On the Way to Paramedic in Northern VA
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Wednesday, July 26 2006
The Tool

A few months ago, She Who Must Be Obeyed returned from work and set down upon Our Hero's desk a cardboard box loaded with what appeared to be... crap.

"A guy at work left," she explained, "And my friend and I were asked to clean up his work space. This stuff was in there and going into the trash, so I brought it home for you."

Thanks bunches, honey. Let's see here, what's this?

A PDA, specifically an old Palm M105. Little black thing with a touch screen, just as cute as it could be. It has all of 8MB of memory, no expansion slot, 8-bit greyscale, no MIDI, MP3 or other capabilities, a little piezo-speaker which can squeak but not reproduce sound. How nice!

Folks, DTs is old - in his teen years he was at one point the proud owner of an acoustic coupler, using which he could dial into work over the phone lines at an astounding 600 baud. Kids, Google these terms but get your parent's permission first! Thus, although no longer state of the art, neither is DTs -this PDA was a Pretty Cool Thing.

What clinched the deal for the PDA, though, was the stylish leather belt case. Another toy for the Utility Belt? Hells yeah! I can use it to... I'll think of something.

A week goes by, and in the transport gig we're dispatched to transport a patient with some obscure medical condition, I forget exactly what. The condition was a strange one but oddly familiar. I knew I'd been exposed to it (the term and definition, not the disease) way back when, but did not of course have my textbooks and notes in the bambulance.

Curses and double-curse my swiss-cheese memory. Doubtless the destruction of those cells was predestined as I guzzled cheap booze, waiting for downloads at 600 baud in the dim and distant past. If only there were some way to harness the incredible power of a really small notebook.

Lo! This here PDA thing is just the sort of gizmo one might require.

Indeed. A shareware-ish program called HanDBase was just the thing. It allows one to create any type of database, defining fields and all sorts of stuff. Neat thing. Using considerably more than 600 baud DTs downloaded this fine program and set to work.

The first database created was GenMedGloss.PDB (Palm DataBase), and is as the name suggests a Generic or General Medical Glossary, a list of useful terms and definitions. Help yourself, no warranty, blah blah blah.

Hmmm. Methinks docs do loves they Latin sometimes. A shortcut might be to have a little list of Latin roots, prefixes, and suffixes - if it's not in the generic med database, one might be able to parse it. Thus, Latin.PDB was created.

Hey, this crap's fun. And useful, damned if it wasn't. And yet, what happens? We transport a patient from the language-rich vicinity of Northern Virginia, where one may find Bilingual Nurses Galore, to an inner-city facility in Baltimore which, although rich with accent and colloquialisms, did not exactly seethe with language skills.

"We need to create a chart," says the BaltiNurse. "Ask her when her birthday is at" or something like that.

"Uhhmmm..." says DTs. Dammit. Helpless again, but not for long.

No problem after that - MedSpanish.PDB is now a-swing at DTs' hip. A Neat Thing (he said, buffing his nails) about the way this one is set up is that one may select Views, cutting down on the list of entries shown on the screen. Pickup, for instance, has words and phrases especially useful during patient pickup, as do Dropoff, Assess, Body, etc. The Pronounce view shows vowel, consonant, and dipthong pronunciation, and the Rules view describes the conjugation of verbs, subject-number agreement, and junk like that.

Anyway, if you have a Palm device, help yourself. In the works is MedFarsi and MedTurkish, they'll be up and available soon.


Friday, July 14 2006
TCR

En route to a call, morning rush hour.

Arrive to find patient prone on street, oriented to self but otherwise confused. My partner hit the lights and blocked off traffic with the ambulance while I hopped out and went over. Patient seemed uninjured and was attempting to ambulate (walk) further into the street.

Another quick glance to make sure traffic was indeed stopped, a couple of steps and I was at the patient's side. A quick head-to-toes visual assessment revealed no lacerations, contusions, abrasions, punctures or burns. Good movement and sensation in all four limbs, no head or neck trauma noted as the patient watched my approach.

Lifted the patient, noted one last time that the thirty or so cars behind us were patiently waiting behind the blinky lights of our ambulance. The patient began decorticate posturing.

Since we were on our way to a non-911 call already, I transported the patient to the other side of the road and placed him in some tall grass to the sound of cheers and clapping from the motorists we were making late for work.

Stupid turtle.


Saturday, July 08 2006
Stealthoscope

People tend to personalize their EMS gear.

Lots of folk put a sock-like thing along the tubing of their stethoscope, sort of a hollowed-out weasel in da-glo orange. Googly-eyes pasted on, tufts of yarn hair, you know the thing. It's a fun little addition which you can wiggle at the kiddies to distract them from needles.

It also separates your 'scope from a crowd in the event all the scopes in the ER end up in one big box or whatever. This is a fate which so far is reserved for gunbelts in Westerns like the Magnificent Seven - "You want food? I give you food. The guns... the guns, they stay here!", but there it is.

I have also seen, again available in da-glo orange, what can only be described as "bell condoms". Kind of like having the chestpiece glove up before patient contact. These amount to stretchy slippers which fit over the bell-end of the stethoscope, the bit that actually contacts patients. Actually, these make good sense - if the patient is bloody or covered in mucus or whatnot one can get lung sounds, then chuck the contaminated bell condom.

And then we come to my Father's Day present - the Stealthoscope.

27" long, flat black, cool-as-all-hell looking. This is what the Stealth fighter would look like if it had little nubbins that went in your ears.

The chestpiece is a masterwork of sculpted black steel. There is no wrong way to hold it, and it morphs. The only way it could be cooler is if it was turned black by being affixed to the outside of the Space Shuttle and carbonized during re-entry.

Tubing - black. Binaurals - black. Ear tips - black.

As an FD present it was tricked out. My name was inscribed - "laser etched" - on the chestpiece, but an extra little monetary something ensured the use of a special black-wavelength laser, and the etching was performed at midnight. Delivery was delayed as they waited for a New Moon to perform the ceremony.

Aesthetically, putting a skinned muppet along the tube would be a Bad Idea, as I'm pretty sure the puppet would smolder, then burst into dark flame and vanish - an experiment I am loathe to try.

Besides, such a diversionary decoration is unneeded. The Stealthoscope can go in, get lung sounds, heart tones, bowel sounds, and a BP and be out long before the patient is aware of it. With the nubbins in your ears you are in a sensory deprivation chamber with a chestpiece-sized peephole. Outside noises do not interfere with your assessment.

We are in the taming process, the Stealthoscope and I. New 'scopes have factory-straight tubing which must be "conditioned" to lie correctly across the shoulders, a process which takes time.

Constantly wearing it, while at work anyway, is a good thing. It accustoms me to knowing where the thing is at all times. My last Littman up and "disappeared" on me, and Steps Have Been Taken to ensure that this doesn't happen again.

I ordered a third-party proximity alarm over a week ago. Neat thing, this: affix small Part 1 to any item, affix small Part 2 to your keychain or belt loop. If parts one and two ever separate by more than 10 feet, both start chirping. No more leaving the scope at a facility, or losing it on-scene. Black, of course.


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Posted Tuesday, August 29 2006 16:22  Site Meter