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Dealing With Death Suddenly and After the Fact


Kschuppan

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I'm up for the emt student of the quarter, or semester?

To many strong folks showing up these days to pick one a year. As well, I think that there are many different ways to be strong, all could be rewarded..

Dwayne

Rodger that ... I liked the "tribal" bling thing you did as an incentive back a bit .. will kick a few pesos myself if so required.

cheers

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I'm not sure if you're responding to my post or not, but if not, you probably should be. And if so, I'm afraid that I've not made myself very clear.

When I talk about dehumanizing (I don't remember if I used that term or not, but it's not inaccurate.) I think that I'm talking more about necessary focus. In fact it has a nearly perfect inverse relationship to the severity of the pts pathology. As the patient gets better, their humanness comes more into focus.

For example I once has a young boy that had been ejected from a vehicle and skidded down the asphalt. He had multiple fractures to both arms, and one leg, lots of skin missing, his nose nearly gone. In my mind I don't see a wounded child for more than just a second or two. I see a set of pathologies that is trying to kill a kid, and trying to defeat me. And that really pisses me off.

To be honest am not sure if i was responding to you or not. Mainly just expressing an idea. I guess I was thinking about the guys who treat their patients like they were a machanical part that needs to be fixed. The guys that don't respect their patients or their dignity don't deserve the job. Doing the job well includes caring as well.

And if it sounds as if I was offended by your statement, man, that's just the weakness of my communication here. I liked it a lot, but wanted to try and make sure that I left no one with the impression that I believe being an ice cube is a good way to do medicine. I think love is awesome medicine for every patient, if you have time.

Dwayne

Not at all. I think we are on the same page.

I was on a MVA with a 15 yr old DOA in the back seat. The dad shows up on the scene asking about his son and wanting to see him. I had gone to high school with the dad but did not know the kid. We sat on the sidewalk and shared a cry then I walked over to see the boy. That was a turning point for me. I decided to care and to care deeply. I don't think caring is baggage it is more like a privilege.

.When I mentioned dehumanizing I wasn't implying that the science can be ignored. I have to constantly work not to have tunnel vision toward the condition and ignore the person. Yea, thare is a time to ignore their screams (or thank God they are screaming) as well a time when I know I am about to inflict pain to give them the best chance I can at survival. There is also a time for a soft touch and a kind word. Most of our patients deserve both.

Man, it occurs to me that I must sound like a complete moron...But, there you have it...It truly is the way that I see forggy calls..like a mini war.

I had never really considered calls in those terms but I like it. We can either win or loose against the condititions. It will be food for thought on my next call. I guess every call is a fight, against nature, trauma, time. We either win or loose.

[

Anyway. I think that it's because I love my patients that I become so focused, not the opposite. Of course, like all of us, I could just be bullshitting myself.

We all express love in different ways, protecting is one of them .... loving patients will make a good medic great.

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...That was a turning point for me. I decided to care and to care deeply. I don't think caring is baggage it is more like a privilege....

+1

Man, that is the statement of the month right there. Though I believe that some of that will depend on coping mechanisms as well. If you cope poorly more than likely you're unable to care deeply without creating issues for yourself.

It's good to have you here, and to get to hear your thoughts. When are you going to do the right thing and turn that EMT into an EMTP? :-)

We've got some basic providers here that are crazy smart..it would be nice to see them as leaders on the street as well..

Dwayne

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Really great advice and thoughts guys,

I thought of another thing to ask, and i hope i do not sound juvenile for this. But another thing i was thinking of is the gruesome side of the job. I now know that death and gruesome incidents are not to be thought of as every second of every day type stuff for a EMT. But when seeing the anatomy and such in that way is it basically just have a "strong" stomach? How do you guys look/deal with that aspect.

Thanks again,

Kyle

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+1

Man, that is the statement of the month right there. Though I believe that some of that will depend on coping mechanisms as well. If you cope poorly more than likely you're unable to care deeply without creating issues for yourself.

It's good to have you here, and to get to hear your thoughts. When are you going to do the right thing and turn that EMT into an EMTP? :-)

We've got some basic providers here that are crazy smart..it would be nice to see them as leaders on the street as well..

Dwayne

Thanks buddy. I am impresed all the time by everyones post. There is an occasional "goober smooch" but most of the post are dead on.

I will start EMT-I next month. I am really looking forward to movin' up the food chain.

Really great advice and thoughts guys,

I thought of another thing to ask, and i hope i do not sound juvenile for this. But another thing i was thinking of is the gruesome side of the job. I now know that death and gruesome incidents are not to be thought of as every second of every day type stuff for a EMT. But when seeing the anatomy and such in that way is it basically just have a "strong" stomach? How do you guys look/deal with that aspect.

Thanks again,

Kyle

Your question is not juvenile. We all wonder about the unknown.

