Wow!

Hey! it works! My "new" website: clickthrough

Nifty Internet Stuff

So being an Internet "Have-Not," I envy the ease and finesse of the Internet "Have." Which is why I'm trying to add new features at this page, but seem to be failing miserably. Anywho, tried to register a new domain name for this: www.flashingbluelights.org and have it automatically forward (and step 2: mask) to my nice little Blogger address. So far, no pie.

We'll see what happens in a day or so.

Try it!

Vehicle (and Mental) Disfunction (or rather, Malfunction)

We had our ambulance malfunction today. I mean, the vehicle that shouldn't be malfunctioning was malfunctioning, as opposed to our other vehicle which is in a state of constant, perpetual malfunction. The latter will, sooner or later, end up in the scrap heap. This former will too, but hopefully not for many more years to come.

No, the problem was that we park our ambulance in a nice, convenient location on a usually pedestrian only street which is suited just as much for display purposes as accessibility. Free advertising you see. The other reason we park it there is that being in Manhattan, no one wanted to buy us a building with a garage. Unfortunately, when it gets cold out, our ambulance gets cold too. And while the fine first responders on our corps. can bundle up, our ambulance can't. So cold ambulance + diesel engine = vehicle that does not start.

This is all fine and well until one tries to respond in said ambulance, and instead of sailing away with blinkies and woowoos to the rescue. Said first responders, call the Fire Department for assistance, and hoof it on foot to the scene with trauma and O2 bags slung across our fine, broad shoulders. Luckily campus is not all that big, so we can walk to just about any scene in a few minutes. (Insert comment on how FDNY arrived on scene 15 whole minutes after we did, a sum total of 25 minutes after the call initially went out.)

But I stray...

How, you may ask, does this occur when modern block heaters and shore-powered space heaters, and magic heaters of thine heart, and all the rest are there to there to prevent such occurrence? Answer: I have no clue. All I can say is that hopefully, we'll get the rig checked out top to bottom, and maybe a problem will be caught. Something along the lines of, "oh, there is no engine block heater after all...!" (When this happens, I'll be the one going "Thwack!" followed by our Operations Officer going "Owwww!").

In the meantime, we were able to jump the engine (and the battery was cranking just fine, which is odd) and get her started after the call was completed. For the past day or so, at three hour intervals, I'm also going out and starting the bus and letting it run for 15-20 minutes. So far so good, but I'm just waiting for the moment at the next call when I realize she's not going run this time either.

All I can do, I suppose, is turn up the heat of mine heart, and hopefully, prayerfully, there'll be enough warmth to light a fire of fuel injected diesel and metered amounts of air in a cast iron block to keep the public safe and happy.










P.S. I realize there hasn't been a simple medical related post in a while (or ever?), so the next one will be. I promise, I swear. I's gots me some good idears. I's swears. I's promises.

Driver Training, part Deux

As a solution to the lack of an EVOC course, or even a large parking lot nearby where I can set up pylons, I've been taking willing guinea pigs to the famed Fairway supermarket near 125th St. on the Hudson River here in Manhattan. This is the only place within twenty miles that I know of that has a clear stretch of pavement that will hold more than five cars. In fact, in itself, it's like a pre-built obstacle course just waiting to be used by college aged EMTs learning to drive the rig for the first time.

Of course, a few weekends before the Christmas break, I was having my pro tempore preceptee doing the serpentine in reverse around the thick steel columns that held the West Side Highway fifty feet above our heads when a friendly RMP from the local 26th Precinct pulls up as I'm walking alongside the vehicle, spotting the driver.

"Good Lord, what the Hell are you guys doing now?!?" says over-caffeinated patrolman.

"Driver Training," replies Yours Truly.

"Wow, you guys train a lot."

"Name of the game."

"You know, we were following you guys the other day, you were doing CPR in the back of your bus..." the Officer says.

'Uh-oh' I think, I know where this is going...

"Yeah, but we got a little confused when you guys drove past the hospital. Guess you guys were training, huh?" Officer says with a smirk.

"Yep, had to show the newbies what it felt like to be chest-pounding in the back of a moving vehicle," I respond.

'Great,' methinks, 'At least I know we getting talked about the the Precinct house, but you gotta make do with what you have.'

Louisiana?!

