Twelve Years.

Sometimes life sets you up for something amazing, something incredible, something life changing that just takes your breath away. A chance post, thanking the EMTs and Paramedics who shaped me into who I am now led to a quick conversation with a Medic I haven’t seen or had a lengthy conversation with in over a decade…12 years to be exact.


I wrote about Byron as being the first Medic I ever ran an Arrest with. That was a life altering day for me. I remember the red, high wing back chair, her pink shirt, blue jeans…the weird brown shag carpet…I also remember the fear, the anxiety, the terror, and then finally elation after it was over.


I only worked with him for a year…a year to the day exactly…I know, odd memory. He went off to do bigger and better things, both inside and out of EMS. I stayed on my path and that was that.


Well, I got a rare Friday off and in a chance message to Byron, he said his band would be playing at a nearby bar. I kinda had a ‘why not’ moment; it seemed like a good idea, he was game for a reunion after 12 years…I got to go to a Guinness Bar and drink beer and listen to good music after a shitty week.


What I wasn’t expecting…it was a watershed moment. I wish I could write well enough to adequately describe what happened, but I can’t. I do wish someone would have caught the initial moment on film…I’m sure it was quite the sight. We talked, we laughed, we reminisced, we drank Guinness  (Told you) , I danced to amazing music with people I didn’t know, but I didn’t care. The moment was right and the moment was amazing.


I had three main Paramedics in my life that I could honestly say made an impact on the Paramedic I am now. They know who they are and how much I love, care for, and appreciate them for all I’m worth…which isn’t much. Byron taught me a whole crap ton of things I still do because, well, he did them and it worked, not unlike the things Lt. Dan and Buddha taught me. The other Medic is constantly there, kicking me into gear, reminding me that I am Shao. Fucking. Trommashere. I need that when I get lost in myself, get down on myself, whatever.


What I didn’t expect or really realize was how Byron had shaped my development as a Medic. It was weird…and scary…and fascinating when it sunk in.


So, a very random moment in my life turned into something amazing. I reconnected with an old friend who’s impact on my career I hadn’t truly noticed until tonight. I’m not really sure why I’m writing this other than to try to quantify what happened. In 48 hours, I’ve had my mentors, the Paramedics I aspire to be, kicking my ass over my doubts, reminding me of who I am and what I’m worth.  It’s been an emotional 48 hour Rollercoaster, but, strangely, it all came together tonight under a hazy dark sky while listening to a band play a song by Dropkick Murphys and drinking one of the most beautifully poured Guinness I’ve ever had.


Going tonight was my way of not missing my shot. I’ve swung and missed many times over 29 years, but one big thing Byron taught me was that, I’d miss every shot I didn’t take. Needless to say, I think it worked. I got to reconnect and laugh with someone I haven’t seen in 12 years.


Life is amazing.

Have fun and be safe,



Lessons Learned.

This is probably one of the hardest posts I’ll ever write, but my hope is that I can impart some wisdom on my fellow EMS providers in how to deal with family in regards to their family dying or already being dead.


On September 11, 2014, I get a phone call that changed my life forever. MamaTrommashere called me to tell me that PapaTrommashere had collapsed on a business trip and was in cardiac arrest. Here is my own personal story on how I ceased to be a provider and became The Family.


1) Family will never react normally to shitty news.

When my mother called me, the first words out of her mouth were, “Your dad collapsed and he’s dead…I think.” MamaTrommashere is absolutely not medical, but she went to school to be a therapist. I was asleep in bed and I really didn’t register what she said, so my response was, “O…okay. Call me later *click*.” She called me right back and she used her “Therapist voice” on me.

“Shao. Your dad’s heart stopped beating. They won’t tell me what’s going on since I’m not there.”

“Your point?”

“Shao…listen closely…your father is dying. ”

*deadpan* “Mom…I have to go to work.”

*therapy voice* “Honey…you need to call off of work and drive to Maryland, but don’t worry about getting on the road right away. I have to pick up Grandma. I’ll call you when we’re leaving.”

*Angrily* “Mom. I am NOT waiting around. He is my fucking father and I WILL NOT just wait. I’m packed and I’ll beat you there. What hospital?”

*sigh* Meritus in Hagerstown, MD.

“Fine.” *click*


The next thing I do is scream and cry for exactly 2 minutes, then I start acting like it was a normal day. I grabbed a bag and packed for an overnight. Why an overnight bag? I couldn’t deal with my Dad, so I slipped into denial mode and began to get my things together to go to the hospital, then I was coming home for the comedy show the next day. Seriously, my main focus was not getting to my critically ill Father, but how I had waited for months to go to this show and I wasn’t going to miss it. I called my friends I was going with and told them to expect me the next day, but I had to run out of town on an Emergency. Some asked what was wrong and I very calmly told them my Father was dying, but…and I wouldn’t believe it if I hadn’t been told this by several people…that I said, “It’s no big deal. I’ll see you tomorrow.”


I have never really had a normal response to death. One of my parents favorite stories involves me finding out my Grandfather and Great Grandmother died on the same day. Nana had been gorked with Dementia for years and Grandad died over a botched medical procedure. He lingered on life support for a week before they took him off. During the two weeks of funerals and spending time at the hospital, my only concern was a report I was doing on the medical advances during WWII. I never showed any frustration or anger towards the death of two of my close family members…I was just more pissed that I didn’t have access to the school library to do my report. So, needless to say, I’ve never had a normal response to death and dying, this just happened to be one of the times it was more pronounced.

