Fight for your life, in EMS?

During my last shift, I responded to an “Unknown Medical.” As we arrived, dispatch told us that the caller thought there was something wrong with her son, and he was hallucinating. When I opened the door, I saw a teen male who was covered in sweat and acting quite twitchy. Mom states that she took him in for his methadone injection, that they gave him 25 mg, and that he started acting funny about a half hour before, she also says that he has been with her all day and he has not had any other drugs. As she was explaining this, the teen kicked me in the balls, then the fight started.

Any fight that begins with a kick to the balls is going to get nasty. My first hit was a hammer fist to his brachial plexus. He didn’t even flinch. He hit me several more times, and kicked my knee fairly hard. I followed with hits to his abdomen, kidneys, and a hard punch to the throat. Then I closed the distance, managed to get a grip on his arm, and got him in a headlock. Since I outweighed him by about 100 pounds, I took us to the ground. My partner (remember Paramedic George?) then decided to join the pile. My attacker decided it was time to start biting, and threw an elbow into my stomach. I had had enough, and I really felt that I was in danger. I grabbed him by the trachea and choked off his air supply until he stopped fighting, then I let go.

The two minutes it took the first cop to get there seemed like forever. We handcuffed him to the stretcher. He still began to fight, and bent the rails of the stretcher. He stuck his hand down his pants and started masturbating in front of the female medic that came in on the second EMS unit. She reached out to stop him, and he grabbed her arm. I pushed very hard on his parotid gland and he let go. He fought us nearly the entire way to the hospital, until the drugs finally kicked in. It took 10mg of Haldol and 5mg of diazepam to calm him down. His heart rate was 190, he was too combative for us to get a BP, RR 40.

His tox screen showed cocaine, methamphetamine, the diazepam, and the methadone. The cops asked if I wanted to press charges, but I didn’t bother. The four times that I have pressed charges, the actors got probation and a fine. Besides, I know he is hurting at least as bad as I am at this point. My back, left knee, my balls, and elbows are pretty sore. I have been physically attacked more times than I can count during my career.

This illustrates a growing problem in EMS: 52% of all EMS responders report having been attacked on the job. According to the University of Maryland, the risk of nonfatal assault resulting in lost work time among EMS workers is 57 cases per 10,000 workers per year. The national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. This isn’t just EMS getting hurt: in 1999, the Bureau of Labor Statistics estimated that 2,637 nonfatal assaults occurred to hospital workers–a rate of 8.3 assaults per 10,000 workers. Healthcare providers are twice as likely, and EMS workers 15 times as likely to be assaulted on the job than police officers or prison guards.

The Occupational Safety and Health Administration (OSHA) has identified violence in the medical setting as a potential hazard, and found the training of medical staff to identify and deal with potential violence ineffective. It is the the third leading cause of on the job injuries in EMS (only lifting patients and vehicle collisions injure more EMS workers) and the second leading cause of on the job fatalities (behind vehicle accidents), yet the only training we get is “don’t enter the scene unless it is safe.” This approach is obviously not working. There remains a reluctance on the part of EMS agencies and hospital administrators to provide training to effectively address workplace violence. Some may not recognize the extent of the problem, and thus don’t perceive the need for training personnel in basic defensive measures, while others erroneously perceive using defensive tactics as fighting, or a form of aggression.

My employer has no official position on self defense. Does yours?

Anniversary of the bomb, part 2

On this date 65 years ago, the Mayor of Nagasaki placed himself in the history books by calling the Mayor of Hiroshima and exclaiming: “Did you see that shit? What the hell was that?”

For those apologists that think we should apologize for dropping the bomb, I remind you that the empire of Japan was a savage, warmongering people, whose soldiers killed 200,000 people and raped over 20,000 women and young girls during the winter of 1937-1938  in “The rape of Nanking”. Japan was hardly an innocent victim.
 

Why I can’t be a conservative

The New Beginnings Ministries church in Warsaw, Ohio has taken up the cause of harassing and protesting a local strip club. Click here to watch the video.

