WARNING: If you think that this will be even half as entertaining as "Fish in the ass" press the "Back" button NOW! This is kind of a depressing story, but has information that should re-enforce what you already know.
Gather around boys and girls for the second edition of "Ambulance Tales". Today, this story is a cautionary tale that is more educational than entertaining. This applies to everyone because one day we will all check-out to the "Great Big AR15.com in the Sky": the place where all the threads are BOTD, black rifles are all legal/pre-pre-ban (even in PRK), and whenever you post a vid, nobody ever calls "dupe". Yes, we are all going to have to die someday. Some of us will go out in service to our country and to them, they have my eternal gratitude. Some will go suddenly due to heart attack, aneurisms, or trauma. But most of us will slowly decay in "skilled nursing facilities" waiting for the day when our hearts stop beating or when someone we thought was close to us decides that you have suffered in an undignified position a few years to long and don't want the financial burden anymore.

In case you were not around for the last edition of "Ambulance Tales", allow me to introduce myself. I am a glorified taxi driver, also known as an EMT. I call myself a "glorified taxi driver" because most of the time all I do is ferry people from place-to-place, once in a great while stuffing something up thier noses or down thier throats. Every once in greater while, when I'm not sitting in a parking, lot leaching off wireless internet hot spots while downloading porn to my laptop, I have something interesting happen to me. This is one of those stories.

A long, long time ago, when I was still in employment training, I had a strange series of calls involving the same person. It was an unseasonably warm day when we arrived at a Skilled Nursing Facility (SNF). We were taking an old lady to the hospital because she had contracted pneumonia. No big deal. She was in no immediate danger, but she did need medical attention that is only available at hospitals. I took my time and went through her paper work. In getting the report from the nurse, among other things, I got her "code" status.

A "code status" is the level of care a patient would like to recieve. If a patient is "Full Code", they want every possible type of care to prolong thier life. Give them drugs, chest compressions, artificial respiration, the whole nine yards. If they are "No Code" and you have the document, you cannot legally administer care to them because they want to die. There is "full code", "no code" and everything in between.

Anyway, back to the story. This ladies code status was "Full code", which was fine. I drove her to the hospital without anything happening. No big deal. Later that afternoon, she was treated and discharged back to the SNF. At the hospital, my training officer spoke with the daughter of the patient who informed us that she had "power of attourney". She showed the papers showing power of attourney and told us that she did not want her mother to be recucitated: "no code". Fine, she is up in years and is not alert/oriented and has multiple degenerative desieses. It is normal for family members to change code status. Just like the ride over, nothing happened and all I did was take vitals. So far, nothing out of the ordinary happened.... At around 3 a.m. we got a call to the same SNF. When we got there, it was the SAME DAMN LADY. She was barely breathing and her daughter was standing there telling us to get her to the ER. This is the same daughter mind you that told us that she wanted her mother to not be recucitated! She changed her mind when she saw her mom dying. Well, this woman was in bad shape, we took her to the hospital lights/sirens, using the bag valve mask (BVM) to give her artificial respirations. Her vitals were not good and I thought for sure she would die on us. But we passed her off to the ER and went away shaking our heads. That was the last day I worked for the cycle and I had the next four days off. When I got back the next week, we got a discharge order and when we get to the room, we found out that the poor lady pulled through and was alive (if you can call it that). In going through her discharge papers, I found that she was once again "no code". Her daughter came back once again and changed her status the day before.

The lesson boys and girls is this. In case you didn't learn from Terry Schiavo, know what the hell you want done to you in the case you become incapacitated. Not only that, FUCKING WRITE IT DOWN GODDAMNIT!!! Make it legal too. I am not trying to criticize the daughter or pass judgement on anyone. Everyone is entitled to thier beliefs, but for Christ sake, when you make a decision and stick to it. Changing back and forth only screws the patient. For the record, if any of you see mr. sewer_urchin in a decrepid state, where he is unable to bath himself, feed himself or use the bathroom on his own PLEASE!!! I IMPLORE YOU FOR THE LOVE OF HUMANITY PULL THE DAMN PLUG! Now go back to your seats and be good. Stay tuned next month for another edition (if I feel like it).

I didn't know I HAD a code status.

My code status is up up down down left right left right B A start.

Quoted: Quoted: I didn't know I HAD a code status. If I had to guess, there's a default to "full" unless you say otherwise.

You are correct. Everyone is full code unless the patient or guardian decides otherwise.

Quoted: My code status is up up down down left right left right B A select start.

Fixed it...you selfish bastard.

Quoted: Gather around boys and girls for the second edition of "Ambulance Tales".

Keep 'em coming, S_U.

You may call yourself a "taxi driver", but I'll bet
the people who have pulled through due to your
prompt care think otherwise.

Are all blackrifles F/A in the afterlife? Im guessing there are no tax stamps in heaven

Cool story!

I am the ambulance driver here at work, and driving to the local hospital is a welcome diversion from a normal workday.  Especially after working hours, good for 5 hours OT.