On my way to Hagerstown, I decided to stop for Pierogies and a Beer. Once again…my Dad is dying at a hospital and I decide to stop for an hour and eat Pierogies and bullshit with a bartender. Looking back, I can only imagine what the Bartender was thinking when I told him, “I just wanted to grab some food…my Dad is dying.” in a calm, non emotional voice.


2) Information overload is a very real thing.

The voice of clarity broke through about 10 minutes into the whole incident and voice told me to call the hospital and find out what’s going on. I was transferred to a nurse and I very officially stated, “My name is Shao Trommashere, you have my Father Papa Trommashere in your emergency department. The nurse passed me off to the charge nurse and I calmly repeated the same phrase. She then transfers me to the Doctor in charge.

The Physician who spoke to me was extremely kind.  He ran down the list: He collapsed at a Sheetz, a Pepsi delivery guy who just happened to be an off-duty Montgomery Co. Fire Fighter started CPR, one of the employees at Sheetz brought out the AED, and Community Rescue Service was less than 10 minutes away. He was defibrillated seven times before he got pulses back en route to the hospital. All his chemistries came back normal, except for his Trop which was .85. His lactate and ABG came back within normal limits. Pupils were reactive….

I got all of this information and more within 20 minutes of finding out my Father tried to die. I remember the whole conversation, but I didn’t digest it. It was way too much information to process at one time. I understand that the Doctor was offering me a bit of professional courtesy by giving me the run down…but it was something I didn’t need at that time. If I could go back, I would’ve asked for the specifics and nothing more. I found myself focusing on one thing; his Troponin level. I became so hyperfocused on that one thing that I kind of zoned out on everything else. My next conversation with my mother consisted of me explaining the lab work and nothing else. She kept asking about how he was doing and I kept circling right back around to how his Troponin was high, but that was to be expected after prolonged CPR.


3) Tunnel Vision.

The drive to Hagerstown, after my stop for food, was uneventful. I’d call the CICU for updates and brief my mother, but past that, I just turned on the music and drove. I don’t really remember the drive, honestly. I just know I beat my mother to the hospital…even though she had a full 90 minute head start. I’m sure someone could’ve told me my hair was on fire and I probably wouldn’t have cared. I wasn’t feeling emotional, I didn’t cry, I wasn’t begging God for him to live…I just had a flat affect and all I could focus on was getting to Meritus.  My mother, on the other hand, knew my personal fallout was probably coming and it was going to be bad. She warned the CICU nurses that I’d most likely come in raising all sorts of Hell. To everyone’s surprise, I actually remained pretty calm and relaxed. Mary, one of the nurses, even made a comment about how she expected me to come in like Hellfire, yet I was so calm and professional that she was expecting another daughter to come in any minute.


I was in full Tunnel Vision mode. I knew I had to get to the CICU and see my Dad. Past that? Fuck it. I didn’t care how it was going to happen, I didn’t care what was going on around me, all I cared about was getting in that room.


4) The Aftermath.


My Dad made it just fine. He was sedated and they had him on the Hypothermic Protocol. It was 72 hours of just sitting in his room, fielding phone calls and e-mails, visitors, and whatever else. When he woke up, he asked who won the Steelers game…and Baltimore won. He rolled his eyes and went back to sleep. It was a full day before all the sedation wore off and he was complaining about the food, the coffee, and whatever else he could bitch about, but he was fine.


Here’s where it got really interesting for me. I dealt so much with my family and how they were doing that I forgot to worry about myself. I don’t like talking about myself or opening up to people, so I wasn’t ever going to ask someone to talk about how I was feeling, but I wanted so badly for someone to ask how I was doing. I wasn’t doing well at all.  Everyone was concerned for my parents and Grandmother, but I found it odd that no one asked me how I was doing. It seems selfish, but I really just wanted someone to talk to, someone to cry on. I’ve never told anyone how I was feeling until now, where I’m writing it for the world to see.


I felt so alone, so scared, so tired, and so depressed. I became wreckless, I made very poor decisions and even more questionable ones. I felt alone since I was dealing with my family, yet no one ever seemed to want to know how I was doing, what was going through my mind. I never really…and still haven’t dealt with it.  Seeing my Dad is a mix of happiness and sadness…a humbling experience that usually leaves me crying in my car as I pull away from my childhood home. I know one of the prevailing feelings is that I feel like my father could’ve died without seeing his oldest daughter amount to something. My sister is married with three kids to an awesome guy who’s in the Army…my brother just finished Army Basic Training and is being deployed in August, but me…well…it’s not hard to feel like you’ve amounted to nothing when everyone in your family is doing something awesome.


All I know now is that I need to just keep putting one foot in front of the other. I’ve learned a lot over the past several months…some of them are very good lessons, others…not so much. I know I’ve become a bit more reserved, a bit more closed off…but in time I’ll be back to myself.


Have fun, be safe, and tell everyone you know that you love them,




“My Life Saver.”

So. I had one of the wildest experiences of my life today.