So I accepted a job drilling for oil in offshore in Louisiana (details not so relevant), which I may or may not report to come June, but anyway, I was browsing for apartments and the like in the towns around Lafayette. Interestingly around, this is my first major move in around four years, which is a little more than the total time I've been involved with EMS. So I was surprised when I discovered myself looking first for towns that had volunteer EMS squads and fire departments as the primary criteria of where I might want to go live. Oddly enough, I found out that many towns (in fact all of them) are serviced by a single commercial ambulance company. Investigating further, I discovered that much of the entire STATE of Louisiana's EMS system is this single outfit.

Now, there are many volley fire gigs, but most of the fire gigs don't do EMS, as evidenced by the online lists of members with only one or two members at most being certified as EMT-Bs. I'm a little disconcerted about this situation, and as much as I like working the fire service, EMS was always (and I hope forever will be) my primary emergency gig. This is quite a conundrum since I swore that I work never work commercial EMS. This quandary turns out to be the principle misgiving of moving from New York City to Louisiana. Anyway, two concerns: (1) I hope the single commercial ambulance outfit that runs everything down there has good QA/QI because they own the business, and no one has a choice to the EMS they get. (2) I wonder if they hire per diem Basics who spend 3 weeks a month offshore?

Bite Nails and say, "Driver Training!"

New found duties as Crew Chief: (1) Driver Training (2) Crew Chief Training (3) Probie Training... I'm sensing a theme here. Regardless, it is issue #1 that scares the bejeezes out of me. Now, to refresh your memory, recall that Our Fair Lady is a COLLEGE ambulance service in MANHATTAN! Driver Training just isn't so easy.

Our squad is jointly run by the college Health Service and the Department of Public Safety. The Health Service's job is to give us as little money as possible and reduce that amount every time we screw up. Public Safety's job is to let us do whatever we want and not ask questions.... until recently. Apparently their vehicle insurance rates are increasing, which means questions are coming down from the TOP. Specifically, questions phrased as commandments: i.e., STOP GETTING IN ACCIDENTS! Not an unreasonable request.

In Manhattan you're bound to get in minor fender benders here and there. But some drivers new to the art of Emergency Vehicle Operations don't seem to realize that one needs to be a more conservative driver when going blinkies and woowoos (sorry DTs -- such a great phrase), rather than blowing through every intersection without looking and twice on Sundays.

Don't get us wrong, we train our new vehicle operators. First we give them CEVO (the cheaper, textbook only version of EVOC), then they hook up with the wayyyyy overprotective CCs (of which, may I add, I have recently joined the club) and start driving.... slowly.... around the streets of Manhattan. Going Cold, aka, no blinkies. No woowoos. This phase (DiT 1 -- Driver in Training 1) lasts until the trainee gets used to driving an ambulance, that is, a vehicle with a big ole butt (We have Type IIIs) and no rear-view mirrors. This phase sometimes lasts months. However, when a DiT 1 has proved himself, they get promoted to DiT 2. Eligibility to drive HOT! (Fun Fun). Believe you me, if a DiT 1 EVER got in an accident while driving, they would NEVER make it to DiT 2. Oddly enought, not many DiT 1s get into accidents.

Now another note: We have a relatively small campus. It's only 3 blocks wide and 10 blocks long. Response times are not very long at all. So why is it, that after that certain moment when the Captain grants a certain person the privledge to drive HOT and forever after, that the drivers just can't stop banging into EVERYTHING!?!?!

While I was still a Driver, the rank directly below Crew Chief, responding to a call, my crew chief was driving. We were HOT -- full blinkies, full woowoos. We enter an intersection. We need to make a left hand turn. We stop behind a car waiting to make the same turn. The (I assume) nervous driver in front of us panics a bit. He pulls his car forward a few feet. My crew chief sees him starting to move and starts to move as well. Two seconds later: BAM! We've rear-ended the car in front of us.

Now both vehicles could not have been traveling faster than 0.5 mph. Yet somehow, we've just got in an accident. Luckily it was late at night, and there was no other traffic. We sustained a dented quarterpanel, the other driver was unscathed. No one was hurt.

