Apr 17, 2017

Read my Open Letter to Mr John Bendel here. For today’s post, we are going to continue to analyze the saga of the Asbury Park Press editorial battle regarding EMS in New Jersey.  The EMS Council of New Jersey has sounded off.  Last week on April 10th, the EMSCNJ’s president, one Mr. Joseph G Walsh, wrote a letter of his own in order to, as he puts it, “correct several points.”  So let’s fact check some of Mr. Walsh’s statements, and dig deeper into what the EMSCNJ has said in the past. “Paid or volunteer, every New Jersey EMT must pass the same certification exam. Volunteers conduct monthly drills, and education and skills sessions to stay current. The misleading editorial might have panicked some readers into falsely thinking their local volunteer squads are not staffed with properly trained responders.” It is true, indeed, that every EMT must pass the same certification exam.  So what?  I would dare to say that the ability to study and regurgitate information from a textbook is not the be-all-end-all in evaluating one’s effectiveness as an EMT.  I have worked with great EMTs, and I have worked with people who could not be trusted to work on a crew of two because they lacked the ability that they needed to take the knowledge in their head and apply it in a real-life practical setting.  They all had one thing in common though, they passed the same test. Then there is the other statement that Mr. Walsh makes here about proper staffing.  While all EMTs take the same test, that fact alone does not mean that every person operating on a volunteer ambulance in New Jersey is a certified EMT.  In actuality, many responders might just be certified at a lesser level.  How do I know this?  Mr. Walsh tells us. “Every one of our member squads is required to respond to calls with at least one EMT who remains with the patient. On many calls, two or more EMTs respond. The EMS Council of New Jersey (EMSCNJ) is unaware of any squad — member or nonmember — answering calls without such trained responders.” Currently, when a paid or career ambulance...

Apr 13, 2017

  I am happy to share with everyone that Mr. Bendel has seen and read the post from earlier this week.  I look forward to speaking with him in the future. The issue with BLS care in New Jersey has never and will never be about passion.  It’s about training.  Every good EMT needs to possess a balance of passion, compassion, medical knowledge, and the ability to apply that knowledge.  I am happy to say that I come from a family that possesses those values.  I have two parents who both had lengthy careers as volunteer EMTs.  After reading my letter to Mr. Bendel, my mom, Karen Kier, decided to share some of her thoughts about what it means to be a small town EMT.  What you will read below are her thoughts, from the heart. Mr. Bendel and MedicSBK: First off, EMS is one of the defining aspects of my life. To go one step further, EMS in Island Heights (where you both either currently or have formerly resided) creates this passion.  It’s a passion both for the profession and for the people I so dearly cared for during my 22-year career as an EMT on the Island Heights First Aid Squad. MedicSBK, you, above all, should know this about me.  I watched you closely (and protectively at first) as your skills developed – and then we switched roles.  I knew that you were bound for great things – and I proudly watched you fly. I have performed CPR (successfully) on a dear friend, the parents of friends, people I have known and not known . . . and watched others drift away after a devastating stroke.  I have simply and quietly held many hands.  Was it hard?  Yes.  But it would have been harder not to have been there. I like to believe that with few exceptions I brought this same compassion to all of my calls, whether in Island Heights or in one of our neighboring communities.  In my own simple, naïve way I can only hope that this is something that permeates the entire profession. For personal reasons I have made the decision not to renew my EMT certification –...