The strippers have responded by protesting and harassing the church goers.

What an asshole. That preacher needs to mind his own business. This is the key reason why I tune out conservatives every time they mention religion or the bible during a political debate. I don’t believe what you believe, I just want to be left alone, you hypocritical piece of crap.

I like looking at naked women, I like having an occasional drink, and I don’t care what you think about it.

Taxes

In 2008, the best year that my wife and I have ever had financially, broke down like this:

We made a combined $106,743. To make this money, we both had jobs AND we ran our business.
We paid $6,932 in Social Security
We paid $1,621 in Medicare
We paid $12,506 in income tax
We paid $2,639 in property taxes
We paid $2,884 in Sales Taxes
The total of the above is  $26,582, and doesn’t include hidden taxes like 46 cents in taxes on each gallon of gasoline, and other taxes like cell phone taxes, fees, the matching half of our Social Security and Medicare taxes that are paid by our employer on our behalf, and other hidden costs. These direct taxes comprise 25% of our labor for the year.

Someone explain to me how forcing me to spend a quarter of my year working for others differs from forcing me to work as a slave for 10 of my 40 productive years.

Scene safety and psychotics

Last night, there was a patient who called 911 and told dispatch that he thought someone had poisoned his drink. Now we get people who are mildly paranoid pretty frequently, but this one was different. The transport medic on this run thinks he has ten years experience. He has been on the job for two and a half years, but actually has one year of experience that he repeats over and over, because he learns nothing. Paramedic George has been precepted three times.

There was a couple on scene who told us that our 20 year old patient had a history of psychosis, had not taken his meds in weeks, and was on this night convinced that his parents were working with a demon to try and poison him. When I joined paramedic George in the back of the rig, the patient was already showing signs of aggression: he was trying to stare each of us down. Domination games. His thoughts are rambling between asking where his parents are, to making statements about how we are all doomed because Satan is coming.

By the time we get to the hospital, his statements have evolved to saying things like, “You are going to beat me up, aren’t you? You know you want to. WE both know where this is headed, so lets just get it over with.”

By then, there are 8 of us there, including the hospital staff. I look over at George, and he is standing in front of the patient, within arms reach, and is stretching and yawning with a full on, open mouthed, eyes closed yawn. The patient bowed up to fight, and an ER medic and myself jumped him before he could move. We wound up holding the patient down for some Haldol and some leather restraints.

Some people just never learn.

Twenty Broken Promises

Here we are, 18 months into the Obama Presidency. With one third of his term behind us, lets take a look at the progress he has made on his campaign promises:

1 Close Guantanamo Bay within one year. Status: Broken.
2 Create or save 1 million jobs using $25 billion in Federal Funds. Status: FAIL. He spent a trillion dollars, yet the unemployment rate has risen from 7.7% to 9.5% over the last 18 months.
3 All troops out of Iraq within 16 months. Status: Broken. There are still 133,000 troops in Iraq. (85,000 more than are in Iraq)
4. Create secure borders. Status: Broken. He is actually suing people who are trying to secure the borders. Sure, he promised to send 1200 guardsmen, but that is another broken promise.
5. Reform government spending. Status: FAIL. 18 months into his presidency, he spent as much as all presidents prior to George W Bush combined. GW Bush himself was the former record holder, having run a $4.9 trillion deficit during his 8 years in office. Obama has borrowed $2.6 trillion in 18 months.
6. End torture: Status: Misleading. Using the process of extraordinary rendition, where terrorists are taken to countries where torture is legal, and letting THEM do the torturing on your behalf is dishonest.
7. Require new hires to deny cronyism. Status: DO I REALLY have to point this one out?
8. Deliver weekly fireside chats online Status: Broken. Not a single one has been released in the last 16 months.
9. Toughen hate crime laws Status: Broken, also see the next one:
10. Remove discriminatory obstacles to voting. Status: a twofer with the Black Panther case
11. Lift ban on gays serving openly in the military Status: Broken.
12. Penalize vote fraud. Status: Broken, but the voter fraud was all in his favor, so why should he?
13. End American dependence on foreign oil in ten years Status: with his ban on Gulf oil drilling, I don’t see this happening. We are more dependent on foreign oil than we were 18 months ago.
14 Ban executive employees from taking gifts from lobbyists. BROKEN.
15 But I can promise you this: I will always tell you what I think and where I stand. Need I say more?
16 Post bills online 72 hours before signing them Status: Congress doesn’t even read bills before Obama signs them
17 Increase minimum wage every year Status: Broken
18 Ensure taxes don’t go up for families with incomes lower than $250,000 Status: Broken
19 Cut taxes on the middle class Status: Broken
20 Defend Israel Status: Broken