These incidents happen all the time. The most common one is that a driver will, while reversing, back the ambulance directly up into one of the giant yellow concrete posts that sits on either side of the bays at the hospital. (Almost as bad as reversing directly into the side of the fire house -- but a story for another day.) How can we improve? We have a fairly rigorous and conservative training program. But unfortunately, the nature of our personnel is that they are all young, inexperienced drivers, who have never driven an emergency vehicle before coming to us.

We have even considered hiring out and getting an instructor to teach the Corps. the full EVOC class, practical and everything. Trouble is, our budget isn't very big, and it would require us to take our one main ambulance out of service, drive one hour (each way) to the Northern Bronx, just to find a parking lot big enough to set up an obstacle course. We also have a second ambulance, which we don't run since we don't have the required call volume to justify keeping two crews fully staffed 24/7. It is, fortunately older, and unfortunately, smaller, than our main 2003 Horton Type III. Upside: No one cares that we ding it, Downside: it is not a good training platform. It seems to be asking for trouble requiring our new drivers to learn on a smaller ambulance. I can just hear it now: "Well, he got into the accident because he didn't realize that his vehicle is actually 2 feet longer than he thought it was."

The conclusion that everyone seems to draw at the end is that we're just going to have to do the best with what we've got, and accept the fact that we won't ever cure our problem. We will always get into the minor accidents, and perhaps, even small dings and scratches to the paint job are OK, just so long as we never get into a major accident, no laws are broken, and we NEVER hurt someone because of poor driver training.

The End.

...Now where did I put my Probie Whipping Stick?

Crew Chief -- At Last!!!

As of tonight, Yours Truly has finally been promoted to Crew Chief! Ahhh, three long years...

MARS: "Mutual Aid Response System"

There once was a little pig called MARS. He was the system set up by the FDNY administrators to send jobs to and recieve requests from EMS agencies not affiliated with the Fire Department, or field requests from agencies for additional resources, including ALS, Fire, PD, HazMat, and more. Unfortunately this little pig is dead, and we're not talking about freshly killed. No, we're talking carcass hit by a bus years ago, and all that remains is a clean little skeleton that the flies have long since left.

You see, as one of two volunteer ambulance agencies headquartered in Manhattan, and the only one in service 24/7, we are relatively small. We have a group of eagar college students by day / EMT by night that staff our single ambulance. Mainly, we serve the campus: but since the university is the third largest landholder in the city, that area is relatively large. We crank a good 700 calls a year.

OK, enough shameless self-promotion -- The real problem is Big Red has a very long history of not paying attention to or establishing links with other agencies in the city. While many agencies outside of the Manhattan proper seem to have more success, within the city, there is not much support. Here are the problems with MARS:

1.) No Training -- Us college kids have never been trained in using MARS by the Fire Department. What we know is limited to what gets passed from the Seniors to the Freshmeat.

Solution: One FDNY rep could spend an hour talking about how to and when to inplement the radio system*

2.) VHF -- The Fire Department is on VHF. We're on UHF. MARS is essentially a radio based system. There is a work around where we use our cell phone to call the MARS number, but that's just ridiculous! Can you imagine calling a dispatcher on the phone only to tell them that you're 10-XX.

3.) 10-Codes. They're all different. 'Nuf Said.

4.) It's easier to call 911 -- Yes, that's right. Our current system for when a drunken 250lb. football player starts wailing on my crew. Step 1: Run! Step 2: Dial 911. Step 3: Dispatcher sends an RMP (Radio Motor Patrol -- The guys with guns!) AND another BLS unit.

5.) BLS arriveth -- #1 reason to call for help: Request ALS. #1 response from FDNY after requesting ALS for our patient through 911: BLS car.

6.) Computer Assisted Dispatch -- Yeah, we don't have it. Do you know what it costs to put one of those systems in your truck!?! Unlike the Voluntary units (for-profits), the Fire Department (the professionals), the volunteers don't make money (we don't do cost-recovery), hence we can't afford toys.

7.) CPMU has NYPD -- The other volunteer EMS unit in Manhattan is dispatched by NYPD. Their radio system works just fine: it the police system! (Might I mention how odd it seems for every other agency in the five boroughs to talk with Fire, but the Central Park Medical Unit talks with Police -- even if it is the Central Park Precinct.)

8.) Disaster Strikes! -- Please don't, hopefully it won't happen again, but the way things are going, it's bound to sooner or later. Then what?

Someone help!



