Oct 20, 2014

In light of all of the media attention being made about the most recent Ebola outbreak that has now spread to the United States, I thought it would be beneficial to put together a three part series about the Ebola Virus.  In this first part, we will talk about the history of the disease to help us better understand where it came from, and the impact that it has had over the past nearly forty years.  Part two will talk about what you as an EMS responder needs to know about the disease, and in the final part we will talk about things that you should think about after dealing with a potentially infected patient. The Discovery of Ebola Ebola was discovered after its first documented outbreak in 1976 which occurred from June through November in Nzara, South Sudan.  The World Health Organization (WHO) knew that they were dealing with some sort of hemmoragic fever but did not realize that it would be as deadly as the Ebola virus turned out to be. The first documented case of Ebola was discovered on June 27th when a Sudanese store owner became symptomatic and died just nine days later.  In total, the first outbreak of Ebola infected 284 people and resulted in 151 deaths. The disease was named nearly six months later for the Ebola River which is located near the location of the first documented outbreak.  With the disease becoming more publicized thanks to the WHO and Center for Disease Control and Prevention’s (CDC) involvement, an additional 318 cases were identified with 280 of them proving to be fatal.  The two departments undertook a combined effort to contain the disease and were eventually successful in doing so.  Interestingly enough, one of the most effective strategies that was used to contain the outbreak was the advocating of the discontinuation of reusing needles by local medical providers. Over the next nearly twenty years the disease stayed out of the headlines and off the radar of the CDC and WHO then in 1995, the second major outbreak of Ebola occurred in Congo infecting 315 people and killing 254.  Five years later, another outbreak occurred in Uganda claiming an...

Aug 17, 2014

Every year, American Medical Response holds a nationwide skills competition amongst their divisions.  Tryouts are held regionally and eventually the top six divisions in the country who scored the highest in the preliminary competition are sent to Colorado to compete for the right to brag that they are the best in the country.  For the second year in a row, the Springfield, Massachusetts division is represented in the finals.  Last year, it was a pair of paramedics Erin Markt and Kim Arnone who represented my old stomping grounds.  This year it is a pair of paramedics Nick Chirekos an Roy Rudolph who will be representing Western Massachusetts. The event is held in a large “simulated” city where a crew is given a fully stocked ambulance and asked to respond to calls in this mock setting where they are heavily monitored and thrown curve balls around every corner.  The stories that Kim and Erin told me last year were great.  It sounds like such a fun experience, and each of them took something from the competition. First of all, I want to to say how great it is to see AMR holding an event like this.  As the largest ambulance company in the United States, it rests on their shoulders to also strive for clinical excellence.  Putting their divisions in the spotlight like this is a great way to showcase just how good the company has become clinically.  While I am not surprised to see Springfield heading to the finals yet again, I feel like it is something that deserves quite a lot of attention. With the brewing turf war in Holyoke, Massachusetts with their fire department, and past investigative “reporting” on the division’s performance in Springfield that revolved around response times this is yet another example of how great the clinical care being provided in the greater Springfield area really is.  While some will complain about AMR as a corporation and their motives in the medical field which are occasionally driven by their need to be a profitable company for the stakeholder’s sake, the motive for the street personnel has and always will be to deliver the best patient care that they are capable...

May 7, 2014

While the initial plan was to post my podcasts on Mondays, this one was too good to pass up on posting a little early.  In this episode, I talk with Kevin Bigley and Kevin Daniels who play Brian and Hank respectively on USA’s new comedy series Sirens.  I have been a supporter of this project from the start.  Personally, I think it is hilarious.  If you have not watched it yet, you really need to. I had a great time talking to both Kevin Bigley and Kevin Daniels.  Hopefully you enjoy listening to the podcast as much as I enjoyed recording it! To download the podcast, click this link!  Otherwise, use the player...

Apr 30, 2014

Yes, you read that title right: The Podcast.  The time has come for me to finally do what I have wanted to do for a couple years now.  On Monday May 5, I will release the first episode of my podcast carrying the same title as this blog.  This is something that I have wanted to do for a long, long time, and have been asked to do by a few people but I never really felt that I had the time. A lot of the roadblocks that I had keeping me from doing this are not there anymore, and it is time for me to take the plunge.  Monday’s show will be an overview of what to expect from the episodes to come.  Shows will be posted weekly on Monday mornings at 10:30am EST, and will be listed along with my other blog posts on the homepage of my blog.  In addition to that, there will be a link in the menu to take you to the index of all of my podcast episodes.  Also, I am currently creating an index of past episodes of other shows that I have been part of.  They will be part of this menu page as well. It feels really good to be back writing at 100%.  The major life change, and employer change took its toll on me for a while.  It is not easy to start over in a new system with new people, new protocols, and new everything.  I was ripped from my comfort zone, and it took me a while to get back close to it.  I’m not there yet, and there’s challenges that I am dealing with every day, but to be back writing is an important part of that for me.  It just seems like the next logical step for me is to get back into podcasting, and even more logical to finally host my own show. I really cannot tell you how excited I am about this.  Thanks to the support of people like Ben Neal, RJ Stine, Random Ward, Natalie Quebodeaux, and of course Kyle David Bates, Chris Montera and Jamie Davis, I am finally going to make it...

