A year ago today, I made the decision to take the leap into the EMS Blog world.I remember the days leading up.So much was going through my head.What should I write about?Will anyone actually read it?Well, almost 70 posts later, I’m still going strong, and I have you, the readers to thank for that. My first post was quite simple, it was just a little overview of who I was, and what I was hoping to accomplish in the coming posts.I say “who I was” because in the 365 days since that first post went up, I’ve grown and changed quite a bit.What started out as the simple musings of a Paramedic is now viewed over 1,000 times a month, and has over 50 registered followers.#MyEMSDay has been created, and over 200 EMS 2.0 pins are being worn by Paramedics and EMTs fromSpringfield,Massachusetts toMelbourneAustralia. To those of you who have read what I’ve had to say over the last year, I thank you.To any new readers I might have, welcome to year 2!And finally, toEMSin the New Decade, HAPPY...

This past September, I attended my first “real” EMS Conference. Sure, I’ve been to a few small ones out in my side of Massachusetts, but I had never seen anything quite like what I experienced down in Dallas. It was amazing, and I was completely overwhelmed. Now, as I prepare to head off to Baltimore for EMS Today in just a couple of weeks, I think its time to share with you some of the lessons I learned at EMS Expo. 1. Wear comfortable shoes! – You are going to be on your feet and walking around a lot. A large conference isn’t the place for flip flops (I’m looking at you, April) or brand new shoes that haven’t been broken in yet. I was able to find some inserts down there that they were selling on the conference floor that made a huge difference, but I definitely wasn’t prepared for all of the walking that I had to do. 2. Carry a spare wall charger for your phone — I’m a social media addict. There were many times where I was chomping at the bit to get my phone charged, but my charger, of course, was on my desk in my hotel room. It would have been great if I had a wall charger with me that I could have plugged into an outlet somewhere to just get myself a little more juice. 3. Get a business card made up — You never know who you’re going to meet when you go to a conference, and having some way to identify yourself, and making a lasting impression after the fact is great. Conferences aren’t just about education, they’re also terrific networking opportunities. Not only did I make and strengthen some great friendships in Dallas, I met some people who have been valuable resources for helping to improve the place I work in. 4. Pack a couple of resumes — As I said, conferences aren’t just about education. You’re going to find services and recruiters there too. If you see someone you like, tossing a resume their way might not be a bad idea. You never know where it might take you. 5. Leave...

Are you going to be in Baltimore on Wednesday March 2nd? Are you looking to meet up with folks from the EMS Social Media community? Do you like beer? Well, here’s your first chance. Russell Stine from Hybridmedic and I are putting together a Meetup which will be starting at the Pratt St Ale House across the street from the Convention Center at 206 West Pratt St. There is also a very good chance that we might have a sponsor for this event, but I don’t want to attach anyone’s name to it. We should be starting up at around 7:30 or 8pm after the first round of classes is out. It will be a very informal, fun way to meet other f0lks in the community, and if its anything like the EMS Expo Meetup at the House of Blues in Dallas, it will prove to be a great time. EMS Today is just two weeks away! Are you ready? I...

For the last couple of months, the term Personal Responsibility has become one of my favorites.I think it’s the answer to many of the questions that we ask day in and day out not only on the streets as we take care of our patients, but in life in general. I constantly struggle with how to provide effective QA/QI and where Chart Review falls into that whole mix.Now, I haven’t done a ton of Chart Review in my day, but I’ve read some truly bad ones, and I’m sure I’ve written my share of less than desirable charts in my day, but does it go without saying that a poorly written chart means substandard care was provided?I don’t think that is always the case.A strong argument could be made that the quality of the chart written can be a direct reflection of quality of care, just like the cleanliness and readiness of one’s ambulance could indicate the same, but ultimately, what is a Patient Care Report? That PCR isn’t just the picture that we paint for those that we turn care over to, or those that review our charts in the Chart Review process.Ask yourself this: Do you think James Patterson, Stephen King, or your favorite author could write an effective chart?I’d say they could probably paint a pretty clear picture of what happened.Does that mean they have the patient care to back it up?Absolutely not. Effective documentation shows a person’s ability to tell a story and craft words.Don’t let the term “Craft words” confuse you.I’m not saying that people are not truthful, because I have a lot of faith in the people that work in this field.I think that a majority of the time, what is documented is an accurate account of the call, but we need to start looking at patient care beyond the chart, and beyond the capacity that an English Professor, or a Math Teacher would look at it from. How do we do that?Well, that’s the difficult question.When practicing medicine in the pre-hospital setting, we often act alone, in the back of an ambulance, or with one other knowledgeable person present to help us.Random visits on calls by Supervisors,...

