/05OsX
  • 15:56 Wishing I could be playing Paramedic on an ambulance.
  • 15:59 Does anyone think Advanced Practice Paramedic program will be comming to Kentucky? I bet not. Surprised we are not using hurses still
  • 16:20 Pass this along!!! - hour of silence(no tweets) tonight on Twitter from 8p-9p EDT in memoriam of the slain officers in Oakland.
  • 16:30 I was going to take a RapidCE class, but I think I'll wash the engine first.
  • 19:01 Watching Axe men on History Channel. People think firefighting is crazy?
  • 19:05 JUST IN -- The Middle Tennessee University is on lockdown after an armed man reportedly ran into a building on campus. (via @BreakingNewsOn)
  • 20:41 About time Patterson took a freaking shot! He's killing me with his lack of shots. #nit
  • 20:45 Hey Kentucky, if you can't defend against the 3 you aren't going to win. This isn't rocket science
  • 20:50 UK might as well get off the court if they are going to play like that. High school teams play better than this
  • 21:01 WTG Kentucky, you officially SUCK. Can we get a New coach yet?
  • 21:05 Last 2 minutes are always the best. #nit
  • 21:16 Ok, now on to Notre Dame in the Quarterfinals. IF we could only play consistantly, we might have a chance. #NIT
  • 21:26 Who wants to see a UCONN & Louisville rematch in the Final Four? #FInalFour
  • 21:47 Unreal sheep hearding is.gd/nHjt (via @Chrismatthieu)
  • 21:54 Getting sleepy. Have to go make bed. Then maybe @planetmoney podcast of the day. Crap, still need a photo of the day :(
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22 March 2009

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21 March 2009

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  • 01:48 I think some of our EMTs are getting sloppy at the firehouse. Poor clinicians and lazy about taking vitals.
  • 02:32 I'd like Louisville more if it were not the allergy capitol of the US. My congested head agrees. Never had problems till I moved here
  • 03:21 So my stomach didn't like the decongestant I took a little while ago. Add that to sinus congestion = no sleep
  • 07:36 Home. More sleep soon. First take care of dogs. Working special event for Rural Metro tonight @ Science Center
  • 08:09 Mechanical sirens in the distance. E10 must have a med run somewhere. There was a fatal mvc Bardstown rd. At county line about an hour ago.
  • 11:03 I give. World 1 me 0. No sleep this morning.
  • 14:19 Home. Have a few chores to do. Maybe a nap before work tonight
  • 20:14 Equipment checked; Truck checked. Ready to go
  • 21:40 College dance party in celebration of heart awareness week. - bkite.com/05LqT
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20 March 2009

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  • 07:04 Going to get recertified in ACLS this morning
  • 14:23 Waiting for dealship to give an oil change to l Asst. Chief command car. How did I get the easy gig today?
  • 14:23 I'm at Buckner - bkite.com/05IoN
  • 16:33 PPE distributing fool. I am responsable for issuing PPE at my FD now. Oh boy how exciting.
  • 18:09 Getting groceries! Soup & grilled cheese for dinner - bkite.com/05IOk
  • 19:10 Two runs and we haven't finished making dinner yet!
  • 21:35 Back up to date on my photo of the day. Trying to keep up with posting to the blog is getting harder. joelneild.com/blog
  • 21:36 Why the Monkey? 078/365 ACLS Recert tinyurl.com/cr36h5
  • 21:36 Why the Monkey? 079/365 Practice tinyurl.com/c8hfyh
  • 21:59 Going to make my bed and listen to the EMSeducast. Hope @buckman is funny this time ;)
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19 March 2009

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  • 06:52 Didn't sleep well. Got about 4 hours on and off. Working on the ambulance today.
  • 11:23 6 medics on the street today. Loads of bls transfers. Almost got an ALS run but a closer truck took the run
  • 13:08 They are trying to send me home. Too many trucks on the street not enough runs
  • 13:19 Hey Louisville why is poplar level closed at 264?
  • 14:22 RT @Squirrel325: Hug a third-year med school student today, they're ALL finding out where they're going for residency today.
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18 March 2009

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  • 10:45 I'm waiting to see a few leaf trombone players get together and perform.
  • 13:38 Trying Pocket Informant app for iPhone. Really liked the winmo version. Hopefully they can do good with this app
  • 17:11 Why is KYTelco Bank not in the 21st century? They need to get with the freaking program so I can D/L my accounts into Quicken.
  • 17:15 Feeling crappy. I'm going to vent frustrations of virtual airplanes.
  • 17:27 Pink Floyd on the iPod & flying. This should be good
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17 March 2009

