The 2013 Massachusetts EMS Conference

The cat is out of the bag!  I am proud to announce that I will be presenting at the 2013 Massachusetts EMS Conference on October 19th in Springfield, Massachusetts! It is a great feeling to be accepted to present back in the state that I so recently left where I spent the first twelve years of my paramedic career.  The title of my presentation is “The Solution is Pollution: Using Capnography to Guide Your Treatment.”  Exciting, huh? Are you in or around Massachusetts?  Come out and take some great classes given by a number of great speakers.  Want to contribute in your own way?  Take a look at the advertising and exhibitor packages that are being offered.  The committee that puts this conference together each year is doing a great job conference is growing exponentially every year.  If you ask me, I would say that the Massachusetts EMS Conference is well on its way to becoming the premier EMS Conference in New England.  It is great to be part of it as a presenter this year. Interested in attending?  Click here!  Be sure to check out the Exclusive Facebook Pre-Sale Do you want to be an exhibitor or sponsor?  Click here! Share...

Talking with Bob Moore and Hoppy

At EMS Today I had a great opportunity to cohost with my friend Dave Aber on his podcast: EMS Classroom Conundrums.  In this episode we brought on Bob Moore and Bob Hopkins who were two of my instructors during my days at Springfield College.  It was an honor to be involved with this show, and great to talk to Bob and Hoppy about where education has been, where it is, and where it is going.  Check out the video below. Share...

This One is for Me

I had someone very close to me point out that sometimes I have the ability to get rather negative, as of late, about where I came from.  Looking back at some posts and some Tweets, I couldn’t help but see what she was talking about.  I don’t know exactly why that manifests itself.  Some of it is frustration, some of it is my own pride.  While 2012 posed a lot of crossroads for me that led to my inevitable departure from Springfield, I count my blessings every day for the experiences I had and the friends that I made in my twelve years working there. I learned many lessons from many, many different people: patients, doctors, professors, EMTs that I worked with, supervisors who both supervised me and supervised with me, paramedics who reported to me. . . the list goes on and on.  I had a long way to go to be good at my job when I started in Springfield and without those experiences, without those calls that I did both with good and bad outcomes I would not be the person or the paramedic that I am today. I left for a number of reasons, the culmination of it all contributing to the fact that I was not happy.  Part of it was issues with the local direction of my company, part of it was the major changes happening way above my head that I had absolutely no control over.  I wanted and needed a change, and that is exactly what I got.  None of that took away from the fact that I had some amazing supervisors that I got to work with, and two hundred plus EMT’s and paramedics who I was proud to work in the street with. Now that I am almost four months out from my departure, I just wanted to once again share that with everyone.  I have written a lot in the last month about the team at AMR Springfield because I believe in them and I believe that no one could do a better job for the people in Springfield.  I believe in the EMTs, the paramedics, the dispatchers, and the team that leads...

An Open Letter to the City of Springfield

Tuesday afternoon at 3:30pm, there will be a meeting held at Springfield City Hall to discuss American Medical Response and their ability to provide prehospital care to the citizens of Springfield.  Below is something I would like to share with the City Councilors who will be in attendance Tuesday. City Councilors of Springfield, Despite the favorable findings of WGGB in their investigation on emergency response, you have decided to hold a forum to discuss potential short comings of the current EMS provider to the City of Springfield.  Yes, that is right, I said it was favorable.  Although the ebb and flow of the story might not have showed it, all of the information provided shows that AMR exceeds the expectations set for it.  But maybe you should dig a little deeper.  Prior to walking in the door to Tuesday’s meeting, I would like to urge you to do a little research and maybe expand your vocabulary a bit. For instance, for just a second, let’s forget about response times.  They don’t nearly matter as much as you might think.  Try researching what a ROSC rate is, or how CPAP has reduced the mortality of shortness of breath patients, particularly in Springfield.  Ask Baystate Medical Center about the success of their ST-Elevation Myocardial Infarction program (STEMI for short) and ask them how many of those patients are delivered by AMR. Still not convinced?  Why not take a good hard look at other communities around the country and see for yourself how good you have it in Springfield.  An ambulance is on scene in a preset amount of time or less 97% of the time.  How do you think that compares to communities like Detroit, Washington DC, or Philadelphia just to name a few? Or how about closer to home?  Ask around to some of the neighboring more rural communities and see what their response times are like.  I guarantee that some will be longer than the average time publicized by AMR in WGGB’s article, but the patient outcomes will still be favorable. Just like with in-hospital medicine, perfection will never be obtained in prehospital medicine.  Errors are going to happen because not only are the...