I went to Starbucks today to get a cup of coffee. I’ve gone to the same place several times a week for the last four years. One of my favorite Baristas was there; we always share a bit of conversation and she makes a fantastic Macchiato. There’s another reason why she’s one of my favorites…

I was hanging out at the Fire Department, helping to teach a bunch of Rookies when we got dispatched for a car accident. I secured my place on the Rescue Engine and we were off. The dispatch was for a two vehicle MVC, one patient entrapped.

On scene, I began normal rescue duties as the ambulance was already there. I chalked the vehicle, cut the battery, and was setting up the extrication tools when one of the supervisors came over to me. He asked me to help with the medical side of the extrication as the EMTs that were in the vehicle were brand new and had no clue what to do.

No biggie.

I walked over and the EMT nearly kissed my boots. Looking in the vehicle, there was a young woman screaming her head off; the steering wheel had collapsed down on her lap, pinning her in the vehicle. Her left foot was contorted at a funny angle and she was complaining of chest pain. I knelt down next to her and I put a hand on her shoulder.

“Ma’am. My name is Shao, I’m here to help.”

She looked over at me and started crying. She kept saying her chest and leg hurt. I directed the EMTs to put a collar on her and hold C Spine while I did a quick trauma assessment. Slipping a NRB over her face, I calmly told her that the Oxygen would help and that her ankle was broken.

I looked down and blood was pouring onto the floorboard. Her BP was low; 92/60 and her heart rate was sky high: 134. I looked at her, a gentle smile on my face.

“We’re going to get an IV started on you and I’m going to try to stop the bleeding from your ankle…”

I unzipped her boot and her entire boot was filled with blood. A decent sized section of her Tibia was sticking out of the wound and even applying direct pressure wasn’t stopping the bleeding. I tried wrapping her leg, but due to the buckles and snaps on the boot, I couldn’t get it wrapped properly. I pulled out my trusty pink shears and I looked up at her.

“Ma’am…I’m going to have to cut off your boot.”

“No!!!” She began grabbing my arm, “Please! I just bought them! Just take the boot off!!”

I shook my head as I held onto her hand. I went ahead and ducked under the blanket as they were about ready to pull the steering wheel up.

“Your ankle is so badly fractured, it’ll hurt more for me to pull off the boot than it will for me to cut it off. I have to stop the bleeding…”

She started crying, but she stopped hitting me. I made short work of the boot and had the bleeding stopped within moments. While I was working, all she kept saying was, “My boot…my boot!”

With a proper wrap, we quickly extricated her from the car. She held my hand all the way to the ambulance and I got the Holy Hazmaticus from my Line Officer to accompany her to the Landing Zone. In the ambulance, she quickly lapsed into unconsciousness. Her last words to me?

“Why did you cut my boot?”

About six months later, I saw her while I was out shopping. It’s not hard to recognize me; I’m a black chick with pink hair. She gave me a huge hug and thanked me for helping her. I then realized she worked at the local Starbucks and we’d always have a nice chat every time I’d go in. As I said up top, it also helped that she made a freaking good cup of coffee. We never really talked about the accident outside of when I asked her if she bought a new pair of boots. She said she e-mailed the company asking where she could find a similar pair as they were just out of style and they sent her a new pair when she explained what happened to the first pair.

Today, when I went to get my coffee, she was there. We had our normal conversation while she made my coffee. The place was busy, but not obscenely so. She handed me my cup and this is what I saw:









She then says:

“You saved my life exactly three years ago, today. Thank you.”

I could barely get out a “You’re welcome.” I was stunned. I can honestly count the times I’ve gotten a Thank You from a patient or patients’ family and every time it happens, it leaves me speechless. I was just doing my job…the job I love and can’t get enough of, and she was so grateful for the less than thirty minutes I spent with her. I know she had taken time and had sent a very lovely fruit basket and card to both the Fire Department and EMS Department, but being singled out for a thank you was so unexpected it was overwhelming.

Have fun and Be safe.


Insulin Pumps and You.

Insulin Pumps. We are starting to see them more and more, but do we know how to effectively treat a Diabetic who has one? Hawkeye has graciously allowed me to write a blog post about him, his battle with Diabetes, and his

Insulin Pump. To give you a background, Hawkeye’s Pancreas shut down when he was 21. He has no family history of Diabetes, but he rapidly began to lose weight (Went from 280lbs to 160 in less than six months), had Cataracts form in both eyes resulting in needing eye surgery to replace the lenses in his eyes…which need to be cleared of film and deposits every couple of years, and basically became very, very ill.  In August of 2002, he collapsed in his kitchen and was unresponsive. Once at the hospital, it was determined his blood sugar was over 800 mg/dL. His A1C was 16.2. His mother was told that he would not make it through the night and she needed to plan a funeral for her first born by the end of the week. Hawkeye remained intubated for several weeks, came down with double Lung Pneumonia, and had a severe UTI…think beef broth urine. He pulled through, obviously, and lives to tell the tale.  His Pancreas does not secrete any insulin and does not control his blood sugar at all. If he is without his Pump for longer than an hour, his blood sugar will begin to skyrocket out of control. He’s had an Insulin Pump since 2006 and he loves it. So, a bit about pumps. There are multiple pumps out there, but I will be discussing the Medtronic MiniMed pump and its assorted supplies. The insulin is contained in an internal reservoir that contains 300 units or 3mL of Insulin. The insulin is given over a period of time in what’s called a Basal Rate; a metered amount of constantly infused insulin. Right now, Hawkeye gets about eight units an hour, but it runs in like a drip through what’s called an Infusion Set. The infusion set looks like this:


