With that headline, one might think this is an article about Calvin Johnson and the resurgence of the Detroit Lions.  I wish that were true! Is anyone else tired of hearing about the Detroit Fire Department? In a recent story reported by the Fox affiliate in Detroit who has been following the department’s struggles rather closely, it was reported that they had not even ordered the promised 20+ ambulances promised to be on the road by January of 2012.  Not even ordered yet?  Come on! While it does not take long to get a truck on the road once it is licensed and put together, the steps leading up to that point can take some time.  Lettering needs to be decided on, equipment needs to be ordered, and the trucks need to be manufactured.  Once again, the Detroit Fire Department has dropped the ball. This brings up the question: when is enough enough?  When is the City of Detroit going to step up, tell the Fire Department they are not cutting it, and start looking elsewhere for EMS coverage?  While that can be a difficult undertaking, especially in a city in the financial dire straits that Detroit is in, it may be a necessary step to provide a better service to the city.  In other settings around the country, cities would be calling for the heads of the administrators of a department that has failed as badly as Detroit Fire has, but it almost seems like their answers of “we’re doing the best that we can” and the promises of improvement are enough to keep the city pacified. Providing EMS service in an urban setting is a difficult undertaking.  Providing quality service is exponentially more difficult, and yes, there is a difference.  Volumes tend to be higher, and acuity is lower.  Sometimes convincing municipalities that maybe an entire fleet of paramedic level ambulances is not the answer to the problem is difficult.  Detroit is in the perfect situation to bring someone in who can say “trust us, let us run the service.  The calls will be done, and people will be taken care of.”  Who knows, it could be the perfect blank canvas to...

Being a paramedic student is difficult.  When you start, you never know what to expect.  Different paramedic preceptors have different attitudes, work ethics, and paces.  While a student might not match up perfectly with their preceptor, they must be ready to take as much as they can from their shift. First of all, a student should walk in the door ready to learn.  One of my favorite questions to ask a student is “why are you here?”  In a way, I am setting them up.  I’m hoping that I don’t hear what I don’t want to which is “I just need hours” or “I’m just looking for a tube or electricity.”  No one is welcome on my truck if they intend on sitting back and twiddling their thumbs for twelve hours.  Paramedic school does not teach a person everything, and there is always plenty more to learn. Make sure your preceptor understands your comfort and experience level, because they are two totally different things.  A friend told me the other day about a student he recently had on his truck.  They were rushed out the door on their first call, and when they finally got to the hospital and turned over their patient, he asked the student how much experience he had.  The reply he got was “actually, that was my first time in the back of an ambulance.” Shocking answer, huh?  In my area we are seeing students getting on trucks with less and less experience that does not mean that they’re not capable though.  One must keep in mind, however, that as a student with less experience, there is more to learn, and the journey to being a well-rounded provider might be a longer one.  For the student described above, on his or her first shift out, I’d be more concerned about their ability to take a blood pressure in a moving ambulance, or bandage up a laceration than I would be about how well they could establish an IV or read a 12-Lead EKG.  Student time is a great opportunity to learn how to walk before you’re required to run.  It is best though that you know how to crawl first....

Here is a video from The MedicCast.  As part of my podcasting in Las Vegas, the hosts were able to select what I thought was an innovative product on the show floor.  My choice was this new line of laryngoscope handles and blades made by a company called IntuBrite.  Here, Natalie Quebodeaux, Chris Montera and I speak with Todd McKinney, president of...

Throughout one’s journey through their EMT and paramedic education, a student is taught a lot of skills, assessment techniques, and they are expected to retain a lot of medical knowledge.  All of that is done with one thing in mind: to make sure that their patient has the best possible outcome. Early on, we are taught CPR to help get someone’s heart going again.  We are taught to splint, to take vital signs, to administer medications that are intended to reduce suffering and save their lives.  No where in paramedic class are we taught to “just let them go.” I did my first code when I was just shy of my sixteenth birthday.  Like most cardiac arrests at the time, we did not save the patient, who died at home with his family.  I did not know how to react.  I did not know if I should be sad, if I should just brush it off, or if I should be angry and disappointed in myself for not getting him back.  With time, I was able to accept that death was part of this job, but it is not easy.  It goes against every prinicple that we are taught. I remember once I had a patient code right in front of me while we were transferring them from the stair chair to the stretcher.  Our time with the patient was short, but it was a typical code: IV, Epi, lots of CPR, and a quick transport to the hospital.  After we got there, the code continued for some forty minutes with the heart rhythm bouncing from PEA to Asystole to V-Fib to V-Tach, back and forth from rhythm to rhythm.  Despite the efforts of two paramedics, two EMTs, two doctors, some nurses, and a respiratory therapist, there was nothing that we could do. In my eleven years as a paramedic, I have done my fair share of cardiac arrests.  I have some saves, but have lost far more people than I have gotten back.  My attitude at this point: “I did my best for them, they did not make it.  It was their time.”  The call I just described was one of those.  A...