That morning in Dallas, I got to spend about two hours with Chief Skip Kirkwood from Wake County EMS, and boy did it fly by. The interview I posted in that previous post was a pretty good summary of what we covered in the more “formal” part of our talk. From there, the discussion turned to an exchange of ideas and thoughts on where we are at and where we are headed, and if you’re looking for inspiration, look no further than what you can learn from him, and his department in North Carolina. My admiration for Skip Kirkwood started about five years ago. I learned about the National EMS Management Association, and their list serv on Google, and I quickly signed up for both. If you don’t follow the NEMSMA List Serv, what are you waiting for? Its filled with some of the greatest minds in EMS who frequently share ideas and thoughts on the field, and Skip is one of their most frequent and well respected contributors. When he speaks (or in this case writes) people stop, take notice, and listen. I have actually saved many of his emails that I found to be useful, and I’ve shared them with those around me. I’ve closely followed the progress Wake County EMS has made over the years, and I even have a few friends from New Jersey who currently work in his system (who I am very jealous of). To me, Skip Kirkwood comes across as someone who is a fearless, confident leader who expects nothing but the best out of everyone around him, and I don’t see why simply his personality wouldn’t bring that out of people. He also projects himself as a very patient person, eager to share the life and professional lessons he’s gained over the years. I thought the most interesting moment in our interview was his response to the question “What lesson would you like to teach to a new EMT or Paramedic just getting their start in the field?” His response had nothing to do with anything clinical or even operational. It was about their personal well being. “Manage your finances,” he said, “don’t live outside of...

When I was in California, I had three similar conversations with three different crews. It went something like this: Paramedic/EMT — “So, you said you’re from Massachusetts, right?” Me — “Yes I am!” Paramedic/EMT — “How the heck do you work in the snow? What do you do?” My response at first was “What do you mean?” But I realized very quickly that in the Bay Area, dealing with a significant snow fall usually isn’t a logistical issue. I’m sitting in my truck right now writing this as I stare at a five and a half foot high snow bank, which is bound to get higher as in the next 48-72 hours, we might see as much as an additional twenty inches of snow fall dumped on us by Mother Nature. I’ve been in Massachusetts for almost fourteen years, and I can honestly say, I don’t remember a winter being that bad. Keep in mind though, that I don’t completely remember some parts of my college years! For those of you who live in warmer climates, I guess I should give you the rundown of what we do, and what we deal with when things get like this. . . right after I share an inappropriate hand gesture with you, and your “Its warm enough in January to wear short sleeves” weather. 1. Plowing, or lack there of. Over the last couple of years, my service has completely transitioned out of Box Ambulances. Our entire fleet of 35 trucks is now made up of vans, and let me tell you, I’m not that heart broken about that, especially at this time of year. Many side streets in our service area end up being very poorly plowed, and with cars parked on the streets, its very difficult to get a Box Truck down the streets. Even a not-so-experienced driver can park a Type II ambulance just about anywhere. 2. Hypothermia. The heat almost always stays on the back, so that all it takes is a flip of the “Master” switch to get that truck nice and toasty. Crews always make sure their IV warmer is stocked, and sometimes will even add a 1000 cc bag...

Ever since I was in college, I’ve always been fascinated by the way different systems ran.I always jumped at any chance I got to get on anyone else’s ambulance just to see how they did things.When I was around twenty years old, I belonged to two Volunteer EMS Departments, and would help out when a third was short.I also spent time doing ride time with out County Medic Units as I got ready to further my career inEMS. When I was a Paramedic Student, I spent the first week of my field internship on a 40-hour ride along with FDNY.I spent three days out ofMetropolitanHospital, and two days out ofJacobyHospitalinBrooklyn.While I got some good skills, I was more interested in how they worked.I took a lot from that experience, much like I did from my time inAlameda County,Californiawhich I’ve talked about ad nausium. Since I got into this whole Social Media craze back in February, I’ve met many people from many different systems big and small.One day this summer, I got to thinking, “How can I get a better picture of what everyone is doing?”The answer was right on my phone: Twitter.The result was the creation of a Hashtag, #MyEMSDay. Over the last six months, what started out as a few different contributors has grown to daily and hourly Tweets, vaguely detailing the events of everyone’s day.Each day, I see Tweets not only from theUSbut from all over the world.I get to see Paramedics and EMTs professionally and respectfully sharing their thoughts about the events of theirEMSsystem on that given day.Some people may vent, and some people may share that big call that they feel really good about, but all in all, it’s a way for everyone to see what everyone else is involved in. Do you follow #MyEMSDay?If not, you should add it to your Twitter, right next to #CoEMS, my other favorite Hashtag.Take a look, read a little bit, and share your own thoughts.We want to hear...