Infusion set

Infusion set

There is a plastic catheter not unlike the catheter on an IV needle that rests in the Subcutaneous tissue and facilitates the delivery of insulin. The set can be placed in the Bicep, Abdomen, Thigh, or any place that you can deliver an Insulin injection. Every Diabetic has different settings for their pumps and each pump can maintain multiple Basal rates for a 24 hour period.  Most pumps enable you to set up six different basal rates for a 24 hour period.  The patient can take their blood sugar every two hours like a good Diabetic and enter the value into their pumps. If the number is normal, it doesn’t do anything. If the value is high, the pump will calculate out an amount of insulin to deliver to bring the BG down.

When an Insulin Pump user eats, they add up the amount of carbs in the food and they enter it into the pump. Depending on the user set parameters, the pump will administer an amount of insulin based upon the Carb to Insulin ratio. For Hawkeye, for every 3 grams of carbs, he will receive 1 unit of insulin. They are also asked to input a BG reading. This is where you get a lot of your Hypoglycemic episodes; a person over calculates their carbs along with having a borderline low blood sugar. In a few minutes, you’ll have someone unconscious in their Spaghetti. Humalog, which is what many Insulin Pump users use, is a very rapid acting Insulin. You can see a change in the Blood Glucose values in approximately 5-7 minutes, more or less depending on just how much Insulin they are getting in one shot. Someone doing regular injections, who are getting their whole 20 units at once will have a quicker change than someone who is using a Pump, but a pump user can still experience a dramatic low while eating, especially after eating if they do not stop the bolus if they stop eating before they’ve eaten the proper amount of carbs.

Now, the fun comes in when we as EMS Providers need to treat a Diabetic emergency when someone is wearing a pump. The newest version of the Insulin Pumps have Continuous Glucose Monitoring (CGM) which takes a Glucose reading every fifteen minutes. The pump itself stores the information and can tell the person if the sugar is high, low, or even show if the BG is going to go high or low by predicting a trend. You can access the log by pressing the Esc button on the pump:





Older style pumps will not stop delivering Insulin no matter the BG that’s input. The newest version with the CGM will do something called a Threshold Suspend. This is when the user has set a lower limit for the blood glucose and the pump will shut off and stop delivering insulin for a finite period of time, but will restart once the time period has passed and the BG is above the lower limit. The Threshold Suspend goes off the BG reading from the CGM. If there is a weak signal or the pump has lost communications with the sensor, the pump will not shut off.  There’s an alarm that sounds and a message pops up that says, I have Diabetes, Call for Emergency Assistance., but only if the pump and sensor are communicating.









One of the biggest things a Paramedic needs to do is to Suspend the pump before trying to raise the blood sugar. Since Insulin is running into the body on a continual basis, you will be fighting an uphill battle against the machine. To suspend the pump, you can hit the Act button, press the down button to highlight Suspend, then hit Act again. You can do this on the newer pump if you are unsure if the pump has suspended or not. You can then treat Hypoglycemia accordingly.

Insulin Pump Menu.

Insulin Pump Menu.










Just press Act.

Just press Act.










If the pump is not suspended, then you can spend a very long time trying to raise the blood glucose depending on how low the value is. Hawkeye recently had a BG of 27. He was shockingly not unresponsive, but he was extremely altered. The pump had not suspended itself as the signal from the CGM to the Pump was weak, so it was still delivering his basal rate on schedule. After two amps of D50 and twenty minutes, his BG was only 32. Once the pump was shut off, it went from 32 up to 88 in about fifteen minutes. Now, mileage may vary on this as I’ve seen Diabetics who haven’t suspended their pumps have a normal increase in blood sugar in response to D50. I think a lot of it has to do with what caused the low; if it’s a Bolus mistake

In the end, your mileage may vary with this advice. Your Local Protocols may say that EMS are not allowed to mess with an Insulin pump, but you can always ask a friend or family member with the patient to operate the pump if it’s seeming like you are getting nowhere with raising the blood sugar. Many patients who have pumps are very good at keeping track of their blood sugar, but can experience very dramatic lows due to just how the insulin is delivered.

Have fun and Be safe!



Who’s Nelson Mandela?

I promise, I don’t plan on making this a waitress blog. I would hate to incur the wrath of Springs1…just…no.

Anywho, I will relate the more bizarre tales as I need some place to let them out. Tonight, it came over ESPN than Nelson Mendela had passed away. Very sad. I went to a table of adults…all were over the age of 40 to include military personnel. I looked at the table and made a remark about how sad it was that he passed. The person sitting next to me, a Captain in the US Navy, looked at me and said, “Who’s Nelson Mandela?”

I nearly dropped the beer I was holding. Who could not know who Nelson Mandela was?! I go over to the computer to enter in an order and one of the servers asked me what was wrong, as I was grumbling to myself. I looked at her and said, “This guy didn’t know who Nelson Mandela was!” She looked at me with a vapid expression and said, “Who are you talking about? I have no idea who that is.”