Those of us in the blogging community write for a number of different reasons.  We want to share our frustrations, educate our peers and the general public, and sometimes just share a story.  Regardless of our motivation we all have one common thread: we have something to say. A number of people out there have a fear of what might be said though.  They’re afraid that our profession or their specific service might be cast in a negative light.  A respectable blogger maintains a strict code of ethics both when it comes to telling stories about specific calls and patients, and when talking about the services that we work for.  Justin Schorr says it best: when he tells the story of a call, he tries to change as many identifiable features about the call that he can.  If the call was last week, he says it was last year.  If it was a 60 year old male, he writes the story about a 40 year old female.  His goal when talking about the call is to make it so that no one, not even the patient themselves will recognize what is being talked about. Regardless of the service one works for or what may go on at that service, a respectable blogger does not air their dirty laundry.  While frustrations about a partner, supervisor, or subordinate might be aired, this is done in such a way that, again, even those directly involved would have a difficult time identifying the incident or specific person being talked about. It’s all about being responsible, and it’s all about being constructive. Over the last two weeks, in two separate conversations with two EMS related bloggers that I respect very much, I have heard stories of them having to shut down their blogs due to the narrow-minded views of others, one by an educational institution, and the second by his employer. EMT and paramedic school can be a frustrating and exhilarating time.  I remember being told by my didactic instructor to forget about anything else going on in life, because that class was going to take precedence over anything else.  We were given a month at the end of...

Recently, I was asked to review the book We’re Not Leaving: 9/11 Responders Tell Their Stories of Courage, Sacrifice, and Renewal  by Dr. Benjamin J. Luft.  The book is a collection of stories from responders to the terrorist attacks on New York City on September 11, 2001.  Broken into five parts from more than thirty unique points of view, the book starts with the story of responders on the day of the attacks from the viewpoint of the police, EMTs, and firefighters.  The second section of the book deals with the days that followed the attacks and those who participated int he search for survivors.  Part three continues to deal with those who participated in the recovery efforts in the weeks and months following September 11th.  Part four was one of the most difficult for me to read.  It discussed the services, both mental and physical provided both at the site and away from it.  While their contributions were vital, I can only imagine the damage, heartache, and despair that they experienced and witnessed.  In the book’s final section, Renewal, talks about organizations established and contributions made for the long term benefit of the responders who participated throughout the ordeal. We’re Not Leaving is a well written, easy to read first person narrative account of the experiences of a number of different people connected to the 9/11 attacks.  Some powerful words and stories were shared, the most moving for me were some of the statements made by “Marvin” a paramedic who survived both collapses.  In my opinion, he sums up the struggles experienced by the EMS responders who participated that day: “And one of the things that I do resent with this whole 9/11 thing is – and no disrespect to the cops or firefighters, but just so we can make a point – everything was about the cops and the firefighters, and they act like the EMS (Emergency Medical Services) people were all on a fishing trip that day.  And I did not her anybody screaming for a cop or a fireman.  All I heard people screaming for were medics.  And even the cops and firefighters were screaming for medics.  But yet, the way the media...

After a busy September 10th I was looking forward to sleeping in on the 11th.  During my fourteen hour shift, my partner and I responded to nineteen calls.  It was an incredibly busy shift, and coupled with a few drinks afterwards at our favorite local establishment, I was ready for a morning off.  I was living in downtown Springfield in my nice little one bedroom apartment that I had occupied since graduating college earlier that year.  While I had my cell phone, I still had an apartment phone at that point, and its ringing woke me up just before 9am. I had no intention of getting out of bed so I let my answering machine pick it up.  After the greeting played and the beep sounded, my mother’s voice filled the room: “Hey, are you up?  If so, I’m sure you’re watching TV.  If not, I suggest you go turn the news on.  Call me.”  I rubbed my eyes and made my way into my living room, flopped down on the couch and grabbed the remote.  When I turned on the TV, I saw that one of the towers was on fire with reports of a plane having crashed into it.  “Must have been an airline accident” I thought.  Minutes later though, my worst fears were confirmed: as I sat on my couch, I watched United Airlines Flight 175 strike the second tower. We were under attack. I sat on my couch for the next couple of hours and watched history unfold before my eyes.  I was joined by a few friends for a couple of hours before it was time for me to head off to my Tuesday 3-11 shift.  When I went into work, I found that my partner and I were split up and I’d be working with an EMT for the day instead of my usual paramedic partner.  He was on a truck that had been deployed down into Connecticut with the anticipation that casualties from the attacks in New York City would be sent north due to overflow in the New York hospitals.  Those patients never arrived.  Everyone feared and prepared for the worst.  No one knew what to...

