Did anyone else see the story that came across EMS1 yesterday about Dennis Leary producing a pilot for an EMS show?  After what I’ve seen him do with Rescue Me, I must say, I am excited, but I’m also reserved.  I’ve been burned one too many times. Maybe its because we compare every show that comes out to Emergency! or maybe its because we compare them to our everyday experiences.  Regardless, there are some bad ones that have been out there. Need I list the complete failures of EMS shows that I’ve seen in my time? Let’s face it. . . It’d be a short blog post if I didn’t. Rescue 77 — This one came out in 1999.  I was a few years into my EMS career, and excited to watch something a little more modern that Emergency! which was a show that I loved.  Well, I couldn’t be more disappointed.  This was filled with unrealistic scenarios, people doing handstands on patients so they didn’t have to defibrillate someone in water, and a doctor reducing a patient’s intercranial pressure in the field with a Black & Decker drill after being begged to “think like a medic!”  It’s a shame the producers couldn’t do the same thing.  This one was dead after 8 episodes. Third Watch — This was a favorite of a lot of people, and I will probably take some flack for mentioning it, but boy this show just didn’t do it for me.  It was too much adrenaline, and went a bit too far at times.  From the EMS side, there really weren’t any likeable characters for me either. Trauma — Um Hello?  Do I really need to say anything about this one?  There are really only two cool things this show gave us: The term Captain Versed, and the Halloween costume associated with it created by Ms. Paramedic. Paramedics — Okay, so it was a reality series.  Great, right?  Sure.  It had a lot of redeeming qualities, but it failed me due to poor editing.  Treatments were out of sequence, and to anyone who had a trained eye, it was easy to notice. Saved — This one was the best...

Over the last week I’ve been giving a lot of thought as to how I would relate my experiences after a tornado hit my city.  I could give you all a play by play of where I was when everything happened, and what I did, but the truth is, my role  in the response from a provider stand point was pretty small. That isn’t to say that I didn’t do a lot, but for the first time in a long time, it was a “gloves off “situation for me.  In the first 72 hours of the tornado response, which were arguably the most crucial, I touched only two patients, put two pair of gloves on, and never actually made it to an emergency room.  That was by far the strangest part of the entire experience for me. I’ve always enjoyed being in the field, and have always been a hands on provider, but this time around, that wasn’t my job.  That was the responsibility of the great field employees I had working with me, and they did a hell of a job.  Instead, I was running staging locations, organizing the next 48-72 hours of our response, and keeping track of where my people were.  I had to do some of that “big picture” thinking that I talked about a few posts ago.  It wasn’t as large as what would affect my service for the distant future that EMS managers have to tackle, but it was more than the “next 24 hours” thinking that I do in my day-to-day supervisory role, and a lot more than the call-to-call problem solving that I did in my years before I was promoted. The success of our endeavors over those first four or five days was a team effort.  I really feel that I am blessed with a great group of EMTs and paramedics that work for me, and I can’t say enough about them, and the job that they did.  They made the “personnel management” part of my job very easy.  Our schedule was overflowing with people willing to help, trucks were stocked, cleaned and ready to go, and whether people were on their 4th or 24th...

