Medics on the scene

[firetender]

I’m not getting on my high horse here, I genuinely am curious about your take on this.

It started with this post in the 100% Directionless thread.

Sitting in the er with my 5 yo with what looks like a full thickness burn on her leg from a motorcycle muffler. What a way to end a terrific weekend.

Six posts later (just reporting) BigBaldGuy chimes in with some sympathy.

Anjel and nemedic chime in on the supportive side, and then, this from MrBrown:

Brown got really badly sunburnt last summer, well by "really bad" Brown means severe first degree.

If Brown is ever severe, third degree, full thickness burn victim Mrs Brown knows to have Brown overdosed on painkillers. No joke, even Browns friend who is a HEMS Doctor/Senior Anaes Reg agrees with Brown.

Usalsfyre chimes in with support, a few directionless comments and then this:

I agree. I told my family if I'm ever badly burned or will be paralyzed or mentally "not all there" from some form of trauma that I want to die. I don't care how they get it done, but I want to be gone.

I know it sounds morbid, but I've seriously ran the scenario through my head. If I'm ever in a vehicle wreck and the car is on fire I plan on shooting myself with my concealed pistol when I start to burn.

Yes, it’s true abckidsmom is one of us and she’s proven she can take it.

Yet, metaphorically, a bunch of medics are at a scene where a mother comes in and announces her 5 y.o. has just suffered “full-thickness” burns. Two of the medics on scene agree that they’d rather be dead than go through the trauma of recovery from them.

Of course, they’re talking potentially fatal, but still, children’s legs get amputated over such stuff.

And Mom is right there, listening!

Of course, I have questions about this, but I’m really more interested in the questions that come up for you.

What’s your take, what does this mean in terms of how we support each other here? Let me re-emphasize, I’m not looking to judge anyone and hope you won’t either.

 

[rwik123]

Are we discussing the maturity of members or the ethics of euthanasia?

 

[rwik123]

I can't edit on my phone but I'm just confused in the direction of this thread.

 

[MrBrown]

Brown is confused

 

[JPINFV]

Are we discussing the maturity of members or the ethics of euthanasia?

I'd also like clarification for this question. As someone who went with his parents to put down their old dog (12 y/o, numerous tumors, starting to lose a lot of hair, really bad cataracts, was quickly losing her ability to walk and had gone down hill severely over the past two weeks. Quality of life? Very little) this weekend, we really do treat our pets better than we treat people. Interestingly enough, the Humane Society does not have a trade in policy...

 

[emsunit37]

Confused what is the main question?

 

[bigbaldguy]

I picked up on some of the uhoh maybe not here guys, feeling you get when your discussing worst case scenarios in front of a family member. Granted the family member in this case is a medic but I think the same basic principals should apply.

 

[MediMike]

I think its more the fact that we are all so desensitized to these situations that it doesn't even cross our minds that what we say/do has an effect on others around us. I personally find myself biting my tongue around folks no involved in the field, so I believe that we have no concern regarding these types of comments when we're amongst ourselves.

Couple pints deep, not too good at these philo-mah-sophical conversations

 

[fast65]

I'm pretty confused about the actual question here, it kind of seems like your wanting to address the appropriate timing to discuss such things?

 

[firetender]

Well, thanks for reading, anyway!

Okay...fair questions.

abckidsmom brought a concern to us while we were standing around talking to each other. She gave us little to go on. A number of us showed concern and support -- reflecting the topic was worthy of concern --

and then a couple of us turned to each other and affirmed they'd prefer to be dead than suffer through injuries in the realm of what abckidsmom's child was going through. She will hear what they say.

One of us whom we know and respect was surely worried over the welfare of her child.

Is this site a place where we should be aware of others' feelings just as if we were physically present with them?

Maybe this question should be asked directly of MrB and L&S5:

Based on the information you were given, would that be a conversation you would have in front of a woman who's child was going through trauma?

Maybe where I'm going with this is, since we DO work in a field where the words we use have power, to what degree should we always be aware of their impact on others?

I hope this helps.

 

[CAOX3]

No offense but I think the comments made by LightsandSirens are selfish.

Why would you put a family member in that situation? Commit a criminal act to satisfy the wishes of a loved one.

And I can seperate my professional behavior from my personal beliefs. What I choose to live through or with is my personal decision. I would never project my beliefs on quality of life on a patient or they're family member its they're choice and they're wishes.

 

[fast65]

Alright, that makes more sense now.

It's kind of tough to say whether or not we should be more aware of the feelings of others on here as if they were physically present because this is a place where people should feel open to express their ideas. However, at the same time this site is kind of like a family, and as such we might want to be a little more sensitive. Obviously with the anonymity of the internet it becomes much easier for us to be a lot less sensitive, sometimes without even realizing it, but do I think that means we shouldn't be more aware of other peoples feelings? No, I do not.

