Trauma Redux, Oct. 26 episode

It's nice to see "Trauma" share some of the truisms about EMS. My favorite was the scene with "Rabbit" and Marisa, the EMT who was carrying all of the gear, heading to a cardiac call. Marisa had the temerity to ask why her partner, a paramedic, wasn't carrying anything. "ALS stands for 'Aint Lifting Stuff," Rabbit replied. I've heard it phrased with a profanity, but what can you expect from network TV? I thought the interplay between Rabbit and the patient's agitated wife was authentic and very much in line with what EMTs deal with. I thought how he asked for her to hold the door (a subtle way to keep her occupied) is a very good tactic to deal with frantic family members. Make them helpful and then they can focus and not get in the way.
Overall, the Halloween episode was pretty good. It also had shown Rabbit's limits to being a "cowboy" and trouncing on standing orders. He had refrained from administering morphine to a child trauma patient. Other emergencies seemed to be handled well (paramedics or more experienced EMTs may take issue with that assessment).
The preview of an ambulance accident for next week's episode should be interesting, because there are too many ambulance accidents. Some have killed EMTs in the line of duty. My training and experience tell me that most other people on the road are too stupid to watch for ambulances. Assume the worst -- especially in New Jersey -- and don't just think the lights and sirens will keep you safe in the rig.

The TV Show 'Trauma'

I enjoy watching the show "Trauma," not for its portrayal of EMTs. It falls into that realm of entertainment with James Bond movies, disaster films, and "Die Hard." Shut the brain off and enjoy the ride.


As an EMT, many of the things that I see on the show make me chuckle. A lot of these guys forget about scene safety among other basic tasks. One of the first lessons in EMT class is to stay safe so you don't become a patient and burden other first responders. What sometimes passes itself off as emergency medicine on this show would get EMT cards yanked. A paramedic would not fill an IV with ice water to intentionally induce hypothermia on a patient with a spinal injury. There are plenty of other examples cited by people better qualified than me. If you want to learn about EMS, there are plenty of emergency medicine sites and this one is one of my favorites, The EMT Spot. Or even better, get some first aid classes, join a squad and work toward an EMT certificate.


But just take the TV show with a grain of salt and enjoy it for what it's worth: an hour of drama with great production values. Roy and Johnny from "Emergency!" did it better and captured more of the flavor of being an EMT. However, the name of the show is "Trauma" not "80 Year Olds with General Illness." Neither is pretty, but bowel troubles of the elderly don't make good television.

The latest cool stuff...

This is an adolescent thing to do, but I thought it would be fun to share some things that I like right now. Some of this probably already appeared on my facebook profile. Apologies to those who have seen some of this before. I even liked some TV this week, a rarity:
-- Mad Men's episode "A Guy Walks into an Advertising Agency" shook up some of the listlessness from the first few episodes this season. Matt Weiner shows off his Soprano roots by placing unusually violent action into a plot. The show worked well on an acting and literary level. The title was a nice play on words. The symbol of snakes figured prominently. (Guy being a snake in the grass, Don speaking with Connie Hilton, Pryce's gift) A bit of foreshadowing of the JFK assassination (the tractor ride with the woman riding through the office and Joan looking like Jackie Kennedy) and Vietnam (the boys who never saw combat at sterling cooper covered with blood). Roger Sterling (played by John Slattery) had some great lines in the episode. "It looks like Iwo Jima here" ... "He was just getting his foot in the door."

-- House's premier was exceptional. It was nice to see Hugh Laurie working someone that could dish out as well as him, Andre Braugher (a favorite from Homocide: Life on the Street).

-- The EMT Spot -- I ride for Metuchen EMS. We are not a busy first aid squad. I consider myself fortunate, but it is important to refresh skills or keep certain things in mind when responding to calls. This page and the yahoo bulletin boards for NJ EMTs are very useful. On a related note, Congratulations are in store for Travis Hendon, who delivered a baby on a call at a gas station earlier this week when he was riding for Edison. I managed to get some ambulance driver training in this weekend!
-- Joe Perri, my colleague at Coyne PR, attempted to eat half a sheet cake in 10 minutes. I salute you for the effort! Nice work by Coyne's graphics department with the video footage.
-- Yo La Tengo came out with a new album, Popular Songs.

Ouch

Martial arts classes are leaving me a bit achy! Had jiu jistsu class and learned choke holds and counters.

Also had dicey first aid call last night. Lesson to smokers: Quit now! COPD is a bitch. Patient was unresponsive and lung sounds were absent when I first listened even though she was breathing (accessory muscles were working to inhale). We brought her to the hospital alive. It was my scariest call so far as an EMT and I couldn't sleep until 3:30.

Now to leave you with some cool stuff:

Mexico drug gangs threaten cops on radio, kill them

A real tragedy that reflects a breakdown of law and order in Mexico's border cities. It's affecting not just Tijuana, but cities where drugs are being trafficked into the U.S. Even EMTs in Mexico are not safe (gangsters shooting them while treating patients or threatening them for failing to save patients). It's a sad plight for a country whose people deserve much better. This Reuters story spells out the threats to police.

read more | digg story

Joining a first aid squad

When I was younger, I had a very weak stomach. Many of my car trips were spent with my head out the window splashing what I ate for breakfast down the side of my parents' orange '72 Chevy Nova as we drove from Point Pleasant to Red Bank. Seasickness was an element of every fishing trip when I was 8 or 9. My breakfasts often served as chum for the fish. After emptying my stomach, I would have to rest inside the party boat's cabin. Even into early adulthood, changing diapers sometimes would test my stomach. When I joined Metuchen EMS, my family was stunned. They weren't stunned by my willingness to volunteer for an organization or that I wanted to help sick people. They were stunned that I was willing to test a weak stomach in such a fashion.

I wanted to do something involving health care. I like the intellectual challenge, but I didn't have the grades for medical school. I did better in my English classes than my science classes, however, and started a career in journalism, eventually becoming a health care reporter. I also worked as a copy editor at the Daily Record. As the slot editor, I had to edit the obituary page. You can take stock of one's life and commitments when they try to boil it down to a few paragraphs. When it comes time to write mine after I'm in my 80s, I don't want it only to say "Bill thought South Park really kicked ass." I also don't want it to serve as some simple regurgitation of my resume. When the kids get older, you need to do other stuff to keep you busy. Those commitments outside the job may as well be worthwhile -- whether it's community service or just doing stuff that makes you happy.

This is ultimately about karma. Give and expect nothing in return except the feeling that you helped someone at their moment of greatest need. I'm not independently wealthy where I could do this full time, since EMTs make less per hour than an average Costco worker. I'm not one of those starry-eyed idealists who think they can save the world and cure hunger, fight disease and right all of the world's wrongs. I'm too old for that idealism and I have to cut the grass. However, I can get off the couch one night a week and the occasional weekend to ride on an ambulance. Metuchen is not as busy as some of the Edison squads, but there are still calls in the middle of the night.

I've been taking EMT classes since early September. Every weekend I spend 8 hours learning about how to respond to diabetes emergencies, cardiac, and respiratory emergencies. We take exams every few weeks. In a few weeks, I'll be doing clinical time at an emergency room in Perth Amboy on a Friday and again on a Saturday. It should be a real test and a definite change of pace from Metuchen.