What Would You Do?

I was working at my part-time job the other day, and we got into a lengthy discussion about Do Not resuscitate orders and when to honor them versus when to treat a patient.  Today, the conversation continued and we came up with an interesting scenario, and I wanted to see what everyone out there thought both from a moral/ethical stand point as well as a legal one. Here’s the story: You are called to the home of an 80-year-old male who lives alone.  His neighbor frequently checks on him.  Today, his door is locked, which is unusual.  Your unit arrives at the same time as the fire department who is there to help you gain entry and assist with patient care. You enter the patient’s apartment and find him supine on his couch.  His breathing is clearly agonal and you cannot detect a pulse.  In plain view sitting on the coffee table in front of him are the following: A bottle of hydromorphone which was filled two days ago.  The cap is off and the bottle is empty. An appropriately filled out Do Not Resuscitate order which clearly states that the patient does not wish to have CPR performed on him. A suicide note stating that he had been recently diagnosed with cancer and does not want to live anymore.  It outlines what he would like to be done with his personal effects. What would you do?  Would you start CPR on the patient?  Would you honor the DNR?  Does the suicide attempt void the presence of the DNR? Normally, I would expect a bunch of comments on this topic to say “I would contact medical control to see what they would like me to do.”  While I understand that, I would like to know what YOU would do as a provider. Also legal folks, I know you’re out there, what do you...

Practically Practical

Twelve years ago I walked out of my state KED station declaring to everyone who would listen that “I hope I never have to do that again.”  I passed my state practicals the first time around which really was the bigger piece that worried me.  The written would come as I was a pretty good test taker but the hands on stuff needed to be done correctly on the first pass.  There was no passing by a skill and coming back to it if I was not sure about it. In August I plan on heading up to New Hampshire and taking my practical station for National Registry and I have to revisit all of this again.  My practical day for both my EMT and paramedic exams were pretty anxiety filled.  I wanted to get it done and never look back and that is really what I did.  Now I have twelve years of bad habits to put aside for one day of testing. Still though, even after all these years my paramedic instrutor Gary Childs, or GAC as he was known back then, standing over me reminding me to “rip the tape” on my IV station or stressing the importance of that first rhythm interperatation on a quick look.  I was well educated in paramedic school and for that I am extremely greatful. Paramedic school was extremely fun but challenging all at the same time.  I had a great group of classmates and we were close.  Some of us were college students who had entered a small four year program together while others were from fire departments, private services, and the community.  Regardless of our background we all bonded quickly and even today when I see any of them it is always nice to catch up on the old times and figure out where everyone is today.  Having them around helped surpress a lot of that anxiety that I had.  I always knew that if I had a problem that an insturctor did not point out to me one of them would share it with me. When it came time for state testing though I was on my own.  I had no partner...

Study, Study, Study!

I have a confession to make.  I have not taken a test in 11 years that was not based on material that I was taught in the few days prior.  That is to say, since college, if it was not ACLS, PHTLS, or some other EMS related course, I have not tested on it.  It has also been 12 years since I took a standardized paramedic certification test.  Now, I am on the verge of facing the National Registry paramedic test head on.  Every piece of information that I obtained in 1999 and 2000 will be called out, along with anything else that I might have learned along the way.  No pressure, right? The biggest change that I have seen over the years is the way that we are able to study is completely different.  Back then, having information “at my finger tips” involved me adjurning to my book shelf or hoping that the correct material was hiding in my bag somewhere.  Now with the inventions of Google, the enhancement and growth of the internet answers are even easier to come by, as they should be.  I am struggling though to figure out if that will make it easier for me to study or harder. I feel like I am a prety computer savvy individual with a good grasp on what is out there in cyber space but in embracing that I am also putting aside much of what I previously knew. For my entire academic career, when I had to I buried my nose in a book.  I was not very good at studying mainly because I did not do it.  My grades in high school were good, not great but good.  They were that way because as I look back now, I was bored.  I did not study very often and somehow still did well on tests but my grades were brought down becuase I was one of those lazy kids that did not see the value of homework.  When I got to college that hurt me in some of my classes because my study skills were not as good as some of my peers.  It was not until I got into...

Where has SBK Been?

Yes, I know, it has been a while. I feel like an absentee landlord failing to plug a leak in the blogosphere but here I am, back for a quick update. To put it lightly, June was a stressful month for a number of reasons both professional and personal. As time has gone on, I have pushed through, mainly with a focus on studying for my national and getting that Disco Patch on my shoulder. Because of this my time to spend updating you all on my progress and sharing my thoughts on what is going on in the world of EMS has suffered. Rest assured though that I am still here. With each day that I spend studying and with each practice test that I take I am feeling more and more confident with the information I have refreshed on and retained. Still though, I am still dealing with a considerable amount of test anxiety. Want to read about what I am going through? Check out my Wednesday and Friday posts. They will give you a better idea! Rest assured, as my Quest continues, I will keep you all updated. Failure is not an option. Stay safe out...