For this week’s podcast it is just me. That’s right, 15 minutes of me rambling (and ranting) a bit about the situation in Belchertown Massachusetts and the direction that I feel that EMS needs to go in the future. I make some bold statements in regards to departments who are trying to get into EMS. To read more about the four Belchertown paramedics who were laid off, click here. For the Holyoke Fire story, click here. To check out Inside EMS where Rom Duckworth, Chris Cebollero and Kelly Grayson talk about fire-based vs private EMS, follow this link. As always, I welcome your comments on any of these matters. To download this week’s podcast, click this link! Otherwise, use the player...
The Podcast
We took the week off last weeks or Labor Day and this week the podcast is back with a short interview that I did on Jamie Davis’ The Medicast where we talk about the show and what it is all about. Regular shows will be back next week! Enjoy! To download the show in MP3 format, follow this link! Otherwise check the show out below: ...
Read MoreFor Leadership
Roughly twelve years ago, AMR and AEV’s Safety Concept Vehicle made its way to Springfield for us to take a look at. It included a number of interesting features like an expanded harness setup to allow providers to move a little more freely around the box while still being anchored. There were mounting brackets for cardiac monitors, and video cameras to monitor both the rear of the truck for backing up, and the passenger side to check for traffic before opening the curbside door. The vehicle itself contained a lot of positives that have been adopted over the years. I see more cameras used in emergency vehicles and I’m a a fan of the checkered or striped patterns on the backs of trucks to make them more visible to oncoming traffic. I have also seen a few more monitor brackets. But where is everything else? When is that ambulance of the future going to get here? Year after year at conference after conference, there will undoubtedly be some ambulance parked on the exhibit hall floor touting itself as the “ambulance of...
Read MoreFor the Field
There has been a lot of buzz over the past week about California’s EMS Bill of Rights. Dave Konig has a great take on it over at The Social Medic that I encourage you to read. American Medical Response has even launched a counter campaign to it complete with the hashtag #LivesBeforeLunch. While that makes me cringe a bit, I want to touch on one line of AMR’s response to the bill that stuck with me. “As written, AB 263 is an unprecedented political power grab, and will heavily penalize private – but not public – employers of EMTs and paramedics.” When I look back at my career with AMR that spanned more than twelve years, I had a lot of ups and downs. Had busy shifts and I had slow shifts. I found myself mandated to work despite being sick, or just needing a day off. Through the highlights and the lowlights of working in a busy 9-1-1 system that amassed roughly 40,000 calls per year, the instances where my 12 hour shifts hit double digits were rare when compared...
Read MoreLessons to Learn
Any time I peruse the pages of EMS related articles I will inevitably come across some service that is trying to take over another service’s area. Diving deeper into those articles usually reveals the same usual arguments. Imagine my surprise when I clicked on an article about the East Longmeadow Fire Department’s move to take over EMS response in the town of East Longmeadow. I should first point out that what I am about to write is meant to represent my own personal views on the state of the industry. I have not inquired about anything having to do with the current staffing of ambulances and volume. What I am reflecting on is the article and just the article coupled with my years of experience in the greater Springfield area. Just to give a little bit of background here, I used to have a dog in this fight. As many of you know, I was a 12-year employee of American Medical Response, the last seven of which as a supervisor. I participated in contract bids for the town, and saw service...
Read MoreRecent Posts
Multiple Jobs and Way Too Many Hours
Last week, actor Tracy Morgan was involved in a serious motor vehicle accident that also killed a friend of his. The pair were struck by a Walmart owned tractor trailer that was being driven by a driver who had reportedly been awake for more than 24 hours. When I heard reports of the accident the circumstances surrounding it, I started to wonder how many responders at the scene were in the same boat as the driver. Long hours are a well known part of our job, however how long is too long? In the system that I work in now, many of our BLS units are staffed by people who are on 24 hour shifts. A number of the people working these units have a number of different shirts in their drawers from the departments that they work part time for. It is not an unusual occurrence to find some people working back-to-back 24 hour shifts in an attempt to cram a good number of hours into their work week to maximize their days off. In the study that Fitch & Associates did of Alameda County back in the mid-2000’s, it was noted while riding with some crews that “many responders appeared exhausted.” They added that one even “nodded off during a midday conversation.” Again, ALCO was a system where people would try to cram their work week into a couple of days. The effects of sleep deprivation and sleep inertia are well documented in the medical industry as well as the transportation industries. This is why medical interns have seen their hours cut, and pilots and truckers are required to have a certain amount of downtime. Here in the world of EMS though, we push forward. Many of us work multiple jobs. For the first time in my career, I do not have one. It was not unusual for me to work sixty-plus hours at my full time job at AMR, and follow that up with a shift or two at my part time job without a second thought. It was natural to me. I remember days as a supervisor where I would encounter certain employees in the same boat as me who...
