While I only fit one of the above listed categories, a friend and colleague in the department I work for now shared with his Facebook friends a great piece he wrote on being both a paramedic and a father.  Seeing as how he has been at this for around twenty years, and has four little ones at home, i bow to his expertise on both.  So for today’s post, I bow to the wisdom of Paramedic Corporal Lee Morris: “I’ve come to realize that being a father and a paramedic is quite alike. Both titles involve a steady stream of people trying to excrete things on me and my attempts to dodge the mess. Both titles often require I solve problems others have caused for themselves. Both involve my efforts to keep others from playing in traffic or fixing the boo-boos associated with similar activity. Both involve long overnight hours, busy weekends and holidays, occasional soul-crushing fatigue, and little time to rest before my charges are out to play again. Both titles require I respond at rapid pace to the siren call of someone in dire need, and at times they really only think they are in dire need. Sometimes in both jobs I have to medicate people or stick things in people that don’t want to be stuck. Occasionally they both involve me holding someone down who is inconsolable, kicking and screaming and completely unresponsive to reason. Sometimes in both I have to attend to people creating a scene in a public place, help them while remaining calm, and try to keep them from disturbing the general public. In both titles I am expected to be professional, positive, helpful, and have a never-ending source of energy and solutions. Sadly, I occasionally miss the mark when performing in both jobs and have to humbly ask forgiveness and move on. For one title I am paid, the other I am not, and there are days during which I would gladly trade that fact between the jobs. (Neither title pays enough, by the way.) Both involve the occasional sense of extreme accomplishment as I look back at my efforts to see the difference I have made...

With the general public clamoring for help, the debate over Narcan and who should have it rages on.  Recently, I read a post by EMS and fire author and blogger Captain Michael Morse from Rescuing Providence.  Michael relates some of his own personal experiences as well as those as a paramedic firefighter with the Providence, Rhode Island Fire Department to shape his opinion that making Narcan available to the public will allow drug users to “push their high to the limit and then return from the brink of death trough the judicious use of the miracle drug that they can now get as easily as they can their drug of choice.” While I respect Captain Morse and his willingness to share his personal experiences with the community at large, I think he is missing the mark here. There comes a time in medicine when we have to weigh the risks of the care and medications that we provide against its benefits and that is exactly what we need to do with Narcan.  I am sure that somewhere in the United States the scenario that Captain Morse has shared with us could happen.  Heck, I’m sure it probably has already happened, but we just don’t know about it, but making this argument is as absurd as saying that someone who is allergic to shell-fish would want to try lobster just once, Epi Pen in hand, ready to bring them back from the “brink of death.”  While I am sure that it has happened, it is the exception to the rule. “What if the drug is given too fast and the patient vomits?” “What if the patient is actually speed balling and comes up violent?” There could be a million and one “what ifs” that we throw out there, much like we could for C-Spining patients, or putting a patient on CPAP.  The medical world is full of “what ifs” which is why every drug commercial on TV is followed by a long list of side effects that I am pretty sure include spontaneous combustion. Rogue Medic will tell you that the problem with an opiate overdose is not Narcan deficiency, and that effective ventilation can...

Friday the Washington Post published an opinion article by Toby Halliday.  Mr. Halliday is apparently the son in law of David Rosenbaum, the New York Times reporter who many feel died because of the inactions of the Washington DC Department of Fire and EMS.  Rosenbaum’s death in 2006 prompted the formation of a committee in 2007 that shaped DC’s EMS system today.    Mr. Halliday was part of that committee. The restructuring that took place in 2007 has been a far cry from an effective solution of the problems that plague DCFEMS.  Some of them were not even addressed, for example, mismanaged ambulances that caught on fire, ran out of gas, or were out of service when they were needed.  While the 2007 study addressed some operational issues it completely ignored many cultural issues the likes of which resulted not only in the death of David Rosenbaum, but also Medric Cecil Mills Jr who died on a DC street while firefighters from Engine Company 26 refused to go across the street and see what was going on. It seems like the article posted by Mr. Halliday is one that is attempting to address and defend the findings and still unfollowed recommendations of the committee that was convened seven years ago in the face of criticism that DC should adopt an EMS system similar to that of Boston, which, arguably is the most effective metropolitan EMS service in the country.  While different systems might be more effective at different levels, I think Washington, DC is a strong testament to the needs of large municipalities when it comes to prehospital medicine.  In Friday’s article, Mr. Halliday shares the “key task force recommendations” from the 2007 committee. 1.  Elevate and strengthen the EMS Mission – While Halliday cite leadership failures and a lack of patient-care experts in leadership positions, if they are searching for an effective mission statement they should look no further than the EMS based EMS system in Boston.  Boston EMS’ mission statement reads as follows, “Boston EMS, the provider of emergency medical service for the City of Boston, is committed to compassionately delivering excellent pre-hospital care and to protecting the safety and health of the...

