I feel bad following up yesterday’s positive CPR piece with a negative one, but I feel like something needs to be said in a greater forum than just the timeline of my Twitter account. I spent Wednesday night reading some articles that I had put aside this week, specifically ones related to the paramedics who were allegedly photographed “smiling” at the scene of a motor vehicle accident and what can loosely be referred to as “reporting” by Fox 2 in Detroit.  I would link the original story but Fox 2 has pulled it from circulation without explanation.  I am not going to beat the dead horse of the issue revolving around the picture.  If you want to read some great articles about it check out Dave Statter’s page, or see what the Rogue Medic has to say about it. After reading a few articles and looking over the Twitter feeds of those involved, I decided that I would make a simple attempt to voice my opinion.  I posted the following four tweets and called it a night.   What I woke up to was a reply from Maurielle Lue, one of Andrea Isom’s colleagues at Fox 2.  Ms. Lue, who states on her Twitter profile that she is an “Emmy Award Winning reporter” posted the following reply on my timeline:             That’s right; an Emmy Award Winning reporter told me to “STFU.”  While, with that simple statement, she lost all credibility in my eyes, I engaged in a lengthy 140 character at a time discussion with her that ended with her telling me I should contact the station if I was so upset.  I took Ms. Lue’s advice and sent the following e-mail to Kevin Roseburger at Fox 2.   Mr. Roseborough, I am writing you in regards to the story that your station did last week about the paramedics who were thought to be smiling at the scene of a motor vehicle accident.  Last night, I sat down to catch up on a number of EMS related stories that I had bookmarked, your story and Dave Statter’s (Statter911.com) thoughts on it being towards the top.  After reading both, as...

Yesterday afternoon I received a press release from Physio Control in my email, and it is a story that I think needs to be shared.  PulsePoint, a revolutionary app designed to notify users that somebody nearby might need CPR played a key role in saving the life of a patient in Portland, Oregon. An off-duty firefighter was working out at is gym when his phone alerted him that somebody outside in the parking lot was unresponsive.  Scott Brawner of the Tualatin Valley Fire & Rescue followed the app’s map to the patient’s side.  57 year old Drew Basse was unresponsive in the gym’s parking lot and found to be pulseless and apneic.  Scott started CPR until paramedics from AMR and the Clackamas Fire Department arrived on scene. Because of the app, a trained provider of CPR was at the patient’s side in less than two minutes.  Firefighter Brawner’s actions, along with the paramedics from AMR and the fire department completed the vital chain of survival that the American Heart Association rightfully promotes as being so vital to survival in sudden cardiac arrest.  The actions of everybody involved in this call resulted in the patient, Mr. Basse’s expected full recovery. It is really remarkable what we can do with technology these days.  While there is a serious shortage of people who are willing to help in situations just like this one, there are still people out there who are willing to make a difference.  Apps like PulsePoint make that possible.  Without Scott Brawner’s presence on May 9th, there could have been a life threatening delay in an emergency where seconds truly count.  While most people would opt to call 9-1-1, and stand back to let someone else take care of the problem, Mr. Brawner allowed the trained he received as a firefighter which, coincidentally is training that anybody can receive, guide him through the treatment that his patient needed until more help arrived. It amazes me that PulsePoint is not in place in more communities around the United States.  Currently, there exists a huge gap in the chain of survival.  In-hospital care is improving.  Pre-hospital care is evolving.  The gap exists though in what happens before...

May 26, 2014

On this week’s episode of EMS in the New Decade, Scott Kier and Ben Neal talk about an inspirational conversation they were part of while sharing a few Happy Hour drinks at a bar called Huck Finn’s in New Orleans at the tail end of EMS Expo 2012.  What started out as a group of medics swapping war stories turned quickly into a conversation about pit crew CPR led by Tom Bouthillet from EMS 12 Lead and Code STEMI that was the jumping off point for some major changes in Ben’s EMS system. So crack open a beer, sit back, and enjoy a night at Huck Finn’s with Scott and Ben. To download this week’s podcast, click this link!  Otherwise, use the player...

As I talked about briefly last week I was recently asked to work a little bit with a paramedic class.  My purpose for being there was two fold.  I was expected to help them review for their National Registry EMT test, and I was also asked to prepare them for the test.  Personally, I feel that these are two completely different things. Way back in 1999, my paramedic instructor told us something very early on.  He said when it came to the paramedic exam and the Massachusetts Office of EMS, “the sky is purple.”  That is to say how we feel about a question and whether we think its answer is right or wrong based on our real world knowledge is a moot point.  We had to be book paramedics, and as far as the book was concerned, the sky was purple. This is not the fault of the authors.  They produce information in a clean form, and one that cannot possibly be updated as fast as the field moves. Revisions take time, and information in industry publications is moving and evolving faster than that in books.  Study the books for the test material (purple sky) but also educate yourself outside of that when the time is right to prepare yourself for the field (blue sky). When we review for a test, we make sure that the information is in our heads.  We talk about things sometimes to the point of exhaustion to make sure that we understand mechanisms, why things work, and concepts behind information that we are expected to know.  Reviewing information makes sure that it is in our head, and that we have retained the right stuff.  Test prep is a completely different animal all together. Test prepping prompts us to then take that information and apply it in answer form to whatever questions are being asked, whether it be multiple choice, narrative answer or true and false for example.  We know the knowledge and information is there and now we need to put it into a readable form that lets someone know that we “get it.” Multiple choice test taking specifically is a skill that one must have if they...

