It is time for me to take a few days off.  I am heading to New Jersey for the weekend to enjoy the annual fire department brewfest/fund raiser in Island Heights where I grew up.  There will be no podcast on Monday, but posts will start up again next Wednesday. Enjoy your weekend, stay safe if you are working and I will see you in July!

For this week’s podcast it is just me.  That’s right, 15 minutes of me rambling (and ranting) a bit about the situation in Belchertown Massachusetts and the direction that I feel that EMS needs to go in the future.  I make some bold statements in regards to departments who are trying to get into EMS. To read more about the four Belchertown paramedics who were laid off, click here. For the Holyoke Fire story, click here. To check out Inside EMS where Rom Duckworth, Chris Cebollero and Kelly Grayson talk about fire-based vs private EMS, follow this link. As always, I welcome your comments on any of these matters. To download this week’s podcast, click this link!  Otherwise, use the player...

Last week, actor Tracy Morgan was involved in a serious motor vehicle accident that also killed a friend of his. The pair were struck by a Walmart owned tractor trailer that was being driven by a driver who had reportedly been awake for more than 24 hours. When I heard reports of the accident the circumstances surrounding it, I started to wonder how many responders at the scene were in the same boat as the driver. Long hours are a well known part of our job, however how long is too long? In the system that I work in now, many of our BLS units are staffed by people who are on 24 hour shifts. A number of the people working these units have a number of different shirts in their drawers from the departments that they work part time for. It is not an unusual occurrence to find some people working back-to-back 24 hour shifts in an attempt to cram a good number of hours into their work week to maximize their days off. In the study that Fitch & Associates did of Alameda County back in the mid-2000’s, it was noted while riding with some crews that “many responders appeared exhausted.” They added that one even “nodded off during a midday conversation.” Again, ALCO was a system where people would try to cram their work week into a couple of days. The effects of sleep deprivation and sleep inertia are well documented in the medical industry as well as the transportation industries. This is why medical interns have seen their hours cut, and pilots and truckers are required to have a certain amount of downtime. Here in the world of EMS though, we push forward. Many of us work multiple jobs. For the first time in my career, I do not have one. It was not unusual for me to work sixty-plus hours at my full time job at AMR, and follow that up with a shift or two at my part time job without a second thought. It was natural to me. I remember days as a supervisor where I would encounter certain employees in the same boat as me who...

“I’m just a volunteer EMT.” Have you ever heard anyone say that?  Neither have I.  Just about every volunteer provider that I have encountered in my career, regardless of how long they have been doing it or what their dreams and aspirations actually are take a ton of pride in serving their community.  As many readers already know, I come from a family full of volunteers and an area that up until about ten years ago, the area that I grew up in was almost 100% maintained by volunteer EMS.  Sadly, volunteerism is on a decline, and there are many, many reasons for that.  A few weeks ago, EMS 1 reposted an article and tried to tackle some of those reasons with a few really good articles. One article cites expanded EMT training for lack of volunteers.  EMS 1 Editor in Chief Art Hsieh then wrote what I feel is an excellent reply pointing out a lack of change and evolution as the culprit.  Both stories make some excellent points. In the past, I have written rather candidly about the problems as I see them that the New Jersey State First Aid Council presents to EMTs in my home state.  Their organization demands different standards for staffing a volunteer ambulance than a paid ambulance to try and keep volunteer EMS alive.  Essentially, they are trying to create a new level of care that is specific to their services resulting in them keeping the EMS system in New Jersey on life support. In many states EMT students are expected to learn more than they have ever been asked to before.  They are asked to expand their assessment skills, provide more invasive treatments, and give medications that previously were reserved only for paramedics.  To be able to properly understand how those medications work, a greater knowledge of body systems is also required. Enough is enough.  Sure, obtaining an EMT certification takes more time now than it did even five years ago, but there is a good reason for that.  No one is trying to circumvent the volunteer system in any state.  The changes instead are in place to improve the level of care that patients receive...

Jun 16, 2014

This week’s show is something that I am really excited about.  Since it was Father’s Day weekend, my dad Peter Kier came down to visit for the night.  I convinced him to sit down and record a show with me about his experiences as an EMT. Those who know me know how important my family is to me.  Both of my parents are EMTs and they are the main reason that I got into this field so many years ago.  Little do they know, but I am as proud of them for their accomplishments in EMS as they are of me. So check out this week’s show as I sit down and interview my dad! To download this week’s podcast, click this link!  Otherwise, use the player...