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  • 11:41 I'm at Louisville - bkite.com/05BMp
  • 11:47 Beer me. At Irish rover. Let festivities begin
  • 12:08 Feeling better. Guiness, fish & chips, all is right in my world
  • 12:21 Did I mention live music here Also? Best place For Irish food & beer. Yup Irish Rover is the place to be
  • 13:08 The rover is filling up with merry people. All ages show. Saw one old lady dancing with her walker. Young at heart indeed
  • 13:11 I wonder how my crew is getting on at the fire station?
  • 13:14 BULLETIN -- ELEVEN A.I.G. EXECUTIVES RESIGN. (via @BreakingNewsOn)
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16 March 2009

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  • 11:18 Working Rural Metro today. My EMT is going to be busy
  • 12:17 Saying of the day: I became a paramedic so I could drive the ambulance
  • 12:34 I'm currently reading "Blood, Sweat and Tea" by an EMT in London UK. He said he used to make more than Nurses
  • 17:45 I am officially registered for FHETS at Disney world in October!
  • 17:55 Off work, no firehouse tomorrow. Got 22oz. Of Sam Adams infront of me and BBQ on the way. Here's to St. Patrick!
  • 20:05 Why the Monkey? 075/365 Riesling tinyurl.com/cculzd
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15 March 2009

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  • 00:44 Trying to sleep. Body not going along with this plan. Very unhappy
  • 07:32 Home. No runs last night. Time for early morning nap. Sunday is a day of rest after all right?
  • 16:13 Youtube is all slow and stuff. Tried to fly in Aces High but keep getting Disco'd. Come on interweb thingie just speed up already
  • 19:59 Updated 6 photos, from project 365. I got behind while being sick with the blog posts, but the photos were taken each day.
  • 20:00 joelneild.com/blog for Project 365
  • 20:05 Why the Monkey? 073/365 He's Joshing me tinyurl.com/cexd3x
  • 20:05 Why the Monkey? 074/365 State of the Art tinyurl.com/cb4zo5
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14 March 2009

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  • 06:33 Going to try and make it through 24hrs at the firehouse.
  • 07:14 The creepy crawly crud is going around the firehouse. Yesterdays Sgt. was sent home sick. Disinfecting everything today. Buy Lysol stock
  • 08:29 It's only been an hour and a half. I could use a nap already.
  • 16:14 I'm at Louisville - bkite.com/05vFJ
  • 16:16 Crew is in the gym working out. I'm monitoring radio traffic, not working out until I feel better. Hopefully only a day or two more til then
  • 16:28 Did I mention that I am now in charge of PPE? I've got some organizing to do. Pairing spare boots is first on the list
  • 16:53 "Looking for love, or an angel to forgive my sins....the way the big wheel spins"
  • 19:49 On a run waiting for my crew to find the scouce of a malificent odor in a house
  • 20:00 Holy cow. I'm 3 shows behind on the EMS educast. Need to catch up
  • 20:07 I was practicing my scale on the chanter before this run came in.
  • 20:08 Practice chanter for bagpipes only has 9 notes. So do the great highland pipes
  • 21:29 AIG is going to Pay execs $100 million in bonuses, after taking $170 billion in bailout per @NYT
  • 21:30 Who is pissed about that AIG bonus payout?
  • 21:33 I'm going to practice my Highland bagpipes near @buckman
  • 21:39 Wow I am 4 shows behind @firephotos. Too many podcasts, not enough time.
  • 22:36 Listening to Ems educast ep.2. I wish I could get in on the conversation.
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13 March 2009

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  • 09:47 Working Friday 13th on the ambulance. Dialysis pick up is first on list. 3 medics on today
  • 09:49 #followfriday funny as hell and a bit twisted @buckman paramedic & educator extrodinair.
  • 09:51 I had to wait 30 minutes so mechanics could replace fuel filter. We are finally available for shift
  • 10:04 Our PT has 20 minutes left on machine. Disp. Told us to wait. No medics available. Go figure
  • 10:07 2nd BLS truck taking code 3 run. ALS trucks are all on BLS runs. Very poor unit management. Doesn't bother me, My ass isn't on the line
  • 10:32 Wanna hear something funny? The BLS truck that just cleared my location is on a code 3 run, we are still waiting for our bls patient
  • 10:33 They are holding another code 3 run. We are still waiting for our patient. Training needed for dispatchers
  • 13:33 I have affirmed my dislike for Sts. Mary & Elizabeth hosp. Staff there are always rude, and unpleasant to deal with.
  • 13:55 Question: Who thinks Billy G. Will be looking for a new job next year?
  • 17:29 Home at last. Let dogs out, enjoying sunny afternoon.
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12 March 2009