*PS: Any fire folk out there: Could we borrow your training academy? We've looking for a place to do EVOC.

Back on Campus

As promised, here is the down low on EMS in a chemical plant. A little background info to start with:

I worked over the summer in a small-to-medium sized chemical plant in Upstate NY. Located in Rotterdam Junction there were two side to the plant, the "Chemical" division, and the Performance Resins Division (PRD). I worked mostly with PRD, but also spent some time on the ChemDiv side, and also at the Waste Water Treatment Plant (WWTP). The ChemDiv manufacturtures alkylphenols from phenol raw material. A decidedly boring process, but extremely dangerous. Phenol (and alkylphenol) will kill you in under a minute if you get exposed to a 3"x3" splash of it on your skin. PRD uses the alkylphenol produced in ChemDiv, reacts it with formaldehyde and produces resin. The resin is sold to company who use it in many different products, but the most prominent customer is Goodyear which puts loads of it in their tires.

I've been holding off on writing this entry for a while because I wanted to see some EMS in action. The plant has a First Response Team that could respond to any medical emergencies, and they also took care of fire, confined space rescue, and incident command.

The biggest hazard in the plant is response to phenol spills. As mentioned above, it's nasty stuff if it gets on you. Luckily, there is a treatment. Polyethylene Gylcol, or PEG, is effective in stopping the action of the phenol, and application to an area of exposure alternating the PEG with water is essential. PEG stations are located throughout the plant. Initial response is straightfoward and usually a person exposed is able to start treatment on his own, and with the assistance of a coworker, can do an effective job. The FRT will be contacted by radio, and an ambulance will be called as well.

Here is where things could get hairy, I believe. All the workers in the plant are trained to the precautions to take when handling and being around the material. The FRT members are EMTs who can provide more initial care. However, the personnel staffing the ambulance, assumedly from an outside municiple or commercial agency would not have the training necessary to avoid accidents or becoming contaminated themselves through contact with the patient. Many EMTs (and hospital staff, as well) are trained in use of PPE to avoid bloodborne pathogens, but I know of very few who are trained in chemical precautions. For example, many solvents will easily penetrate or even dissolve latex gloves. With nitrile gloves you're a lot safer, but they still won't protect you from fuming chemicals or agents.

The plant I worked for had a visitor's video that was shown to all guests, but in an emergency situation where transport to a hospital is critical, ambulance personnel may very well be quickly shoved into a situation where they were not trained and are not prepared for. Here are the lessons learned: (1) Scene Safety!!!! -- more important than ever in an industrial setting. (2) Proper PPE -- Most hazards can be mitigated by protecting yourself. (3) Advanced Preparation and Knowledge -- If you know that there is an industrial facility in your jurisdiction, ask them to bring someone to your agency to give a presentation on the risks, hazards, and precautions they should take when they respond. You can also simply try going up to the front gate and asking for a quick overview yourself.

Summer Transition

After an extended absence, during which I passed by practical (again), finished off the current semester at school, worked graduation, moved back home, and started my glamorous summer job working at a chemical plant.

With the transition from collegiate volunteer ambulance corps to town volunteer fire dept complete, I eagerly wait some interesting calls. My town is home to about 30,000 people, covering about 25 square miles, spanning three independent fire districts. Zoning is mostly residential, some commercial and just about no industrial. It's a mainly commuter town while much of the population traveling for work and play. We're located in the Capital Region of Upstate New York. The fire department is dispatched by the police department. PD sets off one-way radio pagers and whoever wants, responds to the station to pick up a truck (EMS, fire, or Rescue) and heads to the call. Volunteers are issued blue lights ("courtesy lights") and only lieutenants, captains, and chiefs are allowed to head directly to the scene. Only chiefs have red lights.

It's a pretty decent system, but no guarantee of a response, hence automatic mutual aid. However, I think it's been years since AMA had to be implemented for our district. Overall, I think we have some of the most dedicated volunteers I've ever worked with, who get up at all hours of the night to help strangers.

It's this reason why I love EMS so much, and it's not just my town. I plan on going to Medic school after I graduate college, but I never plan on working the system as a full-time job. True, I enjoy the medical applications and such of the job, but I enjoy the job more because of the great people I get to work with. They tend to be the most honest and selfless people in all of society.


