GhostMedic28

After 10 years in this field, I still look forward to going to work. I love this job and I don't think I could see myself doing anything else that's not related to EMS.

Sigh.

Questionable source, sensible and essentially TRUE answer

"Dear Cecil:

As a professional sex educator and sex writer, I thought I'd mention a few minor sticking points in your recent column about vaginal foreign bodies. I have gotten the "can't things get stuck up there?" question quite frequently, often from young women who are afraid of irrevocably losing a tampon inside themselves, so I've answered the general question a time or six thousand myself.

In your answer, you overlooked two things. The most important is that in fact it's quite difficult for something to get "lost" or "stuck" in the vagina. The main reason is that the woman was too damned squeamish to stick a finger or two up her own coochie and pull it out. The vagina, as you undoubtedly know, man of the world that you are, is a cul-de-sac, not a thoroughfare. The os, the opening that runs between the vagina and the uterus through the cervix, is extremely narrow--in its normal state, about as wide as a pencil lead. Generally speaking, objects inserted into the vagina cannot fit through the os and get into the cervix or uterus (to insert objects into the uterus, like IUDs, the cervix and os have to be manually dilated or opened).

Therefore, what we're talking about is, if you'll forgive the analogy, something like a pocket with a hole the size of a pencil lead in the bottom of it. Loose change is not going to fall through that tiny hole and get lost down your pants leg. Neither are sex toys, tampons, marbles, candles, tubes of lip gloss, hairbrush handles, fruits and vegetables, or any of the other myriad things people frequently stick in their vaginas in the spirit of exploration or eroticism.

Any object that does go in but doesn't seem to want to come back out can be retrieved by simply reaching in with a finger or two and gently tugging it out (a woman can do this herself or have a partner do it for her). If that doesn't work, as sometimes happens with large objects that are hard to get a grip on, it's likely because the woman is afraid or tense and is reflexively tightening the pubococcygeal muscles, effectively narrowing the vaginal opening. The solution is to squat and bear down and push it out, just as if one were straining with a bowel movement. One can also use a finger or two to help direct the object out of the vagina while doing this. It might be a little uncomfortable, but in this case, the corollary to "what goes up must come down" is "what went in can certainly come out again."

If a woman has inserted an object while masturbating and finds it difficult to remove after she has orgasmed, it usually helps to wait 15-20 minutes for all of the tissues to indilate before trying again to remove it. Vasocongestion during arousal causes swelling of many portions of the vulva, including the entrance to the vagina. Once that blood has had a chance to drain and the tissues have gone back to normal, it'll be easier to remove the object. (Relax. Read a few Straight Dope columns. It's not going anywhere, I promise. Then try again.)

So, basically, there's no good reason that a woman would EVER need to make an embarrassing visit to the ER for most types of objects people commonly insert into their own vaginas.

There are two cases where an ER visit is warranted, though. If a woman has got something sharp up there, or something that has broken (don't be stupid: light bulbs and fragile glass and plastic objects are not good sex toys!) or which has already caused an injury, the ER is the best bet. Same goes if she has been sexually assaulted with an object that has been left inside her vagina: medical intervention is the best bet, not only for safe extraction of the object but for documentation of the assault.

The second thing I wanted to mention in regard to your things-stuck-up-the-hoochie column is that not all the objects you mentioned are actually stuck up the hoochie at all. IUDs, particularly, are inserted via the vagina, but actually are inserted into the uterus (as I mentioned above). The uterus is not the vagina, it's a separate organ. And, as I mentioned, it's a hell of a lot more difficult to insert something into the uterus than it is to insert something into the vagina. I daresay that no one is likely to manage to insert an object into their uterus accidentally--the undilated os simply won't accommodate it.