A Chat with Brendan Monahan

Shortly after my post went up yesterday regarding WGGB Springfield’s story about AMR’s response time in the City of Springfield I received an email from reporter Brendan Monahan who did the story asking me if I wanted to talk about my concerns with the way WGGB depicted emergency response in Springfield, MA. Even before the story was aired Wednesday night on ABC 40, it had generated quite a buzz mostly on Facebook.  WGGB’s website received close to 400 comments and private messages in response to an inquiry looking for anyone who had waited more than 10 minutes for an ambulance to arrive after calling 9-1-1.  Some of those comments and messages were productive and informative others not so much, but such is the world of social media today. I had a very productive talk with Brendan lasting about 30 minutes.  The first thing that he wanted to point out was that his intention for this story was in no way to attack or offend any paramedics, EMTs, or anyone else affiliated with the industry.  His intention was to generate discussion about whether or not AMR should add ambulances to the upcoming contract, or if the city should consider making some changes.  He felt that he and the team at WGGB were presenting fact based information utilizing data that they had been given by the City of Springfield, and interviews with some officials with the city.  He acknowledged that the information I highlighted as what I felt to be most important in my response to his story was featured in Wednesday night’s segment, however it might not have been as prominent as I wanted it to be.  He stated, and I agree that as the reporter putting the story together, the structure of that story is his to determine. I shared with Brendan my feelings about the quality of response in Springfield as compared to other municipalities in the greater Springfield area as well as nationwide.  I tried to stress to Brendan that while 97% is not perfect, it not only exceeds Springfield’s standards, but it is also much better than some of the largest cities in the country, and if put up against other...

Emergency Response

  Recently, WGGB News Channel 40 in my old stomping grounds up in Springfield, MA posted a news article about “Emergency Response” in the city of Springfield.  The source of this story is said to be anonymous, however many of us have our speculations as to where it came from, none of which will be shared here, because they are after all speculation. WGGB raises concern over 350 responses that were considered “lengthy” by the city.  A concern created by one of those “lengthy” responses on a snowy morning January where a shooting victim waited 17 minutes for a response due to system overload.  There are, however, a few facts in the story that WGGB does not do a good job at pointing out that I feel need to be brought to light. The city contract, as documented in pages seen in the report, calls for a response of under 10 minutes 95% of the time to “Priority 1” calls.  According to the report, AMR in Springfield meets that standard 97% of the time.  They exceed expectations set for them. Annually in the city of Springfield, there are approximately 35,000 calls for 9-1-1 service.  WGGB is taking issue over 350 of these.  I do not have to break out my calculator to be able to tell you that this is 1% of their responses. Take a trip to Detroit, Philadelphia, or Washington DC and ask them how they would feel if they got an under-10 response 97% of the time.  Ask them how they would feel if they got that response 80% of the time.  Chances are, they would be thrilled with that improvement. In my opinion, WGGB and Brendan Monahan are trying to make a story out of a non-story. Medicine is a constantly evolving creature.  That is why we say we “practice” medicine.  Recently, I watched Killing Lincoln on the History Channel about the days leading up to and following the assassination of President Abraham Lincoln.  After he was shot, a doctor is shown telling two men to “move his arms up and down to expand and contract the thorax.”  Do you know why we don’t do that anymore?  Because we know...

