Nov 6, 2014

This week I started what is essentially my first real true vacation since my trip to New Orleans for EMS Expo 2012.  I’ve had time off, however most of it has been because of swaps.  This time around though, I burned enough vacation time to put me out of work until the 22nd of November.  It’s an exciting break to say the least. No fall break would be complete without a trip to EMS World’s annual EMS conference being held this year in Nashville, Tennessee.  For those of you who have never been to a national conference I ask you again, what are you waiting for?  If you want to see the latest products, or have a chance to rub elbows with some of the most brilliant thinkers in this industry then conferences like EMS Expo or EMS Today are for you.  This trip marks my 9th consecutive major conference.  I’ve made some great friends, amazing professional contacts, and I have always walked away with a little different view of our field and where we are heading. I am sure that many of you are wondering what happened to the podcast.  Well, it’s not dead.  Not even close.  The last couple of months has been taken up by a lot of extra work, extra teaching and side projects which have taken time away from my social media existence, particularly the development of the podcast.  Schedules clash, ideas need to be saved until the right people are available to talk about them, and some ideas just never seem to fully develop.  We will be recording an episode of the show on the exhibit hall floor thanks to Jamie Davis and the crew at the ProMed Network.  They have always been so good to me, and continue to be supportive. Furthermore, I hope to get together with some people down there to actually have a chance to schedule some upcoming shows.  So the podcast is not even close to being a dead project.  I have invested in it, and plan on getting back to it in Nashville and in the coming months.  In the meantime, check out the already recorded episodes here. Tomorrow I hop on...

Nov 3, 2014

I spent some time listening to Chris Cebollero and Kelly Grayson’s show about the presence of cameras being present in the back of an ambulance, and I cannot figure out what everyone is afraid of.  I know what most will say that their fears are, but is there any foundation for those fears?  First of all, let’s throw HIPAA right out the window, or as many on the internet call it, HIPPA.  People who complain about patient privacy issues with cameras and HIPAA laws are people who do not understand HIPAA. A little more than ten years ago, I had the dubious honor of being my union’s chief steward.  One of the major fights that were dropped on our plates was the arrival of the infamous “black box” driver tracking devices in our ambulances.  If your system does not have them, I will briefly explain their function. The boxes track the truck’s speed, breaking, use of lights of sirens, use of seatbelts, and use of a spotter while backing up.  All of their information is downloaded to a master computer and is fully accessible if needed for any sort of investigation.  In addition to its, tracking, the boxes used accelerometers and g-force detection devices to give Pavlovian real time feedback to drivers in the form of growls and beeps from an audible speaker to create a safer and smoother ride. The fear from street personnel was always that “Big Brother” was watching.  People were absolutely petrified that information would be randomly pulled, and people would be disciplined as a result of their driving techniques.  I had to be the mouthpiece for the employee body, and because of a number of factors, we did not get very far with our argument, and the company pushed forward and installed the boxes into the ambulances. In the two years that followed, the number of disciplinary hearings that I remember taking place as a result of the boxes were few and far between.  Most of them were ones where someone would try to tamper with or fool the box.  The most amusing of them was a crew that was being investigated for “repeatedly slamming the truck into ‘reverse’...