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  • 09:43 Morning world. I've got things to do, so let's get to feeling better already
  • 11:48 Ok, Bills paid. Feeling better. Need to do a little cleaning around the house. Hopefully I can find a winning lotto ticket around here
  • 11:57 Rescue_monkey is awake, alert and oriented to person, place, and event. #thirdpersontursday
  • 12:13 Submitting paperwork to my Batt. Chief for USAR training and ACLS recert.
  • 12:16 The Rad 57 does, but that company is making a modual for lifepack 15
  • 12:45 If you can dodge a wrench you can dodge space debris. @ISStation @Canageek
  • 12:47 LOL, they don't have the book handy. What were they thinking running for their lives? @ISStation
  • 13:08 NWS is predicting SNOW for KY? WTF?
  • 13:09 Sorry @michellej I used the 'S' word. I'm just the messenger
  • 13:17 Alrighty then, #ISS crisis averted, time to achieve something now, snow inbound to metro Louisville, need to get bread, eggs and milk.
  • 15:05 UK 71 Ole Miss 58! Holy cow we actually won
  • 17:06 Why the Monkey? 068/365 Fierce Protector tinyurl.com/cer86f
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11 March 2009

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  • 11:29 Morning Social media nerds! No fever this AM, just feeling a little achy. Will probably be going to work tomorrow.
  • 11:38 15 people killed in Stuttgart, Germany school shooting. 17yo suspect killed by Police while fleeing
  • 12:28 RT @amymichael: you wanted the links people, so i am on a roll shitamericaneeds.com/
  • 13:06 Watching "The Strangers" not based on any actual event. Just a creative story.
  • 13:45 WTF is source Boston and why should I care? No offense intended.
  • 13:47 1st death abou to occur in movie. Irony, he shot his friend. #strangers
  • 13:50 Anyone in twitterville going to FHETS @ Disney this October? #fhets
  • 13:55 Everyone asleep at the wheel todar except Ben?
  • 14:02 LOL ham radio makes a cameo in The Strangers! #strangers #ham
  • 14:19 Glad I didn't pay to see that I'm theaters. Kind of predictable. #strangers
  • 14:38 Temp. Holding at 99. Time for Tylenol, and more water
  • 14:40 Gross Pointe Blank is on. Nothing funnier that comedy based on two assassins
  • 14:43 "I've killed the president of Paraguay with a for, how are you doing?" LOL
  • 14:44 With a fork. Damn keyboard.
  • 14:47 "Don't kill anyone for a few days, see how that feels."
  • 14:54 "You can never go home again, Oatman, but I guess you can shop there"
  • 15:10 "Thank you for profiting on my childhood" #grosspointeblank
  • 15:19 Everyone needs "A swift spiritual kick to the head that alters your reality" #grosspointeblank
  • 15:39 "What do you do for a living?" "Professional Killer" "Good for you, it's a growth industry" #grosspointblank
  • 16:21 Next? Evan almighty. Tried watching Epic Movie but had to quit. It was horrible
  • 16:28 Is Keep Louisville Weird on Twitter or Facebook?
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10 March 2009

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  • 07:29 Enthralled to be at a mandatory meeting @ firehouse on my only day off. 07:30am
  • 14:23 Home after a very productive department meeting. We actually might get some things accomplished!
  • 15:09 Feel like crap. Going to take a nap. Without a night cap. Don't be such a sap.
  • 16:58 Apple is supposed to be hip, but have proven that they are clueless to social media. 1984 freaks, they are watching
  • 17:15 Is a temp of 99.6 bad?
  • 17:19 Summary: Tweetie was denied because the dev. cannot regulate the internet. that looks a little...um, stupid. #apple
  • 17:21 Sorry Amazon Kindle App, books might contain words we object to, so you are denied #apple
  • 17:28 Crap, no Pipe Band for me tonight. It's up to 100 degrees. This is bad I think.
  • 17:43 Wow, this Tweetie 1.3 thing is taking off like wildfire. Reading posts on search.twitter.com
  • 17:45 On a positive note, it's a Nyquil night for me! Wait, how is that positive?
  • 18:25 Laying on the couch watching Eagle Eye, waiting for my wife to return home
  • 21:33 Temp down to 99.4 after second Tylenol dose. Nyquil here I come!
  • 21:44 For all the iphone converts from WinMo WebIS submitted pocket informant app to apple today.
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09 March 2009

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  • 06:45 Morning tweeple. Slept through the night. Minor miracle at a fire station. Going to work on ambulance later this AM.
  • 12:17 We had a morning rush at the ambulance. It has slowed for now.
  • 13:01 I'm at Louisville-Jefferson County (Balance) - bkite.com/05kQw
  • 13:02 Posting at Iroqouis Park. Nice sunny day! - bkite.com/05kQI
  • 13:49 I'm wondering why I need to call MCP to give Epi SQ on anaphylaxsis? Protocols say give Benadryl First MPC orders for that also
  • 17:10 I just waited over an hour an a half for a bed in Jewish ER (for my patient not me). Good golly it's busy in ERs around here!
  • 17:18 I'm at Louisville-Jefferson County (Balance) - bkite.com/05lfo
  • 17:19 Going back to station for end of shift!! :) - bkite.com/05lfu
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07 March 2009

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  • 09:45 Watching the movie "W." No very impressed with Stone's story telling abilities.
  • 15:03 Thinking of trying Osaka Sushi on Frankfort ave. Anyone been there?
  • 16:37 Osaka does not open until 5pm. We are trying Simply Thai in St. Mathews
  • 19:05 Dinner was excellent. Settling into a night at home. Got wine, Movie "there will me blood". Losing an hour of sleep, not happy
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06 March 2009

