Jun 12, 2015

I’ve been thinking about writing this post for a week or so.  It’s a tough decision to make, but I feel that its something that I need to do. I started this blog about five and a half years ago on a whim to see if I could get myself back into writing which is something that I have always enjoyed since childhood.  Now, here I am almost 400 posts later, and still going strong.  Anybody who reads what I write regularly knows that there has been a bit of a slowdown as of late.  That is mainly due to the amount of stuff that I currently have going on in my life outside of the blog.  EMS Compass, a part time job, teaching, my full time job, traveling, a social life.  Most of my “EMS related” time ends up pretty tied up leaving less and less time for writing. As far as internet age goes, five and a half years is pretty old.  Most of the blogs that I pick up and read seem to have a shelf life of six months or less.  People get into writing, put 110% into it and then just grind to a halt mostly due to a lack of material.  Somehow, I pushed through that and found that comfortable balance between having things to write about and posting them in moderation so that I could stay ahead or at least keep up with my posting schedule.  Its not easy to do, and for anybody looking to start a blog that is the biggest tip that I can give you. What it comes down to is I think that it is time for me to take a short break from writing here at EMS in the New Decade.  The blog is not going away by any means.  Instead, I am simply going to take a few months off and start fresh in September.  This will give me time to get reorganized, deal with what is shaping up to be a very busy summer, work on some other side projects, and just do some writing in moderation so that when I do come back in September I have lots...

May 18, 2015

With EMS week upon us, I wanted to talk about what this journey through EMS has meant to me, and what it has taken to take some of the steps that I have in my career and there is no better place to start than that first leap. One of the most common questions that I have been asked by new and prospective EMTs and paramedics is “when will I feel comfortable?”  It is one of the most difficult questions to answer and one that I really do not know the answer to.  Truth be told, it took me a lot longer than I ever expected to be comfortable in my skin as a paramedic. When I started medic school I felt confident as an EMT.  I had a strong grasp on what my role was at a scene, and felt that I could effectively perform any of the skills in my toolkit when called upon to do so.  Medic school proved to be a struggle at times, more because of my lack of good study habits but I got through and added that “PARAMEDIC” rocker to my EMT patch.  Once I hit the street as a medic though I felt very overwhelmed. I remember sitting in my car in the parking lot at Springfield College with my door open dry heaving the morning before my first 7:30am shift as a medic.  I was terrified.  Most of it stemmed from the fact that I did not want to disappoint anybody, especially myself.  That first shift went well though, and the first group of shifts did but for the most part, I can fully admit that I was scared.  When it comes to type of air that a medic must carry with themselves on a scene, I tell most brand new medics that they need to be “like a duck.”  Under the water, you might be paddling your little duck behind off but outwardly, above the water line, you need to be cool, calm and collected and just quack your way along with no one any the wiser.  I was a terrible duck. This overall sentiment went on for about the first year or so...

May 11, 2015

What determines “success” in EMS?  How do we know that we are doing a good job?  Is it measured by our department’s ROSC rate?  Or maybe it’s response time compliance (but I hope it’s not).  What makes a good paramedic a good paramedic?  Do we determine it by looking at how successful they are at starting IV’s or intubating patients?  Is it something simpler like the number of people who thank them at the end of the call because they genuinely feel better? With EMS still in its infancy there is still a lot of work that needs to be done to figure out exactly what our impact is on society.  We are a high speed, high volume industry that does not take nearly enough time to slow down and really look at what we are doing.  The biggest reasons for that lie in the fact that we lack the knowledge to really know what data to collect, or once we have the data we lack the guidance from within the industry to understand exactly how to process that data in a way that will allow us to paint a clear picture of how well we are performing. Which brings me to today’s post. As I mentioned in my post last week, I have taken on a lot of different responsibilities over the past couple of months.  One of my favorite ones in my involvement in the EMS Compass project.  I was asked late last year just before I headed out to Nashville, Tennessee for EMS World Expo if I wanted to be involved in a project tasked with developing statistical benchmarks and measurements for prehospital care.  From the sounds of what was to come, EMS Compass combined many of the things that I really enjoy about the field so I had no choice but to say yes. In the last five months we have had a number of conference calls, and two face to face meetings.  The team that I am involved with on the Measurement Design Group is made up of some of the smartest EMS thinkers in the field today.  And then there I am, adding my two cents and contributing...