Throughout my childhood, there were three things that I feared: Jason from Friday the 13th, clowns, and public speaking. The first two are pretty common, I’d say.  What could be scarier than a psychopath in a hockey mask chasing you through the woods with a machete?  I challenge you to find me something.  And clowns?  Do we really even need to go there?  Whoever over the years decided that they were loveable or even funny needs to have their head checked. The fear of public speaking is shared by more people than I feel admit it.  I think that is because as they get older, avoiding getting up in front of a group of people becomes easier to avoid.  Most people start to gravitate towards the back of the room instead of the front and a desire to blend in rather than stand out takes over. Throughout my childhood, I quickly became more and more flustered when I had to get up in front of a group of people.  I can remember my hands sweating, and the death grip I had on a note card back as far as 5th grade.  Things didn’t improve as time went on either.  It was a nerve wracking part of high school and college.  I just could not do it.  It is hard for me to pinpoint why I couldn’t, but it just did not seem to be how I was wired. Over the last six or seven years, I’ve slowly chipped away at my fear, but I hadn’t completely defeated it.  I’ve taught some classes here and there, and spoke to some groups, but never really truly felt comfortable.  I realized though, especially in my year and a half of involvement with the podcasting and social media community that it was something I needed to overcome if I wanted to achieve the goals that I had set for myself. This year at EMS Today it was pointed out to me how many great EMS leaders are so comfortable in front of a room full of people.  People like Skip Kirkwood, Mic Gunderson, Mike Touchstone and countless others up in front of a room full of people talking...

You know, it would not be EMS World Expo if I did not share a recap during my plane ride home.  Right now, we are at a cruising altitude of about 35,000 feet somewhere over Wisconsin en route back home from my layover in Minneapolis.  There is some light turbulance, but it really is not that bad.  The trip home is more than half over, and I should be on the ground in about an hour and a half, so lets get right to it. EMS World Expo, as it was known as this year, was sponsored once again by EMS World Magazine.  The Zoll Blogger Bash that was held Tuesday night was an incredible time that you can read about here.  Wednesday, all of the hard work started. Just like last year’s trip to Dallas, my three days at the convention center were busy ones, but in a very different way.  I did not get to take as many classes as I did last year, but I made the most of the ones that I did make it to.  A majority of my time was spent on the floor, and more specifically, at the Podcasting Studio and Social Media Lounge.  Each day, I was on a show, and I even got to do two of them on Friday. Wednesday, I pinch hit for Chris Ceballero on EMS Leadership and got a chance to have a fascinating interview with Bob Loftus about the traveling  EMS Museum.  Thursday was First Few Moments.  Our topic could be most simply described as enviornmental safety, an expansion on scene safety.  How does one handle themselves and stay safe when the potential scene expands from a few hundred feet to possibly a few hundred miles? Friday I joined Natalie Quebodeaux on the Gen Med Show for a discussion that started with finding the right fit for the provider, and seemed to expand to changing the entire field to better fit the provider.  It was a fascinating discussion featuring Natalie, Sam Bradley, Anne Robinson (better known as @CaringAnne on Twitter) and I that is a must listen for anyone who is new to the field.  There were some points that...

My secod EMS Expo Eve is in the books and boy was it a fun one. Hurricane Irene pushed my flight back a day and I did not get into town until almost a full day later than I had initially planned.  For those of you who are wondering, my area did not get hit very bad, but to the north of us there was a considerable amount if flooding. After getting settled in, and a great dinner at Margaritaville complete with one of their staff sliding down off of a volcano and into a blender, it was off to the Hard Rock Cafe on the strip.  Zoll was once again our gracious host and thanks to Charlotte and her team, we all had a great time.  Zoll secured the third floor of the Cafe (yes the whole thing) complete with an outdoor seating area full bar, and appetizers. What started a year ago with eight friends getting together at the House of Blues in Dallas had now grown to a group of close to one hundred conference attendees and social media gurus.  It provided a great chance for all of us to make some new friends and, for those of us who have not seen each other since EMS Today in March, it gave us an opportunity to catch up with some old friends. If you have never been to Las Vegas, you should know that it is a city that never sleeps, and last night was no exception.  Some of us got to bed at two or three AM, and others did not get to sleep at all.  Today being the first true day of EMS Expo though meant that many of us had to be up early to help set up booths, make classes, and nurse our hangovers. The time since I drove out of Baltimore back in March has seemed to fly by. Some people like Justin, Natalie, and Random, I’ve talked to quite a bit over the last couple of months, and others I have not seen since we parted ways at the Pratt Street Ale House some six months ago.  Regardless, there never seems to be enough time...