Think back, if you will, to the first EMT class you ever took. It might have been a few months ago, or for some folks, it might have been 20-30 years ago. Now, think about what they taught you about your own safety, and what is most important when you hit the streets. Lets take it a step further. Think now about any EMT Practical exam that you’ve taken, whether it be for your EMT-Basic certification right on up to your Paramedic. Lets take the Assessment station. You walk into the station, stethoscope around your neck, with a State or National evaluator sizing you up and staring you down. You look over your station, and indicate you are ready. Your evaluator looks at their sheet of paper, and begins reading the same scenario that the person before you most likely just heard. It could be a car accident, a shooting, or something as routine as a fall, abdominal pain or a chest pain call. Regardless of what the nature of the “call” is, you take the information in, and start your station the same way. “Scene safety, BSI, number of patients.” You might use different terms depending on where you’re at, but the intention is always the same: Is the scene safe for my partner and I to enter? Do I have the necessary protective equipment on? Do I have the resources I need initially to handle this incident? Now, keep that in mind, and read this article that has made its way around the internet: http://www.wlbt.com/Global/story.asp?S=13191657 Take a moment to compose yourself, pick your jaw up off the floor and stop screaming at your computer. I’m sure you’ve already asked out loud, “What is this guy’s problem?” AMR has not written a policy that needs to be changed, the responding crew followed their training perfectly, and did the right thing by not putting themselves in a dangerous situation. If any other Ambulance service, Private, 3rd Service, or Fire based told their crew to just rush in there, I’d question their devotion to their Field Employees. Tim Noonan over at RogueMedic.com has said it better than I could have. The blame here has been...

For the month of July, I was selected to host The Handover, an EMS Blog Carnival. The topic I chose to tackle? The Crisis Patient. Not a day goes by where I don’t have to deal with a psych crisis patient. They’re out there, we all run into them, and the training that we get to be able to deal with them is minimal. Focus moves towards ACS patients, strokes, respiratory patients, or trauma scenarios. While treatment of these patients is usually rather involved, it takes the focus away from our less acute crisis patients, which are viewed as more routine, and easy to care for. They are, however, far from either of those descriptions. Take a read through the blogs below. Chances are you’ll see a situation that you’ve been through in the past. The Insomniac Medic shares the story about an encounter with a patient where a special bond was created, and because of it he was able to get his crisis patient the help that he very much needed. The Happy Medic dug into the archives for his contribution to this month’s Handover. He’s asked by the Police Department to help remove someone that many of us have encountered: a horder. Physically, she’s fine. Mentally, she’s competent, but sometimes we are forced to make decisions in the best interest of our patients. Our friend over at Paramedic Pulp Fiction takes the time to talk to his already restrained crisis patient, and takes the easier, less forceful way out. Taking this approach not only made his job easier, but could potentially make things easier on the next crew that encounters this guy. Often times, its important that the provider takes control when dealing with a crisis patient. Over at Street Watch, we get to hear a story from 2006 about a rather large crisis patient with the potential to escalate a situation to a physical level. He remains in complete control of his scene and his patient, but he gives her the chance to feel like she’s in control with a few simple actions: letting her have a cigarette and giving her simple choices about how care is provided to her. Our...

