I spent my Friday and Saturday traveling through New Jersey, New York, Connecticut, and eventually to Massachusetts after a painful, traffic filled ride up Route 15, a ride that has rewarded me so many times with a much quicker travel than using 95, but I digress.  Friday, our travel framed a stop at Pulse Check, an EMS conference held just north of the New Jersey, New York boarder, and Saturday I spoke at the Massachusetts EMS Conference in Springfield where I spent the first twelve years of my career. Both conferences had some great topics however there was one thing that really summed up one of my major frustrations with EMS on a national scale.  It is something that I have seen at every conference that I have attended including the major ones like EMS World and EMS Today.  A speaker will be talking about his or her topic, and they will get to the treatment and management portion of the lecture.  For example, let’s say someone is presenting on chemically managing a combative patient.  The exchange will go something like this: Speaker: “In MY system, we are able to give the patient 5 mg of Haldol and 5 mg of Versed for sedation, and then we can call our doctors and ask for more.  How do you do it?” Student #1: “We don’t have orders, but we carry Ativan for seizures so if we can convince our doctor to ‘back door’ the protocols, we can give them some Ativan to sedate them” Student #2: “Well, in my system we have the protocol in place the same as yours, but I cannot even take the meds out of my bag unless my doctor says I can, and when I call the hospital I have to speak to a nurse and then ask them for a doctor.” Student #3: “What is chemical restraint?  Are you talking about when they get combative, I call for four more police officers to come and they pepper spray my patient on the stretcher so we can four point them?” So here we have four different experiences from four distinct, different systems dealing with the same problem in four completely...

It took some preparation but the time is almost here. Tomorrow morning I am presenting at the Massachusetts EMS Conference. On a personal level this is quite the first step for me. My goal, ultimately, is to be able to present at EMS Today or EMS World sometime in the next year or two. While I have always been quick to present on topics that have to do with the well being of a paramedic, and better treatment from a provider stand point rather than a clinician’s stand point, my class tomorrow is clinical in nature. The topic is one that I am passionate about: capnography, and specifically, how it should guide and effect your assessment and treatment. Furthermore, this visit marks my first “full” return to Massachusetts. I spent twelve years up there that I valued greatly because of the friendships and work relationships that I made. Truth is, if it was not for the time that I spent up there, I would not be the paramedic that I feel that I am today. In just six short weeks, I will mark my first year in my new system, and it has been quite the ride. My views on a lot of things have changed: skill dilution, and working in a union shop just to name a few. Municipal EMS is fantastic, and I have to say, I am now a firm believer that third service EMS is the best model. It might not be the most fiscally responsible but in my opinion, it does not get much better than that, especially for someone like me who has the utmost respect for fire fighters with zero desire to run into a burning building. But I digress. . . It’s time to suppress the butterflies and make a few last minute changes to my presentation, then tomorrow at 11am, it’s go...

I am the kind of person that craves numbers.  I’l comb the sports section of any website or newspaper looking for the line scores from baseball games, and the statistical leaders for the NFL in a given week.  I’ve always spoken in numbers.  I think that they are a great way to measure effectiveness in EMS. We have gotten to be very good at tracking response times.  We have defined methods of how to do it, and often when a system decides on a tracking method, we stick with it.  The same cannot be said, however, for tracking ROSC rates.  While everyone in EMS can agree on what a ROSC is, we struggle in agreeing upon what a ROSC is not.  Some systems omit traumatic arrests from their ROSC numbers.  Others do not count field pronouncements.  Personally, I feel that if a provider puts his or her hands on a patient’s chest with the intention of doing CPR, then that call should count positively or negatively against their ROSC rate depending on the outcome. I feel, however, that there are a few other statistics that we as EMS systems should be looking at on a regular basis.  Here are a few examples: PMD input vs. paramedic impression – Keeping with the theory that an EMS system is responsible for a patient from the moment the phone is picked up to the moment that they turn the patient over to a higher level provider at a hospital, I feel that tracking the effectiveness of PMD is incredible important.  We need to recognized that being as accurate as possible from step one is extremely important in providing the correct resources for a given EMS call. Last month, I wrote a post about the recoding of shootings and stabbings in Oakland, California and shared my thoughts as to what I felt that the problem was.  In the original article I referenced many were critical of Priority Medical Dispatch.  Over the years, my opinion of it has fluctuated.  I have seen it work tremendously well, and I have seen it be the downfall of an EMS system.  The bottom line though is the industry is moving away from...

Well, here we are, it’s October and in just ten days, I will be back in Massachusetts standing in front of what will hopefully be a room full of people giving a new lecture for the first time: The Solution is Pollution.  It goes without saying that I am quite excited.  I am hoping that this will be the first step for me, and maybe someday, AJ Heightman or Scott Cravens and their teams will see fit to bring me in as a speaker at EMS Today or EMS World Expo. For a long, long time, I was completely terrified of public speaking.  Now, I love it.  I do not know when the change happened, but it did, and hopefully I’ll be able to capitalize on it. The conference is scheduled for two days, October 18th and 19th, and it is being held in Springfield, Massachusetts at the Mass Mutual Center right in the heart of downtown Springfield.  There are hotels just a block away from the convention center, and plenty of places to eat and drink just a few blocks away. Over the last four or five years, the Massachusetts EMS Conference has grown exponentially, and this year is no exception.  They are expanding their exhibit hall, and continue to bring in high quality speakers to lecture on the topics that their audience wants to hear about.  This year, I am lucky enough to be in the company of people like Dave Aber, who had to put up with me as my Field Training Officer for my first six weeks at my new job, Jim Politis, and someone I think very highly of: Dr. Ed Racht, the national medical director for American Medical Response.   Unfortunately, due to my travel schedule I will most likely miss most of the lectures from Friday, but I will be there all day on Saturday, as that is the day that I am presenting. Registration for the conference is not closed yet.  You still have a chance to get in there and not only get some credits but have the opportunity to take control of your field and be a better provider for you and your patients.  Just click...

Over the last couple of years, there has been a group of paramedics that I work with who have taken it upon themselves to grow mustaches in the name of cancer awareness during the month of October.  The event is known as Stachetober, and each year, more and more paramedics and EMTs throughout my county have joined to participate.  Many would ask why we are not doing this in November, as many other people do, but many view November as a month where you do not shave at all.  Sadly, our departmental regulations prevent that.  They do, however, allow you to have a sweet mustache, so we do our own thing in the month of October. This year, against my better judgement, I have decided that I am going to join my colleagues (who are all male by the way) and grow myself as sweet a stache as I possibly can. In keeping with the growth of Stachetober, we have also decided to take on a charity this year, and are soliciting for donations from friends, family, and the general public.  The charity that has been selected is All the Difference Inc Pediatrics Services For Developmental Difference which one of my colleagues rightly describes as “a phenomenal non profit company that works with children with developmental disabilities and special needs.”  It is a charity that is near and dear to one of our paramedics’ hearts. So how can you help?  How can you support us in growing our sweet sweet ‘staches?  Just head over to our GoFundMe account and contribute!  Any amount will help. . . even if it is just a dollar.  Any amount will help us make the itching, the funny looks, and the laughs worth it.  More importantly you will be giving to a GREAT charity. And, as always, thanks to everyone who takes the time to contribute.  The money this year is going to a great cause.  Let’s see how much we can raise!...