Tom Trimble's TaleTurnbullClanCrest.jpg (6056 bytes)
"Audaci Favet Fortuna"

Excerpt from the song:
"San Francisco" 
sung by Miss Jeanette McDonald, (232kb)
TomAtEmerCareSymp 003.jpg (827017 bytes)
Sound of San Francisco:
Cable-Car Bell-Ringing Contest Winner: Ken Lunardi
from San Francisco Cable Cars Website

Biographical Information:

       As a San Francisco native, I have worked in and around that city nearly all my life. For several generations my family have been medical men and women. My interest grew from first aid training in the Boy Scouts, through Red Cross training, ambulance work, the early development days of Emergency Medical Technicians and Paramedics, and through nursing. I am a Registered Nurse and Certified Emergency Nurse who finds personal and professional satisfaction and challenges in providing emergency care .

       I live in San Rafael, the county seat of Marin County which is north of The Golden Gate ggbridge.gif (4414 bytes) and San Francisco.

      My wife, Gail, has for years been a grower and exhibitor of roses, becoming a Consulting Rosarian to share that ability with others, then an Accredited Rose Judge for official shows of the American Rose Society. She has now been honored with selection as an American Rose Society "Master Rosarian"; one of the few to be first chosen for this new distinction. She also serves as the Webmaster of the Marin County Rose Society, a chapter of The American Rose Society, and is Webmaster for the Northern California Nevada Hawaii District of the American Rose Society. was the fourth such page in the country to be established and has an excellent reputation. It features suggestions on choosing roses that do well in the area, timely advice for the current month on rose care, poems related to gardening and nature, the programs and benefits of the society, and some great links to other rose resources upon the Internet.

       Our son, Scott, was graduated from University of California, Berkeley, in Anthropology. His excellent web pages feature a great deal of history. He is an accomplished genealogist who has published a book of family history far beyond what was previously known. His passion for film location is shown by his vast website of Film In America, and his career as a Location Scout for Hollywood feature films such as Mission Impossible III, Star Trek, television shows, and commercials.

      Our son, Daniel, is a Consultant in Software Marketing.  He is also an officer of the United States Coast Guard Reserve. He was graduated from  Golden Gate University.

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Professional Information:

Job title: I am an Emergency Nurse. My opinions as a professional may not represent or be endorsed by any employer or be in any way "official."

Key responsibilities: I carry out the entire range of duties of a a staff nurse in a hospital emergency department. I provide direct care for patients, support for their families, active co-management with physicians of the care provided, patient advocacy, and ensure care is provided in a safe environment in consonance with all applicable laws, regulations, policies, and procedures. I act as Charge Nurse, and support orientation and in-service training within the department.

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Current Projects:

Emergency Nursing World ! Web Page
       My most time-consuming and demanding project is the continuing development of a website that supports Emergency Nurses in their practice throughout the world in all their varied settings. It went online July 4th, 1996 (the 220th Independence Day).
Em-Nsg-L: "The Emergency Nursing List" e-mail group (List Administrator)
{To subscribe, click on the link to activate your browser's mailing feature, , and send the message
"subscribe Em-Nsg-L [your real name]" without, of course, the quotes or brackets}
       This Internet mailing list supports worldwide communication among emergency nurses through the convenience of e-mail. It has become "The Internet Voice of Emergency Nursing" and currently averages over nine hundred members from 16-18 countries.

California Emergency Nurses Association

     I was very pleased to serve for ten years (1997-2007) in a pioneering role as Webmaster for Cal ENA and to support it by hosting and administering the site. It was very satisfying to have contributed to the organization and success of our specialty so directly. Much of Cal ENA's communication has been streamlined this way, It has been honored with awards by both Cal ENA and national ENA.     

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Personal Interests:

Emergency Nursing   
       I enjoy and feel "called" to the broad spectrum of nursing patients with emergencies as it spans ALL specialties, is time and "critical-ity" focused, deals with "raw" and un-diagnosed patients not yet "instutionalized" in their behavioral responses, and seeks to educate and support patients and their families in maximizing their own abilities to cope with sudden changes.

Airway Management of the Emergency Patient and Management of the "Difficult Airway"

       Airway Management is my favorite area of expertise in both "nuts & bolts" and "Art & Science" aspects. When a patient is critical, I am most often at the patient's airway until support arrives and to assist or guide thereafter. This stems from long experience as a paramedic, training, and teaching BLS/ACLS.