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  • 14:25 Still posted downtown. Other medics on BLS transfers. Getting sleepy. Partner already asleep. He worked all night
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05 March 2009

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  • 07:00 Zzzzzzz.....huh?what? Oh, nothing interesting. Just another 24 hours at the firehouse
  • 08:37 yone using Microsoft Office Live workspace? Is it worth the hoopla?
  • 10:19 Going to get me a chanter to practice my piping. Going to switch from Drums to pipes in the next years. Drumming is too stagnent
  • 16:42 Finished training (search & Rescue), refilled air bottles. Trying to motivate myself to hit the kettlebell and stairmaster. Need to workout
  • 16:54 Looked at Ambulance schedule tomorrow, there are 4 medics on. Maybe an easy day? Probably not.
  • 18:07 With 33 seconds left on the stairmaster we made run 2 of the day. At least I got a workout in before dinner!
  • 19:36 Reading EMS magazine March. Insightful article regarding blood pressure. Good one on patient-centric service.
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04 March 2009

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  • 23:05 I'm officially addicted to @planetmoney podcast. Listening to Monday's now.
  • 23:06 Why the Monkey? 062/365 Plane Blue Sky tinyurl.com/bo95xh
  • 23:45 Now listening to TWiAR podcast
  • 07:21 Morning twits. Already hit the weights, let the dogs outside. Time to clean up and make b-fast. Working the ambulance today.
  • 09:48 One of two medics on shift today. We're posted already.
  • 12:11 1st run Nausea & vomiting 2nd to poor pain management. Nursing home didn't think to ask for Fentenyl patch from Dr. It isn't rocket science
  • 13:10 Back to posting in the center. Lunch=Kroger Sushi & small salad.
  • 20:07 Why the Monkey? 063/365 Climbing the wall tinyurl.com/afwcsy
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03 March 2009

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  • 23:17 Finished listening to EMS Garage podcast. I have many opinions on the future of EMS and employee pay. @geekymeeic
  • 01:38 Just back from a med run. So much for sleeping tonight.
  • 16:41 Getting ready to go to Pipe Band practice. Where the hell did I put my drum practice pad? I haven't used it since beginning Paramedic Class
  • 16:42 Surprised I still know "Wings" on the Chanter. And most of "Wild Blue yonder"
  • 18:34 At pipe band practice. I'm the only drummer here. Pipers learning new music. twitpic.com/1tuhh
  • 23:05 I'm officially addicted to @planetmoney podcast. Listening to Monday's now.
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02 March 2009

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  • 06:27 Stuck in the middle again. 24 more hours at the firehouse
  • 10:07 Working on more Firehouse software projects. I should get some real training in database management
  • 10:37 Out doing inspections. Actually we're doing pre-plans. We have all the fun
  • 11:26 Dag nabit, is Twitter & twitpics having issues or is it tweetie? @atebites
  • 11:27 Just a penny on the train tracks waiting for my judgement day... twitpic.com/1stiw
  • 11:28 Finally, I got a photo to post to twitpic. About freaking time!
  • 11:31 Oh now WTF? Error posting photo. Bad gateway. Stupid f'ing technology. Never works when I want it to work.
  • 14:14 Attention East Coast, send my snow back to me damnit! We got jipped!
  • 17:23 20min. kettlebell workout / 20 min on stair master = I'm done. That is all.
  • 17:37 Why the Monkey? 061/365 self portrait by iPhone tinyurl.com/apxp7v
  • 17:47 "Many miles away something crawls from the slim of a dark scottish lake..."
  • 17:50 "packed like lemmings into shinny metal boxes...."
  • 18:16 "Time stand still, I'm not looking back but I won't look around me now; Freeze this moment a little bit longer"
  • 18:56 Fairdale FD working a fire in 2 sty apartment 5507 Hunt Club Lane.
  • 19:59 Is there anything worth watching on TV tonight?
  • 20:13 LOL I forgot I had the i.TV app for iPhone.
  • 21:12 Settled on Apollo 13 on AMC.
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01 March 2009

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  • 00:17 Finnished flying for the night. Didn't do too bad, had a few kills. Time to sleep. Welcome March, be nicer than February was ok?
  • 17:53 The cups and plates are in a conspiracy
  • 20:06 Why the Monkey? 059/365 Who's been a bad Kitty? tinyurl.com/cdq843
  • 20:36 Why the Monkey? 060/365 What's the safe word? tinyurl.com/cwmn54
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28 February 2009

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  • 07:55 I'm officially member of the Louisville USAR team. They sent me my ID via mail. Guess I need to make training next month
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27 February 2009

