This past week, an article posted by EMS 1 caught my eye.  It tells the story of a Minnesota man who had his video camera confiscated and was eventually charged with “interfering an ambulance crew.”  According to the article he was videotaping the interactions between a man living in his building and sheriff’s deputies who were accompanied by EMT’s who intended to transport him to the hospital.  I am not going to get into the article and story itself, as I really truly feel like this should be a non-issue.  In the society we live in today people have video capabilities and use them on a daily basis to shoot a variety of things.  It is part of the social media YouTube society that we live in.  What I found truly alarming was the reaction from the EMS community. The article received over 150 comments on the EMS 1 Facebook page, many stating that there was a “HIPPA” violation.  First of all, it needs to be pointed out that the abbreviation for the law is “HIPAA” and not “HIPPA” and no, the headline of this post was not a typo, I meant to do that. HIPAA, which stands for Health Insurance Portability and Accountability Act, is a law that has multiple parts.  Title II which deals with health care fraud and abuse is the one that is most important to EMS providers.  Covered entities of the HIPAA laws are those who record, collect, or store a patient’s health care information potentially for billing purposes.  Most HIPAA education began in the early 2000’s but judging from the comments that I saw this week; I cannot help but feel like it might be time for some reeducation. Over the years, I have encountered HIPAA on a number of different levels.  I have been told by facilities that I “should not open the sealed envelope” that was containing a patient’s medical information because I would be violating their HIPAA rights.  I have heard HIPAA cited as a stumbling block for QA/QI officers in getting information on patients who were delivered to a medical facility.  Simply put, so many entities that are HIPAA covered keep the information more...

I try not to complain very much, and I think compared to most medics I don’t.  Mind you, that’s not a dig at my fellow caregivers, I just think that we are Type-A personalities who want it all, and we get vocal when we don’t get it.  That said. . . This winter, I have had a huge pet peeve of mine rekindled.  In all of my years working in Springfield, Massachusetts there was one thing that I always checked when I was putting my truck together at the start of my shift.  It was not the oxygen, it wasn’t my backboards, paperwork, or anything else like that.  The one thing that I always made sure that I had was a sheet or blanket sandwiched into my stair chair, especially in the winter time.  For me, there was no more necessary item to carry into a scene. I was what one might refer to as “stair chair dependent.”  Many people liked to bring their stretcher to the door and park it there, or leave it on the curb but frankly I did not and still do not like leaving it unattended.  For me it was always easier to carry a stair chair to my patient’s side regardless of their condition so I could have something to use to move my patient to the back doors of the ambulance.  It got used a lot, and there were a lot of butts of varying conditions that saw time on that chair.  For me, the blanket gave me a barrier for my patents to sit on. In the winter time, it helps keep the patient warm.  In every season it gives you a great way to move your patient if they are not able to get over to your stretcher.  Nothing is easier than scooping a patient up with a sheet and popping them down with a draw sheet.  It is one of the simplest and earliest taught “moves” in the industry. And let’s not lose sight of the “don’t reach out” factor.  We all give that speech to our patients about how important it is for our patients to keep their hands in, don’t grab hand...

The WGGB story that I wrote about last week and some recent discussions with a few friends have gotten me thinking about the common media response that EMS services seem to have.  While there are some services out there that are leading the way and showing us what we need to do when it comes to public relations and the utilization of a public information officer, more times than not the attitude is taken that “no news it good news.”  That could not be farther from the truth.  No news means that you, as a community partner, are not doing your job. Not a month goes by that there is not some news story that an EMS service could add their input to.  For example, did you know that February was Heart Awareness Month?  What a great opportunity for paramedics and their leaders to talk about what a person should do when they start having chest pain at home. Another great two prong approach is to share the accomplishments and milestones of your service and your personnel with the community.  Do you have someone who has been working for the service for 25 years?  Write a press release about it, and invite the local paper to come interview them.  Have you gotten a new cutting edge piece of equipment or a new state of the art ambulance?  Invite a TV station over for a tour a demonstration.  Not only does the community get to see what you are up to, but you get to build a positive relationship with the press, and your people know that you are proud of them and want them to be in the spotlight. With so many media opportunities out there, everyone has a chance to talk about whatever they want.  Look at what I am doing right now.  I am blogging, and people are reading it and while not every entry into the media world whether it is social or traditional requires a response, an EMS service needs to be ready to say something besides “no comment.” If people do not know what happens when they call 9-1-1, that is the service’s fault, not the public.  They should...

