This past weekend I had an opportunity to speak at my first national conference.  A few months ago I submitted and was accepted to present at that National Collegiate Conference which brings together campus based EMS systems and EMTs from around the country.  This year’s gathering was in Boston, so I headed back up to New England for the weekend.  First of all, let me start out by saying that as of late I have become a fan of the train, but i was persuaded by a friend to fly up.  What a great decision.  Fifty five minutes in the air, and I was on the ground at Logan.  It was well worth it. But i digress. . . I was amazed at the number of people who attended this conference.  From what I was told there were over 1,100 collegiate EMTs who had come from as far away as Arizona.  They were probably the group that I felt the worst for.  Sometimes I wonder if they actually sell clothes in Arizona that are capable of handling thirteen degree weather. The conference itself had about 110 presentations over the course of three days, an aggressive undertaking for even the most polished conference, but it was handled well.  Each block had five or six presentations dealing with everything from MCI response to toxicology, and over to career related ones like mine, and ones on administrating and running collegiate based EMS services and developing best practices for them.  To me, it was also a training session for these kids (and I use that term loosely) for how they should perform and what they should be ready for should they head off to EMS Today or EMS Expo in the future. The collegiate audience presents an interesting one.  Personally, I feel that there are two kinds of conferences that we attend.  The first is to just put credits in our bank so that we can re-up our cards.  People sit back with folded arms, sighing and looking at their watches waiting for the next break, and asking questions like “Are we going to go all the way to 5pm today?”  Those are not as much fun to...

    LEVEL ZERO – The Movie from Thaddeus @Setla on Vimeo. Yesterday marked the four year anniversary of this blog, and what a ride it has been, and sitting here in a completely different system in a different state with different friends and colleagues around me, I cannot help but reflect back at how crazy this journey has been.  For me it all started with a trip to California provided to me by AMR, and a few conversations out there with a few paramedics about a little movie called Level Zero that I had stumbled across on the internet. For those of you who have read through the posts of this blog, you know where it went from there.  I started writing.  I connected with Ted Setla and Justin Schorr.  The EMS 2.0 logo and pin were created.  I came out of my shell and found a love for teaching and now, four years later, I am still at it. The road has not been without bumps, and times have not always been easy but ultimately I could not be happier about where I landed.  I wonder sometimes what i would be doing had Mike Taigman not reached out to the east coast for help, or had I not gotten a ride down to one of the southern hospitals in the county from one of their Clinical Specialists.  Any little turn in that road could have changed everything.  I was lucky though.  I have come out of this four year rollercoaster with some great friends who I would not trade for anything.  I have had a little hand in sparking change in my old system in Springfield, and still love following their accomplishments even now, over a year after I left.  I’ve sung Karaoke with people from EMS World and EMS Today.  I’ve sat down and interviewed a man who someday I hope to have a shred of his ability to lead.  Justin Schorr’s number is in my phone, although I don’t talk to him nearly as much as I’d like.  I’ve lobbied on Capitol Hill.  I’ve hosted a podcast that I used to listen to and wish that maybe someday I would...

Now that I got my charger fixed for my Netbook I can finally share this post that I wrote on my train ride back from EMS Today 2014.  Enjoy!! Here I sit on the train ready to head back home after another series of adventures at EMS Today.  Although the vibe at this year’s conference was different than years passed, the one factor that remains constant is there are a number of people who are extremely motivated to do more than just spend their 40 hours on a truck, collect a paycheck, and go home.  For the most part, the people who attend these conferences are doing so in the hopes that they become better clinicians both for themselves as well as their patients. Lines were drawn in the sand at this year’s EMS Today conference and the goals and direction was apparent from the get go.  The major focus of many of the classes was what some call community paramedicine which others have termed mobile integrated healthcare.  There were  a number of classes about branding, data, attitudes, and expectations that should be important to a service as well as a paramedic as they prepare themselves to provide care outside of the traditional “emergency” environment so many of us are active in today.  While the classes and churiculum are great, however, I want more. This year’s conference marked the 8th major one that I have attended dating back to EMS World EXPO in Dallas in 2010.  I have seen a number of fads come and go.  I remember just a few years ago when the exhibit hall was full of venders looking to sell everyone on the importance of their products when it came to prehospital ultrasound, something that a lot of us thought might have a practical use in the field.  For the past two or three conferences, community paramedicine has been showing up more and more.  I remember last year, when NAEMT’s EMS on the Hill Day was canceled, Chris and Anne Montera (then known as Anne Robinson) along with a team from MedSTAR in Texas lead by Matt Zavadsky held a half day workshop for the NAEMT delegates to talk about...