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  • 07:51 Waiting for world destruction thanks to @sockington. My crew is pulling ceilings at a kitchen fire in berrytown. I'm driving we're 3rd in.
  • 10:37 EMS training. Rescue pod
  • 11:54 #followfriday @gfriese @buckman for all your EMS education needs. These two are tops in the field.
  • 11:56 Showing our crew the new Lifepack 1000 AED. Wish we got the upgrade model so I can see the rhythm.
  • 15:05 Going to pick up engine 31 from repair. It went in for PM and found leaking hydraulic hose & cracked spring
  • 21:08 Why the Monkey? 058/365 What's your number? tinyurl.com/aounzj
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26 February 2009

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  • 11:05 Giving all my money away to various companies, regardless of how good the service provided is. AKA: Paying the bills
  • 12:56 Heading out to run a few errands. Fun and joy.
  • 12:57 I was informed of a manditory meeting for the entire Department on the 10th of March. Probably not good news. 100% Insurance going away?
  • 13:13 Might be going to FHETS in Florida (Disney's Coranado Springs) Oct. 13-16
  • 15:08 Playing Aces High. It's been a long time since I've flown
  • 18:09 Why the Monkey? 055/365 Motion Tabled tinyurl.com/dxlvj8
  • 18:36 Why the Monkey? 056/365 Eye like ewe tinyurl.com/b6szaj
  • 20:06 Why the Monkey? 057/365 Is it getting hot in here? tinyurl.com/bfbkle
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23 February 2009

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  • 09:31 Working R/M today. I like being on the street, doing the medic thing.
  • 11:53 1st run chest pain. I'm thinking PE. 12 lead, IV O2. Easy ride to Hosp.
  • 13:54 4 ALS on the road today. Lighten the load for me.
  • 19:47 Working on photo of the day.
  • 20:36 Why the Monkey? 054/365 Big Boy Toy tinyurl.com/dy3poq
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22 February 2009

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  • 04:00 Got back from 3rd run of the night. No sleep this shift. Yes, it does get old fast. All false alarms
  • 07:15 Just got back from run 4. Really tired, going home to sleep.
  • 08:21 Home now. Sleep soon.
  • 20:35 Why the Monkey? 053/365 Take a Brake tinyurl.com/d68gpo
  • 22:12 There's some one in my head and it's not me
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21 February 2009

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  • 05:07 Been awake since 03:30am. Time to get ready for work.
  • 06:28 Listening to EMSeducast w/ @gfriese @geekymedic and my instructor, to be named later :)
  • 06:31 Odd fact, I am a consumer of two people on emseducast. One was my medic instructor, and I use RapidCE online, which uses @gfreise PPTs
  • 06:32 Good day yesterday. Not much sleep last night. Hope today is good also.
  • 12:08 More bailout system training. Missed a good photo op of a hawk flying overhead
  • 14:55 Rode in a trauma alert with Ems. Head injury, Cpr 2 times SROC. He's in CT now. I'm stuck at hosp. With EMS crew.
  • 15:58 Headed back to the firehouse. I suspect I have a report to write.
  • 17:36 Downloading photos, hoping to find photo of the day.
  • 18:06 Why the Monkey? 051/365 Flan tinyurl.com/bdaot5
  • 18:06 Why the Monkey? 052/365 Just Joshing You tinyurl.com/brfjvl
  • 18:11 Why the Monkey? 050/365 Red joelneild.com/blog/?p=303
  • 18:21 Just when I thought I could relax, I'm told that the ENTIRE platoon is taking the Hazmat ICS class on Tuesday. I've got homework 2 read
  • 19:50 Watching Lie to Me on Hulu.com
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20 February 2009

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  • 09:31 Working R/M again. Look out world new medic on the loose!
  • 11:38 1st run Cath lab transfer. What purpose does a diagnostic lab if you can't fix the problem?
  • 11:40 I don't understand the kindle craze. I like books
  • 13:11 Still waiting for a bed a the hospital. Been here for almost an hour
  • 15:19 Another ALS run down. Demand pacemaker running @ 123. Not good.
  • 15:31 Returning to station to pick up vent & replace main O2. May not get off on time
  • 15:35 Sorry folks, I was waiting at hospital for a patient, not me. Thanks for the concern
  • 15:59 Making Als pickup that was scheduled an hour ago. Definately not getting off on time
  • 16:17 Lunch (3hr late) Wendy's fish sandwich. Not bad for fast food fish.
  • 18:43 Returning from ALS transport. Balloon pump in LAD, 3 IVs monitor, O2, and loads of patience. All went well considering
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19 February 2009

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  • 23:32 Med run. Sure wish LMEMS would let us run ALS engines. Kentucky really is 20 years behind the curve in emergency servces. Fire, Ems, police
  • 23:34 Example: Now they boast about transmitting ekg to hospital. Didn't Johnny & Roy do that in the 70's? Rampart, sending EKG now!
  • 04:42 EMS is messing with my sleep. Woke up@ 23:00 for a run; just got back from ride to hosp w/ possible cva. Only 3 hrs sleep so far
  • 07:37 Home at last. Let dogs out; feed dogs then back to sleep. @photomonkey was right, fire gods not kind last night
  • 16:12 Heading out to run some errands. Someone tell the migit in my head banging the gong to cut it out ok?
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17 February 2009

