Back in September of 2010 when this blog was still in its infant stages and living on Blogspot, I wrote a post about STAR CARE, which I described as the “magnetic north of your moral compass.”  In light of the recent events in Washington, DC (say it with me folks: WHICH ONE?!) I want to take a look at the decision made by Lieutenant Kellene Davis that led to her granted retirement and dodging of department discipline. For those of you who have spent the last couple of months living under a rock, or just recently have been introduced to the wonderful world of the internet, Lieutenant Davis was the officer in charge of Truck 15.  To summarize, and keep the story short, she failed to act when 77 year old Cecil Mills had collapsed across the street from her fire station.  He eventually died.  While we cannot be sure that a response by Truck 15 would have saved the man, what we can be sure of there was no action taken. Now, Dave Konig was quick to point out to me that STAR CARE is an EMS tool and not a fire department tool, but DCFEMS is an EMS provider, so STAR CARE can and should apply to them as well.  As the commanding officer on Truck 15 that day, the responsibility ultimately rests on her shoulders, or at least that is what DCFEMS wants us to believe, so looking at her actions seems to me like the appropriate thing to do.  Let’s take a look at this and see how Lieutenant Davis did. S: SAFETY This was an unknown medical, so looking at it from the most positive side of things, she did not send her crew into danger or allow them to cross a busy street. T: TEAM BASED By preventing her crew from acting, she did not allow them to serve the purpose that the crew was deployed to do which is protect the people and property of Washington, DC. A: ATTENTATIVE TO HUMAN NEEDS I doubt that Lieutenant Davis would want a medical emergency experienced by herself or a member of her family with the same disregard that she...

Over the course of the last year I have developed an established morning ritual.  One piece of that is sitting down and reading a series of links for the day that include local and national news sources as well as posts from selected blogs.  It helps pass the time in the morning, and it is something to do while I enjoy my coffee. Last month, I read a very moving post by Chris Kaiser over at Life Under the Lights about provider suicide.  That particular morning I was teaching at my department’s monthly educational day for one of our platoons, and one of the topics that I was tackling was stress management.  The post made such an impression with me that I included it in my lecture while describing the “code of silence” and how it applies to EMS professionals. It was a blunt reminder of the stress that each of us in this field deal with both as a provider and as a person.  We are not only expected to shoulder our own problems but we are expected to tackle the problems that everyone else around us has as well.  The result is us burying and burying and burying until our own feelings are so suppressed that when they do surface they are so overwhelming that they are that much harder to deal with. Sad to say, I am seeing more and more cases of provider suicide in the field.  It is a problem that is not going away.  In fact, my whole reason for writing this post is because I recently learned of the passing of someone that I met a number of years ago.  He was a hard-nosed paramedic who was never afraid to speak his mind.  Although he was one of those people who could clearly be a thorn in your side it was obvious to me that he had his peers’ and his patients’ best interest in mind.  Much like my other experiences with provider suicide, the news that I heard came out of the blue and based on what I have heard from friends, while there were some warning signs out there no one ever thought that he...

Fifteen years ago I was just getting ready to wrap up my first semester of paramedic class.  We started in January and ran straight through to December with most of our summer dedicated to ACLS.  My teacher, Gary Childs, was tough on us through the first five months, but once we started getting it, we looked at it less as him being critical and more so of him challenging us.  Many pushed to get in his practical station first and as CJ Bartone, one of my classmates often said, “If you want the bull, you’ve got to take it by the horns!” Through the first two semesters of class, I started a list of what would go on to be known as GAC’isms.  G.A.C. were Gary’s initials, and that is what he put on any check sheet a student might have when they went walking out of class.  This list comprises some of the more common statements he made in class as well as some of the more noteworthy and less frequent ones.  Many of my readers might not completely understand this but I feel like there are many out there that have encountered Gary, either as one of their head instructors at Springfield College, or as a lecturer in some other CEU class.  Enjoy! 1. Then we’re going to turn around… 2. Does this sound like… 3. Do you see where we’re going with this? 4. You’ve got to make the soup. 5. Do you need to know if you’re putting the sugar in the bath tub or in Island Pond? 6. Chase the lion or be chased by the lion. 7. Chase the PVTA bus or be chased by the PVTA bus. 8. Palpate, auscoltate and inspect. 9. A P-Wave… 10. Harley’s going to do his ET(O2)IVMONITOR… 11. That’s a snowball thrown at the police cruiser. 12. Eating the Lion and celebrating eating the lion. 13. The TV set doesn’t know what the cable company is. 14. I want to watch Sipowitz on NBC. 15. We’re hitting the ground running. 16. Its all coming together now. 17. You’ve paid the cable bill. 18. Does this patient need to go to Cooley Dic...

I did some thinking this week in the wake of the loss of two of Boston’s Bravest, Michael Kennedy and Edward Walsh and it is a point that I think the world commonly over looks when it comes to police, fire, and EMS.  We have to deal with death far too often most of the time in the form of the general public and the patients that many of us encounter in the streets.  Death is never an easy thing to digest in any setting but we push on, despite it sometimes being a child, or maybe a scenario that is all too familiar to us that triggers some sort of memory from our own personal past.  We are there to deal with it though, and we are there to help the survivors through the early stages of their loss.  The truck stays in service, and we are ready for the next call.  We are not afforded the luxuries that many other people get. If the person who died owned a business for example, that business might close its doors the day of their funeral to allow their employees to pay their respects.  The employers of their loved ones most likely will give them the day off so that they can properly mourn their loss in their own way.  When it comes to public safety though, there is no day off.  There are no locks on the doors or a sign that we can put up in the window that says “be back in 15!” that expects people to be patient and await the return of someone, anyone who might be working that day. Firefighter Kennedy and Lieutenant Walsh were lost on Wednesday March 26th.  On Thursday morning March 27th, there was a group of brave responders who despite their loss put their own grief on the back burner every time the tones dropped because somebody needs them.  The magnitude of that seemed to hit me today as I read through the outpouring of support for Boston Fire over the last couple of days. When the Springfield Police Department tragically lost Kevin Ambrose on June 4, 2012, I was working.  I was on the...

Through my career I have worked in a couple of different style of EMS systems.  I started out in a volunteer system that commonly saw anywhere between 2 and 4 people riding on an ambulance, cramming themselves in back with a medic and a patient for transport to the hospital.  Despite how big our ambulances were (and granted, they were smaller than many of the ones on the street today) things still felt cramped.  I must admit that from my BLS stand point things seemed to run smoothly.  It was all that I knew.  Everyone had their role.  Things seemed to go well, however, now, twenty years later I can certainly see where things could have been frustrating for an ALS provider. Fast forward a few years to my tenure in Springfield.  There was no predicting who I would be in an ambulance with, and more importantly, how much help I would get if I asked for it and it was actually granted to me.  Sometimes I worked with another medic, sometimes an intermediate, and sometimes an EMT.  I did not mind the work load that was generated by not working double medic because such a high volume of our runs were BLS runs anyway.  Admittedly though, there were certainly some frustrating times in the early years of my career as I felt like I could never get enough done.  I was and am my own worst critic.  When things don’t go how intend them to, I beat myself up.  That seemed even easier when I was the only medic there. On most cardiac arrests, we had a fire engine or ladder company with us ready to do compressions, but they were not always the easiest to give feedback to if compressions weren’t being done well enough, or there was something that needed to change.  Don’t get me wrong, many of them were fantastic but it was certainly a barrier we encountered.  Finally, the question of “how many EMTs do you need to run a code?” was a common question that was asked.  A lack of recognition for the evolution of medicine was something that constantly held us back.  My opinion was always that...