Next time: EMS in a Chemical Plant

Patience with Patients

Fair Maiden is dispatched by the university's Public Safety department. Given this, you can understand that we don't always get the best or most reliable dispatches in the business. No times of transmissions, no detailed information, and no chance for updated reports., though PS is usually pretty good about sending an officer (read: security guard) to meet us at the job. We got toned out for a 'possible intoxication' at a student's dorm room around 3AM towards the tail end of the Friday night shift. Of course, this was the one time PS doesn't send an officer when we might actually need one.

We step off the elevator and walk into the suite... "EMS!" Note that PS wasn't able to obtain a specific room number, and so there we were: standing in the suite, everything quiet as a dormouse on Christmas Day. I was about to start knocking on random doors, when out pops a tall, slender, rather flamboyant looking kid, ~20 y/o...

"Oh hey guys! Heh heh, sorry about that. False alarm..." Note: this kid wasn't even close to needing an ambulance, so course that makes him only the supporting character, i.e., the friend trying to cover up for his pal who's currently in the room either puking or high. This is going to be pleasant, thought I...

"Well, can you tell me what's going on?"

"Oh, my friend had a little too much to drink, but she's alright, she's sleeping now. I just got off the phone with her mom, and she said to just let her be."

"Do you mind if I have a look?"

"Ummm, well, gee..." You could almost see the wheels turning in his head -- trying to figure out a way to prevent me from entering the room. Finally, "Alright, but she's sleeping."

I walk into the room to see exactly what he said, a female (wearing all her clothes), laying in bed, apparently sleeping. 'Great!' thinks I -- quick, easy RMA. Back to the friend, "What's her name?"

"Oh, Monique," says he. (Names changed, of course, to protect the guilty, and cover me from big bad HIPAA.)

Shaking the poor soul, "Hey Monique, how are you feeling? Monique... Monique..." Nothing. I can see she's breathing, and she feels warm and dry, and I'd be a monkey's uncle if she was actually asleep, but I'm not too concerned... "Monique, honey, what's wrong?" Suddenly...

"Will you just leave me alone! And stop calling me Monique! My name's Sandra!" Hmmm. The plot thickens. She's too drunk to realize her friend was trying to cover for her. Being drunk in a dry dorm won't get you in a lot of trouble, but it will earn you a call to your mother in the morning. I look back at the friend, giving him my best, "Monique...?" look.

"Oh, it's just a nickname...." Yeah, suuuurrrre.

As my partner tries to talk to the friend to get some real info and start the PCR, I try to talk to our patient, and ask her about the night's events.


Things quickly get out of hand.


I hear the friend shout, "I don't see why you need her phone number!" why the patient starts throwing a tantrum, flailing and screaming, "Leave me alone! Leave me alone! Leave me alone!"Now there were a lot of other people in the room, who started getting agitated as well.

Seeing as we run crews of three, a lead, a driver, a third, and this go we had a probie, for a grand total of four, there were just enough ruffians in the room so my crew could have just gotten away with a man-to-man defense. Seeing as that setup only seems to work for the Jets, I needed to turn the tables in our favor. "Medic to Base, can we get a PS officer up here?" "10-4, he's on his way."

As the arguing escalated, I tried to deal with the patient and the rest of my crew dealt with everyone else. My partner taps me, "Want me to ask for a 10-50?" He's from Jersey. "A what?" I say. "911." replies he. Let's give me another thirty seconds. It seemed like hours before it happened,

In walks, like the shining figure of authority the square badge on his chest might imply, the Public Safety officer. My trusty partner starts explaining the situation to him. Everyone looks expectantly... unfortunately, it seems the HE doesn't speak English, oddly enough. So what does he do...? Picks up the phone, dials, and says, "Yeah, it's XXXXX, can you give me a sgt? Alright, bye."

Oy!

At this point, I'm thinking, 'OK, if we just grab the patient and go, we may get away with it. AMS is great. Under the protocols, that's not kidnapping. If she slugs me, great. I'll slug her back. If the friends get involved, it's a felony...' Happily, I put my brain in before I got out of bed this morning.


---And here I end the story--- Quick finish: The sarge walks in with a complement of five more officers and clears the room (finally!). So all that was left in the room was my half my crew (I sent the other half outside to wait with some of the officers) the sarge, another officer, and the patient. First the sarge talks to her. Then my partner, then the sarge, then me. Finally after a FIFTY-FIVE MINUTE on scene time, the poor soul jumps from her bed to our stretcher and we make boogie faster than mice on ice. Good times.



