Just before the New Year, someone dropped off a huge bag full of Beanie Babies at our office. While its difficult to put unwrapped toys in the trucks for kids due to regulations, we graciously accepted the gift. In the weeks that followed, some of us adopted them as our personal “Mascots.” This guy caught my eye, and I snatched him up! His little Tag says his name was Paul. That really doesn’t seem appropriate to me, so I want to name him, and I want YOUR help! While some folks on Twitter offered up a few great suggestions, I think I’m looking for something more EMS related. So what do you think? What should I name...

I was visiting with one of our Educational Coordinators the other day, and I noticed this cartoon drawn by Paul Combs who you might have heard of over at The Happy Medic’s blog. Now, how does that cartoon make you feel?Do you have a little chuckle over it?Its very well drawn, and rather amusing, but to me, its quite alarming, and it defines our struggle pretty accurately. I fall short of saying that its the perfect depiction of the struggle of EMS because I would make one change to it.The yoke and egg whites would actually be money.Isn’t that really what it comes down to?Isn’t that really what is holding us back?Everyone is worried about getting their hand in the cookie jar, instead of worrying about what is truly important: the patients.Until that changes, we will continue to struggle, stay stagnant and fail to evolve Think about it: we are seeing abuse in every size and type of system, and if we redesign them to reduce transports, what does that mean?Less income.It will be very difficult the reduction of revenue flow in any service if you can’t supplement it from elsewhere.Municipal services such as Fire or 3rd Services use it to reduce their necessary tax basis.Private services use it to keep the trucks on the road, and the stakeholders happy. Simply put: money makes the EMS world go ’round. It shouldn’t matter if you get paid for this or you do it as a volunteer.It shouldn’t matter if you park your truck next to one that has hoses, or a police car, or another unstaffed ambulance.If you want the real answer to the question “Who does the best job providing prehospital care to the sick and injured?”it was best put into words by Michael Morse, author of Rescuing Providence: “An EMS system staffed by trained and motivated individuals is the most effective way to deliver quality patient care to the community.” I admit that I am taking his words out of context.At the time, he was talking about how efficient Providence Fire is at handling the EMS side of things in their city, but that sentence could be applied to any EMS system in...

2010 was a year of change for me, and a year of growth.EMSin the New Decade wasn’t my first attempt at blogging, but it’s the first time I’ve actually stuck with it.I was able to find my voice, and thanks to some help from some great people, I was able to get my voice out there to a much larger portion of our community. It all started with blogging for me, and after my experiences with some of the great friends I have made through the Social Media Community, that love of blogging expanded to Podcasting, which has become quite the addiction for me.What it all comes down to is if it wasn’t for people like RJ Stine, Kyle David Bates, Chris Montera, Natalie Quebodeaux and the whole Generation Medicine team, no one would have heard me. I created a simple pin, a symbol that has become a frequently displayed image on the internet, and has become associated with a great cause: EMS 2.0 and Chronicles of EMS.Thanks to Justin, Ted, and Mark for letting me play a little role as part of their team! Above everything else though, I’ve made some terrific friends.I could take up pages and pages naming them here.Through Tweets, text messages, Skype calls and blog comments, I’ve shared some great times and great moments with some incredible people.It’s an honor to know each and every one of you and I can’t wait to see what this year has to offer us. I have realized though that as 2011 opens, I still have a long way to go.While I have found my “voice” I am still growing comfortable with it.Very few people that I work with know about this blog.Slowly, I’ve become more comfortable with sharing it with some people, but that hasn’t been easy for me.I want more people to read it, but I also want more people to understand it, and learn from what I have said here, and the messages I plan on sharing in the future. While I was at EMS Expo in Dallas, I was sitting at the bar in the Sheraton with Steve Whitehead sharing a beer, while we waited for the rest of...

The first post of EMS in the New Decade went up on February 26th of this year. Now, 49 posts later, I’m finishing out 2010. I thought though, that I’d finish up the year with a story from the earlier part of my career. December 18th, 1998 started out not unlike many of my EMS shifts. I was home from college and working a volunteer day shift at Toms River EMS. This was my winter break before I started medic school, so this break would be my last opportunity to have any sort of “freedom” before I spent the next year learning how to be a Paramedic. We were dispatched across town for the female, possible CVA. I didn’t recognize the house when I pulled up and walked in, with the district’s police officer, the son of a family friend, right behind me. The woman sitting on the couch looked up at me, “Scott? Jeff?” I realized at that moment that this was a close friend both my parent’s and the parents of the officer. She had some increased generalized weakness and speech problems before calling 911. The symptoms had since resolved, much to her relief. Her BP was a little bit high, but everything out seemed to check out. My partner and I packaged her up and we were off to the hospital. I rode in back with her having a generally pleasant conversation, spending time catching up since I hadn’t seen her since my high school graduation party almost a year and a half prior. Once we turned over care, she thanked me for everything and gave me a big hug. I made sure to check back on her as much as I could during the rest of my shift just to make sure she was alright. Fast forward now, to two and a half years later. I had just graduated from College was having a graduation party down at my parent’s place in New Jersey. My parent’s friend, the TIA patient from a few years prior, came with a wrapped present for me. I opened it up, and found a framed copy of the following: “FIRST RESPONDER” A blood soaked hand...