As far as if I would have a conversation like that in front of a parent who is having a child that is experiencing a traumatic event, I can absolutely say that I wouldn't. More than likely that parent is having a very difficult time trying to comprehend exactly what has happened and what is currently happening to their child, they do not need to be burdened with the thoughts of what the outcome may be or what their child's quality of life will become. As EMS providers we have a duty to care for our patients not only physically, but emotionally as well, this includes the parents of an injured child; now are we really keeping to that principle if we're putting ideas such as the aforementioned in the parent's head? While we all have our own set of personal, spiritual and ethical beliefs, it is not our job to express those to our patients.

Btw, I want to point out that I am in now way condemning nor supporting what forum members may have said in the 100% directionless thread.

 

[abckidsmom]

I think that the directionless thread is a lot different than talk standing around on a scene. It's just not the same.

Plus, I think that most of us can picture a burn on a child's leg from a motorcycle muffler, and while it can be pretty bad, it doesn't approach the level of no ears and eyelids kind of burn that Brown is probably talking about.

While I disagree entirely with him about the euthanasia part of things, he does get to have his own opinion.

I learned a whole lot about medics when I semi-retired 8 years ago and entered the mom world. The fact is, we don't even know the half of how badly our perspective is skewed from normal...most people wouldn't even begin to joke around about things that we can totally handle, indeed we *must* joke a little bit or we will just go nuts.

Darkness follows us where ever we go, or rather we follow darkness. If we don't grow accustomed to it, learn to deal with it in its many permutations, and even learn to enjoy it or embrace it, we won't last long.

My girl is fine, it was all partial thickness and under 2% TBSA. She doesn't even think it hurts, which is a total miracle when it's all blistered and nasty looking. Initially I thought it looked waxy and gray, which made me think it was full thickness.

Firetender, I appreciate the sentiment, but I think you're a little bit off base here. Medics talking amongst themselves can be expected to say some shockingly bad things, but this doesn't approach the level of badness I've seen IRL. Sometimes, the more bad the talk is, the funnier it is in the blowing off steam moment. This is one of the reasons my department doesn't allow on-duty medics to eat in at any restaurants. You just never know where the directionless conversation is going to go.

 

[abckidsmom]

As far as if I would have a conversation like that in front of a parent who is having a child that is experiencing a traumatic event, I can absolutely say that I wouldn't. More than likely that parent is having a very difficult time trying to comprehend exactly what has happened and what is currently happening to their child, they do not need to be burdened with the thoughts of what the outcome may be or what their child's quality of life will become. As EMS providers we have a duty to care for our patients not only physically, but emotionally as well, this includes the parents of an injured child; now are we really keeping to that principle if we're putting ideas such as the aforementioned in the parent's head? While we all have our own set of personal, spiritual and ethical beliefs, it is not our job to express those to our patients.

Btw, I want to point out that I am in now way condemning nor supporting what forum members may have said in the 100% directionless thread.

We just need to be aware of on-scene talk, and how it's heard by the bystanders. I trust Brown's professionalism to the point where I believe he would never let his personal beliefs about burn recovery surface while he was in the middle of caring for someone with serious burns. Whatever your personal beliefs are, you don't get to pick for the other guy.

The scene is completely not the place to be making these kinds of decisions, anyway. Burns almost always look worse on the scene than they do wrapped up all neat and tidy in the hospital.

What we say among medics, even medic-patients, is totally different than what we say among "normal" people. We just have to make sure the audience is right for the topic of conversation.

 

[crazycajun]

OK I really hat when I have a busy weekend and don't get to catch up on my reading. IMHO we all have been guilty saying things that just shouldn't be said on here. We tend to forget that although the people here are faceless and sometimes nameless, they are part of the EMS family. Our Family. I must agree with Firetender. When it your child that is hurt or a loved one, the last thing you want to hear is about death or morbid details. When my son was involved in his accident many EMS professionals showed up to check on him. We were all outside talking one morning and someone made the comment that if he was in my sons situation he would want someone to pull the plug to the ventilator. I didn't say anything as I was too worried about my son but it bothered me a great deal. I know what he said wasn't intentional but it still upset me because it was a decision I was already trying to avoid. I guess my point is this, when it comes to friends that are also in EMS remember they need compassion as well.

 

[fast65]

We just need to be aware of on-scene talk, and how it's heard by the bystanders. I trust Brown's professionalism to the point where I believe he would never let his personal beliefs about burn recovery surface while he was in the middle of caring for someone with serious burns. Whatever your personal beliefs are, you don't get to pick for the other guy.

The scene is completely not the place to be making these kinds of decisions, anyway. Burns almost always look worse on the scene than they do wrapped up all neat and tidy in the hospital.

What we say among medics, even medic-patients, is totally different than what we say among "normal" people. We just have to make sure the audience is right for the topic of conversation.

