SAR and EMS advice sought...

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pip the dog

Mountain climber

planet dogboy

Mar 21, 2009 - 01:13am PT

johnboy,

i liked your post. and it brought two things to mind.

> Getting hardened with time is unavoidable and inevitable.

would you define "hardened" as fried emotional synapses -- or as a growing sense of what can, and cannot, be done by even very skilled first responders. i suspect it is the latter. a form of wisdom, albeit hard earned.

i have a brother who is an ER MD and after an especially ugly and in the end entirely unsuccessful SAR event, as i ripped holes in his liquor cabinet, he recounted to me what an ancient emeritus professor where he did his residency had told him: "it is almost impossible to kill someone destined to live, and almost impossible to save someone destined to die." i much appreciated hearing that. seems especially valid in wilderness SAR.
~~~

> trauma in infants or people I know well are my hardest runs to
> deal with.

i once volunteered with this SAR outfit that had as the centerpiece of their application wad the question "What are you especially good at?" umm, OK. but in time i convinced them to add another question "What are you especially not good at?"

i was always most interested in reading that answer. for me the answer is "instances of child abuse and sexual abuse" tough stuff for anyone, surely. but real pros handle it. me, it cracked my machine mode and rendered me at best useless, if not worse.

i myself kinda leaned towards anyone willing to write more than a single sentance in response to that other question.

^,,^

johnboy

Trad climber

Can't get here from there

Mar 21, 2009 - 10:03am PT

Pip

Hardened is a conditioning that makes a person somewhat immune to what would be an otherwise shocking experience. Its automatic over time and gives you a buffer from the morbid aspects of a severe situation. More of a defense to something offensive.

tom woods

Gym climber

Bishop, CA

Mar 21, 2009 - 10:42am PT

"it is almost impossible to kill someone destined to live, and almost impossible to save someone destined to die."

This is a good way to say something, I've learned over the years, they are either dead or stable (in SAR) you rarely get anywhere fast enough to "save" someone. It does happen though, that a person can hang on ten hours, but would otherwise die with out the help.

luggi

Trad climber

Mar 21, 2009 - 10:44am PT

Guernica, Werner and Ken have very good points. The only thing I would add looking back 30 years..started young, would be don't be the one that thinks I can handle it. Your mind can handle I believe only so much. For me even after all those years and so many incidents I can remember my first fatality. Make sure your company has some type of Critical incident de-briefing. If you bosses scoff...they are not professionals in the business. Use the service. The EMS field is not for the faint of heart any longer. The Mother Jugs and Speed stuff is long gone. After field medics came back from Viet Nam, they transformed how medics make a difference in the field...after all that is why that are called para magics>>>>

whatmeworry

Mountain climber

Pasadena, CA

Mar 21, 2009 - 01:17pm PT

Quite a few good comments from knowledgeable people.

Don't hesitate to seek out employee assistance program (EAP) resources if your company has them. Talking through things can be just what you need. Most of the SAR teams are volunteer but their sponsoring agency usually makes their support staff available to team members.

I make it a point to follow-up with new people just coming off their first incidents regardless of the nature of the call, but particularly if the situation was difficult. Good colleagues will be looking out for you as well as the victim.

Knave

climber

Mar 21, 2009 - 01:48pm PT

I'm tired of being a paramedic after 20 years and I still hate being submersed in other peoples misery. However the pay is good in urban fire service and I get 20 days off a month. I'll be retired in my early 50's. For the level of education required it's unbeatable. In a large nutshell from my perspective: It is mercenary work, it is paramilitary (red), it is working through a lot of birthdays and holidays, it is being able to climb on weekdays, it has taken a toll on this soul but I am thankful for my lessons and my thick skin, gallows humor works, stress needs an outlet climbing and running work for me, purposefulness is felt when helping people in their greatest need. street medicine is often futile, they have to pay me to show up, no one ever offered me money to repeat moderates so a fireman am I.

