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...

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...

This week, Scott Kier is joined by David Konig, Sean Eddy, and later in the show Russell Stine.  The group tackle the resignation of Chief Kenneth Ellerbe of the Washington, DC Fire and EMS Department (DCFEMS) and share their viewpoints about what should be next for the department.  Is this a leadership issue?  A cultural one?  Find out what the group thinks this week on EMS in the New Decade! Read more from David Konig at his blog The Social Medic. Check out Sean Eddy’s blog, Medic Madness. Finally, to see more from RJ Stine, check out his website, Hybrid Medic. To download this week’s podcast, click this link!  Or just use the player below....

Jun 2, 2014

On this week’s show, Scott Kier is joined by Sean Eddy from Medic Madness, and first time podcaster the Chicago Medic Jeff Sorenson. After the recent incident where two Michigan paramedics were caught on camera allegedly smiling and “posing” while taking care of a patient, the trio discuss humor and its place in the field. What place does it have in patient care? How do we use it to deal with those more frustrating or stressful calls? How can we prepare new providers for the type of humor they are going to encounter? Do you want to find out the answer to these questions and more? Take a listen below! Read more from Sean Eddy on his blog Medic Madness. Follow Jeff Sorenson on Twitter. To download this week’s podcast, click this link!  Otherwise, use the player...

Yesterday afternoon I received a press release from Physio Control in my email, and it is a story that I think needs to be shared.  PulsePoint, a revolutionary app designed to notify users that somebody nearby might need CPR played a key role in saving the life of a patient in Portland, Oregon. An off-duty firefighter was working out at is gym when his phone alerted him that somebody outside in the parking lot was unresponsive.  Scott Brawner of the Tualatin Valley Fire & Rescue followed the app’s map to the patient’s side.  57 year old Drew Basse was unresponsive in the gym’s parking lot and found to be pulseless and apneic.  Scott started CPR until paramedics from AMR and the Clackamas Fire Department arrived on scene. Because of the app, a trained provider of CPR was at the patient’s side in less than two minutes.  Firefighter Brawner’s actions, along with the paramedics from AMR and the fire department completed the vital chain of survival that the American Heart Association rightfully promotes as being so vital to survival in sudden cardiac arrest.  The actions of everybody involved in this call resulted in the patient, Mr. Basse’s expected full recovery. It is really remarkable what we can do with technology these days.  While there is a serious shortage of people who are willing to help in situations just like this one, there are still people out there who are willing to make a difference.  Apps like PulsePoint make that possible.  Without Scott Brawner’s presence on May 9th, there could have been a life threatening delay in an emergency where seconds truly count.  While most people would opt to call 9-1-1, and stand back to let someone else take care of the problem, Mr. Brawner allowed the trained he received as a firefighter which, coincidentally is training that anybody can receive, guide him through the treatment that his patient needed until more help arrived. It amazes me that PulsePoint is not in place in more communities around the United States.  Currently, there exists a huge gap in the chain of survival.  In-hospital care is improving.  Pre-hospital care is evolving.  The gap exists though in what happens before...

May 26, 2014

On this week’s episode of EMS in the New Decade, Scott Kier and Ben Neal talk about an inspirational conversation they were part of while sharing a few Happy Hour drinks at a bar called Huck Finn’s in New Orleans at the tail end of EMS Expo 2012.  What started out as a group of medics swapping war stories turned quickly into a conversation about pit crew CPR led by Tom Bouthillet from EMS 12 Lead and Code STEMI that was the jumping off point for some major changes in Ben’s EMS system. So crack open a beer, sit back, and enjoy a night at Huck Finn’s with Scott and Ben. To download this week’s podcast, click this link!  Otherwise, use the player...