Administration and Leadership, Operations

Readers Unite to Discuss EMS Suicide

Issue 8 and Volume 40.

CARTOON CONVERSATIONS

In the June issue, we paired a cartoon by Paul Combs about provider stress with the article “Breaking through the Shadows: Six steps to address caregiver suicide & improve mental wellness,” by Jay Fitch, PhD, in the Priority Traffic department. On Facebook, readers united to share stories about their experiences with the harrowing parts of EMS, and together agreed “there is no shame in admitting you’re human.”

SHAMELESS

Talk to your partners! The tough-guy attitude only stops people from getting the help they need. If you’re open with how you’re affected by the job, others will be too.

Harry W. Via Facebook

Informative article about a topic few of the public are aware of. Everyone should be empathetic, understanding, and willing to give support to those who give so much of themselves for all of us.

Carla G. Via Facebook

CLARIFICATION

In the April issue, use of tranexamic acid (TXA) in EMS was discussed. As is the status of many medications and devices utilized in the progressive practice of EMS medicine, TXA isn’t specifically approved by the United States Food and Drug Administration (FDA) in the setting of suspected traumatic hemorrhagic shock, nor is it specifically approved for intraosseous (IO) administration. Although TXA is increasingly being utilized in the practices of EMS medicine, emergency medicine and trauma surgery for the purposes of resuscitation of suspected traumatic hemorrhagic shock, including via IO, EMS professionals are best advised to consult with their local medical oversight physicians regarding the indications and routes approved for TXA administration.

I feel for all of us who face this stuff on a daily basis and have to departmentalize it when we “end of watch.” Stay strong ya’ll!

Tom M.
Via Facebook

For 12 years I was a firefighter paramedic. I also served in the military and worked law enforcement. I’m not sure which left the deeper scars. I’m now treated for PTSD, and no one feels the jobs had anything to do with it.

Robert G.
Via Facebook

FEATURED BLOG: EMS 12-LEAD

Computer misses it, but the medic catches it

True fact: I failed out/dropped out of grad school in mathematics. But despite having little enthusiasm for topology or complex analysis, nothing drives me more nuts than people who say stuff like “I’m not good at math – just not a math person, I guess.” This attitude is not just incorrect, it’s harmful. Most mathematics is quite straight-forward, if you practice and study conscientiously. Same with ECGs.

Stratford EMS was called for a (quite) elderly woman who wasn’t feeling well. And of course, she lived on the 5th floor of a building with narrow, twisting stairs. Nonetheless, the paramedic Jay and his crew humped all their gear, including the Life-Pak, up those stairs. Good thing too.

There was a small language barrier, but Jay ascertained that the woman was complaining of a “burning” in her epigastrium that she also felt in her back. This had started within the last hour. VS were normal, as was the exam, except that she “didn’t look right.” Time for the 12-lead!

Does it meet STEMI criteria? There’s a bunch of ST segment depression in the inferior and lateral leads, but (as you all know) that doesn’t usually count for field activation. There is ST segment in aVL, but it is < 1 mm, and aVR shows only minor STE, while lead I shows none.

V2 and V3 show some STE, but it isn’t much, and it would have been easy for Jay to tell himself that, since the computer didn’t “see” it, it wasn’t really there. Instead, he turned his attention to V4 and noted that the T wave seemed pretty darn tall, relative to the R wave. Along with a hint of STD in V3, it triggered Jay to consider a de Winter-ish pattern.