Buried Acorns and other nuts

We just started shift and were in the waiting room when an elderly gent got out of the passenger side of a car and staggered in. He was clutching his chest. He made it ti the triage sign in stand and collapsed on the floor, before I could get a wheelchair. We got a stretcher, loaded him off the floor and brought him to a code room. He was doing OK. I'm surprised we don't get more of this. So many people use an ambulance as an urban taxi for all sorts of trivial ills. Yet we have unloaded some pretty serious stuff from cars that drive up to the door. Rest of the shift was quiet. Everyone is talking of the impending blizzard. I am off and will ride it out at home. I don't have to worry about my relief not making it in. At least, not this time.

It snowed all day, starting around noon. It was a very dry flaky snow. Only about 2" accumulated.

We got called right away at beginning of shift for a combative female patient in one of the code rooms. When we got there she was

quiet but had a foamy mouth. Nurses thought she was on a crack high, but it looked like just a seizure. They wanted her restrained. One of the nurses was explaining how they were inserting a foley when the patient squirted some pee in her face and she got some on the mouth. It takes a lot to gross out an emergency room nurse, but this did. She went and wiped alcohol on her lips. We then got called to escort the patient to CT scan. She became combative in CT and had to be restrained again. The scan showed some prior trauma, possibly a tumor. Later one of the techs was saying she had a lumbar puncture, the doc was suspecting meningitis.

One of our drunks was found in the waiting room. He was too drunk to walk so I suspect he was dropped off. The shelter doesn't want him, he cant behave there. He was here last night ( I was off, not here) and he kicked at one of the techs who deftly avoided the kick. We stood by while he changed. He had a real mean streak, but was borderline cooperative. He was added to the list of contenders for "most likely to succeed TK as the "most frequent and most obnoxious chronic drunk." TK was found frozen DOA before Christmas behind a bush, on one of the coldest nights of the year. You have to be sober to be admitted to the shelter, so we get the ones that don't meet their admission criteria.

My son called. He went on his first fire call. He is 18 and just completed his training the night before. They gave him his minitor pager Tuesday night. He was a junior since he was 14, but couldn't ride on calls for 4 years. The call was an elderly diff breather who came to our place, via AMR, which is the second backup to the town ambulance. He said he was nervous. I said it will pass, but to write it down, his first call. He will be starting Firefighter 1 training in about 3 weeks. He is still in high school. He will get some good experience. There was a 3 car fatal Tuesday on the interstate.

Its snowing large balls, mixed with rain. It poured all day after being foggy last night. The fog ate the snow.

A very busy night last night in the Emergency Dept. We had 14 psychs at end of shift. Another ETOH psych came in right at end of shift. We had them doubled up in rooms and in hallways. PD brought in a guy early. He was very ETOH and his wife wanted him committed. He wanted to fight the police but backed down from the Taser and came voluntarily. He wouldn't change but he let staff change him. He just sobbed.. He refused to talk to the nurse. The Lt. thought he would bolt at first opportunity, but he went to sleep. He looked Amish, with his under chin beard. I have dealt with his brother in the past. We had a guy come in all hyped on crack cocaine. He had punched an overhead glass globe and cut himself. When the paramedic patched him he stuffed some gauze from the dressing down his nose all the way into his throat in a a suicide attempt. He went into restraints and was medicated and went to sleep. Then a female came in who had barricaded herself in her bathroom and cut her wrist. While this was going on, triage called to report a homicidal patient in the waiting room. We stood by and he was eventually found a room, as they shuffle the lesser violent patients out of the psych rooms for the more violent ones.

We had a drunk 81 year old female last night in the ED and she was very loud. She was funny, but it wears off quickly. We also had a 20 year old came in via police. He had been doing dust,.and he trashed his parents house to the tune of about $30,000 damage, according to the police.

Bush says they have stopped looking for weapons of mass destruction in Iraq. But it was OK to invade a sovereign nation anyway. No wonder the rest of the world is so nervous about America. The Republicans are paying their pundits to promote their agenda. And we are supposed to believe now that social security is broke and needs fixing? This administration has never let facts get in the way of a good agenda.