The upside: No one got hurt, no one got arrested, and no one got sued.
The downside: Looong on scene time, and people could have gotten hurt. Oh, and no one got arrested.


Brings up the questions, when do you handle the situation by yourself, when do you call for backup, when do you call for PD, and when do you run?

The way it was, I could have called for Public Safety the moment I walked off the elevator and started getting sass from the pt's friend. I could have called for an RMP as soon as the sassing friend got out of control. I probably should have gotten my crew out of that room rather than waiting for Public Safety to show up. But where would that have left us? The patient would have been restrained and probably booked, possibly her friends as well. I wouldn't want to do that to someone if I didn't have to, though it would have meant I would have initiated transport a LOT sooner.

I suppose I liked the way I handled this situation the most, but then I'm biased. I know a lot of people who would have liked to get in & get out, and wouldn't have the patience to talk a patient into coming with us. And in the event that this had been a real emergency, and not just a drunk, I would have probably liked to do the same. I know when I was working under someone else, we had a person O/D on an unknown medication (a story for a later day), and I was starting to request RMPs and the cavalry to force this person to the hospital when my partner (and the lead) told them to cancel. Boy that pissed me off. We were on scene there for about thirty minutes, all the while, I'm waiting for this person to collapse, seize, or go crazy while my partner tries to talk her down.

I suppose it's just a judgement call, as like any other, but remember what they teach you: First the safety of your self, then the safety of your partner(s), then the safety of the patient, and finally the safety of others.

Training

$1100 - Cost of average EMT class in NYC, including books, crappy stethoscope and BP cuff.
$550 - Cost of average EMT-B Refresher class.
Opening the envelope with a brand new certification card: Priceless.

Here in New York State, you're required to take the class- over 180 hours of medical knowledge compressed and condensed int0 lectures several times a week, or practice sessions to apply what you learn. All this culminates into a few very panicky days of the oh-so-dreaded State Exam. 6 Practical Stations where we demonstrate our ability to care for a person. Medical, trauma, splinting, boarding, KEDing, AED, CPR, the whole shabang... and you get one thing wrong and you fail. All you have to do is forget to say "...and regular" and it could mean the end: months of wasted effort. Yours truly, however passed the practical with flying colors. That is, I did two years ago. Unfortunately, EMT certifications last only three years... so I'm stuck taking a Refresher course. My opportunity to retake the State Exam for recertifications lies only 12 days away. But I'm not worried... too much.

My point is this: Earning and maintaining an EMT certification is a time-consuming (and expensive -- though in New York State, the Health Department will reimburse volunteer corps for their fees incured paying for their certifications) commitment. One needs to be dedicated. What I don't understand is why there exists people who go through the whole process of obtaining their EMT card, but then don't want to spend any time actually working as an EMT.

When I first got certified, I could not wait to get out there and save some lives... or at least take someone's BP (A real-live sick person!) I got involved with a fire department, a crew supporting a concert venue (You won't believe the one about the two girls at a Dave Matthews concert who, on their own, decided to find out what it feels like to take roofies), and of course, Fair Maiden herself, my university ambulance (name changed to protect the guilty). FM is a funny organization. It's the only place I know where they have so many EMTs they're coming out of our ears. Their solution of course: offer applications and conduct interviews. Of the fifty-some EMTs that apply every semester to join, the squad only invites 10-15 to become Probies. It took me two semesters before I was invited. My friend applied five semesters in a row -- a record as far as I know.

So why are there people around who just don't get it? I was at a general body meeting the other day; there were only maybe twenty-five of us there. A corps with nearly 60 members, and less than 50% in attendence at a MANDATORY meeting. More than that, in the final portion of the night (that is, the last five minutes of a total half-hour romp), we schedule crews for the coming two weekends (weekday/weeknight shifts are staffed by permenent crews the entire semester). I saw more than three guys slinking away and sneaking out of the room without volunteering to take a 12-hour shift, more who simply sat in their chairs keeping their yaps shut. Then it dawned on me, they weren't having fun!