Apr 11, 2017

Last week, the Asbury Park Press posted a letter to the editor entitled “Letter: Emergency response teams must have volunteers.”  The piece was written by John Bendel, a town councilman from Island Heights, NJ; the same Island Heights, NJ where I got my start in EMS more than twenty years ago.  John’s letter is a reply to an editorial done earlier in the week called “EMS system deadly hodgepodge” which addressed several the shortcomings of New Jersey’s EMS system, many of which were identified more than ten years earlier by a study done about the state’s slowly dying prehospital care system. To say the least, Mr. Bendel’s letter sparked a fire in my belly.  I wanted to address some of the points that he attempted to make here. “Sure, it would be nice if every Emergency Medical Technician (EMT) were as qualified as the legislation you endorse would mandate.  But if they were, far more would be paid professionals than volunteers.  In America where health care still bankrupts families, that’s a big deal.  We need volunteers.” Let’s address the semantics of this statement first.  “Health care” is not bankrupting families.  Many have begun pointing out that it is health insurance that is doing this.  Skip Kirkwood has taken to frequently correcting people telling them that what they are seeing is attempts at health insurance reform, and not health care reform.  He’s right. Now, on to the meat and potatoes of this statement.  First, what is the issue with creating more jobs, and putting more money, and insured individuals, into society?  Why is it so bad that some would like to see people compensated for the hundreds of initial training and numerous hours of refresher and continuing educational training that EMTs are required to do?  Career EMS providers (because professionals can be paid or unpaid) guarantee that someone is going to be there when the tones drop.  Volunteers cannot always make that same assertion. And let’s talk, for a second, about the chain of survival that drives health care.  With the exception of bystanders, every other link in that chain is staffed with employed, compensated individuals.  Nurses, doctors, dispatchers, people who work in rehab centers,...

Apr 10, 2017

Or better put, I guess, I’m back. It has been quite some time since I put anything up on this website.  I’ve spent the last year or so setting up and running a site about Drexel University Men’s Basketball called Always A Dragon which has been a nice diversion from EMS in general.  Writing about sports is very, very different and it has helped sharpen my skills in a lot of ways, but I think that its high time that I get back to writing about my passion: EMS. I have noticed a lot of things in myself recently.  I’ve been frustrated by a number of things going on immediately around me, as well as in the industry.  Social media, something that previously opened a lot of doors for collaboration and change in EMS has largely descended into a hodge podge of name calling and “my service is better than yours” debates.  Publications have turned to some providers and former providers who might not always be what they seem at the surface, and leave a lot to be desired for the direction that they are leading our younger generation in.  Health care, or rather health insurance, in our country is in shambles.  Our country as a whole, in fact, is in shambles for many different reasons, depending on who you ask.  Things just are not good right now. For me, writing on these pages has always been rather cathartic.  Finishing up a post and pressing “PUBLISH” for me has always put a smile on my face, and I need that.  Hopefully some of that enthusiasm can spread to those of you who are taking the time to read what I have to say. Tomorrow, we hit the ground running.  We are going to start where I started: Island Heights, NJ and a letter to the editor submitted by a councilman in the town that I called home for the first 19 years of my life.  From there, who knows where we will go...

My name is Scott, and I’ve made mistakes. There. I said it. The medical world is one where we strive for perfection. That seems to be multiplied ten fold in the world of EMS. We expect ourselves to be perfect. We expect ourselves to be better than nurses and sometimes doctors as we stand back and watch residents and attendings make mistakes that we feel we are immune to making. We can point them out or cite the newest evidence but for some reason when it comes to our own industry, we are prohibited from pointing out those same mistakes. Some think that in the absence of protocol or knowledge, a good ol’ diesel bolus is the answer and should continue to be the answer when reeducation and more training would be far more appropriate. “Do no harm” is significantly different from “no harm was done” and we need to realize that. Just because nothing bad happened does not mean that something good happened. The key to success in this field is learning from the things that don’t quite go as well as they should have. When I hit the streets fifteen and a half years ago I was terrified. I made a lot of mistakes, and when things were not going well my partner’s foot had better be getting heavy. Through the course of my career, I have grown and I’d like to think today that I’m a better paramedic. In all of the intricacies of medicine that I learned, and all of the journal articles I have read the biggest lesson that I have learned is humility and the ability to admit when I was wrong. When things do not go well, the first question that I ask myself, or someone who takes my patient over is “what could I have done better?” how could I have improved my patient’s outcome? Which brings me to my ultimate point in this post. The internet has been on fire lately after a Virginia volunteer fire department was cited for transporting a pediatric seizure patient in the cab of the fire engine instead of providing care and assessment and waiting for a responding ambulance to...