Administration and Leadership, Operations, Training

EMS Providers Treat X-Rated Boo Boos

Issue 10 and Volume 36.

Once you read the table of contents in this month’s JEMS and saw my column’s title, I bet you created a gentle breeze as you rapidly flipped to this second-to-the-last page. You sickos! But because you’re here already, let’s explore the “You wouldn’t believe the call I just had!” aspect of our job.

I speak of accidental acts of human behavior that traumatically impact one’s integumentary, reproductive, muscular/skeletal, and dare I say, distal portal digestive system.

The statistics are few when it comes to actually calculating the number and types of injuries resulting from radical acts of erotic stimulation, because most individuals, couples and/or unionized orgy member organizations are unwilling to admit how these injuries occur.

Medic: “So just how did you manage to impale yourself in … in such a manner?”
Patient: “I, uh … uh … fell on it.”
Medic: “Uh huh. I see.”
Patient: “Do you wanna see it?’
Medic: “NO!”

Before I started in EMS, I must admit I was pretty naïve when it came to pelvic/perineal trauma secondary to sexual practices deemed by 10% of all U.S. Congress members as being socially unacceptable. I used to think “auto-erotica” referred to being turned on by a Cadillac Seville. I even initially anticipated, regarding mating mismanagement, that I’d be primarily responding to epi-induced heart attacks or strokes, which in fact rarely happen. Apparently, people expend the same amount of energy climbing two flights of stairs as they do during the act of procreation. A truth few will argue.

EMS responders are unfamiliar with recognizing, treating and transporting (usually prone) the autoerotic trauma patient, despite these types of sexual mishaps being not all that uncommon. Yet little in the way of EMS education deals with these highly imaginative, anal retentive (sorry) individuals, who have no clue of their own anatomical limitations.

A few personal clinical observations:
1. Some people should not be left alone in a pool or Jacuzzi.
2. Prophylactics and latex allergies can be a bad combination.
3. Romantic candles should be kept at a distance.
4. Pets should be kept at a distance, especially cats. Meeoweee!
5. Showers are slippery.
6. Spherical shapes—avoid them.
7. Pointy objects—avoid them.
8. If you’re not a gymnast, don’t pretend you are.
9. If your partner is a gymnast—avoid them.
10. Safe sex may require an AED, O2 and nitro on standby.
11. If it is uncomfortable, stop doing it.
12. Some people should not own vacuums.
13. Hazmat will not respond to lost-in-the-act condoms.

Could I go on? No doubt, but I’m still holding out for the movie rights. Many of you out there have your own copulation catastrophe war stories that make mine pale in comparison.

We have all been there—finding ourselves at scenes where suddenly everyone is volunteering to get the cot from the ambulance to avoid busting a gut in front of the patient. You avoid eye contact with colleagues because you know it would shatter any attempt at self-composure. Even while at the hospital, we migrate toward radiology in the hopes of getting a peek of the colorectal foreign body.

Being in EMS means you can always say you’ve seen worse. We frequently find ourselves laughing at things we know we shouldn’t, but humor can provide a brief release of tension when we’re taken out of our comfort zone—a zone few outside our profession can comprehend, much less find humor in.

Yes, we laugh. But our hearts should still know what’s going on. One can only imagine the pain a patient must be experiencing not only physically, but also psychologically when having to call us for help. And don’t think they haven’t already tried to overcome their dilemma before relenting to your care. I’ve had some of these patients go on to develop septicemia, peritonitis, subdiaphragmatic air, asphyxiation—many requiring a laparotomy and subsequent colonostomy.

There will always be those who indulge in sexual acrobatics in non-traditional settings with objects that normally don’t carry insertion may be hazardous to your health warning labels. And they’ll always be a part of your, “Have I got a story for you” legacy, as they well should be. But until you hand these patients off to the astounded ED nurses, keep them alive and safe, maintain their privacy, be compassionate, manage their pain and hold the laughter until the break room.

Until next time, stay healthy and happy in your attempt to climb more than two flights of stairs. JEMS

This article originally appeared in October 2011 JEMS as “X-Rated Boo Boos: Try not to laugh.”