Apr 30, 2015

I am a vocal supporter of the police in the world of social media and in my every day life.  My stance has gotten me called many different names such as asshole, racist, conformist, and even boot licker by some.  Much of the support that I express for them is derived from my life experiences with people in law enforcement.  I grew up in a small town where every cop was on a first name basis with just about every resident.  I worked for twelve years in a metropolitan area that was recently named the second most dangerous metropolitan area in the northeast.  I have been pulled over a few times in my now twenty years of driving and received two tickets.  Regardless of the offense that I committed or the fine I always treated the officer that pulled me over with respect because you respect. Over the last ten months tensions in this country have hit a new high.  Dumping fuel on the fire, as usual, are people like Al Sharpton or Joe Madison to name just a few.  City Council members in the City of Baltimore have done press conferences standing next to the “leadership” of street gangs.  Their mayor is now back peddling after she talked about her poor choice of wording or justification for the destruction in her city (depending on which side of the fence you are on).  Leadership in other cities continue to stand on the wrong side of the lines that have been drawn, much like Rebecca Lisi has in Holyoke, Massachusetts.  Mainstream news outlets like Fox, CNN, or MSNBC do not try to put a stop it because it gives them things to fill their 24 hour news cycle and the people who suffer are the citizens and the responders.  I will be the first to admit that not every police officer is the most legitimate, upstanding person.  There are bad eggs in every single profession including my own, but the vastly overwhelming majority of those who have chosen law enforcement as their careers do their job because they care.  Sometimes, sadly, they are asked to care for those who could care less about their well-being. Everybody...

Apr 27, 2015

Some of you might have noticed a little bit of a slowdown through the month of April.  There are pluses and minuses to this sort of thing.  The minus, of course, is me putting out less content for those of you who read this blog regularly and for that I apologize.  The plus side though is that with the additional projects that I have recently taken on, I am actually in a position to add more content.  So for anybody who has been wondering, here is where I have been and here is what I have been up to. My time has been divided lately on two fronts.  If you look to the right side of this page you will notice a new disclaimer specifically addressing the EMS Compass project.  About six or seven months ago I was asked by a colleague to be part of a work group that was going to have a hand in developing statistical measures and benchmarks for EMS.  This initiative by the National Highway Traffic Safety Administration (NHTSA) and the National Association of State EMS Officials (NASEMSO) has since been given the appropriate name EMS Compass.  Expect a post about it and what it means for us in the next week. The other fire that my iron has recently spent a lot of time in is a new role as a Field Training Officer at my service.  The way that the system here is setup takes a considerable amount of time and asks a lot of the FTO.  A lot of my writing over the last year or so has been done during some of my downtime and lately I have not had much downtime at all.  My new responsibilities have made me think back to my days of podcasting about being an FTO with Natalie Cavander over at the now defunct GenMed Show, and some of my philosophies of the role.  I am currently developing some content specific to training and educating new EMTs and paramedics. I never thought that being an FTO would take up as much of my energy as it has but its a role that I have been out of for quite some...