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  • 10:53 Working R/M today. First day as a medic solo.
  • 10:54 First run dialysis transport, you guessed correctly, I made my EMT tech the run.
  • 11:12 Yup, I did 8 hours last week being precepted. Now I am flying solo. 2nd dialysis pick-up. May tech the next run either way. Getting bored.
  • 11:29 Semi lost it's trailer 1st & broadway. 1st St blocked
  • 14:37 I teched a bls in to the ER. Dialysis PT needed shunt secured. It was pulling out.
  • 15:10 3rd dialysis run. My Partner is working hard today!
  • 21:11 Back from pipe band practice. Not much has changed in the 2 years I've been absent
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16 February 2009

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  • 09:23 Time for early morning nap. Didn't get much sleep last night, I dislike other people's cell phones.
  • 09:24 Really, general public, if you are not willing to stop and offer assistance then don't call 911 while passing an old MVC by.
  • 09:24 Cell phones are the bain of the 911 services. People think everything requires calling in, while they drive past at 90MPH.
  • 09:29 Nap time commences in 3, 2, 1.......
  • 15:01 I need to get outs and walk the dogs. Head hurts though.
  • 17:22 Going to the Rover for dinner
  • 19:42 Good beer at Irish rover twitpic.com/1j3gc
  • 20:35 Why the Monkey? 047/365 Black Sheep Ale tinyurl.com/dhdr9t
  • 20:40 Discovering (and getting discovered by) relevant people with @MrTweet's help. Get him as your personal assistant! mrtweet.net?v=12
  • 21:21 Thinking my next goal should be upgrading my amature radio ticket. Would like to give hf dx a try.
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13 February 2009

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  • 08:25 Working R/M today. Finally getting paid for being a medic
  • 09:23 Waiting for my preceptor to return from a run. His truck is a 24 he truck. I'm only here for 8 hrs
  • 12:15 1st run hypotensive 2nd to sepsis. Obviously This will challenge my IV skills. Missed twice, but rolling on.
  • 12:16 My preceptor has recently been accepted to medical school. That is very cool.
  • 15:56 Just finished difficult vent transport. Wish we did clinical hours at Kindred @buckman. Learned a lot About our vents
  • 20:35 Why the Monkey? 044/365 Thomas the cat tinyurl.com/azrp4o
  • 21:14 Listening to TWiR international podcast.
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12 February 2009

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  • 06:56 In the jailhouse now, eh I mean firehouse.
  • 08:34 Engine checked and washed. Off to station 2 for training. Beautiful sunny morning!
  • 12:36 Finished workout, EMS run to a guy who fell out of a tree. Be carefule cleaning up storm debris people Seriously
  • 14:06 Cup of John Conti coffee tastes surprisingly good this afternoon.
  • 15:51 Watching rapidCE lesson General Science.
  • 16:32 Any one have EMS podcasts they can recommend?
  • 21:35 Why the Monkey? 043/365 When pulleys go bad tinyurl.com/b2bkma
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10 February 2009

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  • 09:24 WooHoo! Going to work for Rural Metro. They win, the first to get back to me. Orientation tomorrow. Party on wayne
  • 10:39 That's a first. Someone called me asking from a price quote for a wedding shoot. I really don't shoot weddings.
  • 10:39 Highland Baptist has me on their list of photographers. I wonder how that happened?
  • 11:11 Wow Sen Chris Dodd is looking worse for the wear.
  • 11:59 Watching Max Payne. Ankle/foot hurts, resting
  • 18:25 Left Ocems enroute home. Picking up dinner @ Penn station. Not healthy, but tastey!
  • 19:24 My otter box defender case for iPhone arrived today! Hooray for protection!
  • 21:06 Why the Monkey? 041/365 Mortimer tinyurl.com/cyv78p
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09 February 2009

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  • 06:51 Guten Tag, 24 Warm hours at the firehouse. Going to continue job search this week.
  • 08:44 Detailed quint and chief car for funeral this morning. Off to do inspection & preplan at same business.
  • 11:06 Any iPhone junkies have a good task manager app?
  • 12:15 Lunch time. More inspections after lunch.
  • 13:00 Called Rural metro & Yellow ambulance back. Passing 2 weeks still no medic job. Bullitt Co. Is next ok my phone list.
  • 13:46 I have an interview at Yellow ambulance Wed. Finally some headway!
  • 14:52 More inspections. Next gym for workout.
  • 15:55 Recieved call back from Rural Metro. Corp. HR lost power for 7 days. They still want to hire me. It's looking up now!
  • 20:00 Photo of the day posted. Look for why the monkey?
  • 20:06 Why the Monkey? 040/365 Axe to Grind tinyurl.com/cm56y6
  • 21:08 Watching Anthony Bourdain No reservations in Japan. Food looks awesome
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08 February 2009