I’ve sat through many tornado watches and warnings in my time, but I had never seen one before in my life.  When I was four, a small tornado ripped through a nearby elderly community in New Jersey, but I was too young to truly realize what happened.  After I had overcome my terror of the watches, I always just shrugged them off and waited them out, always saying “It’ll never happen.” This past week, that all changed. Wednesday was like any other day for me.  I had worked Tuesday night, which meant I spent most of the first part of it sleeping.  When I woke up in the afternoon, I heard about the Tornado Watch that had been issued in the area.  I did my usual shrug, and went about my business.  I my neighbor was even nice enough to stop by and make sure I had heard about it, and hadn’t been sleeping all day.  I sat down at my computer, and checked out the radar feed, which raised an eyebrow.  From the looks of it, much of the Pioneer Valley was about to be hit with a sizeable storm, the worst of which looked like it was far to the north of us. I flipped on my scanner (because yes, I have one) and made sure my uniform was ready to go, but I was still planning on just waiting out what I expected to be a bad thunderstorm until I went in for my overnight shift at 6:30pm. The Springfield Police Department called out the funnel cloud as it descended into the Connecticut River at 4:30, and I fully expected it to either lift, or proceed down the Connecticut River as a water spout, and be done.  I thought that we would have a fun story to tell over beers about that tornado that almost hit us.  Boy, was I wrong. The funnel cloud quickly turned and headed through the downtown area of Springfield, and swung straight up through the center of the city.  It cut a path through Springfield, and made its way east into some of the towns east of us.  Thankfully, the damage done was the worst of...

This post can also be found on the First Few Moments website. When working on a scene, especially one with a larger patient count, one must be conscious of developing tunnel vision.  Its very easy to get centered in on one patient for one reason or another.  In my experience, there seem to be a few reasons for this: 1. Â The patient is another provider — When one of our own gets hurt, we tend to want to do everything we can for them, right then and there.  Most Incident Command structures account for this: Get them off the scene.  When they are out of the picture, it’s easier to move on and work on whomever else is injured. 2. Â Kids — Everyone’s pulse goes a little faster when there are children involved.  Bystanders will bring them to you, and lesser trained individuals will not be able to leave their side.  We need to work with those around us to make sure the lesser injured children are taken care of while we care for and triage those who could be more seriously injured. 3. Â Cardiac Arrest — When someone is pulseless, there is a desire to do whatever we can for them.  One of the hardest things you’ll ever be faced with in your career will be to look at a patient at the scene of a major incident and say “no, stop.  There are other people here who need us.”  Keep a cool head, stay calm, and remember, you need to do the best you can for everyone at the scene. 4. Â Distracting Injuries — Finally, the one we are going to talk about more in depth this week is those patients who have Distracting Injuries.  You know what I am talking about; those angulated fractures, those more grotesque injuries that make you stop in your tracks and stare.  Just because it doesn’t look pretty though doesn’t mean it needs to be off the scene immediately. As we move through a scene and triage patients, tag or not, think about what you need to look at.  Think, for example, about the scene of a 2 car MVA with three or more patients.  Sitting on one side of...

In the past, I have written posts about the worst jobs in America.  I tackled both the 2009 and 2010 lists of the worst jobs in America, where EMS and being an EMT was way down at the bottom (or right at the top) and that is a huge issue.  It’s time to get out of that rut, and as Skip Kirkwood, Scott Brown, and a few other posters pointed out on JEMS Connect and LinkedIn, it all starts with leadership. It’s time to acknowledge what our greatest asset is.  It’s not the trucks that we drive around, it’s not those $20,000 cardiac monitors in the back of those trucks, and it’s not our stretchers, our buildings or our contracts.  It’s our people.  We send them our everyday expecting them to do “do their jobs.”  We ask them to respond to calls of all sorts of types, transport patients, put their lives on the line, and take the lives of others into their hands, and then when they are ready to go home, we look at their body of work for that day, whether its large or small, shrug our shoulders and say “it’s their job.” The first step towards this is improving our leadership, and improving how we handle people, or how we “engage” them.  Employee engagement is extremely important, and how well it is done depends largely on what your motivation is for doing it. First of all, what is engagement?  I did some searching, and found my favorite definition written by Ken Scarlett, President and CEO of Scarlett Surveys International.  He defines employee engagement as “a measureable degree of an employee’s positive or negative emotional attachment to their job, colleagues and organization which profoundly influences their willingness to learn & perform at work.”  To put it more simply, an employee who is engaged is one who has invested in the ideas and ideals of the organization, and the investment an employee puts into their organization is directly connected to the investment the organization makes in them. Some view employee engagement as a way of interacting with an employee, sort of an ice breaker.  A way of saying, “Hey, Bob.  How are...