Apr 16, 2013

First of all I want to send out thoughts and prayers to everyone involved in yesterday’s explosion at the Boston Marathon.  It is a shame that we live in a world where we even have to deal with these incredibly tragic events, however, they also show the resilience of the American people.  We will recover, and we will overcome. In the wake of yesterday’s tragedy one thing I think everyone needs to realize is how lucky Boston is to have the men and women of Boston EMS caring for the people of their city.  In the days leading up to the Marathon, the Boston EMS Twitter was extremely active talking about the immense amount of preparation leading up to Monday morning.  From the looks of it they were ready for almost anything.  And kudos to Boston EMS for sharing that fact with the world. If nothing else, those of us in the EMS community need to walk away from this with recognition of how important preplanning is.  None of us should ever take for granted our own personal safety or the safety of any event that we cover.  No one should ever utter the words, “that will never happen here.”  Instead, take the extra time to draw up a detailed plan.  Know your staging areas, know your egress routes, and make sure that every single provider involved is aware of them as well. Another thing that needs to be pointed out that I think many people not involved in public safety lose sight of rather quickly is while this large response was going on in Copley Square the rest of Boston was still calling 9-1-1.  Boston EMS, Fire, and Police were just as busy as they were on Sunday, and just as busy as they will be today.  In my eyes, that is one of the most remarkable things about incidents like this.  Not only does the public safety community step up to deal with a major crisis at hand, they also continue to handle those routine emergencies that so frequently flood communities. While watching the news, I saw a number of different ambulances down at that scene: Cataldo, Lifeline, McCabe, AMR, and Professional...

Apr 2, 2013

First of all I would like to make it clear that what you are about to read is largely driven by my own opinions based on what I have read, and what I have seen in my years both as an EMT and a paramedic.  With enough research though, I feel confident that I could present a substantial amount of “facts” to back this up. Response times DO NOT improve ROSC rates. Directly. In article after article about response times, there is always that little asterisk that says “in MOST cases response times do not matter.”  Well, I am going to go as far to say that in ALL cases response times do not matter.  There are far more important things than response times in providing a high quality Emergency Medical Service.  I say specifically Emergency Medical Service because Skip Kirkwood made a terrific point in his comment in a recent blog post: “(An) ‘ambulance service’ is not the same thing as ‘EMS.’” Now, let’s just suppose for a second that we go with the common statement that response times improve outcomes.  An ambulance pulls out of their station or away from their street corner and goes flying across a city, or through suburbia, lights and sirens blaring, and they pull up in front of the address of a patient in cardiac arrest.  Then what?  If that ambulance makes it there in 8 minutes and 59 seconds or less, do the EMS gods simply smile, say “job well done!” and your patient is magically resuscitated?  No.  Far more goes into it than that. So if response times do not improve ROSC rates, what does make a difference?  Well, let’s start from the beginning: 1.  Public CPR education – Seattle has proven that when trained, people are willing to help.  The rest of the country should follow their example and push public education.  That does not exactly mean putting a CPR card in the back pocket of every citizen, it might just mean educating them on the importance of compressions only CPR. 2.  Public access AED’s – Again, here is another piece in the pie that rests mainly on the public.  Since I have been...

Nov 26, 2012

Someone can have the ability to make command decisions that steer an organization whether it be large or small but that person is not a leader until they find someone who is willing to follow them.  In the last year and a half, I have written about a few of the incidents that I have been part of, mainly the tornado that hit Springfield on June 1 and the ice storm that we had last year around Halloween.  Just the other day though, I added another one to my list. In the downtown area of my city, we had what started out as a simple gas leak.  That all changed when four miles away, sitting in our office, I heard a loud bang.  The building with the leak exploded with two of my crews only a short distance away.  Thankfully, they were okay, but we were called to action to organize and take care of close to twenty people who were injured.  Everyone involved is still counting our blessings that no one was killed. In moments, the people that I had in the streets started to mobilize.  Crews cleared the hospital.  People in their homes, not 100% sure what had just occurred started to put their uniforms on and head to work.  I took the new supervisor I was training to take my spot and started a ride that felt like it took an eternity down to the scene.  It took about twenty minutes to get organized, get a staging area setup, and to really start getting a grasp on what we were dealing with but once we did, we were ready for whatever would be thrown at us.  The response from the EMS community was amazing.  At peek, we had more than twenty ambulances in our staging area ready to do whatever it took to make sure every patient got out of there.  The unsung heroes though were the fifteen people who showed up at the office who were not even scheduled to be in that day ready to jump on ambulances and go wherever they were needed.  With all of the trucks that we had assigned to the explosion, we were able...

May 25, 2011

I am writing this blog post this morning from my favorite bar.  Its 7am, and I’m waiting for them to start serving breakfast.  According to the sign, it’s the “Best Breakfast in the City” and I’d tend to agree.  I’ve put a lot of money into this place over my years working here, and it’s been well worth it. Eleven years ago this week, I started my career with the service that I currently work for and it’s been quite the ride.  When I started I was 22 and had just finished my paramedic student time.  I was waiting for my test date to come around so I could get myself upgraded and start my career as a paramedic, something that I had dreamed of doing for a long, long time. As I stated in a post last week, ten years ago this month, I also graduated college.  That marked the start of my career as a full-time paramedic.  My work weeks were 60+ hours long, and I had to work some shifts that was viewed as “less desirable” due to my lack of seniority.  My very first shift was 3p-11p on Mondays and Tuesdays, and 7p-7a on Fridays and Saturdays.  The evening crew on my 8 hour shifts were your typical group, nothing really special.  We spent our evenings running here and there, and really didn’t have too much contact with each other simply due to the sheer volume of calls that we’d run.  The group that I got to work with on the weekends though was a different story all together. We were the younger crowd.  I’d dare to say that the oldest of us was probably in their early 30’s and most of us were between the ages of 20 and 25.  When we worked, we traveled as a pack from post to post.  Our trucks had hackee sacks, decks of cards, frisbees, and plenty of other stuff to keep us occupied.  When the calls started coming in though, we were quick to pack it up and get the calls done. There was a strong sense of camaraderie between the crews.  If someone had a bad call in a shady area of...