For the last couple of days, I’ve been reading a lot about the changes that have happened in Detroit, regarding their responses to EMS Calls.If you want to see a great summary of how it is working, check out RJ Stine’s take on it over at Hybridmedic. I’m not going to get into my views on tiered responses, and Priority Dispatch.Do I think its the right thing forDetroit?Honestly?I don’t.I think they have bigger problems to solve systemically that has nothing to do with putting more of their leadership on the chopping block, but for me to sit here and bad mouth what they are doing from 500 miles away just isn’t fair, so I am going to reserve my right to share my opinion until things progress a little more. I realize that I might have been very critical in the months that closed out 2010, and it was because all that I was hearing from Detroit Fire’s hierarchy was excuses and half hearted solutions to problems.Brainstorming, and tossing ideas around the table is one of my favorite things to do, but when you have the ear of the people who can make those changes happen, and you don’t take advantage of it, it just turns to lip service.That’s all that I was hearing from the previous leadership of Detroit Fire: lip service. I have decided to turn this post into positive words for the new leadership ofDetroit Fire.Why am I applauding them?Because without really saying it, they’ve admitted that there is a problem, and they’ve taken a step towards fixing it.Romewasn’t built in a day, andDetroit’sEMSproblems won’t be fixed overnight, but showing the willingness to change how things are done is a giant step in the right direction. Now, my advice to them as they progress is to continue to embrace change as an organization.Everything you try might not work the way you intend it to.Don’t get discouraged.Carry on with what works, and learn from the mistakes that are bound to happen.In time, you will find the formula that works perfectly forDetroit, and being fluid and willing to evolve over the next year or two will make that happen a lot quicker than...

CareerCast’s Best and Worst Jobs of 2011 have been released, and guess where Emergency Medical Technician ranks?That’s right, number 195!The career I have chosen is the 6th worst in the country. CareerCast evaluates the jobs based on Work Environment, Stress, Physical Demands, Hiring Outlook, and Income.If you’re interested in seeing their full methodology, its right here. I took a closer look at our score, and how we stood up against some higher ranked jobs.Our Work Environment score is comparable to that of a General Practice Physician, which is ranked #83.Job Stress is similar to that of a Lawyer, ranked #82.Our Physical Demands score is about the same as Heating and Refrigeration Mechanics, who are ranked #93, and our Hiring Outlook is better than the #20 ranked job of Economist. Where do we fall short?Its really no mystery: Income.As I perused the articles that accompanied CareerCast’s report, I stumbled on a great quote from Andrew Strieber in his piece about The Ten Worst Jobs of 2011: “. . . jobs like EMT have considerably better hiring prospects (than the others at the bottom of the list), but rank in the bottom 10 due to harsh working conditions, high stress, and inexcusably low pay given the extremely important nature of their work.“ Let those last couple of words resonate for just a few seconds: “inexcusably low pay given the extremely important nature of their work.”Mr. Strieber gets it.While his words are alarming, and spell out the struggle of our profession, its refreshing to me to see someone in the media voicing a concern with how our profession is treated, even if it is just an excerpt out of a Paragraph.So how do we fix it?How do we move forward in improving our profession, and moving up on the list? Its time to focus on establishing a united front as a profession.Once we come together, and take control of our own fate, we can improve so much of what we do, not only for ourselves but for our patients as well.For now though, we are left to be the pawns of the Public Safety and Medical communities. What’s the first step in getting out of this rut...

As I am writing this, its Tuesday afternoon, and my area is planning on spending much of Wednesday dealing with Blizzard-Like conditions.Predictions for my area are going anywhere from six inches of snow to a foot and a half.Only time will tell how much we end up getting. It’s Winter Time, and snow is a given where I live.We might not get as much as say, Tonawanda,New York, but we do alright here.So far this year, we have gotten pretty lucky, but all of that could change tomorrow.If a blizzard was to hit where you work, how ready are you for it?I’m not talking about your service, I’m talking about you personally. Do you have a Winter EMS Survival Kit?Maybe its time that you make one.I am fortunate enough that I live about a mile and a half from where I work, so the need for me to be “fully prepared” is not as great as it was, but when I lived farther away from work, I always had a kit in the trunk of my car that was ready to go if I ever needed it.Here’s what it had: 1.Spare clothes — I always carried a spare uniform with me, right down to the skivvies!You never know when you might need them, especially in the snowy, winter tundra ofNew England. 2.Two Pairs of Socks — As funny as it may sound, its always important to take care of your feet.One extra pair is good, but two will get you through for a while, if need be. 3.Shower Supplies — I always had an extra towel, along with soap, shampoo, and flip flops!While the towels in my service get washed, they’re also used to clean up the ambulances.Gross, right? 4.Toiletries — Always have a spare stick of deodorant, and a tooth brush and toothpaste handy.No one wants to sit in the truck with a stinky partner. 5.Extra Boots — Again, think about those feet!I usually go through two pairs of boots a year, one in the Spring and one in the Fall.Usually, my Spring/Summer boots are in good enough shape that they could still be worn if needed, so I keep them as a...