My post today is loosely in support of one called “EMS Week Resolution” that went up this morning at The Ambulance Chaser.com.  Have a look; it is a good read essentially about “growing up.”  My take on it though is slightly different, and is something that I am not alarmed about because it is a trend that I see from system to system and while attending EMS conferences. Our friendly neighborhood Ambo Chaser points out to us that he was involved in a message board discussion about a state that was mandating all paramedics who were even short a half a credit on their continuing education to retake their National Registry exam.  How dare a state demand that?  How dare they penalize their paramedics and jeopardize the infrastructure of their EMS system over a half an hour of training?  While our favorite attorney/paramedic makes some great points about accountability and professionalism and (yet again) personal responsibility, I want to look at it from a slightly different angle. Why the heck is anyone even close to the minimum hours when it comes to training?  How could you let that happen?  We are surrounded by education in this field.  You can get it online through great sites like MedicEd and CentreLearn, and you can find enough educational classes that both provide and don’t provide CEU’s that there is no excuse to even be near that bare minimum that we all seem to try to strive for when thinking about getting ourselves educated in our chosen profession. A friend of mine once used a great saying which I have used many, many times since hearing it and frankly, it seems to fit perfectly here: “Don’t shuffle your feet you’ll trip over the bar!”  We set the bar so low that there is not only no excuse to clear it but there is absolutely no excuse to even be close to it.  If you want to talk about professionalism and being responsible for our patient actions, well, this is where it starts. Greg Friese pointed out in a class of his that I took at EMS Today one year that free pizza brings in more students than good...

This week, Scott Kier is joined by RJ Stine, Ben Neal, and Amy Eisenhauer to talk about EMS Week.  The discussion quickly turns to the panel’s attempt to answer the question of “how do we make sure that people working in EMS see as many EMS weeks as possible?” Enjoy this week’s show, and Happy EMS Week! To read more from Amy Eisenhauer, check out her blog, The EMS Siren To read more from RJ Stine, check out his blog, Hybrid Medic To download this week’s podcast, click this link!  Otherwise, use the player...

After doing some work with a paramedic class and looking at the way they studied it made me think back to how I studied when I was taking my first paramedic class back in college.  When I got to college my study habits were poor to say the least.  I was one of those people who always got it or I did not.  I can count the number of tests that I studied for in four years of high school on one hand, because I would just absorb information. I could have gotten better grades if I had applied myself more.  While I was a good test taker, I skipped a lot of homework assignments because I saw them as being busy work.  When it would come time to take a test my score would be solid.  When I would have to do a report I could research it and put something good down on paper.  Homework though, that was my downfall. Once I got to college the game had changed all together.  I went from not having to study to having to learn how to study because it was something that I had never done all that much.   I had trouble confirming for myself that I knew something without some concrete evidence in front of me.  That is why products like Dan Limmer’s Paramedic Review app were so important to me when I got my National Registry Paramedic certification a few years ago.  I could take a test, get immediate feedback on it and then have a score in front of me that gave me an idea of how well I was grasping the information. Once I got to my paramedic class I found myself having to study more and more, especially in the first semester.  While carrying a moderately high class load I had to deal with the Fick principle, acid/base balancing and pharmacology.  Oh yes.  Pharmacology.  My program brought in a doctor for a month who gave us his own four inch d-ring binder full of information.  We did not just have to learn each medication, its purpose and its dose but we had to also know contra indications, mechanism...

I’ve been giving a lot of thought lately to what would make an EPCR system perfect for me. Most of these thoughts have stemmed from the last year that I have been using what arguably is the worst EPCR system that I have encountered out of the four that I have used. Yes, I know, four really is not that many when you consider how many products are out on the market still, the thing has a long way to go to reduce the frustration that I seem to consistently encounter. What I decided to do was create a few “Do’s and Don’ts” that might give someone developing or improving an EPCR system some things to think about when working on their product. DO have an open source coding system that will allow different products like cardiac monitors to upload their data to it with the greatest accuracy possible. Make sure that event markers line up with the wording in the monitor and if possible allow the patient information we put into the monitor (name, age, case number) to import into the chart so that it only has to be entered once. Also, allow preferences to be set for each person that can include truck number, crew member, and other information that is the same for every single shift. DON’T try to do too much of my job for me. I have never met an auto generated narrative that I like. It does not matter if it is CHART, SOAPE, or anything else that you can name, things just never seem to add up. Facts get missed, and what I see with my eyes is either left under described or completely missed. Anyone who teaches a PCR writing class will reinforce the concept that your narrative is your bread and butter. It is what will tell you the most about a call if you get called to the carpet for it years down the road. It is what will get you paid if there is a dispute with MEDICARE. Narratives are so incredibly important that they need to be left to the tech to write them, not the computer. DO have a repeat or...