It’s currently Thursday night, at 8pm and as I write this blog, I am counting down the hours until Sirens premiers on the USA Network.  From looking around social media I have found that there are some out there who not only are not excited about this show, but are damning its existence.  To them, and to everyone else in the field I am here to say, lighten up! I used do the opening lecture for an EMT class in Massachusetts that I called “So, You Want to be an EMT” that talked about a lot of the factors that one must think about before even considering getting into this field.  One of the subjects that I touched upon was what I personally consider the best PR machine that this field has ever had: the 1970’s show Emergency!  The show, which premiered in 1972, loosely chronicled the creation of the Los Angeles Fire Department’s paramedic program and shared the brand new concept of paramedicine with the world through the eyes of Johnny Gage and Roy Desoto.  Since the show went off the air in 1979, a few networks have tried to recreate it and have failed.  Miserably. Do I even have to bring up the horror show that was Trauma! that introduced Captain Versed (portrayed by social media’s own Ms Paramedic Natalie Quebodeaux Cavender)?  Or, if you really want a laugh, go on YouTube and search for episodes of a show from 1999 called Rescue 77 that once featured a paramedic doing a handstand on a patient to defibrillate them in a pool of water.  It was truly cringe worthy. While I thought that Rescue Me was a great character study, and the first season had a lot of telling tales about the stress that many in the field are subjected to day in and day out it was more about the people than the department.  Third Watch, again, was a show that I could never get in to, and I have yet to even bother watching an episode of Chicago Fire.  Saved, which lasted just one season, might have been my favorite but the show was not without its share of glaring flaws. ...

This past week, an article posted by EMS 1 caught my eye.  It tells the story of a Minnesota man who had his video camera confiscated and was eventually charged with “interfering an ambulance crew.”  According to the article he was videotaping the interactions between a man living in his building and sheriff’s deputies who were accompanied by EMT’s who intended to transport him to the hospital.  I am not going to get into the article and story itself, as I really truly feel like this should be a non-issue.  In the society we live in today people have video capabilities and use them on a daily basis to shoot a variety of things.  It is part of the social media YouTube society that we live in.  What I found truly alarming was the reaction from the EMS community. The article received over 150 comments on the EMS 1 Facebook page, many stating that there was a “HIPPA” violation.  First of all, it needs to be pointed out that the abbreviation for the law is “HIPAA” and not “HIPPA” and no, the headline of this post was not a typo, I meant to do that. HIPAA, which stands for Health Insurance Portability and Accountability Act, is a law that has multiple parts.  Title II which deals with health care fraud and abuse is the one that is most important to EMS providers.  Covered entities of the HIPAA laws are those who record, collect, or store a patient’s health care information potentially for billing purposes.  Most HIPAA education began in the early 2000’s but judging from the comments that I saw this week; I cannot help but feel like it might be time for some reeducation. Over the years, I have encountered HIPAA on a number of different levels.  I have been told by facilities that I “should not open the sealed envelope” that was containing a patient’s medical information because I would be violating their HIPAA rights.  I have heard HIPAA cited as a stumbling block for QA/QI officers in getting information on patients who were delivered to a medical facility.  Simply put, so many entities that are HIPAA covered keep the information more...