Eleven years ago this month, I finished up my hospital clinical time and was getting ready to head out into my field internship.  Prior to that, I completed my 12 month classroom time, and a grueling hospital schedule that was close to 450 hours in length.  Not only did I spend time in the emergency room, but I was also in the ICU, the CCU, the psych unit (not as a patient), the operating room, pediatrics, and the adolescents unit.  While skill requirements were not broken down by department, I was required to get numerous IV starts, establish a number of IV drips, successfully intubate 10 patients, and document a number of patient assessments broken down into different categories. Finishing up my clinical time was like a breath of fresh air.  For four months, I was spending over 40 hours a week in different hospital departments, surviving on coffee and little sleep.  Now that I was done, I’d start my Field Rotation off with 24 hours in Manhattan and 16 hours in Brooklyn assigned to different FDNY EMS Units. My experience in New York was like none I’ve ever had before or since.  While it wasn’t this battle zone where you were constantly dropping patients and moving on to the next call, it was definitely exciting.  The sheer size of the system was staggering.  I was able to meet many of my skill requirements down in New York, which allowed me to come back to Massachusetts and spend a good amount of time concentrating on becoming a good paramedic, and not sweating it out for an apneic patient for 200 extra hours, as one of my colleagues had to do. My sixteen month journey to become a paramedic was worth it, to put it lightly.  When I got that card in my pocket a few months after I finished my ride time, I knew I still had more to learn, but the education I’d obtained so far made me ready to step onto the streets. Then, in 2004, the State of Massachusetts changed the standard, and it seems recently, in the last couple of years, Paramedic programs are starting to adopt the changes in...

When did it become “cool” to complain?  When did it become an accomplishment in one’s day to do less work? We were having a discussion on Twitter a few weeks ago about complaining, and a perceived negativity that was starting to bleed its way from some folks onto the Interweb, and it needs to end. Do we all have bad days?  Absolutely.  Are there times where I want nothing to do with EMS?  Without a doubt.  Ultimately though, being involved in EMS is a chance for me to do what I love, and I love what I do. Since I was promoted almost 6 years ago, my time on the actual ambulance has been greatly reduced.  In the past, I’ve gone months at a time where I wouldn’t set foot on a truck, unless I was intercepting a crew, but I’ve moved past that and I’m getting more time on the streets where I get to “play” Paramedic.  When that happens though, I’m happy to be there and I don’t feel like I had a good day at work if I’m not sitting next to someone that wants to be there as much as I do, and I don’t end up with a lot of runs under my belt for the shift. That desire has nothing to do with being a “company man” or my position in leadership that I hold; it’s out of a love for EMS.  I go out there and do the best that I can for each and every patient that I encounter.  It’s done selflessly, and without regard for how hard I work.  To be quite honest, if I come home and I had a particularly slow shift, I don’t feel like I was productive, and I don’t feel like I did enough.  I crave that feeling when you walk back into the office and drop a stack of completed paperwork on the desk.  I like having to completely restock and rebuild an ambulance at the end of the day because we needed everything in it. In our services we all have those people who strive to do the absolute minimum, and their behavior can be contagious.  Instead of...