IUDs are inserted by health care professionals who dilate the cervix to do it. One is supposed to check for the string periodically to make sure the placement is still correct. But sometimes the string (a tiny bit of monofilament thread usually) gets retracted back into the os so that it can't be felt by inserting a finger into

the vagina and touching the cervix at the os. I dare say that doesn't count as a "lost" object, even so. Provided both the woman and her health care provider(s) remember that an IUD was inserted, they can still arrange to keep track of it and make sure it's still doing its job and not causing problems. And even if it were "lost," there's not far for it to go. A "lost" IUD can't exactly go drifting around the body like the Flying Dalkon Dutchman, it's going to stay inside the uterus."

As far as your story about the woman having an orgasm goes...........have you ever had sex with a woman? It's going to take more then a violently vibrating gear shift with eighteen fire monkeys and a couple EMT's standing around gawking to do the trick.

You are either a liar or a complete friggin moron who works with a bunch of complete friggin morons, and had a very clever and intuitive (perhaps a little sexually perverse) psych pt on your hands. To reiterate, I call bullsh*t on your story.

Go on, tell us how you really feel.

Like I stated in my post, I am rather sure that drugs played a part in this little fiasco. As far as the orgasm comment "that is what SHE (the pt.) told us". Now whether or not she had one, I don't know and frankly I don't give a flying f*ck!! All I know is that up until that time we had NEVER encountered this type of response, so EVERYONE on scene was quite unsure of what to do with regards to the well being of the patient. Maybe she was sexually perverse and just craved the attention, again I don't know and I don't really care.

However since we were unfamiliar with this type of situtation and since we are not permitted to remove any type of foreign body regardless of the type of foreign object it is or where on the body or in this case in the body the penetration occured, medical control was informed and the physician on the other end of the phone informed us to "cut it" and transport her and the foreign body to the hospital for further evaluation and treatment.

This incident also occured 9 or so f*cking years ago, when I first got involved in EMS. I was a Basic, and this type of medical / trauma emergency was not taught to us. So maybe that will make you get off my case about it.

However, if you still feel opiniated about this whole post and you still want to call it bulls*it, then that's your opnion. But you know what they say...."Opinions are like assholes, everybody has one"

Frankly I don't care about yours.

Post Deleted

You forgot to mention low-training, low-professionalism, low-hemoglobin.

What is your malfunction?? Do you just hate the American people, or are you just naturally a smart-ass? I joined this community to talk with other EMS providers, not to be slammed because one provider thinks his or her country's EMS system is better. I pride myself on my professionalism and the continous training that myself and my fellow American EMS workers have to have. Aside from your kindergarten-like comments, what have I or any other American provider done to you.

You don't know anything about me, you don't know anything about the EMS system that trained me, nor do you know anything about the EMS system that I currently work for. While no one system is perfect, the current EMS system I work for holds it's employee's to a higher standard than most. We constantly train, for any number of incidents that we may respond to.

I don't know why you feel the need to criticize fellow EMS providers, but if that's how you get your rocks off, if that's what makes you feel better, then go ahead. I have nothing more to say to you on this subject.

Now hammerpcp, why did you feel the need to criticize the American people at large just because you disagreed with what I quoted. I have yet to hear of this, from "any provider", but if you guys say you have heard this little story then I am not going to try and disprove you. All I was doing was placing one of my most memorable calls on a message board, if I had known that it was going to illicit such a negative response from this community, I never would have posted it.

This call was "silly, stupid' and funny" all rolled into one. I am quite sure that drugs were involved with regards to this individual and her little exhibition. Hopefully she learned a valuable lesson from this experience, but then again according to hammperpcp, "Americans a have diminished cerebral function".

Guess that's why we have so many individuals who are involved in EMS, guess that :oops: "diminished cerebral function" :oops: just doesn't allow us to hold any other type of position other than that of low-paying EMS providers.

Sounds like bullsh*t to me.

You can say what you want, I was there, I know what I witnessed, and what occured. What would make anyone do something as stupid as this is beyond me. BTW, what is your problem hammerpcp, why do you wanna accuse me of making something up like that. Your in Canada, eh?? I am in the US, to very different EMS systems.