I have lost all faith in humanity today. I will now continue to assault my liver and kidneys with a few more glasses of Jameson… two fingers, neat.

Have fun and be safe.

What’s Ahead…

Hey everyone!

I just wanted to give everyone an update about my life and what’s going on with me.

In a few weeks, I’ll finally be done with all this back injury bullshit. I have to thank my lucky stars that it’s done. I’ve never been so frustrated in my life with this process, but it’s done.

What have I been doing? I’m currently working as a waitress at a sports bar. Do I like it? Meh. It’s kind of like being a Paramedic, actually. You have to be on your toes and things are constantly changing and I need to adapt at a moments’ notice. I don’t like what I’m doing because…well…I feel like a dancing monkey; I need to be this happy go lucky person basically making the person I’m serving feel like they are the best thing on the planet so they give me an extra dollar when tipping me when they are done. It’s not hard when the people are nice and they interact with you. I get the ones who snap their fingers and yell for me from across the bar. I also get the super needy ones who modify everything on the menu: “I’ll take the Grilled Steak Wrap, but sub the steak for chicken, no cheese, lettuce, tomatoes, or onions, but add the Pico de Gallo and Ranch dressing. Oh, and cut it into eight pieces, not four and box up four of the pieces.”

Speaking of ranch dressing. I now officially hate that stuff. I think customers drink it, honestly. We serve GALLONS of this stuff and no one can ever get enough of it. I served someone 18oz of Ranch; six 3oz cups for less than 10 wings. By the end of the night, this is what I was thinking of:

So…what’s ahead for me and the blog:

I plan on going to EMS Instructor school so I can teach the new crop of students. I’m still teaching ACLS and PALS classes, which I’m having so much fun doing. I usually teach nurses and doctors, but when I get a few Medics in the group, I have way too much fun. The last class I taught, I met a Paramedic who moved from New York to BigCity. We spent several hours talking and we ended up going out to a bar for Happy Hour to grab a bite and a drink. Happy Hour turned into standing on the bar singing “Piano Man” and “Don’t Stop Believin'” with the entire bar. I also found myself drinking shots with great names such as a Flaming Orgasm, Statue of Liberty, and my favorite, the Blow Job. He will be joining me this year at EMS Today. Should be fun! Speaking of EMS Today, I will be there with Hawkeye and we will be trying to regain our status as Best EMS Chefs for the EMS Today cook-off. Our recipe is top secret, but it stands to be our best recipe yet. I have to give thanks to Papa Trommashere who kept me from making a major cooking faux paus when I had him glance over the recipe to make sure it looked edible.

I also plan on making a return to EMS in some capacity. I don’t know what that’ll be yet, but I plan on getting back into “Truck Work” at some point.

As for the blog…I’m going to try something a bit different. I spent the last few months helping a Paramedic student get through her class and National Registry. She did all the hard work and graduated, but I had a lot of the lessons written down. She was the one who gave me the inspiration to bring them here and share them with the world. So, mixed in with war stories from the truck and from the eatery, I’ll throw in a few lessons here and there to see what happens.

Other than that, it’s been an eventful year. The Stupid Puppy passed away last year, but I added a Foster Failure to the group. I now have The White Pup and The Crack Puppy. The Crack Puppy is just under a year old and she is a Pomeranian. I love her to pieces and she is making herself out to be a great addition.

Anywho, I’m going to finish off my beer (I <3 Flying Dog!) and I’m going to hit the sack.

Have fun and be safe!

The Biggest Mistake of my Career

I have never talked about this call…ever. It shows my humanity, how even I, Ms. Super Medic, could make huge mistakes. I owned up to it through Medical Command and a Medical Review and I didn’t even get a slap on the wrist due to the circumstances. What remains is that, I could have very easily killed someone and I was damn lucky I didn’t.

The call started out on a bad day in January. I got into work on a blustery, rainy morning and I had come in early because we were supposed to get slammed by a bad snowstorm. I didn’t have a four wheel drive vehicle, so I wanted to avoid the slick roads. By 0900, what was supposed to be a snow storm ended up being an ice storm. The roads were coated in a thick sheen of ice. I could hear accidents going out all through the area, but for some reason, our 5 miles of highway and side roads remained free of accidents. Around 1000, we got dispatched for a female complaining she was dizzy.

