Ambulance Driver

Yesterday’s election of Republican Scott Brown in the Massachusetts special election to fill the seat held by Sen. Ted Kennedy can only be labeled a disaster for the current health care reform efforts in Congress. Already many members of both the Senate and House are getting Tony Romo-like “happy feet” in the face of the repudiation of a liberal candidate running for a seat once held by a liberal icon in the most liberal state in the country.

One could excuse them from thinking, “Am I next?”           

Consequently, don’t expect Democratic leadership to be able to keep their majorities in lock-step and push something through to the President’s desk. Many moderate votes that seemed solid as late as last week are going to switch to “no.”

ObamaCare is deader than Julius Caesar.

But that’s not the only thing to learn from this bombshell of an election. The Brown campaign is now saying that while voter opposition to Congress’ health care reform was strong, their internal polling pointed to Brown’s stance on terrorism to be his biggest wedge issue.

Brown was consistent in his message that terrorists did not have a right to a tax-payer funded lawyer, that they should be brought before military tribunals and not the Federal Courts, that detaining them without trial was fine with him and that waterboarding was not torture and was a technique that should be used to garner information.

Ambulance Driver believes that a vast majority of Americans agree with this and those elected officials who have misjudged the electorate on this issue now have a lot to think about.                      

Busier day today. The Department had 82 911 calls during my 5a-5p shift. Things were slow until around 11am when everyone decided to call at once. The entire system was out of available ambulances for a time with dispatchers holding runs and waiting for rigs to clear the hospitals. I’m told that St Paul Fire handled one of our runs and I don’t remember the last time that has happened.

• Call #1 was for an elderly gentleman who had two syncopal episodes after getting out of bed. Had a significant heart history but generally in good health. Our exam did not reveal any obvious problems – which seems to be the case most of the time in this type of situation.
• Call #2 involved a very elderly male who did not speak English and whose family’s English was poor. He was having abdominal pain that seemed to be associated with his urinary catheter. Due to the language barrier, we really couldn’t figure much out – including his past medical history.
• Call #3 was for a lady who had burnt food on her stove that produced an impressive amount of smoke. She consequently developed difficulty breathing as she put the fire out and attempted to ventilate her apartment. She did not have soot in her throat or nose and her lungs were clear. She was not obviously dyspnic but did have a mild, persistent cough and a feeling of “congestion.”
• Call #4 was for a wheelchair bound elderly gentleman with a barrel full of medical problems. He had been getting progressively weaker over a long period of time and for the past 4 days has not been able to get out of his chair. Needless to say, he was quite a mess. The upshot of sitting in urine and feces soaked clothes for all this time was some rather serious pressure ulcers. “Bed sores,” as they are sometimes called, are a potentially serious medical malady. One of these days I’ll have to do a separate post on this ailment.
• Call #5 has the distinction of being my most interesting run of the week. We responded to an non-English speaking male that was “ill.” We entered a room full of people and immediately knew who the sick person was – he was obviously weak, holding his chest and had sweat pouring off of him. We quickly took him to the ambulance where a 12 lead EKG was very suggestive of a inferior MI. However it was not diagnostic enough for us to activate a catheterization lab (more on STEMI’s in an upcoming post).  My partner and I were pretty certain that the patient was having a heart attack. Nitro and aspirin were given and we sped off to a nearby hospital. When we arrived, a second EKG was obtained that was unmistakable, the guy was having an ST Elevation Myocardial Infarction (STEMI) that appeared to have inferior and anterior involvement. We took him into the Emergency Room where a third EKG showed the situation getting even worse. The Cath Lab was activated. It will be interesting to see how he makes out and what the door to balloon time was for a Sunday afternoon. But the real lesson here is this – 911 was called within minutes of onset of symptoms and if they would have waited much longer we would have been dealing with a cardiac arrest in the field.
• Call #6 was a nursing home patient that took a fall from a standing position. He had blunt trauma to the head (but no loss of consciousness) with a main complaint of neck pain. Given the mechanism of injury and his age, I was very suspicious of a neck fracture even though he had no neuro deficits. He was handled and transported carefully.
• Call #7 was for a group of intoxicated homeless folks that had just exited from a church where they were given a meal. They kept falling down. We arrived with the police and were able to determine that, with the proper amount of encouragement, all were able to stumble off on their own power.

That’s it for this update.