Here is one of my most memorable calls. My unit was dispatched Code 3 to a female, with foreign object penetration. Thats's all the information that dispatch was given, so we were puzzled at first. AOS, and located the patient in a small. to mid-size compact vehicle, surronded by approximately 25-30 people most of which were snickering when we walked up. The other half were pretty much in awe, to say the least.

What I found when I made my way through the crowd was an 22 year-old female who on a DARE had umm....how to put this (sexually molested) a 5-speed gear shift. During the process of her show, a vaccum formed, thus making it impossible for her to remove herself from the object. We had to request for a fire unit to respond for extrication as our units do not have extrication capability (at least not then). When the fire department arrived, they had to use the cutter from their extrication equipment to extract the patient from the vehicle. Patient was transported to the trauma center, where she underwent surgery to remove the "foreign" object.

The most unusual part of this call, was during the time it took FD to "cut" the gear shift, the patient actually experienced an orgasm, from the vibration of the cutter.

I swear to God, I am not making this up. That is the most memorable call, I have ever responded to.

Just thought you guys would like to know.

On Friday September 22, 2006 my unit was dispatched to a MVA (head-on) with entrapment. Our reponse time from notification to arriving on scene was under 4 minutes. I am pleased to announce that a local emergency physician who lives near the accident scene was the first medical personnel on scene prior to the arrival of my EMS unit.

The physician's name is Dr. Lance K. Dyess of Elba, Alabama. Dr. Dyess, responded to the scene and without any regards for his own personal safety, heroically extriacted one of the patient's from the vehicle while it was on fire. Approximately 2 minutes after Dr. Dyess, removed the patient, the vehicle became fully-involved.

I as an EMS professional want to give Dr. Dyess a pat on the back for a job well done. I have also contacted the Governor's Office to inquire about having Dr. Dyess recgonized for his actions that saved the life of a local resident. I have also contacted my EMS Chief about presenting Dr. Dyess with my departments highest award, the Medal of Valor.

Yes, Glucagon has just been added to our protocols. Unfortunately it doesn't go into effect until Jan. 1, 2007. Until then.....well you know

Why would the oral glucose hinder you? It is a basic medication and all that was available to you.

The oral glucose might become a hinderance if the patient is unable to swallow. If you administer an oral medication to a patient who otherwise is unresponsive or unable to swallow you risk causing an obstructed airway. For any hypoglycemic patient who exhibits the signs like what James described, D50 is almost always the best treatment.

Did you check a CBG on this patient. If so, what was the results? Any history of diabetes?

I would love for my service to put the Stryker Power Pro stretchers in service, but they (management) are too cheap to buy them. I do physical training, but there is only so much one person can lift. I work in a rural area, where usually it is just me and my partner and on more than one occasion, I have been placed with a female who weighs all of 115lbs and can't lift, even if her life depended on it.

Now I am not saying that females shouldn't be in EMS, but I think a physical assessment test or physical agility test should be required prior to employment so that the individual can demonstrate the ability to perform the essential functions of the job. This applies to both males and females.

As one of many EMS veterans in here I feel that I should comment on this as each area and service has it's own protocols and SOP's regarding transport. First off, I have worked for both BLS and ALS services, and in doing so I got quite a bit of experience. Ok, now on to the point.

If your partner was treating a patient whose c/c was nausea and dizziness with stable vitals and in no immediate distress, ask him what his medical reason was for wanting transporting emergency versus non-emergency. Granted, nausea and vomiting are some key signs for an MI, but nausea can also accompany a host of other illnesses. If he was so concerned for the patients condition, then he should have instructed you to transport in an emergency mode. After all, we aren't mind readers. To this day I still ask my partner how they want the transport (emergency or non-emergency).

Since we are from different states, and each state has it's own laws regarding the operation of emergency vehicles, remind your partner this....should you have transported the patient emergency, and in the course been involved in an accident, can YOU being the operator of the vehicle justify your decision to transport the way you did. After all, since you are the operator, it's your license/certification that may be suspended or revoked because you are in control of the vehicle.

I have worked with people like him in my career and I just tell them to do their job, and I will mine.