The distance from our station to the scene was no more than a quarter of a mile if that. I could see the freaking apartment building from the station. I called the dispatch center and told them to relay to the patient that it would be a minute; we couldn’t even get out of the parking lot because we were just slipping and spinning on the ice. Once we got on scene, I remember getting out of the truck and immediately face planting in the parking lot. I smacked my face off one of those parking berms and I gave myself a black eye and nose bleed. My partner slipped on the ice and fell on his back; he ended up having a bruise the size of a Cadillac on his ass. It extended from the top of his butt and halfway down his thigh. Trying to walk the fifty feet to the front door had us falling twice more apiece; I added a bruise on my side after I slipped up the concrete steps where I thought I broke a rib and a fall on my butt, but because of the junk in my trunk, I was fine. My partner fell on the same spot both times which contributed to the bruise. Once we got to the apartment, we both looked like hell. I had already shoved a 4×4 up my nose to staunch the bleeding and my partner was limping. When the woman answered the door, she smiled smugly at us and said, “Took you long enough. You went en route fifteen minutes ago.” I apologized, saying we had to drive very slowly through the hilly, cobblestone streets and we had slipped and fallen outside. She rolled her eyes and told us to come in. We walked in and she sat back down on her couch. I set down the ECG (A LP-10. This is very important), my House Bag, and the O2 tank. I sat next to her and went into my normal conversation; I introduced myself and my partner, asked her what was going on, all the while I had gently taken her wrist and began to feel her pulse. It was fast under my fingers, but I caught it at between 100-110bpm. The patient told me that she had woken up when she heard her scanner going off and she sat with a cup of coffee listening to everyone run around. She admitted that she had stood up too quickly when she heard that a cop car had wrecked at the bottom of the hill and she felt a bit woozy, but she felt fine immediately. I took her blood pressure, which was normal and I put her on the monitor. The rhythm was Sinus Tach, but the rate number was flashing and kept going back and forth between 110 and 240bpm. I printed out a strip and counted out the QRS complexes manually and I got 118. As I was working, I asked her if the dizzy spell was why she called 911. She then admits that, she wanted to see how quickly we could get there in bad weather, so yes, that was why she called. I remember wanting to throttle her at that exact moment. She was feeling fine, no ill effects, and she called 911 to see how fast we could get there. I held my composure and asked if she wanted to go to the ER and she rolled her eyes and said, “Well, duh. I’m not paying taxes and your salary just for you to check my blood pressure. I paid for your truck, lady.” I was itching to tell her that none of her taxes went to paying for our ambulance as it was purchased in the early 90’s at an auction in Texas. The funds were raised from various bake sales and private donations, but I bit my tongue and asked which hospital she wanted to go to. I cut her off immediately by saying that we couldn’t go to one of the hospitals in the city due to the road conditions; we were more likely to crash than to make it, but she had the choice of two community hospitals, one of which was a cardiac center. She chose the cardiac center. I asked if she wanted to walk to the ambulance; she had been walking around the apartment putting food down for her cat and dog, getting changed into clothes, and tidying up in the kitchen all the while ignoring our objections. She gave us the line that she paid for our salaries, so we needed to do our job correctly. She then began demanding oxygen because “my taxes paid for it”…even though she sat’ed above 98% the whole time. We put her in the stair chair and wheeled her to the lobby where we left the stretcher (stretcher didn’t fit into the elevator, even broken down). We lowered the stretcher and placed it right next to her chair. I asked nicely for her to stand and pivot, then sit on the stretcher. She crossed her arms over her chest and stared at me with this evil, soul stealing gaze, so we picked her up and put her on the stretcher.

I had the LP-10 slung over my shoulder and I kept looking at the rate; it never popped over 110. We wheeled the stretcher outside, managing to not kill ourselves, and we loaded it into the ambulance. I did a quick IV and hung a bag of saline KVO while I fitted her with a nasal cannula at 4lpm. It took us over 20 minutes to get to a hospital that usually takes us less than 10 without lights and sirens. We slipped and slid all over the road…at one point we spun out and I remember looking out the back windows and I realized we were sliding backwards down this little hill. The woman kept criticizing us; we were horrible ambulance drivers and she couldn’t believe we were having that much trouble driving. What she didn’t realize and what she couldn’t see is that my partner managed to keep us from wrecking I don’t know how many times. I remember looking up front and the MPH gauge was below 5 and my partner was sitting funny. He told me later on that he was standing on the brake, yet we continued to slide on the ice due to forward momentum. The entire time, I kept her on the LP and it kept up a steady rhythm at 110. The pulse ox, which had its own pulse monitor had her at 99% and 112bpm. Feeling her pulse, I got her at 110. Her BP never wavered from the 130’s systolic. We got into the ER and out of pure habit, I hooked her up to the hospital monitor while waiting to give report. The hospital machine started alarming and I looked up; she was in a full SVT at 198. A nurse ran in and started yelling at me; this wasn’t a dizzy spell, this was SVT. I grabbed the Adenosine from my house bag that was on the stretcher and the nurse grabbed it out of my hand and pushed it for me. I remember standing up against the wall, not sure what to do.

Boy, did I get chewed out by the nurse, the patient, and the ER doctor. I swore they were going to cut up my Medic card right there. The rhythm broke with the first dose of Adenosine, but I handed them the strips I printed out; all the strips were time stamped as well as marked with the BPM: 110. I told them I never felt it go above 110 and I don’t know why I didn’t see it.

Several weeks and several meetings went by. Come to find out, the patient went back into SVT while in the ER. The nurse was manually feeling a pulse and she herself didn’t feel a rate over 100. The patient never became symptomatic and it was documented in her chart that she had a history of Asymptomatic SVT. It was also found that the monitor was malfunctioning, but I was never told exactly how.

