This past week, Washington DC finally took a step in the right direction by hiring what they call “civilian paramedics.” While I am not a huge fan of the term they use for their new employees, I cannot help but stand up and applaud their move to hire staff that can be 100% dedicated to addressing the department’s shortages. I have seen a lot of numbers of the past week: 38 paramedics on a shift with only 14 in ambulances. 80% of the department’s 160,000 calls medical in nature. Trucks out of service. Running out of gas. Catching on fire. Lately, it has been one horror story after another for DCFEMS. While hiring paramedics seems like a logical move, one city councilman went as far to call it a “step in the backwards” for the department. City Councilman Phil Mendelson was part of the Rosenbaum Commission which, in response to the assault and death of New York Times reporter David Rosenbaum. That commission was a driving force in the cross-training of EMS personnel, and the overall integration of the fire and EMS systems in the nation’s capital. The circumstances surrounding Rosenbaum’s death seem more to me to be driven by complacency and burnout than the failure of the EMS system. The EMTs involved failed to recognize a serious medical emergency and wrote the patient off as being drunk. Because of this, he did not get the care that he needed. The only place where the system failed was by not having the EMTs that initially responded to the call properly prepared for what they encountered. Now, almost six years after that committee’s recommendation, it is easy to see that the changes that were aimed at improving the system have failed. The biggest sign of this is not the response times. It’s not the number of trucks out of service. It is the number of overworked and underappreciated paramedics who carried 80% of the department’s volume who have left the department because they have seen the writing on the wall. The time for change clearly is now. Many have called for the firing of Chief Kenneth Ellerbe. Some would even argue that due to his...
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
A Typical Call. . . A Follow Up
As a follow up to last week’s article about violence against EMS professionals, I wanted to share with everyone the state law that was passed in Delaware at the end of June. On June 30, the state of Delaware added “emergency medical technicians and paramedics” to a state law that makes “offensive touching” a class A misdemeanor. To summarize the law, offensive touching is defined as “touching another person either with a member of his or her body or with any instrument, knowing that the person is thereby likely to cause offense or alarm to (the) other person. . . “ Interestingly enough, the law also includes “intentionally striking the other person with saliva, urine, feces, or any other bodily fluid” and mandates that a defendant be tested for “diseases transmittable through bodily fluids.” In the state of Delaware, punishment for a class A misdemeanor could land someone in prison for up to a year, and could result in a fine up to $2,300. EMS advocates, services, and unions that represent EMS professionals should take note of this, and start laying the groundwork with their local law makers if laws similar to this do not already exist within their state. This is a major victory for EMS professionals everywhere. While laws such as this one do not make my job any safer persay, they do at least create greater consequences for those who choose to assault EMS professionals. Like I said, take note, share and advocate. Our safety is no one’s responsibility but our...
Toronto EMS
The other day, I had a chance to read an article about Toronto EMS, and their relationship with the fire department, or more specifically, the fire department’s union. In a recent study done by a third party, it was recommended that paramedic unit hours be increased, and that a fire station on the city’s west side be closed down. Ever since then, it seems like in Toronto, the fight has been on, and boy is it an ugly one. With headlines like the one on a 2010 article reading “We’re in a War with the Fire Department” do nothing but draw unnecessary lines in the sand. Dispatch protocols were reviewed, and fire first response was removed from 50 of those protocols, but added to 22 others. In the year since the revamping, they have been added back onto less than ten of those they were removed from. It is the position of the Toronto Paramedic Association that what the citizens of Toronto need is exactly what last year’s study calls for: more paramedics. Ed Kennedy, president of the Toronto Professional Fire Fighters’ Association disagrees. He feels that care being provided to the citizens of Toronto suffers without the fire department’s first response, and even says that Toronto should scrap their third service paramedic system in favor of a fire-based EMS service. My question to Mr. Kennedy is a simple one: where is the evidence? What does he have to hang his hat on that says not only that fire fighters should be added back as first responders but should, in fact, take over the ambulance service? The study, which provides evidence to the contrary, recommends against consolidation and advocates for the addition of 25 ambulances per day, a jaw dropping number regardless of the current size of the service. It is time to cut through the B.S. and let the evidence speak for itself. Toronto EMS, however, is not without their problems. Their response goal of under 9 minutes 90% of the time is not even close to being achieved, and currently sits at an abysmal 65%. Does that mean that the system needs first response, or does that say that the need for...
Just a Typical Call. . .
Imagine if you will. . . It’s a typical day for you. You came into work, just like any other shift, you got assigned your truck, and you hit the streets. You did a few calls, here and there, mostly routine, you transported them, finished your paperwork for each, and got yourself back on the road. Then, you are dispatched to a male in crisis. You arrive on scene, just like any other call to find the depressed, suicidal, and slightly intoxicated patient. You put him on the stretcher, and place his bag on his lap and load him into the ambulance. Initially, your patient is calm and cooperative, so you hop in back, sit on the bench seat, and get on your way to the city hospital, just like any other call. Without warning, the patient goes into his bag and pulls from it a black handgun. A scuffle ensues, and you are able to disarm the patient, restrain him and finish the transport. After removing your heart from your stomach, you inspect the gun and find it to be a BB gun. Regardless though, you feared for your life, and you are assured that after being medically cleared, the patient will be dealt with by the proper authorities. This really happened to a good friend of mine. Lucky for him and his family, he was fine. The outcome of the patient, or rather the assailant, however, is unknown to me. Safety is a growing issue. Recently, a Jersey City EMT had a knife pulled on them in the back of an ambulance. They were able to dodge the first swipe, sustaining only a minor laceration, but the party they were transporting then impaled the knife in the EMT’s shoulder. Fortunately, the injuries sustained by the EMT were not serious, and according to an article I read, they will be fine. An official in Jersey City made some eye opening comments in the article. Robert Luckritz, the Director of Jersey City Medical Center Emergency Medical Services said that “some EMTs accept it as part of the job.” He went on to add that “it is relatively common that EMTs are assaulted and it...
It’s Official!
Just when I thought all hope was lost, all the chips fall into place. . . I have not missed a major EMS conference (EMS Expo or EMS Today) since my first trip to Dallas in 2010. Because of all of the life changes that have happened over the year, and my demotion to “FNG” at my new job, I thought that this year’s EMS World Expo in Las Vegas might just be the first one. It was tough to listen to everyone making plans, and talking about classes, and realizing that I just might miss it because of my work schedule. It took a little bit of work and a lot of overtime, but thanks to the generosity of some of my new coworkers in the form of swaps and their vacation days that allowed me to work almost non-stop, I have booked my hotel room, and scheduled my flights. I will be arriving in Las Vegas on Sunday September 8th in the morning for four days and three nights of quality time with some of the best friends a guy could ever ask for. Yup, that’s right: our semi annual “reunion” will happen again! I really did not realize how much I would have missed it until I took the time to schedule the trip. The excitement that I am overcome with now, just about a month away, is overwhelming. There is no better place than those conferences, and its not because of their location, its because of the people that I get to see there. To those of you who will be joining us for Expo this year, I look forward to seeing you all and catching up with you! For anyone who is missing it, you will sorely be missed. And finally, if you have never been, what are you thinking?! You have no idea what you are...
Recent Comments