luggi

Trad climber

Mar 21, 2009 - 02:58pm PT

Knave...330 days left...yahoo...I agree with ya

Tan Slacks

Social climber

Joshua Tree

Mar 21, 2009 - 03:00pm PT

First, Steve thanks for the very kind words, after so long doing this work it's easy to forget that people notice what you do. As to the OP.. The drama can be like a movie, some you like and some you don't.

After thousands of scenes and patients, it still surprises me what gets through and what does not. Being in EMS can be very mechanical or emotional and almost always creative. It is the creative part that keeps me in it. Over the years I have been pretty burnt, but it is a cycle. Continuing education often can turn the "burn out" around. I have been very lucky so far in that I have changed my arena so many times. Ten years on the ground, ten in the air, and now I am contracted with the Marines flying all their injured off the training ranges.

By far ten years on the ground was the most difficult for me. Entering peoples homes and dealing with the injured along with all the crap that often led up to the injuries can be draining to say the least. Partners, humor, drugs, family and friends will get you through it. I could list so many instances where certain calls that were haunting. For me, the "bad" call goes by and a few weeks later I will start to get angry. That's my clue a call has gotten to me. It took me years to figure this out. Don't take so long to find your "sign" Before I got in touch with my clues I was dangerous at times. I beat the hell out of a spouse that had beaten his wife, I screamed and screamed at a mother who OD'd her baby and I became a nightmare to live with plus much more. Just a few examples of how things can start to unwind.

Someone mentioned the EAP stuff that are common now. Years ago that did not exist, but I was lucky to find some stress place that chills me out when ever I need it. I should even mention here because this is a climbing forum that I had one of my worst falls while consumed with work stress. So my advice, don't be the tough guy. It did not work for, instead I have to take my "temperature" often.

Ten years in the air covering an extremly high volume area is different. The gore is un-describable, but for me, landing, scooping, and dropping off without all the other stuff suits me. Don't get me wrong. There are still those calls that get to me... andd the anger will follow, but it is less often. Perhaps it is because working in helicopters is so dangerous that the patient can become secondary. Lets not forget the stress of losing friends. 6 in the last two years drove me back to the debrief place. This new gig I have with the Marines is again differnet and I find very rewarding. I have been exposed to some very incredible young men and their sacrifice keeps me grounded. I hoep to finish my career here.

I am starting to lose my focus with this post. You pm'd me to post, so here it is. I doubt it will help, but here's the deal. Find people to be open with. If you do choose EMS, always continue learning... don't find a comfortable place and treat each patient like the last. Keep going to classes, it will make you more confident and in the end it wil affect the reason you are there...., the patient.

In a selfish moment I would like to thank those on this site who have been there for me over the years, helping me cope with this confusing profession and a special thank you to Locker, who really carried me through some pretty tough years and he doesn't even know it.

dirtineye

Trad climber

the south

Mar 21, 2009 - 04:34pm PT

first, what a good thread to have on ST. wish we had more like this.

Second, skitp, nice post! see, I do give credit when due, even to a scumbag rethuglican whacko, ROTFLMAO!

THird, a bump for a solid thread. Could be this thread will encourage some of you to do the WRF deal, which I might mention can be upgraded to WEMT (I may be confused here-- is EMT higher or lower than EMT-B? I seriously foreget) with a really short course if you do it within the first year of the WFR course. And you can upgrade to the next one from there too at any rate.

And then for you EMTs and EMT-B's, it is very reasonable to get a W in front of your title and you will learn a few things about wilderness medicine that city EMTs are not even allowed to do.

I really whsh I were not about to kick the bucket, cause I would certainly keep my WFR current and definately up it to WEMT.