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  • 23:35 Why the Monkey? 038/365 Windy city tinyurl.com/bhcxa2
  • 07:59 Greetings, awake early. Fed the dogs, lounging around the house
  • 21:35 Why the Monkey? 039/365 Whiskey by the drink tinyurl.com/aaut5w
  • 22:33 Listening to FAP, going to sleep soon.
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07 February 2009

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  • 10:31 Breakfast @ northend cafe
  • 14:27 Cleaned up storm debris. Hooray for chainsaw!
  • 17:03 Ordered Windy city pizza, going to rent movie. Quiet night at home with the wife.
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06 February 2009

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  • 08:54 24 hours of washing command cars at the fire house
  • 11:37 Lunch done, time to Finnish daily routine duties.
  • 13:56 Back to working on SQL in firehouse database. In over my head bit.ly/1NHywe
  • 14:10 Any one good with Sql within Visual fox pro?
  • 17:58 Having too much fun playing games on iPhone.These games rock!
  • 20:06 Why the Monkey? 037/365 Moon tinyurl.com/dgtae2
  • 21:53 Added @scoooooooooooty's blog switchcities.com/ to my RSS reader
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05 February 2009

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  • 23:37 @joschmoblo Why is the drama always surrounding you?
  • 23:52 @OutlanderUSA Yes, but a little quiet today
  • 23:57 @OutlanderUSA Twitter has been quiet today
  • 23:57 @OutlanderUSA You have been busy I guess.
  • 23:57 @fire_fighter Morning already?
  • 23:57 @joschmoblo Maybe you shouldn't be driving?
  • 01:22 Listening to a little Pink Floyd while my Iphone syncs the music.
  • 02:58 I should try to sleep now. I'm tired
  • 09:18 Twits, it's morning again. I was up too late last night playing with phone. Still tired
  • 09:30 Any one have a good RSS reader for iphone?
  • 09:33 Iphone syncs to Outlook better than Windows Mobile did. I have Exchange mail box AND Outlook email at home. It syncs both!
  • 10:54 Iphone Update, the audio (during phone calls) is absolutely amazing. Clearest I've heard in a cell phone
  • 11:09 I'm game tinyurl.com/asawdn
  • 16:01 Any one know of twitter app that shows # unread tweets on home screen?
  • 17:53 Cooked dinner, wash cloths. Time to relax.
  • 19:06 Why the Monkey? Two for one tinyurl.com/alrro7
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  • 07:50 @dancanon negligent hiring? Glad I don't have to speak lawyer at my job. Medical Lingo is enough for me.
  • 08:33 @joschmoblo Sleep much lately?
  • 08:54 @joschmoblo Sick day, mental health is important also.
  • 08:54 @PhotoMonkey Go for it. You only live once
  • 09:03 "I met a girl who sang the blues, I asked her for some happy news but she just smiled and turned away"
  • 09:08 I need to head out and get some hands on with the new phones. Must say that the Iphone is enticing
  • 09:27 @michellej Seems like veryone is writting apps for Iphone and not for Windows mobile
  • 09:38 @michellej The entire staff of OCEMS have iphones, they are addicted. I think Iphone addiction is incurable.
  • 09:47 @lbrenner They use little butterfly needles for that. I've got 14 ga IV's in my bag they look like stirring straws.
  • 09:48 I am really going to leave, but Pandora Radio is playing songs I haven't heard in a long time. Don't want to turn it off :(
  • 09:51 @GrantGresham They best they have is the Blackberry storm.
  • 09:58 @ConstantineXVI I know, they will cater to what is popular, but even Microsoft is behind in their WinMo updates. Deepfish was canceled
  • 10:02 @ConstantineXVI You're right. They can't get a decent UI, and they are always behind the curve. Lots of 3rd party apps though
  • 10:33 @michellej You need to see this. It is about anhour long, but GREAT for presentations. pktinyurl.com/bok66y
  • 10:33 @michellej I try to make all my classes more interesting, and less Death by power point.
  • 10:33 @Buckman ROTF, thats freaking funny
  • 10:35 @michellej www.youtube.com/watch?v=DZ2vtQCES
  • 10:39 @michellej I do most of my teaching in the narrative style. I use the slides as simple examples. I despise bullet points.
  • 10:40 I'm headed out, to test drive a few phone/PDA (and an Iphone of course). Can't tweet cause mine is broken :(
  • 10:43 @joschmoblo www.youtube.com/watch?v=DZ2vtQCES show them this
  • 11:04 Testing an iphone. hard to type
  • 11:14 moved to fuze. looks nice, still winmo laggy though.
  • 11:36 Tried cracknberry curve, I didn't like it at all
  • 11:37 Looks like iPhone is best 4 me
  • 11:56 tinyurl.com/ywxsr7 Presentation Zen @joschmoblo @michellej
  • 11:58 @joschmoblo w/o touchflo it would be same old lame WM6.1 interface. I wouldn't upgrade for that
  • 11:59 Blackbery curve, does not easily connect to MS exchange server. Can't get work email with curve
  • 12:01 @joschmoblo No problem. Getting used to typing will be toughest I think. But motor memory will kick in i hope
  • 12:05 @ConstantineXVI We had a few people at Firehouse that traded their BB in for something WinMo based.
  • 12:07 @ConstantineXVI Maybe it was Small business server that didn't integrate well. THey all called BB support with no resolution
  • 12:55 @bdunckel Really? Our windchill now is 7. Tonights temp is 9. Wanna move north to Kentucky?
  • 13:00 Listening to SOA with LYO. Hope they play something good
  • 13:02 @OutlanderUSA looking for replacement phone. Not much fun seeing the prices.
  • 13:24 @OutlanderUSA Yes, I have a tilt that is now broken (due to a fall yesterday) tinyurl.com/atox6v
  • 13:24 O, I feel kind of lost without my PDA phone. I have no idea whats going on. Keep having to check desktop for info.
  • 13:32 I would seriously consider a HTC touch pro (fuze) if I didn't have to pay the full $499 for it. Phone company scam, I tell you
  • 13:51 @heyitsmare It's even worse there. They are hocking 'unlocked' phones and charge $200 more than MSRP
  • 13:52 @heyitsmare No problem. I'm always looking for new ideas. The wife surely doesn't want to drop $500 for a new phone for me.
  • 13:58 Not too bad. Not much surface bruising, but Left ankle/foot hurts today.
  • 14:01 @heyitsmare thanks me too.
  • 15:41 @joschmoblo Still thinking it over. Leaning towards Iphone 8gb for $399
  • 15:42 @Squirrel325 Nope, I posted one last week, hey wait...now my phone is broken? Coincidence?
  • 15:46 Tried an old phone I had laying around. It's broken too, no wonder I upgraded. I didn't break the old one.
  • 16:27 @joschmoblo Looks like I'm going to buy Iphone tonight before Actors Theater show. WooHoo!
  • 16:45 RT @funambulator: cursebird.com/dancanon Swaers like a Gangsta Rapper
  • 16:46 @dancanon I don't believe @funambulator is that innocent. No one is.
  • 23:07 I have now become one of the sheep. I bought the iphone. Time to play :)
  • 23:37 @joschmoblo Why is the drama always surrounding you?
  • 23:52 @OutlanderUSA Yes, but a little quiet today
  • 23:57 @OutlanderUSA Twitter has been quiet today
  • 23:57 @OutlanderUSA You have been busy I guess.
  • 23:57 @fire_fighter Morning already?
  • 23:57 @joschmoblo Maybe you shouldn't be driving?
  • 01:22 Listening to a little Pink Floyd while my Iphone syncs the music.
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03 February 2009