Oct 30, 2014

This morning I saw a video come across pretty much all of the major EMS related news sites about a fire crew from Glendale, Arizona who were filmed while restraining a patient.  I fired up the video and sat there watching saying to myself over and over “it looks fine to me. . . still looks fine. . .” and then one of the firefighters opened his mouth, and lost his cool.  He informed the patient that he was “dead meat” and began swearing at the patient and the family.  Have a look at the video, but be aware that there is potentially offensive language used in it.  It might not be suitable for work. The backstory on the call is sketchy: a patient who had a “seizure” after overdosing on medications who first punched his father and then assaulted the crew.  During their restraint of the patient, the stretcher ended up on its side, and at least two firefighters ended up on top of the patient.  Operating in a vacuum, and putting the video on mute, the crew did a pretty good job retraining the patient.  He was being held down by an adequate number of people leaving other responders to watch the scene, and monitor bystanders.  If two people can effectively hold a patient down, then there is no reason to have five people on top of him, so kudos for that.  Keeping with the desired online theme of not armchair quarterbacking this call, I feel that this is a good time to touch on a couple of different points that we can remind ourselves of after watching this video. In the world of power stretchers, we no longer have to lift it to its highest level right off the bat to prevent repetitive lifts. Keep your stretcher at a manageable level especially when you have a patient on it who might become combative.  If you start off at a level higher than your patient, then they will be easier to control, and while you might put yourself at risk for strikes to some areas that men specifically might be more protective of, you will prevent yourself from being struck in the...

Oct 29, 2014

Anonymity on the internet is a powerful tool.  Some use it for good, and some use it to put their coworkers, colleagues, and services on blast.  When I started writing almost five years ago, I first started perusing blogs like Kelly Grayson’s and Justin Schorr’s.  Justin had recently gone public with where he worked with the release of Chronicles of EMS right around the corner.  I always looked at Justin as one of the lucky ones because his service so openly embraced his writing. When EMS in the New Decade was started, I had hopes that I would get it to where it is today, but looked at things more realistically in that so many blogs are started on the internet but not followed through on.  While my name was made public i did not mention who my employer was, and i did not talk about my writing at work.  I maintained this stance for more than a year, mentioning it to some people here and there but for the most part I kept my social media life divided, not discussing my writing very heavily on Facebook, and promoting the heck out of it on Twitter.  Once I did start letting people know what I was doing, the response to me was overwhelmingly supportive.  It is not that I doubted my friends and colleagues, I just did not know that the response would be so overwhelmingly positive. If you met me, it was not very difficult to figure out who I worked for, but I never said it, keeping my description of my employer to “a large national ambulance service in the United States.”  Heck, it was not until I gave my two weeks’ notice that I stated publically that I worked for American Medical Response.  I did not do this out of spite or disrespect for the people that I worked for.  Truth is, if you did know who I worked for, or figured it out, it was pretty easy to put names to a lot of the examples that I gave.  I used this blog to arm chair quarterback a lot of what I saw as failures in the system that I worked...

Oct 22, 2014

In the first part of this series, we took a look at the disease of Ebola itself.  In the second installment we looked at the disease’s signs and symptoms, and took at look at how we as prehospital providers could be put at risk.  In this final part we take a look at the role EMS will be paying in the battle against Ebola. The EMS Response to Ebola In a recent EMS1 article, Dr. Alex Garza took a look at Ebola and how it will affect EMS responders.  One of the first things that he pointed out was the need for specialized air ambulances to transport these patients.  Personally, I feel that we need specialized responders as well.  Dealing with highly infectious diseases such as Ebola requires specialized training and treatment for the patients.  The infection control training that EMTs and paramedics receive is usually focused on “universal precautions and Body Substance Isolation” heck, if you don’t say that at the start of every National Registry station, you’re most likely going to have to retest, but I digress. . . Much like we have specialized HazMat technicians in many systems, and SWAT medics maybe we need specially trained medics and EMTs to handle specifically the interfacility transport of potentially contagious patients. I also spend a lot of time reading the National EMS Management Association (NEMSMA) ListServ on Google.  There has been a lot of talk over the past couple of weeks about different services developing policies and procedures for dealing with patients who possibly have contracted Ebola.  If your department releases anything, read it.  Memorize it.  Make sure you know what your point of entry plan is.  Is one hospital being designated as an Ebola receiving facility?  Who do you have to notify if you have a possibly infected patient?  Are there any radio codes that you need to be aware of?  Also do not be afraid to ask your leadership for answers to any of these questions.  If they don’t have them, suggest that they might be important.  If they’re resistant go higher up the chain if you have to, or at least as high as you are comfortable going. The Center...