Seeing the news coming from the California mud slides gets me wondering why they were allowed to build homes in zones that were clearly labeled as geologically so dangerous. But then much of this country's population is either on a hurricane coast, tornado alley, or wildfire area. I guess all the good lots are taken.

Seems like of of our "supervisors" screwed up again. His nickname is TL which stands for Team Leader. It also means total loser and tremendously lazy, We ran short on our shift even though there were two other guys on the schedule. A midnight guy was going to have to work alone, because we were not going to stay over. We got a fill-in for midnight shift. Of course he showed up 20 minutes late. If we stay over, we are enabling the supervisors incompetence and laziness. We are all so tired of bailing them out.

PD brought in a guy who was hitchhiking and jumping in front of cars. He expressed anger homicidal ideations to the cop. So they shipped him to us on paper. He has that scary angry facial expression. No wonder no one would stop and give him a ride. He wasnt a problem and was discharged before end of shift.

PD brought in another guy handcuffed. He wanted to commit suicide by cop. He went for a cop's gun. They Tasered him twice then rushed him. He had been drinking, which negates his psych meds. He has tried suicide by cop before and has been shot once when he rushed a cop with a broken bottle after a pursuit. He also has tried to hang himself in the past. We were very cautious with him. He would be pleasant one minute and enraged the next. If he were to get loose or out of restraints, I have no doubt he would hurt someone very badly. Some people are fakers and exaggerators. Others are the real deal. This one is a real deal.

They held a funeral service for TK this morning. He was the frequent flyer who was found frozen last week behind a bush. A couple of people were going. Most of us were not. We were all happy that he got what he wanted and that we don't have to deal with him anymore. His obit said how he had a very high !Q and was in mensa. Too bad his brain became pickled by vodka and all that IQ went to waste. To be gifted, and not be able to figure out how to deal with your anger is a shame. There could have been a real positive contribution to society hiding somewhere in that urine soaked body.

We got rain today. Was supposed to be snow. It wasn't. I'm grateful.

We had our usual contingent of drunks and psychs in the emergency dept last night. HB showed up, He was found unconscious and presumed dead in a road somewhere. We hadnt seen him in 3 weeks. Last time he was in, he was nasty and we had to cut his clothing off to change him. Tonight he was mellow. We had another guy, suicidal, come in who didnt want to change. Per the psych RN, previously he (said he) had gone to Greece so he could get beat up, so he could die. Every psych and drunk has to change before they see a doctor. That is for patient safety and staff safety. Emergency rooms can be very violent places.

One of the 3 scheduled midnight guys booked off. Unbeknown to all of us, one of our mensa candidate supervisors had given another guy the day off in the morning. He hadnt told anyone or written it down anywhere. No one even told the second shift supervisor, who left early to go to his other full time job, as he does every night. Minimum staffing is two. The lone guy shows up and tells us about the day off for the first guy. We never tried to replace guy two because we assumed there would be two. Anyhow, not my problem. I went home at midnight. The laziness and lack of brains on the part of our supervisors sometimes borders on criminal. Each time they pick up their paycheck they are committing larceny. Neither one could ever make it in the "real" world. Competence and accountability seem to be in short supply.

An area police officer was shot and killed last Thursday by an ex correction officer, while responding to a domestic at the ex CO house. The bad guy, who had been convicted of weapons violations in the past, shot him with his AR15, which had been modified to full auto.

The bad guy, after a standoff all night, suicided out. This saved the state the expense of a long drawn out trial. It reminded me of a judge who had rejected the death penalty for a dirtbag who had ambushed a state trooper and emptied 19 rounds at him during a gun store burgalry. The judge refused to invoke the death penalty because the crime was not "heinous"enough. The trooper had not "suffered" enough.

The funeral on TV, with about 5,000 officer lined up outside, listening to the service on loudspeakers, reminded me of some of the police funerals I have attended in the past.

My condolences to the family of the 19 year veteran officer.


Interesting article, linked via cryptome, on why President Bush is "wired."
Bulge theory