I was out with some coworkers for some frosty beverages last night in celebration of a friend’s birthday, and of course, predictably, the conversation turned to our profession.  We got talking about how we handle and respond to cardiac arrests, and mainly the medications that we give.  While we are all proud of our 40% ROSC rate, one of my friends made a bold, and not complete unexpected comment, “I think we need to get rid of epinephrine.” It is an argument that has been made by numerous people, including my friend the Rogue Medic, and it is one that is not completely unfounded.  Patients who receive epinephrine in cardiac arrests have worse outcomes.  To me, that is not completely surprising.  Personally, I feel that patients who we save with epi are people we would have not gotten back without it.  That statement might be slightly confusing, but as far as I am concerned, people with better outcomes without epi have those improved outcomes because their cardiac arrest was intervened with sooner, and the underlying cause was one that made them an easier save. So now we have these ROSC patients who end up with poor long term outcomes and some who might not even make it out of the hospital.  We are saving people only to put them in a vegetative state, or only prolong their lives for a short time, right?  One might think so. . . Then I looked a couple of seats down at the bar, and the whole purpose of epi, and the entire argument became clear to me.  We were joined that night by and celebrating the birthday of, a former paramedic who gave up her career to go into organ procurement and transplantation.  When we brought in one of these patients that was expected to have a poor or short outcome, which is when her company got involved.  They match donors to transplant recipients and get the ball rolling with screening and dealing with a family.  Her company and profession have saved countless lives over the years. If our documented ROSC rate tells us we are “saving” four of out every ten cardiac arrests, let’s say, for...

This post can also be found at TheEMSLeader.com With EMS Today right around the corner, I got thinking the other day about the past conferences that I have been to.  This year’s gathering in Washington, DC marks my ninth consecutive major conference that I have attended.  I’ve been to Baltimore three times, this will be my second appearance in DC, Las Vegas twice, New Orleans, and the first conference that I attended back in 2010 in Dallas. That year in Dallas, Had quite the opportunity drop in my lap.  One morning, I had the chance to sit down and interview a person who I very quickly came to admire because of his involvement in the National EMS Management Association, Skip Kirkwood, who at the time was the chief of Wake County EMS.  Even before I had a chance to meet Skip the words “Well, in Wake County. . . ” were a constantly used phrase in my vocabulary.  I admired the changes and strides that they had made in their quest to provide the best possible patient care for the residents of Wake County. More than that though, I admired Skip’s approaches to problem solving.  For years to follow, presentations that I have given have involved little pearls of wisdom that I have obtained at the hands (and fingers) of skip over the years from e-mails and posts that I have received from him, so while I had a long standing admiration for Skip, having the chance to sit down with him as a captive audience and pick his brain was quite the opportunity for me. One thing that stood out to me was how he approached change and progression in Wake County.  As I read about his service it was clear that things always seemed to progress quickly there.  Skip’s answer to me was that he always promotes an environment that is comfortable and welcoming to change.  He wanted his people to be ready to walk in one day and find a new piece of equipment, or a new policy change.  By doing this, when major changes were rolled out his staff was more welcoming and willing to adapt. I cannot tell you how...