Our jobs don’t stop for Holidays. The 911 phones keep ringing and facilities keep calling. For a number of years, I always worked the holidays. I come from a family of EMS professionals who were always very understanding, and willing to float a holiday to a day or two after Christmas or Thanksgiving, admittedly also for my own personal gain (holiday pay) but the knowledge that I let someone have some time with their kids was always equally rewarding. This month, I felt the need to throw my hat into the Ring for my friend Leanne’s topic for The Handover, an EMS Blog Carnival. Leanne writes a terrific blog over at Just My Blog, and was the 2010 recipient of the Bob Nixon Scholarship for EMS Expo. This month, she’s asking for everyone’s funniest EMS Holiday moment. While my story might not be that funny knee slapper, it was a moment that really put a smile on my face. My partner and I were finishing up our overnight shift from December 23rd into Christmas Eve. We were going to be off for eight hours and then start another sixteen hour shift into Christmas Day. Early in the morning, shortly before we were supposed to go home, we were dispatched to the “Unresponsive Male.” When we arrived, we found a girl who had brought her new boyfriend home with her from college for Christmas with the family. He was in bed, and she couldn’t wake him up. We could tell what was wrong with this kid simply by looking at him. He was diaphoretic, and would not wake up no matter what we did. The Sugar check confirmed our suspicions: He was Hypoglycemic. I went to work on the line, and my partner loaded up the D50. Within ten minutes of our arrival, our patient was up and talking to us. They had gotten in late the night before, and he had taken his insulin before dozing off, and didn’t have dinner. We asked his girlfriend’s mother to make some breakfast for him, and I gave him a stern lecture while my partner got on the horn to Medical Control to get permission to release...

There are a lot of good clinically focused blogs out there on the Internet, and mine certainly isn’t one of them. That’s not to say that I don’t feel I’m a sound, clinical paramedic, because really I do, I just don’t write about the medical topics. “Being a provider” and the challenges that we face as an industry interest me more. I do, however, feel the need to talk a bit about Quality Assurance and Quality Improvement and what they mean to me. I came from very humble, small EMS Beginnings. Growing up in Suburban New Jersey, most of the BLS 911 work was done solely by Volunteers. While my clinical experience was great, my knowledge that went into documentation and the feedback that I saw from it was almost non-existent. Although we would provide what I felt was excellent care, when we got to the Emergency Room, it seemed to me that the care started over. Run forms that were written were poorly written at best, some as short as one or two sentences that attempted to sum up the events that led to the patient landing in the ER. Fast forward now a few years to my freshman year of college. I didn’t know any better from what I learned in New Jersey. I thought that was “the way” to write a run form. I participated for four years in our Campus EMS Department, and in my freshman year, our advisor brought in a Lawyer to review our run forms and let us know how we were doing. I’ll never forget it; mine was one of the ones that ended up on the overhead projector: “Patient fell during a flag football game and injured his ankle. Patient refused treatment.” That was it. Two sentences and I was done. There I sat, a young 19 year old EMT, raked across the coals by a lawyer pointing out all of the problems with documenting like this. I quickly learned my lesson, and put 100% into my documentation, both at college and at home in New Jersey. Now, here I am, 13 years later, working in a busy urban system as a Supervisor and ten...