I honestly feel that this was the biggest mistake of my career. For weeks, I felt so ashamed, as I had done something horribly wrong. At the time, I was a pretty new Paramedic, but I was making one heck of a name for myself by being spot on with every differential diagnosis I made. I felt that my reputation would be tarnished by what had happened. What I didn’t realize was, these things happened. Several of my well seasoned partners came out and told me their “newbie” mistakes; forgetting to take Nitro Patches off while administering Nitro, using Latex gloves on a patient with latex allergies, and even worse things that I refuse to even write about.

Once I was vindicated, I remember being almost neurotic in my actions afterwards for several months. I was double and triple checking all of my actions, my vitals, everything. I became a scared Medic, which is never a good thing. I would hesitate before doing something without an okay. It took one of my command physicians who was a dear friend and mentor to sit down with me and go over every one of my cases with me. He showed me that, outside of that one thing, I had made no mistakes. He even pulled up a case that had been used in Grand Rounds, showing how I identified that the patient was having an Antro-Inferior MI; the monitor printout showed Anterior, but the patients’ BP and heart rate had me wondering if the patient was also having an infarct of the Inferior wall. There was ST elevation in V2-4 as well as II,III, and avF. It was a weird presentation and I remember pondering why I wasn’t seeing the reciprocal changes in II,III, and avF, but I saw the reciprocal in I, avL, V5, and V6. Med Command told me to follow the print out, but I told them that due to low BP, I couldn’t follow protocol by giving Nitro. Once in the ER, I got my butt chewed, but I showed them both the strips and my vital signs. My command doc gave me huge kudos for knowing the different STEMI’s and used my case in presentation to show how the print out and subsequent transmission of 12-leads could lead to mis-interpretation.

I realized then that mistakes were a part of the business. I’m not talking about giving the wrong drug or doing a procedure wrong, but shit happens on scenes and all we can do is fess up immediately and try to move on. I’m sure all of us can talk about an instance where our equipment failed us and we went about, doing our thing, only to find out later that the ECG failed us or the BP cuff had been damaged and the needle didn’t go past 130 or even the Glucometer wasn’t working properly and was giving false highs and lows even after a proper calibration. As careful as we are with equipment checks, sometimes Murphy’s Laws of EMS come into play…there’s nothing like losing all power to the ambulance during a Cardiac Arrest while you are on some road in the middle of nowhere…and it just came back from the shop.

If you learn anything from this, I hope you learn that a mistake isn’t the end of the world as long as you are willing to step up and own up to it immediately.

Have fun and be safe.

I was going to come on and complain about my neighbors deciding to re-do their deck and how work started promptly at 0700 this morning and start a series on how not to make the same mistakes I have recenty, both with my back, and how to make moving to a new state and restarting your EMS/Fire career a bit smoother…

But what happened in Colorado makes getting little sleep and the crap I’ve gone through seem like a walk in the park.

My heart, prayers, and deepest sympathies go out to the victims and families who were injured and who lost their lives last night. I also want to extend my prayers, thoughts, and long distance hugs to all of the first responders who decended on that scene last night and the providers in the Emergency Rooms, Operating Rooms, and Hospitals. Thank you for doing what you did under the most crazy of circumstances. You did the best that anyone could ever ask for you to do. My thoughts and prayers are with you.

All my love,

End of an Era.

So, I received some rather sad news today.  The department that I cut my teeth on, learned how to be a semi-decent medic, closed its doors.

It had been open for over twenty years, first as a BLS Volunteer Department, then as a Combination ALS department.  We didn’t have the best trucks, the best equipment, or even the best base, but we loved that place.  I remember sitting out in the parking lot in the middle of January grilling steaks while we hung with the guys from the police department and the fire department.

If the garage could talk…the stories it would tell….I’m sure I’d go to jail over some of them.

I have to admit, I did have mixed feelings at first.  I didn’t leave there under the best of circumstances and deep down in the places I don’t talk about at parties, I kind of wanted them to fail epically, but in the end, it wasn’t about the service, it was about the people.  I worked with people who I will never forget. They happen to be some of my closest and dearest friends. The memories we have; my very first arrest as a medic that prompted the quote, “What do you mean she’s in Cardiac Arrest?!”, my first shooting that became the county record for fastest incident-to-door time for 3 years running (23 minutes, 45 seconds), fastest on scene time ( 3 minutes, 10 seconds), and being the Medic who got a patient to rap their ABC’s.

The bad; we lost a lot of good people in a very small amount of time, some to LODD, others to the passing of time.  We also had so much drama going on that we all threatened to write a book called, As The Siren Blows…yeah, take that however you want.

I learned so much in my time there.  I learned very quickly that just because I don’t get paid well, doesn’t mean I won’t love it more than the best paid service.  I grew my thick skin; only so many people can call you outside your name before it rolls off of you.  My fighting spirit grew; I can throw down with the best of them.  I don’t shy away from the fight, I jump right into it.  I got to learn how to be a leader, how to deal with the public, the politics, and the media.  I learned that it’s not what you say, it’s how you act.  I also learned that, yes, a little 80 year old woman can and will level a Taurus Judge at you because she’s so out of her mind she thinks you’re breaking into her house.

I left a lot of my soul there.  On the bridge on 890, I left a bit.  In the garage where I tried my first cigar, (loved it), and in the ambulance I had the honor to shroud three times and make ready for a casket, I left my blood, sweat, tears, and soul.  In the trailer where I cooked three Thanksgiving, Christmas, New Years, Super Bowl, and Easter meals, and in the office where I wrote some of the hardest reports of my life and where I received some of the greatest news.