Accountability for Providers
“I’m just a volunteer EMT.” Have you ever heard anyone say that? Neither have I. Just about every volunteer provider that I have encountered in my career, regardless of how long they have been doing it or what their dreams and aspirations actually are take a ton of pride in serving their community. As many readers already know, I come from a family full of volunteers and an area that up until about ten years ago, the area that I grew up in was almost 100% maintained by volunteer EMS. Sadly, volunteerism is on a decline, and there are many, many reasons for that. A few weeks ago, EMS 1 reposted an article and tried to tackle some of those reasons with a few really good articles. One article cites expanded EMT training for lack of volunteers. EMS 1 Editor in Chief Art Hsieh then wrote what I feel is an excellent reply pointing out a lack of change and evolution as the culprit. Both stories make some excellent points. In the past, I have written rather candidly about the problems as I see them that the New Jersey State First Aid Council presents to EMTs in my home state. Their organization demands different standards for staffing a volunteer ambulance than a paid ambulance to try and keep volunteer EMS alive. Essentially, they are trying to create a new level of care that is specific to their services resulting in them keeping the EMS system in New Jersey on life support. In many states EMT students are expected to learn more than they have ever been asked to before. They are asked to expand their assessment skills, provide more invasive treatments, and give medications that previously were reserved only for paramedics. To be able to properly understand how those medications work, a greater knowledge of body systems is also required. Enough is enough. Sure, obtaining an EMT certification takes more time now than it did even five years ago, but there is a good reason for that. No one is trying to circumvent the volunteer system in any state. The changes instead are in place to improve the level of care that patients receive...
Podcast Episode 8: Happy Father’s Day!
Jun 16, 2014
This week’s show is something that I am really excited about. Since it was Father’s Day weekend, my dad Peter Kier came down to visit for the night. I convinced him to sit down and record a show with me about his experiences as an EMT. Those who know me know how important my family is to me. Both of my parents are EMTs and they are the main reason that I got into this field so many years ago. Little do they know, but I am as proud of them for their accomplishments in EMS as they are of me. So check out this week’s show as I sit down and interview my dad! To download this week’s podcast, click this link! Otherwise, use the player...
Why So Serious?
Jun 13, 2014
This is going to be my last post on this topic. I actually intended on posting this about a week ago, but so much has come up over the past week that I kept pushing it back. In fact, I was going to push it back even more with my Belchertown post that I released yesterday but I figured that this one could not sit any longer. The events of the “smiling and posing” paramedics in Detroit got me thinking back to a call that I did a few years ago. We were dispatched to a very well-known diner in the city I was working in at the time. It was one that I frequented both while at work and occasionally off the job since it was close to my house. That morning, we were dispatched to the patient having a “diabetic issue.” The waitress told us that our patient was a regular in their establishment. He was an elderly male who would walk down every morning for breakfast, and was a known diabetic. Today, he came in sweaty and disoriented, and just was not himself. While the patient could follow commands, he was just “off.” His sugar came back at 30, so we continued where the waitress had led off: we fed him glass after glass of orange juice and some toast as well. As our treatment of the patient progressed he became more and more alert to the point where he was conversing with and joking with us. We laughed as he jokingly told us how much he hated needles despite having to check his sugar multiple times a day. Being a busy Saturday morning, and this being a small diner (I’m sure many of my readers from Springfield know exactly the spot that I am talking about) we were the center of attention. I’m sure people wondered what was going on as we cracked quiet jokes and then collectively laughed. While the digital age was just starting to really take off, not many people had cameras, and the voyeuristic society that we live in today was not yet dominating the news and the Interwebs, so no pictures of the laughing paramedics...
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