Jun 13, 2014

This is going to be my last post on this topic.  I actually intended on posting this about a week ago, but so much has come up over the past week that I kept pushing it back.  In fact, I was going to push it back even more with my Belchertown post that I released yesterday but I figured that this one could not sit any longer. The events of the “smiling and posing” paramedics in Detroit got me thinking back to a call that I did a few years ago. We were dispatched to a very well-known diner in the city I was working in at the time.  It was one that I frequented both while at work and occasionally off the job since it was close to my house.  That morning, we were dispatched to the patient having a “diabetic issue.”  The waitress told us that our patient was a regular in their establishment.  He was an elderly male who would walk down every morning for breakfast, and was a known diabetic.  Today, he came in sweaty and disoriented, and just was not himself. While the patient could follow commands, he was just “off.”  His sugar came back at 30, so we continued where the waitress had led off: we fed him glass after glass of orange juice and some toast as well.  As our treatment of the patient progressed he became more and more alert to the point where he was conversing with and joking with us.  We laughed as he jokingly told us how much he hated needles despite having to check his sugar multiple times a day. Being a busy Saturday morning, and this being a small diner (I’m sure many of my readers from Springfield know exactly the spot that I am talking about) we were the center of attention.  I’m sure people wondered what was going on as we cracked quiet jokes and then collectively laughed.  While the digital age was just starting to really take off, not many people had cameras, and the voyeuristic society that we live in today was not yet dominating the news and the Interwebs, so no pictures of the laughing paramedics...

I have had more than a few part time jobs in my career in EMS one of which was with Belchertown EMS when I lived in that town for a couple of years.  After I moved out of town, the volunteer fire department that ran less than 300 calls a year absorbed an EMS service that ran over 1,000 calls annually.  One thing to realize is that Belchertown is pretty remote.  If a second ALS ambulance responded from another community, the length of that response could be significant. I remember when the departments combined.  The reaction of many in the community was “Other towns have fire based EMS systems so I am sure that it will work here too.”  The community support for Belchertown EMS was minimal, and their director did not put up much of a fight I would speculate because he was about to transition over into a leadership position within the fire department.  People saw this as a money saving opportunity for the taxpayers.  Consolidate the departments because that was the pattern in most of the Pioneer Valley but what they did not realize is that many of these already established fire based EMS systems were set up by the right people who had an idea of what they were doing.  They recognized the value of experienced providers and stocked their system with not only “home grown” paramedics that their department put through school but people from existing paramedic level services who already had experience. Belchertown, like most EMS services in the country, was different from anything around it.  Due to the isolated nature of the town and the moderately low call volume (1,000 – 1,500) experience was vital.  Transport times to local hospitals were considerably longer than other systems experienced and it was a frequent occurrence that a tech’ing paramedic might find themselves diving deeper into their protocols than they were used to.  The department itself was set up with a lot of input from a small core of full-time employees that kept the place going which made it easier for Chief Bock from Belchertown Fire to just take over.  Turnouts from the call department were low for most fires, especially...

DC Fire and EMS Chief Kenneth Ellerbe has finally seen the light and stepped down from his current position.  Interestingly enough, he had what could be the quote of the year, “I think we’ve left the department in a much better position than when I got here.”  I am not sure what changes Chief Ellerbe made to the “fire side” of the operation, but judging from what has been going on with the EMS side, the most positive thing that has happened to the department is his departure from it. So where does DCFEMS go from here?  Inevitably, they will hire on a chief with a fire department background who might even end up being former Prince George’s County Fire Chief Eugene Jones.  While there are probably some pretty qualified candidates out there with fire based EMS experience, is that really the right direction for DCFEMS to go or should they make a bolder move? One of the best things about moving down to the mid-Atlantic region of the country is the fact that there is now a WaWa superstore on almost every corner.  It meets all my needs, and more importantly keeps my coffee cup full.  I wonder how much business their coffee provides for them in relation to the groceries, gas pumps, and delis do.  I can tell you, however, that the coffee probably takes up less than a quarter of the actual space in the store.  I am sure though that the general managers that the stores hire are well versed in all sections of their store.  I would find it unusual if they hired someone who said, “Well, I know A LOT about coffee, but the other 80% stuff, I guess I’ll find someone who knows a bit about that too.” On this week’s podcast, David Konig, Sean Eddy, and RJ Stine and I discuss this exact issue.  As a host, I try to “steer the ship” if you will, but sometimes it is hard for me to keep my thoughts contained and not soapbox.  Luckily, in this episode, David Konig said a lot of what I wanted to say.  It is time for DCFEMS to do something different. In a...