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Paramedic’s Corner: Bits and Pieces
Paramedic’s Corner: Bits and Pieces

Gary Carmack
The title of this week’s article is “Bits and Pieces” as none of the topics for this week are very long.

First the recent snow storm: Sudden heavy snowfalls always present special challenges for an ambulance company. First of all, the motor vehicle crashes (MVC): Many of the crashes, fortunately, are slide-offs with minor injuries or no injuries. However, the ambulance is still required to respond and check out the people involved in the crash. The paperwork is tremendous because a patient care report (PCR) is required on every patient, regardless of whether they are transported or not. Often the paramedics need to spend time with the person(s) to be sure they are not injured, and if the paramedics are worried they will try to convince the person to go to the emergency room (ER) for a physician’s exam. It is the paramedic’s job to explain the “risk” of not having a physician’s exam and the “benefits” of seeing the doctor. It is not unusual for people to have hidden injuries. For example, we have seen people actually walking around at accident scenes with a fracture in the cervical spine. That is scary!

From about 8 a.m. Saturday until early Sunday morning, the Pulaski County Ambulance District (PCAD) responded to 25 MVCs and transported one patient to area hospital emergency rooms from the crashes.

The second big problem is that ambulance services are about not only emergency care and treatment of the sick and/or injured, but also transport. Therefore, a vehicle response is required and hence we face the same problems as everyone else: the possibilities of sliding off, crashing, or getting stuck. Getting up steep hills is always a challenge.

The next huge problem is the interstate and the hospitals being thirty miles or more away. PCAD is extremely grateful to the General Leonard Wood Army Community Hospital (GLWACH) for allowing us to bring citizens there during these extreme weather conditions who would normally go to civilian hospitals.

I thought the readers might enjoy a poem written in 1835 by Emerson, The Snow-Storm. Sometimes in the world of emergencies, death, sickness and trauma; something beautiful and peaceful are in order.

The Snow-Storm

Announced by all the trumpets of the sky,
Arrives the snow,and,driving o’er the fields,
Seems nowhere to alight: the whited air
Hides hills and woods, the river, and the heaven,
And veils the farmhouse at the garden’s end.
The sled and traveler stopped, the courier’s feet
Delayed, all friends shut out, the housemates sit
Around the radiant fireplace, enclosed
In a tumultuous privacy of storm.
Come see the north wind’s masonary.
Out of an unseen quarry evermore
Furnished with tile, the fierce artificer
Curves his white bastions with projected roof
Round every windward stake, or tree, or door.
Speeding, the myriad-handed, his wild work
So fanciful, so savage, nought cares he
For number or proportion. Mockingly,
On coop or kennel he hangs Parian wreaths;
A swan-like form invests the hidden thorn;
Fills up the farmer’s lane from wall to wall,
Maugre the farmer’s sighs; and at the gate
A tapering turret overtops the work.
And when his hours are numbered, and the world
Is all his own, retiring, as he were not,
Leaves, when the sun appears, astonished Art
To mimic in slow structures, stone by stone,
Built in an age, the mad wind’s night-work,
The frolic architecture of the snow.

Ralph Waldo Emerson, 1835

The next topic I wanted to explain to the readers concerns transports to the Harry S Truman Memorial Veterans’ Hospital in Columbia. The PCAD is glad to and will take our citizens to the VA hospitals, and we frequently do; however, the appropriate procedures must be followed. These are the VA’s procedures, not those of PCAD! The VA Hospital in Columbia does not have an emergency room. Therefore we are expected to take any emergency patient to an ER first and then transfer can be arranged later by the physicians. Arrangements have to be made with VA before we transfer a patient there. The VA requires preauthorization and an accepting physician. Again, these are VA’s rules, not ours!

Once in awhile a patient and family gets really upset at us because we do not take off with an emergency patient to VA. If we do the VA staff orders us to first go to a closer ER or to the ER at the University Hospital.

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