Anyone who follows me on Twitter knows that this was not a good winter in New England.  I’ve lived up here for almost fifteen years, and I have never seen this much snow in my life.  I’ve written about how I prepare for work, and some of the unique challenges that we deal with here in New England including factors we must take into when treating a patient in the dead of winter.  Today though, I want to talk about something else: random acts of kindness by strangers. 1.  The Free Coffee — I can’t start my day without a coffee in my hand.  I’ve got my routine down: shower, get dressed, make sure my bag is packed and head out the door.  It doesn’t matter if I’m working a day shift or a night shift, things always seem to roll the same way. Once I’m out the door, my stop before work is at the convenience store that is right on my way to work.  I always grab my large Green Mountain Roasters coffee, and head to the counter to pay my $2.  I never expect anything free, but much to my surprise, somewhere in the middle of the dead of winter, something changed.  “You’re all set, man.  Coffee’s free for you.”  I have rarely paid for a coffee there since, and always “toast” them and throw the person behind the counter a “thank you” as I head out the door. 2.  “Hey man, he’s a Paramedic.” –  I had to work on the night of what was probably the worst storm that we saw all winter.  My house is on a back street that is off of a back street in the city, so it usually takes a good sixteen hours before I see a plow.  This day, was no exception.  I thought about calling into work and getting picked up, but instead decided to brave the ride in my Jetta.  Oops. I made it to the end of my block, and turned onto the street that leads out to the main drag, only to find two cars down at the end stuck.  Knowing that I’d never get by, I decided to...

Recently, I have been on a huge Field Training Officer kick.  I want the right people training new EMTs and new paramedics.  You know the kind of people I’m talking about: strong role models who can not only provide great patient care but also have the bed side manner to set the example for new EMTs and paramedics, giving them someone positive to compare their actions and the actions of their coworkers against. We need to keep in mind though that whether we are an FTO or not, it is our responsibility to make sure our new Providers are headed down the right path.  We should feel obligated as a community to make sure that every patient receives the best possible care, regardless of whether or not we are personally on the call. It starts with the hiring process.  You need to get the right people in the door, and we all need to remember that its easier to teach someone to backboard a patient properly than it is to show someone how to have the right attitude for this job.  Keep that in mind when dealing with a new EMT.  They might not be as fast as you like, or as clinically rounded as they could be, but ask yourself one important question: “Do they have the right attitude?” Next, a complete orientation process is necessary.  That should go beyond just reviewing the policy and procedure manual.  This is a chance to teach these new impressionable minds the things that they didn’t get to learn in EMT class.  They need to learn how to cope with this job, and have the tools not only to practice as an EMT, but to exist in this world. Life lessons?  In Orientation?  Absolutely.  Take a look back at what Skip Kirkwood said when we sat down with him at EMS Expo.  EMTs need to learn financial responsibility.  They need to learn how to manage their money and be smart, and they need to be taught it early so that when they get that significant (in most cases) pay raise when they get that rocker on their shoulder, they are prepared for it. They need to learn...

In a previous post, we discussed some of the qualities I felt that everyone should know they should have that you don’t get taught in EMT or paramedic school.  For today’s post, I decided to elaborate a bit on one of those traits: The Salesperson. Sometimes, you just need to look at a patient that you know needs to go and say, “What can I do to put you in this ambulance today?”  There are lots of tactics that everyone has and uses, and I felt that I would take you through my thought process when dealing with that resistant patient that I know needs to be at the hospital. “Do it for yourself” — Explain to the patient that there is nothing more important than their health.  Why don’t they want to go to the hospital?  What are their concerns?  Do they not want to wait?  Do they think it’s a waste of time?  Are they just plain scared?  Do what you can to help them get past those fears.  Reassure them that if they are worried about their own health that getting evaluated is the best thing.  I’ve even gone as far as to challenge patients to prove me wrong, and show me that there is nothing wrong with them. “Do it for your family” — I’ve asked patients, “What would you wife think about this?”  or “How do you think your family would feel if something was to happen to you?”  Don’t be afraid to get their family involved as well.  Let that scared son or daughter talk to their parent and try to get them to go to the hospital. Reach out for a higher power — Sometimes law enforcement or a primary care doctor will have an easier time speeding along the process.  I had a patient one time that was incredibly resistant and reluctant to go with us.  While he was alert, he would have brief periods of unresponsiveness.  After debating with him for about a half hour, and having the patient become incredibly agitated with us, we decided to get PD there.  Their presence made the difference and helped changed this guy’s mind. Also, I’ve reached out...