Most of the guys ferried into town are cardiac, usually 2 hours - 1 day after prime rib night.  They say it is symptomatic of an aging workforce but it has to be something more.  I kid you not, some of these construction workers can't walk 100 yards without  losing their breath.  I asked the medic for a running total on these emergencies and he would not even guess.

Saw a guy get shocked for the first time last week.  31, same build as me... scary.  Not like the movies - after the shock, the guy curled up in a ball in pain and started swearing.  

MY advice is to always check the lugnuts on your ambulance before a long trip.  

Yeah, definitely full.  Definitely code.

Thanks, SU!  I appreciate your stories and knowledge.  

Quoted: Quoted: My code status is up up down down left right left right B A select start. Fixed it...you selfish bastard.

that si old school there gentlemen




I am DNR up here (do not resuscitate, which I guess is the same as no code down there, my wife and everyone who knows me knows it, it is also in my Will and in several other legally binding documents

Quoted: Quoted: Quoted: Quoted: My code status is up up down down left right left right B A select start. Fixed it...you selfish bastard. that si old school there gentlemen I am DNR up here (do not resuscitate, which I guess is the same as no code down there, my wife and everyone who knows me knows it, it is also in my Will and in several other legally binding documents You wouldn't think so for the cost of that game used on Ebay, $30+!

You are kiddign right?  Hell, I still ahve at least one copy at my Mother's......


Maybe I should start selling off all my old games

I've got "In case of emergency, keep me fucking alive" tattooed on my chest.

I'll reply because sometimes the SNF has ZERO idea of what code status you are.

Gramps is 89 tomorrow. He has been in and out of SNF and hospitals many times in the last year that I have been living with him and providing 24/7 care for him. He goes to ER usually for aspirated pneumonia. Stroke 2 years ago and has trouble swallowing. Gramps and his grand daughter who has POA, decided he is DNR, but with comfort care. Means that no heroic measure be taken other than o2 and pain meds. No tubes.

Well, Gramps has minor, minor diabetes. So slight that I never really addressed it. It is not life threatening. For God's sake, if he's hungry for a cookie - GIVE IT TO HIM. He's 89.

Well, the last SNF decided that they would give him Glucophage AND INSULIN together and let the drugs fight it out. Gluco will not bottom you out in your blood sugar but keeps it at a good level. He has been on Gluco for 18 months or so. They also decided to check his sugar level every few hours, which is not needed at his level.

Well, idiot nurse checks level at 9p and was 160 or so. She injects insulin at 11 or midnight without feeding him. He goes into a stupor. Non-responsive. HMMMM????? She calls and tells family that he's about to expire because he is in shock and his sugar level is 22. Yes, 22. She tells us she is not going to call EMS because he's DNR. POA quickly corrects her and informs her that she is about to kill him with her mistake. She then calls the ER taxi. The one with the o2, lights and siren.

I meet him at the ER and talk with the Doc on duty. To my surprise, the Doc decides to give him a meal and see if he snaps out of it. He was awake because they gave him some juice somewhere along the line. He perks right up and is fine. Imagine that? We go back to the SNF and then I find out they are giving him insulin for a nearly non-existent issue.

Well, we pull him from this facility and place him in a better one. Still looking at a lawsuit for negligence. Believe me, if he were to kick off, it would be less of a financial burden to us because living in an SNF ain't cheap.

Word of advice to all here. LONG TERM CARE MEDICAL INSURANCE!!!! For you, your parents and your children or grandparents. Medicare will only cover so much and to use Medicaid, you need to have less than $1500 in assets otherwise Medicaid gets it or you need to liquidate and pay for care out of your pocket till you hit to that amount. They go back 3 years and check to see if you have gifted anything worth value. Yes, you need to be poor to use benefits that you MUST pay for all your life. Congress doesn't use Medicaid, but you do.

Good luck and thanks for the insight.

Quoted: I'll reply because sometimes the SNF has ZERO idea of what code status you are. Gramps is 89 tomorrow. He has been in and out of SNF and hospitals many times in the last year that I have been living with him and providing 24/7 care for him. He goes to ER usually for aspirated pneumonia. Stroke 2 years ago and has trouble swallowing. Gramps and his grand daughter who has POA, decided he is DNR, but with comfort care. Means that no heroic measure be taken other than o2 and pain meds. No tubes.

HUGE +1 on that.

SNFs often have no clue in general. I always ask for last set of vitals and they always report b/p within normal limits, but I've can't count the number of times they report 120/80, 70P when the actual blood pressure is something like 84/30 with a pulse of 150. Makes me wonder how many people die because of them. But these facilities keep my company in business so I just do my job. For those of you with children, be nice to them so you don't end up in a shit hole like a lot of these places.

Quoted: I've got "In case of emergency, keep me fucking alive" tattooed on my chest.

I've thought about "CORONER:  Please try CPR one last time."