With all of the writing I’ve done today, this week should be a pretty busy week atEMSin the New Decade.I’m waiting on submissions for my topic for The Handover, the topic of which can be read here.Also, I’ve got a two part post almost completed about the Massachusetts EMT Recertification scandal that is currently taking place.I thought though, on this Sunday, which is supposed to be a day of rest, that I would start things off on a lighter note. Jeramedic called me out in one of his blog posts.The question was, “What reading material do you keep next to the toilet?”I don’t know exactly how this thread started, but from what I’ve researched, it seems that all of it goes back to TheHappyMedic.Thanks, Justin! So when I “sat down” before, I took inventory of my library that would most certainly be flagged in an episode of Seinfeld.Here’s what I found JEMS — If you work in this field, chances are you have at least one copy lying around the bathroom somewhere.My current selection is the 2010 200 City Survey edition.There are some great articles in that one.I highly recommend it. PC Gamer — There are a few month’s worth of this magazine hanging out in the rack.Its my guilty pleasure, and my hobby when I don’t really feel like heading out to face the world.That’s right, folks.MedicSBK is a gamer! Cowboy in the City — This is a book aboutEMSin the area where I practice.The writing style is. . . unique to say the least.I’m not sure about the overall message of it, but I’ll usually read a page or two here and there. The trusty iPhone! — When all else fails, chances are my iPhone is nearby.Not only does this give me plenty of websites to tackle, but I will admit there has been the occasional Tweet (or as I believe its called Shweet) that goes out, but you’ll never know which ones those are! Muahahahahahaha! So there you have it!Plenty of reading material to keep me occupied.Seeing as how everyone who I would call out on this one has already written some great articles about this same topic, I guess I...

As I sit here in my Expedition typing away on my Netbook, I am reminded by the night’s weather of how much I love the City during the summer.13 years ago when I leftNew Jerseyas a naive 19 year old EMT, I figured I was on a “four and out” plan.I would get my EMS Management Degree, get my Paramedic Certification, and bail on out of here and back to my comfort zone: theJerseyShore. Once I graduated College in 2001, I had about 8 months experience as a Paramedic here in the city, and it had gotten its claws into me.At that point in my career, I saw no other option for me than to be an Urban Paramedic, running all of the 911’s I could.In a week at work here, I was personally doing as many 911 responses as my Volunteer Service that I got my start with back in 1993 would do in a month, and I was loving every minute of it. UrbanEMSis definitely unique.Your transport times are commonly shorter, and while per capita, your high acuity patients might be a fewer in number than suburban and rural systems, you still see your share of critically sick and injured people.I’m not just talking about the shootings and stabbings, trust me they’re there, but I’m also talking about the STEMIs, strokes, and generalized respiratory and cardiac patients. Commonly in this busy system, except for a few patient complaints that would also trigger the request for fire to respond, you were on your own with just your partner.On my shift though, we all looked out for each other. We were definitely one big family.If you were going into a bad neighborhood, chances are, someone else would “float” your way for no other reason than to just watch your back.They’d set up your gear, help you stairchair a patient, or just simply make sure that people respect your personal space. This October will mark my 10th anniversary as a Paramedic.Its funny, but I can still remember heading in for my first shift after getting cleared and sitting in the parking lot of my college dorm dry heaving because I was so nervous.(I swear it...

Many of us in the EMS community were shocked this morning when we woke up and read the News Headline about the Bucks County, PA Paramedic who was killed by a Psych Patient he was chasing after. I found out about it from my new friends on Twitter. My thoughts and prayers go out to his wife and children who are now left fatherless. So I went to work today, just like any other day, in my mid-sized far-from-safe American City. It was quite the typical day for the most part: MVA’s, a nice mix of medical, trauma and behavioral calls, busy ERs.. I’m sure many of you know how it goes. But one call stood out to me as soon as I was advised about it. One of my crews had responded to an address for an unknown, which turned out to be a suicidal male. When they arrived, they found a rather irate man in a domestic dispute with is girlfriend. He had taken a handful of pills in an attempt to harm himself. When one of my medics advised him that he had lost any option by his actions of staying at home, and was going to have to take a ride to the ER, he got even more upset, and pulled a knife on my crew. Somehow, the two Medics were able to get it away from him. At this point, they called on the air, and requested that the police department expedite their response. That is when I found out about it. They then stated that the patient was fleeing the scene, and gave out his description. The scenario played over in my head, based on what I had read earlier in the morning. What was going to happen next? My first concern was the safety of my Medics, and making sure they stay safe. I arrived on scene moments before the police department, thankfully to find both medics standing on the front step of the patient’s apartment building, both unharmed. They showed me his weapon of choice: a kitchen knife with a half broken off handle. The patient’s girlfriend then pointed out that he was returning to the...