Have you made the trip to Washington, DC this year for the annual EMS Today hosted by JEMS?  If so, you should come by the JEMS booth on Friday and say hi. Friday morning, and into the early afternoon, I will be there participating in a few podcasts starting at 10am.  The podcast studio will be open and active all day on Friday and Saturday, complete with the social media lounge.  Stop by, say hi, and take in some great...

First of all I would like to thank those of you who commented on my post entitled Stress the other day.  There were some great words of wisdom there, and Bob Sullivan from EMS Patient Perspective shared some links to some really good articles. Greg Friese asked what I do to help those around me with stress.  Personally, I feel that as a field supervisor it is my responsibility to have a grasp on the mood of my employees.  That is a daunting task since I have around two hundred paramedics and EMTs, some full time and some part time, working in my service.  I personally need to be able to watch as many of them as I can for mood changes, and when I see them I need to be able to refer them to the places where they can get help. The resources available to them can be as simple as a walk through the garage and a friendly conversation or it could be a phone call to muster up our regional CISM team.  Additionally, EAP is a great route to refer employees to especially if the root of their issue lies outside of work. Most of all, the most important thing that any leader can do for their people is make themselves available to their employees whenever they may need to talk.  This needs to be a team approach though.  I know all too well that I am not the first choice for everyone to come and talk to.  Personalities clash, and frankly, not everyone gets along all the time and they cannot be expected to do so.  Thankfully, there are a number of other people on my management team, and for the most part, most EMS services are not a one leader shop.  If someone says, “I dont want to talk to Scotty about this” that is fine.  I don’t need to be their sounding board.  The important thing is that they go to someone about it. Availability and access.  That is what is most important.  People cannot get help if they do not know where to find it.  My advice to those in the field is to find someone...

Last week the area that I work in suffered a horrific tragedy: we had a line of duty death of one of our city’s police officers.  The impact of this has been far reaching and very difficult on many of us.  One of the questions that I have heard over the last couple of days has been about scene safety.  The “what if” scenarios are being played out left and right.  “What if we were there?”  “What if it was for a medical call and not a domestic?”  While I too have asked myself these questions, the thing that I keep reminding myself and that I think we all need to remind ourselves is scene safety is not an absolute.  I am not going to talk about specifics of this call however I feel that this is an important topic to reinforce. Kyle David Bates of First Few Moments and Pedi-U fame teaches a class called “Scene Safety Stinks” and I could not agree more with him.  The words “scene safety” and the declaration that the “scene is safe” might give us a piece of mind, but all it truly represents is a false sense of security that we all hold near and dear to our hearts.  We should not “practice scene safety” or even worry about.  What needs to be important is “scene awareness.” Every scene that we are on evolves and changes moment by moment.  Something as simple as the introduction of another family member or a patient uttering the word “ow” in the presence of the family dog could change things in a second, and the number of police officers, fire fighters, or national guard that you have there with you will not be able to prevent whatever happens next.  When responding to any scene, keep the following in mind: 1.  Always have a way to call for help – Cell phones are great, but I’d rather have a radio.  No dialing required, no identifying yourself or asking for anything.  All any of us should need to do is announce our unit number and declare that we need help.  My radio now lives on my hip all the time so I...

I posed this question the other day on Twitter: “If you offered your local politicians a lesson in EMS, how receptive do you think they would be?”  I got a variety of answers some more jaded then others, but it really got me thinking: what would I tell them, and what would I want them to take from what I have to offer? When it comes to EMS, many people both in the community and in positions of power have an attitude of “how hard can it be?”  They think if you put two people with a patch on their shoulder in an ambulance and put them on the street, they will pick someone up and get them to the hospital.  That is true if you want mediocre service that provides nothing more than a “point A to point B” relocation for people.  That, in my opinion, offers virtually nothing to the community.  Prehospital response and care is supposed to be much more than that. We have also accepted incorrectly that EMS is a time sensitive business.  Faster is better.  Fast care means effective care.  Not true.  Those of us IN the field understand that despite what some might think, lights and sirens do not always offer a safe response, and while they might get our ambulances there quickly there is little benefit to the patient in most cases.  Sure, in some having someone there in minutes could be life-saving, but those instances do not occur as often as some might think, but more times than not, I feel that as an industry we have the right tools to guide us in triaging emergencies and when we use them the right way, we do a good job of determining which calls need a fast response and which do not.  Contracts and public perceptions, however, have painted us into a corner and ambulances continue to scream from one end of communities to the other lights and sirens blaring. As an EMS provider, I would rather see a highly trained EMT or paramedic standing at my door equipment in hand ready to assess me or one of my loved ones.  I’d rather see an EMT take...

