Thursday, May 13, 2010

I Was There

Over the past twenty years our ability to treat heart attacks, particularly STEMI heart attacks (ST segment eleveation myocardial infarction), has undergone a revolutionary change for the better.

The other night I was on a shift and a call from Booneyville EMS came in declaring that their patient, at that moment, was having a STEMI. They didn't have the capability of sending us the EKG but, per recent changes in hospital policy (oh it hurts me to admit they did something right), we were to activate the cath lab team and get the cardiologist in.

It's a strange position to be in... On the one hand we hope the EMS guys are wrong, for the patient's sake, on the other hand, we do not want to have 'cried wolf'. Well, this guy was the real deal. Part of his heart was dying.

He made it from our door to the cath lab and had the blocked artery opened in 24 minutes. That's pretty damned good. I mostly just watched and that was fine with me. The patient did well.


  1. Jeez, almost makes me WANT to have a Heart Attack while I can still get State of the Art Treatment instead of the Aspirin and Nitroglycerine you'll be lucky to get in a few years...


  2. From a paramedic, thanks for recognizing our ability to make these calls to enable quicker treatment for the patients. Too many docs think we're only stretcher monkeys, not medical professionals.

  3. Isn't it cool? I still remember how I felt when we had a 30 minute ER door to cath lab patient. Drips and everything. One of my proudest moments as an ER nurse.

  4. frank,
    you an me, or you and someone quicker than me, needs to reprise MST3k.

    love me some EMS

    yes, it was cool.

    chinese person,
    quit spamming me.

  5. Sooo, Doc-in-the Box doesn't fit. The future, as prescribed by others won't fit.

    What is to prevent medical professionals of like minds from starting a completely different field, say, called Blunderbussology? Only customers (hereinafter referred to as Blunderbutts In the Chair, or On the Gurney), that voluntarily join this scam/cult and attest as such, may be admitted to the Church of Blunderbuss (tax free!).

    All Blunderbutts must tithe $10,000 plus an annual 10% of their income towards establishment costs, for an ongoing fund that fights litigation and that's all those tithes apply to. Attending the Church of Blunderbuss, say, for a broken arm or suppurating genital sores requires a donation to the bedpan that is passed around.

    In return, the Blunderbutts may achieve a religious experience, a healing, if you will. Or maybe they will die, and the Blundercosmos shall mourn.

    There shall be proscriptions, such as Blunderbutts talking on cellphones in the sanctuary, or the carrying of clipboards by administrative types.

    We could call it Scientology, but they already have their scam and now own the city of Clearwater, FL.

    The potential clergy of the Church of Blunderbuss own, well, mortgages, alimony, hush money to cheerleaders/Boy Scouts, etc., so owning an entire city, plus an income stream, should seem attractive, in comparison.

    Honestly, guys and gals, in my line of work, there is nothing more satisfying than figuring out a client's problem, then solving it, then charging them money for solving it. Except perhaps, charging them more, the next time they call, because they then get that I'm better at doing the job than the screaming masses that are mostly poor at solving the same problems. I don't mind competing, but you medical folks aren't allowed to compete. Instead, your compassion is used to trap you.

    I have personal compassion and sometimes work for free for private citizens, if I feel they are getting hosed by attorneys or government types. Often, medical people are targeted by both attorneys and the government, to the point that they end up dealing with nothing else.

    But not the Church of Blunderbuss! Imagine it: tax free property ownership; a pliant clientelle that is restricted to only the faithfull!

    Although I am kidding, a bit, there is little that is wrong with this plan that could not be gotten past, were I to take you on a little boat ride around Clearwater, for inspiration.

    I note that a dental organization hit Capitol Hill this week, to complain and lobby. The problem? Offering payment plans for orthodonture included them amongst the suckers about to be wrapped into the new Financial Reform legislation. Stop being suckers! This Sunday, get yourselves to the Church of Blunderbuss, meeting at the golf course, or perhaps fishing on a quiet stream.

  6. 911/ Frank

    I would be a giant fan of the show.

    Although depending how, well, wild Frank gets it would only be allowed on-air between the hours of 3-4am, and on broadcast in the Maldives.

  7. that's the second mention of the maldives on this blog in three weeks. what are the odds?

  8. I second the thank you from the other paramedic. For several years now and while it does not happen all that often, we actually have wheeled the patient through the ER and slid that patient right onto the cath lab table. I don't know how you even record ER time in that case but door to balloon time is often recorded in minutes. That would not ever happen without docs who have come to trust the EMTs and Paramedics they work with.