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  • 08:42 Slick stuck in traffic. Towing our cascade trailer to get filled. I265 @ hwy 22 is full stop.
  • 09:06 Awesome, snow. Almost a white out!. Roads getting slick. Busy day ahead at firehouse.
  • 10:14 The bad new...I fell on the ice. So far I'm ok but my Att tilt didn't make it. Screen is broken. :(
  • 10:44 Anyone have any ideas for PDA phones? I'm looking for a new one.
  • 10:57 Hey Iphone users, is the iphone the way to go? I can get referbed Iphone for less than new HTC device.
  • 11:15 Really? I thought there were more Iphone users out there. No responses.
  • 11:49 Anyone hear anything good about the Fuze?
  • 12:06 Damn $600 for HTC Fuze (Touch Pro)
  • 12:19 Damn. I might just go back to plain phone, no PDA. Stupid technology.
  • 14:44 is youtube not working? or is it our network at the station?
  • 15:31 Even the cheapest phone on ATT website I could buy is $159.00. really?
  • 15:36 a little. Any good deals?
  • 15:46 Still looking for ~ $199 unless you want a broken one. Then I can get one for $78
  • 15:51 That was for a used HTC Tytn II.
  • 15:51 I generally don't like buying electronics on Ebay. I want to feel the device in my hands prior to purchasing.
  • 16:06 I'm suffering from Withdrawal from my device.
  • 16:22 Actually, I think the Fuze would be nice. I have a bunch of WinMo programs that I like and would continue to use.
  • 16:47 Some people on ebay want $250 for used Tilt. Might as well get 16gb Iphone refurb for $299.
  • 18:01 Left hip hurts. Stupid laws of physics.
  • 18:42 Ebay only has phones that are 'unlocked' so they charge a ton more $$$ than the phone is worth.
  • 20:30 Ok, after looking at the compitition I think it's a Windows Mobile phone or Iphone. Samsung Eternity looks cool, but not enough for me.
  • 22:35 Why the Monkey? 034/365 Bad day at the office tinyurl.com/aubvf3
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