Read the original post and the comments it generated: Bad Publicity and Saving Face In my two years of blogging, I have seen what I considered to be a few “big” days.  A post goes up, it generates some buzz, and I get a decent amount of hits, usually a few hundred.  This past Monday though, any previous numbers I had seen were blown out the window.  In the first 24 hours that my post about Joshua Couce and the Newton First Aid Squad was up, I saw almost 4,000 visits to my site.   I received a number of comments about this post, and I thought that I would take some time to highlight some of them for you. First of all, I would like to share with you a few comments from Newton FAS members: Member of 15 years: “It is an unfortunate situation that has come about by someone that has been mentored by some of the finest EMT’s around, yes I am a member of the NFAS and I have to say yes Josh made a bad decision by over indulging in the truth, I believe that youth plays a big role in his decision making process. I am in NO WAY CONDONING his behavior or how he portrayed himself and the squad however there is not one person out there that has not made a bad decision weather it be in the professional sense or the personal sense, and unless your back yard is completely clean maybe people should reach out to Mr. Couce and help him grow and mature within the EMS community rather then hanging him out to dry along with the rest of the squad.” Debora Baldwin Phillips: “Mr Kier, I thank you for your insightful post. Some of the points you address are valid. We, as the squad are aware of them. I will not address them in a public forum. However, I, as Captain of the squad, assure you, and anybody else concerned the issues are being addressed. Deborah Phillips, CT1” Thanks to both of you for sharing your thoughts, especially you, Captain Phillips.  Believe it or not, I wish you well in your future...

Editor’s Note: With this story now being five years old, I have removed the names of those involved.  I do, however, feel that there are a lot of lessons that we can learn from this situation. Late last week Kyle David Bates posted an article from a New York State college paper about a New Jersey EMT from the Newton First Aid and Rescue Squad in Newton, NJ.  In the article this EMT describes such events as “driving over 100 MPH” in an attempt to beat the “golden hour” and being covered in a variety of patients’ bodily fluids.  The outcry and comments on the from EMTs, some of whom know this person personally, are mostly filled with disdain for the way the article painted EMS professionals as a group as an unprofessional group of adrenaline junkies more concerned about what they are able to accomplish with a heavy right foot than the outcome of their patients. The response of the Newton First Aid and Rescue squad was to post a message on the department’s Facebook page denouncing the article, stating that the EMT had been suspended and disciplinary action was being taken effectively hanging him out to dry to take full blame for the statements and quotes within the article.  It stated that the article was written “without the consent of the squad and its officers.”  The only problem with that is, as KDB so aptly points out, the squad’s 2nd Lieutenant was quoted in the article as well. The entire course of events is a real comedy of errors, the fallout of which is far reaching.  Not only have personal reputations been effected, but the squad’s integrity has been brought into question and potentially the values of EMTs everywhere could be brought into question. 1.  The Newton First Aid and Rescue Squad – First of all, a full admission of what knowledge of the article prior to its publishing needs to be explored and put into public record.  I am basing this off of the squad’s swift stroke of the virtual pen in putting the entire burden on the shoulders of an 18 year old kid. Also, it would be wise for the First Aid Squad to take...

I recently spoke with a close friend who related to me a story of a very difficult call that she had to deal with.  Without getting too into detail, she was presented with a young child who was in a very difficult and seemingly hopeless situation.  My friend’s “motherly instinct” kicked in when the child latched onto not her family, not her mother, but my friend.  From listening to the story and everything my friend did, which was not much more than consoling the child and establishing a rapport with her, I could not help but be amazed with the job done by my EMT friend.  This was not an acute medical emergency it was actually nothing more than just a simple transport to an emergency room.  Still though, my friend broke down and couldn’t help but question herself and her ability to do her job as an EMT. In actuality though, she did exactly what she had to do: she stayed calm and did everything someone in her position could for the child: she was supportive and she was an advocate for her, and while after the fact she had trouble dealing with the situation, while it was ongoing, she was as professional as anyone could be. A few days before, I assisted a crew who had a patient unexpectedly get combative on them.  While the scuffle in the back of the truck could have gotten bad, the crew handled themselves as efficiently as any crew I had seen in such a situation.  Within 5 minutes of the patient getting combative, he was properly restrained to the stretcher without a scratch on him and wearing a non-rebreather to prevent him from spitting at anyone.  Again, here was a situation where emotions got high and things could have quickly escalated out of control with one wrong move or one wrong word.  The crew, however, kept as cool a head as possible and handled the situation perfectly. This brings us to the point of this post: no matter what happens, and no matter what the call nature is, one sign of a strong EMT is their ability to put their emotions aside, or as much...