Oh I completely agree, on scene talk happens and it's just not intended to be heard by the patients or bystanders. I really wasn't trying to question the professionalism of anyone, I hope it didn't come off that way.

 

[firetender]

Spot on

we don't even know the half of how badly our perspective is skewed from normal

Darkness follows us where ever we go, or rather we follow darkness. If we don't grow accustomed to it, learn to deal with it in its many permutations, and even learn to enjoy it or embrace it, we won't last long.

Firetender, I appreciate the sentiment, but I think you're a little bit off base here.

...on all counts, especially the off-base part. I've always been that way...but I got people talking! And the responses have helped me better understand some important people in my world right now.

Always willing to be busted!

 

[usalsfyre]

I learned a whole lot about medics when I semi-retired 8 years ago and entered the mom world. The fact is, we don't even know the half of how badly our perspective is skewed from normal...most people wouldn't even begin to joke around about things that we can totally handle, indeed we *must* joke a little bit or we will just go nuts.

This is a big, big, big thing. And it's not just medics, all those around medicine have a different view, although EM and critical care folks seem to be a bit more warped then the rest. My wife's been not working for threeish months now. I've already watched her perspective shift back towards "normal". Which has helped mine swing back that direction, and helped a bunch with me not taking work home. We have a lot more conversations about the house, the kids, what we want to do in retirement, ect rather than "you won't belive this patient I had today". It's helped me decompress a lot. Convinently I have EMTLife to vent to, so I no longer have to take the bad crap home. I just dump it off on you folks .

Darkness follows us where ever we go, or rather we follow darkness. If we don't grow accustomed to it, learn to deal with it in its many permutations, and even learn to enjoy it or embrace it, we won't last long.

Every single person I know who has been in the two fields I mentioned above for longer than a year or two has a small, very, very dark place somewhere within their psyche. The jokes are a way of tiptoeing around it, maybe acknowledging it's existence without opening it. Most won't ever open it unless forced (I know I'm d@mn well not willing to). I do wonder, and perhaps fear, what happens if it ever becomes not such a small part. Enough rambling by me though.

My girl is fine, it was all partial thickness and under 2% TBSA. She doesn't even think it hurts, which is a total miracle when it's all blistered and nasty looking. Initially I thought it looked waxy and gray, which made me think it was full thickness.

Great to hear. She'll have a cool scar story to show her brothers up with .

 

[lightsandsirens5]

No offense but I think the comments made by LightsandSirens are selfish.

Why would you put a family member in that situation? Commit a criminal act to satisfy the wishes of a loved one.

Woah, Woah Woah!!! Not what I was getting at. For one thing I just discovered this thread and am still reeling and trying to understand what exactly is going on. For the other, what I meant was that if I was dying and modern medical care would keep me alive, but nothing else, then just let me die. I do not advocate euthanasia or anything of the sort. In other words, if I'm not dying, don't kill me. But if I am dying, and saving my life would result in a life with no real quality, then let me pass on naturally.

I don't think that is selfish, do you?

And I can seperate my professional behavior from my personal beliefs. What I choose to live through or with is my personal decision. I would never project my beliefs on quality of life on a patient or they're family member its they're choice and they're wishes.

Agreed 110%. I would never let my personal beliefs cause me to force something on someone. I will do everything in my power to keep someone alive when I am at work. My PERSONAL preference for MYSELF and no one else is that I be allowed to die if I am severely burned.

I must stress, if I work a call with a burn pt, I will do everything I can. Even if it's 100% full thickness burns, I'll do my darnedest to keep that person going. I am perfectly capable of completely separating my personal desires for myself from my professional attitude and character when I am working.

 

[CAOX3]

Woah, Woah Woah!!! Not what I was getting at. For one thing I just discovered this thread and am still reeling and trying to understand what exactly is going on. For the other, what I meant was that if I was dying and modern medical care would keep me alive, but nothing else, then just let me die. I do not advocate euthanasia or anything of the sort. In other words, if I'm not dying, don't kill me. But if I am dying, and saving my life would result in a life with no real quality, then let me pass on naturally.

I don't think that is selfish, do you?



Agreed 110%. I would never let my personal beliefs cause me to force something on someone. I will do everything in my power to keep someone alive when I am at work. My PERSONAL preference for MYSELF and no one else is that I be allowed to die if I am severely burned.

I must stress, if I work a call with a burn pt, I will do everything I can. Even if it's 100% full thickness burns, I'll do my darnedest to keep that person going. I am perfectly capable of completely separating my personal desires for myself from my professional attitude and character when I am working.

Your reeling, really?

You made a comment in an online forum and someone quoted it, we should expect that.

I didnt mean to jump on you personally, just the context of the statement is what I take issue with.

Backing off the original comment is kind or well... You know, I still wouldnt agree with it, however I would respect you more for standing by it then attempting to distance yourself from it.

Anyway, nothing personal.