Respiratory Disease

      Respiratory Disease, naturally, therefore comprises an area of special professional interest for me. This is especially so in that it is a field in which patient education can vastly improve the management of the disease, as in Asthma, for example.

Analgesia & Sedation

      Analgesia & Sedation, {conscious, dissociative, deep, and hypnosis-assisted} are a frequent need and therefore a field of concentrated interest for me. This affords me the opportunity to lessen patient suffering, facilitate care, and minimize an obvious area of risk. Safe provision of these services may render hospitalization unnecessary for some patients thus financially helping both patients and the hospital.

           Hypnosis is one name for ways of communication of ideas and feelings and enhancing learning that bedside practitioners have used since ancient times by many names and forms such as "rapport", to "Guided Imagery or "Biofeedback." I find that it is a sensitive and powerful way of enhancing therapeutic effect, minimizing anxiety, strengthening of self-coping, and improving patient learning, or of forgetting unpleasant aspects of care. Training can sharpen these skills, and allow them to be used in naturalistic ways, without fear or even formal trance induction. One simply uses and builds upon the patient's own natural stress responses, and guides them in beneficial ways.

Patient Education
      Patient Education is a large part of what I do and is interwoven in most of these areas of interest. This correlates with my background in teaching First Aid, BLS/ACLS, and my degree in Health Science - Community Health Education.

Professional Training
     I like to share and teach. Teamwork is an essential in delivering good emergency care. The instantaneous and dynamic demands of emergency care put a premium on inter-capabilities of the entire team. As we all support each other's efforts for the sake of the patient, so too do we all learn from each other: ---"a whole greater than the sum of its parts." In my institution's Emergency Department Training Program, I am responsible for didactic instruction in Respiratory Problems & Airway Management, and for Neurological Emergencies, including acute stroke.
Medical & Nursing Informatics

     Medical & Nursing Informatics is a burgeoning field with great potential to help us use computers to help patients. While I am not a programmer, per se, I believe the developments in this area will have great impact on what we do, how we do it , how we store it, and how we manage it.

Hobbies, etc.

      Wow, where does one start? Reading (especially history, biography, travel), Music (I love listening to everything from Opera, bagpipes and the Scottish Games of the Caledonian Club of San Francisco, Country & Western, Broadway, and much more---can't play or sing a thing!), Internet, Travel, Scouting.

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Articles, and resources,
Nursing Links,
Medical [and other] Links {by specialty},
Pre-hospital Care & EMS Links,
useful to the practice of Emergency Nursing..
Marin Rose Society

       I'm really quite proud of my wife and her accomplishment in building this prize-winning website. (It was only the second webpage by a local rose society on the Internet ---preceded only by Santa Clara County Rose Society.) She succeeded sooner and in far less time than I took in laboring on "ENW." She is an outstanding exhibitor, Consulting  Rosarian, and Rose Show Judge. She also edits the website of the Northern California, Nevada, Hawaii District of the American Rose Society.
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Contact Information:

Tom Trimble, RN

Editor and Publisher
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send_e-mailGlobe.gif (2226 bytes)[email protected]

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Comments and Suggestions:

Please tell me what you think about this website and how I might improve it.

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Tom Trimble's Tale (Personal Page) [] is part of:
Emergency Nursing World !   []
Tom Trimble, RN [[email protected]]
Last revised: November 27, 2010







Clinical Articles Special Articles


2003 ASA
"Difficult Airway Practice Guidelines"

Airway 10 Commandments
Action Plan for Airway Hell!

Using Anesthesia Bags
Optimizing Mask Ventilation
Sedation Guidelines
Sedation Principles
Sedation Checklist

Aphorisms, Maxims, and Pearls
Discharge Instructions
I.V. Starts -Improving Your Odds!
Pediatric Hints -An ABC
Tips & Tricks -from Other Nurses
Manipulative Behaviors by Patients

Heat Emergencies
End Tidal CO2 Monitoring
in CPR: A Predictor of Outcome

Fix This Airway!
Crises in Airway Management

Bioterrorism References
Headache & Stroke
Outsize Patients
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The Poisoned Patient
Respiratory Encounters (I Can't BREATHE! Part I)

Respiratory Encounters (I Can't BREATHE! Part II)


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CPEN Review - Putting
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