Thursday, August 7, 2008

Continuity of Care

Ok, so I really haven't written because there hasn't been a lot going on. I am in the middle of my EMS/Toxicology rotation, and I have been going daily to the Poison Control Center of WNY for lectures and to follow up on the cases we have been asked to consult on, and then my afternoons are spent in a variety of different activities. Mostly, I am enjoying driving the SMART 1 vehicle around town, and I am starting to take calls with the fire department and ambulance service.

Last week Friday, I spent the evening with the crew from Rescue 1. There were two calls, both of which were canceled en route. However, there's still something to be said for pulling out of the fire house, lights and sirens, riding the big red truck. I enjoyed the time spent with the fireman, and I wish them continued safety.

I went out with one of the attendings and a fellow resident as medical back-up for Erie County Sheriff's SWAT team. They did a raid on a house, and we were there in case of injury. It was very interesting and exciting in a "Cops" style, up close and watching the action sort of way. No injuries, thank God, and I wish on them continued safety.

I spent a good part of the weekend preparing for a lecture on ventilators that I gave yesterday at our EM grand rounds (oh, yes, grand round Wednesdays are back!) It seems to have been well-received. So kudos for me.

Today I did a ride along with one of the paramedics from the local ambulance company. It was interesting because in the middle of one of our calls, I received a page from Poison Control about a case. As I rode in the back of the bouncing ambulance, I took information about this case. I was on my third phone call by the time we reached the VA to deliver our patient.

After I called back the consulting hospital, ECMC, with our recommendations, the paramedic, Tony, asked if I wanted to go to ECMC and see if the patient had been transferred. I said yes, and we arrived just as the patient was starting to be evaluated. It was nice because I was able to follow the case. We call that "continuity of care;" when the same provider follows a patient through their medical course of treatment. Of course, one of my colleagues took the case over, and I will follow up, along with Poison Control, in the morning, but it was interesting to see one of the patients I get called about in the E.D.

Tony and I spent a good deal of the shift going from call to call, and there's a lot of forms that need to be filled out for each run,so Tony spent most of his time typing on his portable computer. The cases were pretty run of the mill, but it's always good to see what the EMS guys are dealing with "pre-hospital."

Tomorrow it's back to PCC in the morning, but Saturday is my first Mercy Flight shift. I hope the weather clears, and we get to fly! And, yes, I plan to have my camera at the ready.

As for the veggie thing. I am at the end of my last week. How hard has it been? Just a little. I spend so much time out of my home, that I usually eat out. I am realizing just how difficult it is to eat vegetarian and healthy in this town. Choices are very limited. I did find a very tasty eggplant parmesan at a restaurant called Towne near downtown Buffalo. I judge Italian pastas on the sauce, and this one was just the right blend of tomatoes and spices. Yum.

Just a few more days of the pledge, however I am considering more my choices in foods.... I just made the pledge to eat only free range egg products and limit my intake of eggs in general. I think we'd all make a difference if we just considered where our foods are coming from. And, with the gas crunch, more restaurants and local markets are supporting local growers which don't have to be shipped as far. That's something we can all benefit from. (ok, ok, off the soapbox)

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