Apr 15, 2015

This weekend a number of friends on Facebook linked a video that was making the rounds of a person presumed to be in cardiac arrest in a car in front of a bus stop.  This scene provides with a number of important lessons.  First you see an SUV in the middle of the road with people yelling at the driver asking him if he is okay.  9-1-1 is called and somebody starts doing chest compressions on the person before removing him from the car and placing him in the road.  CPR is continued until EMS arrives.  At the end of the video you see the driver being wheeled to the ambulance sitting up appearing to be conscious on the stretcher. The video itself spans about seven minutes and I encourage everyone to take the time to watch the entire thing from beginning to end.  Some content might be difficult to watch and there is some language that might be considered offensive used by those watching the scene unfold.  Regardless of that though, there are a few lessons that I think both the EMS community and the general public can learn from this. http://medicsbk.com/wp-content/uploads/2015/04/Street-CPR.mp4   There are still people out there who are willing to help – In a world dominated by social media, Twitter and cell phones people seem to either want to record or just call for help and make a potential emergency somebody else’s problem. Seeing this video is reassurance that there are still people out there who will get their hands dirty to benefit another person.  They saw somebody in distress and they acted.  They realized that doing something is better than doing nothing. When you call 9-1-1 help is on the way almost immediately – Confusion is common. People misidentify locations in fact, I can tell you that happened here.  Once a location is confirmed help is on the way but for dispatchers that is not where their job ends.  If there is one place that a dispatcher’s role in providing prearrival instructions can save a life it is in the case of a patient in cardiac arrest.  The bystanders can insist that the caller “just tell them to come!” until...

Apr 6, 2015

In almost fifteen years in this field I have seen a lot of people come and go, and that does not just go for coworkers but also spouses and significant others.  I don’t know what it is but so many of us in this field are so self-destructive when it comes to our interpersonal relationships, myself included, and I cannot help but search internally for an answer.  I have yet to find one. This job is difficult.  This career is difficult.  The level of depression, substance abuse, and suicide that we see in emergency responders is way too high.  It goes without saying that one occurrence is too many, but we are so far beyond that and the numbers just keep climbing.  I have seen far too many broken homes through the years and it makes me sad.  I just do not know what we can do to make that better.  Do we need an orientation class for spouses when their loved one gets hired into this field?  Should we be sending take home information with our new EMTs and paramedics to share with their families to help them understand the signs and symptoms of depression, and to guide them in better handling all of that time away that they might have to deal with at special times of the year? Or maybe we just need to do a better job of including our work force’s families.  If your service caters Christmas dinner for the staff, why not extend an open invite to your employee’s families to thank them for the sacrifices they have made over the past year?  On top of that, if you are an EMS manager and you are not strapping on an apron and serving your people on holidays I question your commitment to them.  I realize that people have made sacrifices over the years and “paid their dues” but if you run a department and you are not willing to make the same sacrifices as the front line staff makes then that will make you into a “boss” and not a “leader.” A few of us used to have a very quiet and not so funny inside joke that when...

Mar 25, 2015

Every day you go to work seems to start the same way.  You clock in on time to the sound of your truck backing in to you station.  Your scope goes on the dash, coffee in your cup holder, and gear in the cabinet.  You pull the bag out of the curbside door and start checking through as the loud speaker overhead crackles to life: “Medic 3 respond. . . “ and you’re off. The next ten hours of your day is filled with fourteen more responses every one of them with lights and sirens to the scene, and lights of sirens to the hospital.  As you wait for a nurse to give you your bed assignment, from your radio’s shoulder mic you hear the dispatcher of the day: “Holding a chest pain on the west side.  Is there anybody available to clear?”  “Medic 3, are you ready to go yet?” You’re rushed.  You’re overworked.  The general public thinks that based on the overtime numbers that your department releases you’re overpaid because that choice group of people who torture themselves day in and day out with two or three calls an hour on the ambulance make more than the department’s chief.  And it’s the same thing, day in and day out, for your two days and two nights as you look forward to your four days off. Until. . . Until your department decides that since the guys and girls on the fire trucks are on 24 hour shifts that you should be too.  That is exactly what is getting ready to happen in Baltimore, Maryland.  According to the Baltimore Sun, BCFD is a department that has nearly fifty of their 232 paramedic jobs left unfilled from last year.  That leaves approximately 185 paramedics.  Those 185 paramedics make up just shy of 15% of their department’s 1,250 person staff.  That’s right: 15% of the employee base is responsible for handling nearly 160,000 calls which makes up the vast majority of the department’s annual responses. Now, those 185 paramedics are on the verge of being forced into 24 hours shifts.  It is not right, it is not safe, and it needs to be squashed before...