So for those of you out there who voted for Obama, did you get what you voted for? Are any of the above promises the reason why you voted for him? You can’t blame the Republicans, they don’t have control over Congress.

If not, did you vote for him because of his race? Or because his name wasn’t George Bush? What is different? Are you any better off than you were 18 months ago? If not, think about this: We are being betrayed by BOTH parties. They are willing to cheat us to get more power. It is time for this practice to end. This isn’t about right versus left, or Democrat versus Republican. This is about being left alone to live our lives.

Why is racial profiling bad?

If you were robbed at gunpoint, and told the police that the man was 6’2″, 250 pounds, and black, would it be reasonable for the police to stop all the black men in the area who were close to that description? Or would racial profiling be wrong? Should they also stop tall white and Hispanic men, so that they were not profiling? How about women? After all, we don’t want to be sexual profiling.

Of course not. That would be ridiculous. So why is it wrong for a cop in Arizona to ask a Hispanic man driving a Ford Lobo (which is a truck sold in Mexico) who has already been stopped for a traffic violation for proof that he is here legally?

Deputy Bob Dalton and volunteer Heath Kowacz spotted a driver with a cracked windshield in a poor Phoenix neighborhood near a busy freeway. Dalton triggered the red and blue police lights and pulled over 28-year-old Alfredo Salas, who was born in Mexico but has lived in Phoenix with a resident alien card since 1993.
Dalton gave him a warning after Salas produced his license and registration and told him to get the windshield fixed.
Salas, a married father of two who installs granite, told The Associated Press that he was treated well but he wondered whether he was pulled over because his truck is a Ford Lobo.
“It’s a Mexican truck so I don’t know if they saw that and said, ‘I wonder if he has papers or not,'” Salas said. “If that’s the case, it kind of gets me upset.”

The article says that 600 illegal aliens have been arrested during sweeps in Maricopa County, AZ since 2008. A drop in the bucket.

In the wake of the Federal court ruling that state and local authorities cannot enforce Federal immigration laws, I think that the states should refuse to enforce ALL Federal Laws: Immigration, Tax, Firearms, Drugs, and any other Federal Law that states currently enforce. States should no longer house Federal prisoners in State prisons. They have made their ruling, now let’s see them enforce it.

My Blog Name

I get a whole lot of hits from folks who Google the term “pharmacist blog” and I want to take a minute and explain where the name of this blog came from.

The term “street pharmacist” is a play on words meaning a drug dealer, sort of like “undocumented immigrant” is a euphemism for illegal immigrants. Those of you who work in EMS know that a substantial portion of EMS runs are generated by people who are seeking free pharmaceuticals, in other words, drug seekers.

A few years ago, my partner and I were sitting around awaiting our next opportunity to save lives and snatch a baby from the mouth of an alligator, and during this lull in the action, my partner was doing his taxes. By the time he got to the end of the absurdly long process, he was pretty annoyed. There is a line at the end of the form which asks for your profession, and it was at this point that I told him that when I was in the military, a buddy of mine had entered “paid professional killer” in that particular part of the form.

Thinking that the above comment was pretty funny (comments like that are always funnier at 2 a.m.) he entered “street pharmacist” as his occupation and we dropped it in the mail. We laughed for the rest of the shift.

and so it became the name of this blog.