It’s Thanksgiving. The fire is burning in the fire place, football is on the TV and the bird is in the oven. I’m in New Jersey with my family, and all is well. The way would not be complete without talking about and recognizing the people and things that I’m thankful for. My Family — As some of you may know, I’m an only child. Shocking, right? As a result, I am extremely close with my parents. Over the years, they’ve helped me become the person that I am, taught me to be the best EMT and Paramedic that I can be, and they have supported me through every decision I’ve made in my life, good or bad. Joe and Amy Francis — Joe was my roommate in college for three years, and I have considered him my best friend ever since. He’s helped me through many, many crises in my life, and shared some of my best memories. Three years ago, he and his wife Amy brought into the world their son Thomas. They were the first in our group of friends to have a kid, and he was, as a result, adopted by all of us. I don’t know where I’d be without Joe and his family. Emily — A few of you have met her. She’s one of the strongest people I’ve ever met and she doesn’t realize it. Although she might not be at her best right now, I am proud of her, and will always stand by her no matter what. There are few people that I care about more than her. Natalie — We’ve both been through some tough times over the last couple of months, and frankly, I couldn’t imagine dealing with any of it without her friendship. She always brings a smile to my face, and always knows the right thing to say. She’s a strong, beautiful woman with a huge heart. I’m proud to call her my friend. Ted, Justin, Mark and the whole Chronicles of EMS Team — Never in my life would I have expected to be part of a community lead by a group as strong and amazing as these guys. They’ve...

Think back through your EMS career, whether it is a long one or short one. How many times have you been dispatched to this call: “Unconscious in a vehicle” or “Person slumped over the wheel?” I know in my ten years a paramedic, that’s happened more than a few times. Today, however, those calls carry a great risk that could injure you, your partner, other responders, or the unsuspecting public. Back in 2008, Japan saw an increase in their suicide rate due to something called Hydrogen Sulfide poisoning. The person would mix household chemicals together into a potent combination that with just a few breaths can render someone unconscious, and put them into Respiratory Arrest. This also poses a risk to rescuers and bystanders, because often, these suicides take place in confined spaces, which does not allow the gas to dissipate. When access is gained to the potential patient by rescuers, they could also be overcome by the fumes. In the spirit of Scene Safety, what should you be looking for as warning signs? 1. The Dispatch — As previously mentioned, these suicides often take place in confined spaces, such as a bathroom or closet. Most often though, it is encountered in motor vehicles. 2. Warning “signs” — Thanks to the Internet, information on Hydrogen Sulfide poisoning is easily accessible. Many of the sites that advocate for this form of suicide also share the risks to those around them. Quite often, the suicidal party will place signs around where they are to warn potential rescuers of the risks presented before them. They will often say “Warning: hazardous gas” or “Do not open, HAZMAT team required.” 3. Rotten egg smell — Quite often, there is a detectable rotten egg or sulfur smell present, although if the patient is inside a car, you might not be able to smell it. 4. Presence of chemicals/mixtures — Take a good look inside the car before you open the door. Is there a bucket on the passenger seat? Are there any bottles visible in the car? If so, take a big step back, and wait for more help. Hydrogen Sulfide is created by mixing a Strong Acid source with...

Battle On Over Emergency Response Vs. Emergency Caution – Jackson News Story – WAPT Jackson Jackson, Mississippi is back in the news, and Councilman Kenneth Stokes is at it again. Take a look at the video that I linked above, and reread my previous post on this issue. Why doesn’t Kenneth Stokes see what the problem here really is? Its not faster ambulance response, its a larger police presence. The question at hand is should an ambulance respond into a potentially dangerous scene until it has been secured by the police department? My training and my gut both tell me NO. Kenneth Stokes recommends bullet proof vests for AMR’s staff, but a vest isn’t a magical suit of armor that will keep you safe. The right angle to take of all of this is to promote safety at the scene. Bulk up Jackson’s police force. If the city is that unsafe that this has become so much of a problem, make it safer. Expecting AMR’s Ambulance staff to do some of the police’s work for them is unfair, and it puts more people at risk. But, remember, that would cost tax dollars. Its much cheaper to drag the Ambulance Company through the mud, encouraging them to drive into potential “war zones” and put themselves in the line of potential danger. I looked up some information about Jackson, Mississippi. It ranks 4th in the nation for homicide rates per 100,000 residents behind Baltimore, St Louis and New Orleans. In 2009, it was ranked as the 23rd most dangerous city in the United States. If anything should scream for a larger police department, that should. It doesn’t give Jackson the portrait of being a safe city, or a safe place for EMTs and Paramedics to work. What Councilman Stokes is doing is making it more dangerous for the Paramedics and EMTs in Jackson, Mississippi. He’s setting them up so that each time they walk into a scene after the police department, the perception could be “What took you so long?” Every time a truck is posting in a parking lot, or waiting for police to arrive at the scene, it will spark the question of “What...

For the next couple of weeks, I am changing my Blog Layout to Pink to support my good friend, April Saling, AKA Epi_Junky and EMS for the Cure, a group dedicated to raising money for research and spreading awareness about Breast Cancer. I urge each and every one of you in the Blogging community to do the same. Head on over to Justin Schorr’s blog, and watch his video supporting EMS for the...