The Quest for Perfection

Does the perfect EMS system exist?  Is there really one perfect fit for every municipality and every paramedic as well?  I really don’t think that there is.  What each individual has to search for though is their perfect fit.  They need to look for that system that has what they are looking for, regardless of what it is. Believe it or not, some people like carrying gear up and patients down five story walkups.  Believe it or not, when my career started, I loved it.  I did not think that urban EMS was going to be for me, and did not see myself staying in Springfield, Massachusetts, but it happened.  I spent twelve years there, and for the most part, I really loved it.  I still have a deep seeded love for urban medicine but as the years passed, and as my career progressed, so did my tastes, and what I was ultimately looking for has evolved.  So what does my perfect system need?  What would be absolutely 100% perfect for me?  Here it is. . . 1.  Variety and diversity – I do not just want one “type” of call.  I want a system that can offer me different settings that I can tailor to my mood at that juncture.  I really feel like I have “EMS ADD” that is to say, I am constantly looking to something else, and my moods seem to change often.  Having a system that would provide for that would be great. 2.  Aggressive and progressive medical direction – I want a medical director who is not afraid to enroll in prehospital studies.  I want someone who is not afraid to look at his or her staff and say “what do you think could make us a better system?”  or “what is there that we don’t do well enough?”  They need to be engaged with their medics, and although knowing each and every provider in their system isn’t vital or in some cases reasonable, having an open door policy and being receptive to each and every one of them is, and has to be. 3.  Receptive and engaged leadership – In just about every system I have been...

848810

I have been wracking my brain for the last week as to what to put up for my 200th post.  Yes, folks, this is it.  Number 200.  It has taken almost three years, but it is quite an accomplishment if you ask me. As I take a look at my current career, I cannot help but reflect back on where I have been.  2013 is a year of new experiences for me.  I’m in a new service with new protocols, and new opportunities.  It took me a while to figure out where I wanted to land, and if you had asked me a year ago, I would have told you I was content with where I was.  I might not have been overwhelmingly thrilled with it, but I was content.  The last six months though was like writing on the wall for me that it was time to move on. Fifteen years ago in January of 1998, I tested for my second EMT card.  I had gotten my New Jersey certification a few years prior, and the fall of 1997 found me enrolled in my second EMT class.  I decided to retake the class to refresh myself, because I had the option of trying to get reciprocity and testing out.  By February of 1998, I got that envelope in the mail, the big envelope. In the state of Massachusetts, when a person gets certified as an EMT they are given their own certification number that will travel with them for their career, barring them doing something like forgetting to recertify.  The number on the card that I got in the mail that day was 848810.  Two and a half years later when I got my paramedic card in the mail, it had the same number, 848810. The recertification process in Massachusetts is not an easy one.  Well, from the provider side of things it is not too bad.  A paramedic needs to do 24 hours of continuing education and a 48 hour approved refresher class every two years, and then send all of their recertification in along with a check made out for way too much money via US mail (certified mail if you’re...

Saying Goodbye

My career at AMR in Springfield came to an end this past Monday night.  I was going to put up a post about my last shift, trying to take all of you through my night step by step, but it was a pretty “ordinary” night for the most part.  There were a few goodbyes sent, a few coffees shared, but all in all, the only thing that made it memorable for me was the fact that it was my “swan song.”  My twelve year career came to a close at 6:30am when I punched out for the last time, took a deep breath, and walked out the door. The rest of my week was spent catching up with friends both new and old to say one last goodbye.  I was humbled and overwhelmed by the turnout at our local watering hole of people who showed up to say one last goodbye and share a beer or two.  Or three.  Or maybe four. I have to say that if anyone is ever in Western Massachusetts and you’re looking to enjoy a beer, O’Brien’s Corner in Springfield is the only place to go.  I’ve had many a beer, a lot of breakfasts and some great memories that were created just by pulling up a stool to the bar. Thursday night was my time to say “see you soon” to some folks from my part time job.  They gave me this great picture as a going away present.  I don’t normally work through the fall so I have not been present for many of the group pictures that they’ve taken from year to year.  Their response was to photoshop me into the picture.  Well done guys! The house was completely loaded into a UHaul Thursday night, and Friday I made the move south to my new “headquarters.”  The unpacking was done, a stop was made in New Jersey, and right now I am in my dad’s car typing away as we roll across the Tapanzee Bridge about two hours away from Springfield.  I’ll make one last stop there, pick up some precious cargo (the cat) and head back south for my four hour trek.  Monday I start...