My bosses, for what it’s worth, were fantastic.  Every two weeks, without fail, our paychecks were mounted on the door.  I then found out that, quite often, our bosses went without checks themselves, or even falling behind on a personal bill just so we could have our pay.  The one time…the one and only time we went without, we got extra in our next check. That was the period where it was between repairing our one and only truck so we could stay on the road or getting a paycheck; we all voluntarily gave up our checks just so we could stay in business for two more weeks.  Every bad call we had, they met us at the station for a bull session.  They even came in with extra people to man the trucks so we could sit out for as long as we needed.

This is where I learned the lesson, “No matter what happens, as long as the doors go up and the trucks roll out, it’ll all be okay.”

Today is the day where I remember from whence I came.  I salute the good times, mourn the bad times, and laugh at everything else in between.

To the crew. I love you guys.  You know who you are.  I miss you terribly.

Much Love,


Happy Birthday to Me!

Yes. It's a picture of me.

So, I’m doing this early.  My second Blogaversary will be on June 12th, but since I will be in the midst of recovering from back surgery, I’m going to go ahead and do it early.

I didn’t do one last year; too many things were going on that I was unable to be officially reflective on what happened during the year.  With the sudden illness of my grandmother and several personal issues going on in my life, my post would’ve been nothing but a rant about how horrible my life was at that moment, instead of looking back on the good and bad of the entire year.  So, without further ado, here it is.


My first year was overall fantastic. The warm welcome from both established bloggers and ones who were just as new as me was a very wonderful experience that I will never forget. The friendships that I made, some closer than others, will be cherished forever.

This year has definately been marred by several bad experiences: my injury, losing my certification, the lost of loved ones and the deaths of patients that I will never forget would make me want to say that overall, this year was a bust. At the same time, I realized just how much I grew this year.  In years past, I’m pretty sure…no…positive, that the loss of my certification after I worked so hard to get it would cause me to go find the most secluded place I could and I would conduct an experiment to see just how gunpowder tasted.  That was how vitally important being a Paramedic was to me; without it, I felt like I would be nothing.  I still feel like I’ve lost a body part or broken up with a long term lover, but the sting of failure has gone away, a little each day.

It’s been almost a relief actually, in a very round about sort of way.  The rules here are very specific; long story short, you have to be actively serving as a Paramedic, actively meaning keeping up with a normal schedule of working as a Paramedic, to keep your certification. If you are injured, or for whatever reason out of work for an extended period of time, you will lose your qualifications and have to recert through the entire process to become a Paramedic again. If I wasn’t injured, I would be pulling my hair out, stressing about attaching myself with another service.  Now, I can take it easy and decide if staying here in SmallTown is a good idea, or if moving somewhere else is in my best interest.

I think the theme for this year would be growth. I’ve grown so much over the past 365 days, some of it good, some of it bad. I will say I’m less open emotionally, but that has stemmed from discovering that the people whom I thought were friends really weren’t. It’s not uncommon for me to close myself off after an emotional blow like this, even to the people who have always been there for me, so to anyone who’s noticed my aloofness or that I’ve not been as friendly or as open, I’m sorry.  I’ll come around, eventually.

My faith has grown because it faultered; there’s nothing like questioning the existence of a higher power because of how hurt you feel and how alone you feel, wondering how a ‘good and all powerful being’ could allow someone to feel such pain, and during the next day, hearing of a friends’ child, who was very ill and was given absolutely no chance of survival after a horrific, lenghty illness, to suddenly become well.  It’s just not my time, it’s in someone elses time, and I’m okay with that.

Emotionally I’ve grown because I’ve relearned something I’ve known all along; the world won’t end just because my life sucks.  I decided one night that, I wasn’t going to get out of bed. My world had stopped turning, so my part in everyone elses world would have to end as well. I was taking my toys and going home. No one elses world stopped, though.  I had a dog to handle and for him, his world revolved around me.  If I didn’t insert myself back into his world, he wouldn’t get trained, so I had to do that. As much as I wanted to, I couldn’t hide out.  Too many people wanted to be a part of my world, no matter how bad mine was doing at the moment. I had friends and family who still relied on me to be me, no matter what. I had to put on my big girl panties and deal.

I did have some wonderful times this year.  I got to be a part of something bigger than me. I talk all the time about wanting to leave a footprint, to work on something that’s bigger than myself and to be a part of something.  I got to do that. Even though my name will never be up in lights, I’ll never be the biggest or the best, but the things I got to do this year; become a Godmother (yay!), I became an Aunt three times over (not biological sisters, but we’re close enough we should be), got to watch TWP do his first long distance search and he did extremely well for it being the first time he ever put all the pieces of a search together (yes, I had a proud mama moment!), helped to get the framework together for a friend to begin working as the owner of their own EMS service, and all the little moments; the smiles, the hugs, the handshakes, and the gratitude I got from the patients I worked with.

Along the way I made new friends, reconnected with others, and even found myself letting a few go in the interest of the greater good.

I don’t think I’d change it for the world.

So, happy birthday to me and I hope everyone is having a great summer.

Have fun and be safe,