Ambulance wins, everytime.
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Ambulance wins, everytime.

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Story #19.26
I didnât ask for PTSD⊠it asked for me on that calm fall night. He didnât knock on my front door nor did he announce he was coming. Like the coward in the woods, he laid low until the perfect time where he took his shot and took over.
Sept 12, 2014. I was the first lieutenant of my fire dept at 22. I was on top of my game young passionate and confident. Did I know it all? Hell no, but justâŠ
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From @resuscitationist on Facebook:
CASE: 43yo pedestrian struck by car (~30mph) arrived to ER GCS (14) = Eyes4 Verbal4 Motor 6 and quickly decompensated secondary to a "brain bleed" specific epidural hematoma.
With the bleed anatomically located via CT imaging, the decision was made for immediate decompression at the bedside as the patient was on the verge of herniation and death. A procedure typically done by drill (burr hole) or craniotomy (removal of skull) in an OR.
An EZ-IO intraosseus drill (15guage) needle was used to evacuate the blood from underneath the skull. This is NOT what the drill is intended for and off lable. Do NOT attempt unless specifically training, in a unique situation, and know where the bleed is located. Not a standard approach, but an awesome moment of ingenuity and what extent we in this field go to, to save our patients lives! .
EPIDURAL HEMATOMA:
1. classically from blunt trauma over temporal bone.
2. brief loss of consciousness ?LOC) then an awake "lucid period" prior to acute decompensation
3. typically the Middle Menengial Artery is source of bleed
4. CT outline shape described as "football" .
Bulstrode, Harry & Kabwama, Silvester & Durnford, Andrew & Hempenstall, Jonathan & Chakraborty, Aabir. (2017). Temporising Extradural Haematoma by Craniostomy Using an Intraosseous Needle. Injury. 48. 10.1016/j.injury.2017.02.011.
"Mayor de Blasio, asked during a press conference about the wide gap in salaries between Emergency Medical Service workers and other first-responders that accounts for a high turnover rate at EMS, replied, âWe are trying to make sure people are treated fairly and paid fairly, but I do think the work is different.â So EMS doesnât compare to The Work that PD and FD does?.. my job isnât as dangerous or strenuous as other first responders? So your telling me I donât run up with PD when shots have been fired? I donât fight off attackers because of the environment weâre forced to work in. I donât stand right next to the âfast teamâ waiting for a âmaydayâ to come over the radio on a structure fire? I donât put on a bullet prof vest on a scene of an active shooter or a barricaded EDP with a weapon? I donât get mistaken for a police officer wearing a blue uniform in a bad neighborhood; possibly get attacked for it? I donât drive by a building on fire, which people are trapped on the fire floor and rescue those civilians, then containing the fire from spreading to other floors or potentially another building because FD arenât on scene yet ? Well I can tell you right now Mr. Mayor, I have done all those things in EMS. On every FD call, EMS is there. On high priority PD jobs, we are there. Listen to FD & PD radio frequencies, count how many times they say ârequest EMSâ âwhatâs the ETA for the busâ âRUSH THE BUS TO THIS LOCATION !!â The roles may be different, but the work is the same. Itâs time we get recognized for our contribution to the work we do along side our brothers and sisters in FD & PD. In our profession, we get injured, assaulted and die. On 9/11 the 8 EMTs/Paramedics didnât think âthe work is differentâ they also ran into those buildings to save civilians. How can it be justified that the crew that picks up your garbage makes 40k more than the crew who goes through all of this every single day. So, are we âtreated fairly and paid fairlyâ?"
-Rich Ard
Midwood Ambulance, NYC
Some awesome graphics about different vaso-pressers from Paramedicine 101 over on Facebook.
Paramedicine 101. 27,722 likes · 3,455 talking about this. Paramedicine 101 began as an educational EMS blog, and currently lives at YouTube

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People need to stop letting me get away with this kinda shit...
Every shift. Every day.
No questions. No compromise.
I have a medic student with me today. Somebody say a prayer or two...