I hate funky smells. Melena, "fromundacheese", bacterial vaginitis you can smell across the room, and other degrees of nastiness make me puke. So if I have to barf I get it over with and get back to the task at hand.

Boood is not gory when placed in it's proper context. Blood is the life sustaining fluid that must remain in the body. So a blood leak is simply a problem that must be fixed.

A friend and I were talking about the guy that got his penis droped in the food disposal. His oppinion is that it would be appaling and traumatic to see. I opine that it is simply a bleeding flesh wound that needs attention (no touriquet of course). :0

Don't ever feel like less of a provider if some particular incident makes you "toss your cookies". As long as you keep a clear mind and get the job done it will be OK. Some jerk might give you grief about it but "screw him".

Keep asking the good questions.

Edited by DFIB
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Your question is not juvenile. We all wonder about the unknown.

I hate funky smells. Melena, "fromundacheese", bacterial vaginitis you can smell across the room, and other degrees of nastiness make me puke. So if I have to barf I get it over with and get back to the task at hand.

Boood is not gory when placed in it's proper context. Blood is the life sustaining fluid that must remain in the body. So a blood leak is simply a problem that must be fixed.

A friend and I were talking about the guy that got his penis droped in the food disposal. His oppinion is that it would be appaling and traumatic to see. I opine that it is simply a bleeding flesh wound that needs attention (no touriquet of course). :0

Don't ever feel like less of a provider if some particular incident makes you "toss your cookies". As long as you keep a clear mind and get the job done it will be OK. Some jerk might give you grief about it but "screw him".

Keep asking the good questions.

All good points. There will always be something that gets to you. Like DFib said, melena has to be one of the worst smells. Just as bad is a fecal impaction as it is disimpacted. I've come close to bringing up lunch several times. It's human nature.

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First, I'll address the nerve you struck with some in regards to your FF/EMS thing. I am not as militant about pro EMS and anti- Fire dept. To me, fire/EMS combination is a necessary evil in many places. The highest pay will be on fire departments and while there are some single role EMS providers on fire departments, most places are cross trained. In most cases. even the single role EMS folks on fire make far more than the private counterparts. It's a matter of what you really want. Cross training gives you the best of both worlds. Bottom line- even as a FF, over 80% of your calls will be EMS related, which means you had better be on top of your game. THAT is your bread and butter.

As to your question about death. Everyone is different. Every death is different. Is it a child, or an elderly person who quietly slips away in their bed? Is it a young child who is struck by a stray bullet, or a baby who is a victim of child abuse? Is it a chronic alcoholic who has abused their body for so long that their liver finally gave out? Is it a teenager who succumbs to cancer in the prime of their life? Remember, with nearly every death, someone will be mourning the loss of a loved one or a friend. Be mindful of this fact in your approach, your demeanor, and your actions.

Some deaths WILL affect you. Sometimes a lot, and generally you will be surprised at when it may hit you.. You simply need to be empathetic. Understand how grief works, think about how you would want to be treated in the same situation. Think about how you would want your loved ones to be dealt with by a provider if you are the one who passes away.

It also depends on where you plan on working. In a busy system, you may be looking at the grim reaper's handiwork multiple times each day, in a variety of situations. In a slower area, you may be lucky to see one cardiac arrest or DOA in an entire year. Like anything, the more exposure you get, the easier it becomes to handle it.

Best of luck.

All good points. There will always be something that gets to you. Like DFib said, melena has to be one of the worst smells. Just as bad is a fecal impaction as it is disimpacted. I've come close to bringing up lunch several times. It's human nature.

Melena is a smell that is certainly immediately recognizable- from across the room. LOL The ones that get me- burnt flesh and decomposition. The number one most hideous sight and smell- someone who had an obstructed bowel and actually vomited fecal matter. I will never forget that as long as I live.

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I don't think it's really fecal matter if they can vomit it. I can't remember what's it's called before though.

And I wonder that it did smell like? Not feces I'm thinking as it's not been exposed to the lower gut yet...interesting...

Dwayne

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Herbie: I have been witness to this as well, vomiting fecal matter from bowel obstruction, a skinny little "trapper" this hermit blamed it on his christmas fruit cake. Although he had pretty much all the "other" fragrances as well..... Nasty stuff All.

I count myself lucky as I can tolerate most smells, when I was a rookie we had to "bag 2 bad ones" before we were "accepted" that's back in the day when EMS did body removal. A trick we used is a mask with menthol shaving cream on the outside, works quite well, not 100% but better than full breaths of decomp's sweet fragrances.

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The fecal vomiting is called miserere. Saw that one too, kinda disgusting.

Funny thing - in german, a plight or a misery is called Misere. So, if you have Miserere you are in a Misere. Sorry for the cynic humour, but we found that kind of hilarious (and fitting) back in school.

Had a very, very inflamed and secreting leg with maggot infestation last week - also not really a treat for your nose.

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