The dead ot stable idea may be right, and of course some injuries are just fatal no matter what training you have, adn the victim won't live unless they are IN the emergency room and possibly not even then, but SO MANY things can be treated very easily that without correct and timely treatment woudl be a disaster, that I hope nobody will take the attitued of what's the use?..

Being WFR of WEMT trained is a great advantage for climbers. One good side effect is that along with self and leader rescue training, your safety attitude and persoective is MUCH improved, and that's almost priceless.

neebee

Social climber

calif/texas

Mar 21, 2009 - 05:01pm PT

hey there dirtineye... nice to see you sharing...

say, all, as tami said (think it was)....

many thanks for doing what you feel you were called to do... if not, who would do it?

may god continually bless the work of your hands and minds, and give light and where needed...

Jaybro

Social climber

wuz real!

Mar 21, 2009 - 06:31pm PT

It would be cool if Manny added a few tales to this thread.

Pablo Picasso stayed in Paris during WWII. At one point he was visited by the gestapo.
"Oh, so you are the man who did Guernica?" asked the officer clicking his heels, at least in my imagination.

"No," said Pablo from his formidable 5'2" stature, looking up into the Nazi's eyes, "you did."

Sometimes you just gotta be tough!

neebee

Social climber

calif/texas

Mar 21, 2009 - 06:42pm PT

hey there all... say, after seeing jaybro's war note... i just remembered a nice thing to share here...

dont know if any of you knew this... but a very well known house-hold visitor, by tv, to many, as we were growing up, was:

an ambulance driver...

IT WAS:
walt disney....

from wikipedia, teen years:

Disney became the cartoonist for the school newspaper. His cartoons were very patriotic, focusing on World War I. Disney dropped out of high school at the age of sixteen to join the Army, but the army rejected him because he was underage.[13]

After his rejection from the army, Walt and one of his friends decided to join the Red Cross.[14] Soon after he joined The Red Cross, Walt was sent to France for a year, where he drove an ambulance.[15]

Evel

Trad climber

Nederland

Mar 21, 2009 - 06:55pm PT

First, I'd have to say that tan slacks is right on the money with his advice. After 20 years I have found that it's way important to keep an eye on your "temp". Still, there will be calls that slap ya upside the head. Con-ed and occasional self reevaluation are very helpful. Gallows humor, drugs, etc. all help, but can be detrimental in the long run. Having a good friend to talk to helps, but take care of patient confidetiality. The fact that you're asking about this so early in your career is a very good sign. Also, I'm a firm beliver that those of us drawn to EMS seem to have a natural bent for dealing with it.
Positivly
Another
Retarded
Asshole
Making
Every
Day
Incredibly
Chaotic!

Stephan

Trad climber

Zephyer Cove, NV

Mar 21, 2009 - 08:55pm PT

The goal of every BLS provider is to become an ALS provider.

The goal of every ALS provider is to become a BLS provider.

Works on many levels of your question G....

dirtineye

Trad climber

the south

Mar 22, 2009 - 02:35am PT

shameless bump for a worthy thread.

You are welcome skipt, and remember, offending people is one of my best attributes, ROTFLMAO!

One day MOST of you porr deluded misguided rethugs will see the light, just like bacevich did, ( read his book the limits of power, adn don't worry, he takes em ALL to task, dem and repub alike, going all the wya back to Kennedy)

OOPS, sorry, ranting.

no hijack intended. We now return you to the main focus of this thread. do not adjust your set. do not change the channel...

Guernica

climber

s x sw

Topic Author's Reply - Mar 22, 2009 - 09:02pm PT

Dirtineye, to answer your question, "EMT" is sort of a general term that includes EMT-Basic, EMT-Intermediate, and EMT-Paramedic. So an Emergency Medical Technician could be any of these different levels of training.

And thanks once again for the excellent advice! I knew this would be the place to turn to... it really is all very helpful.

S.Powers

Social climber

Jtree, now in Alaska

Mar 22, 2009 - 11:47pm PT

Just went on my first really bad call

Self inflicted gunshot wound to the head.

Family running around in tears.

It was a f*#kin mess.

I didnt have a problem doing what I could for the patient which wasn't much, it's the family that always gets me, their hurt is real. It sucks because you want to tell them everything is going to be okay but you cant and everyone knows it's not.

Its definatley sobering watching a rythym on a monitor slowly diminsh to nothing.