In a job like EMS, there are two ways to do it: Either you become cynical and dejected -- barely going through the motions, I've been like that before -- or you can take the light-hearted approach, where you can be enjoying yourself even while a drunk, coked-up, more-than-spoiled rich girl swats at you (with those long sharp nails), yelling obscenities enough to make a grown man cry. But what causes the difference? I suppose if I knew, every corporate executive would be vying for me, trying to get me to inspire their suicidal cubical dwellers. I do know one thing though, The people at the top make a big difference. It's funny about growing-up. Coming out of high-school, wouldn't most people you knew rather throw themselves into an icy river before giving you responsibility? Now however, responsibility has (gradually) been piled upon our shoulders. Hell, we're even in charge of some people. I mean, I run an EMS crew and three other guys follow my orders and take my lead, not to mention the patient. Sometimes, if we're in a bad mood, we don't realize how that affects the other people around us. Sure, we'd all like to kill the dork who called us out and all he's got is a finger lac sustained by cutting carrots, but he doesn't have to know that. There is more than one way to let a guy know that by calling 911 for a Band-Aid, he's preventing our unit from responding elsewhere. You don't have to make him feel like an idiot. And the Probie.... just because she handed you a ring cutter when you asked for a collar, doesn't mean you need to berate her until she breaks down and quits. EMS is a funny playground. Perfection is required. But even if you have to get through the teeter-totter, the swing set, the monkey bars, and the tire swing without flaw, you can still have fun. And better yet, you don't have to be the bully that the recess lady will later need to take to the principal's office, you can simply be the kid that plays nicely with the other kid. Why? Because when you have fun, it makes it easy for the other kids to have fun as well.

"Insert title of first post here"

Putting off my schoolwork... as usual... at 4AM ... as usual... I stumbled across an amazing blog about a hobby of mine: EMS. For reference that blog titled 'DTs EMT' can be found at http://mysite.verizon.net/vze25hnc. From there I linked to 'Flatline NYC' at flatlinenyc.com. Half way through reading a post about an 300lb. combative autistic asthmatic, I revelated: I could write something like this. Better yet, I wanted to, and more to the point: here it is.

I am an Emergency Medical Technician, aka an EMT. The lay public calls us ambulance drivers, medics, EMS, heroes, assholes, and on occasion, firemen. I like plain-old "EMT" -- the name is shrouded in layers of professionalism and ideas of experience and sagacity, it doesn't make any claims to things we're not, and doesn't leave us sounding like livery cabbies. The job is hard. Physically, mentally, and emotionally. My fire and PD brethren will have you believe that their profession is more difficult. They would be correct. In general, EMS is the only of the BIG 3 emergency services where you don't line up to risk your life, but it's also the only one where injury, misery, grief and death is the most routine... a part of the job description.

Luckily for me, this is only a part-time gig. I dwell most days as a lowly college student. Engineering school is a reliable existence, albeit the UWS of the borough of Manhattan bleeds just enough caffeine to keep me on my toes. But its when I don my uniform for the University ambulance that I start to really come alive.

I don't remember why I decided to sit the training to become an EMT. Maybe it was the promise of truly, genuinely saving someone's life on every second Tuesday. Or maybe I like flashing lights and sirens. As a kid, I remember calling 911 for my sick grandfather and having the Paramedics arriving seconds later, perform their witchcraft, and save the day. OK, that last statement isn't true, but it would fit the profile wouldn't it? Truth is, I've been doing this for a long time ("how long?" you ask, but if I told you, You'd have to call 911) and love it. Oftentimes we get toned out for silly, inconsequential things: Sprained ankles, cut fingers, and I've waded through more foul, drunken vomit that you could ever imagine (Collegiate EMS remember). But there are more than enough legit calls as well.

And that brings me to the grand bullet of the presentation. I have stories to tell, and ideas to express (which I suppose is the point of all blogs -- cut me some slack, this is my first one ever). I've run EMS in urban and suburban (my home away from home(school) is a little town in Upstate NY) settings. I've been the probie, the chief, and the administrator. I've been in thick as much as thin, sun as much as snow, and day as much as night, and grown right along with the green, green grass. So I write -- not for you, but for me. I'll try to make it interesting, but no guarantees. I like adrenaline, but I like whimsical humor just as much. Anyhow, we'll see how it goes. This is my first post and it's Tuesday. I leave you now, there are people to see.