I am sure that most of you have noticed that I have been wading my way through another bout with writer’s block.  It happens, right?  I’ve beaten it before, and I will beat it again though.  I’ve gotten some great support from some friends who have suggested topics, and offered ideas for future posts.  The one I am sharing with you today though is one I find interesting. Last week, I was complaining on my Facebook wall about my struggles with writer’s block, and my friend friend sent me an interesting question: “I saw that you had writer’s block the other day and was curious to know if you’d be interested in running an informal and non-scientific survey of your faithful readers. Here’s what I am curious to find out: I have the opportunity to watch hundreds of transfers by the various private services in RI take place at various hospitals while I am posting. It seems as though virtually all of the techs riding with their patients sit in the airway seat behind the patient, usually entirely out of view of their patient. About the only time that I sit in that seat is when I have a backboarded patient (so my patient can see me) or a patient with an airway issue, at all other times I am either on the bench or in the “captains” chair, in full view of my patient. I wonder if this is generational/experiential/company SOP, etc. and why so many EMT’s now choose to be out of view of their patients? Just a thought, I am sure you have your own feelings and experiences from Springfield, and maybe this will help break your block.” Personally, my answer is simple, but it comes with an “*”.  Although I often tell people that I am only 5’9” the truth is I am actually 6’5”.  When I am working on a truck, they are 99%-100% of the time, van ambulances.  With my long gangly arms, I can reach everything in the truck from the comfort of the bench seat.  When I say everything, I pretty much mean everything.  Its freakish.  The only time you will find me in the airway...

In the digital age that we live in, it is becoming increasingly important for organizations and their leadership to embrace social media and use it to its fullest capability.  It is the fear of the unknown that really causes the problems that we see, and developing an organizational culture that promotes safe, appropriate use of social media is key. Take, for instance, the Facebook pages of Hennepin EMS in Minnesota and Boston EMS.  They do a great job of not only promoting their members but fearlessly advertising the successes of their organizations.  They report call volumes, medical advances, and in Boston EMS’s case, even tweeted a ride along day that was done a few months ago.  Bravo! While the press plays a key role in the public’s perception of EMS, with an increased emphasis on social media, blogging, and a means of making our own “press releases” we can, as a profession, dictate our own direction.  It is becoming more common for blogs to be just as well respected as some news outlets, and some of those outlets are even looking to bloggers to fill their printed pages with their online content. So how does an organization “get there?”  It starts with structure.  When people do not know what limitations and rules are set for them, they are more apt to push the envelope and see how far they can take things.  Remind them what is appropriate to post and what is not.  More importantly, remind them WHEN it is appropriate to be in their phone.  Nothing irks me more than when I hear about someone in the back of a truck answering a text or a Facebook message.  Let’s keep it confined to the downtime people! The key above all else though is to be responsible.  Think before you post.  That goes for status updates, tweets, pictures, anything you can think of.  While social media can be very useful, it can also present some challenges when the WRONG thing is posted.  Even if you take it down, there is a chance someone out there might have already captured it, and even if something is up for just a few minutes, someone is going...

Staind band member donates ambulance to Hampshire county hilltowns: wwlp.com I am going a bit local with this morning’s post, but I saw this last week and I’ve been wanting to share it with everyone. Last week, Johnny April the bass player for the band Staind who are originally from Springfield, Massachusetts, donated an ambulance to Highland Ambulance, the service that handles calls for the town he lives in.  According to the story, the truck cost approximately $150,000.  Highland Ambulance was formed a few years ago to handle calls in a handful of smaller communities outside of Northampton, Massachusetts.  They have some great people who work for them, and adding this brand new unit will no doubt help increase the quality of service they are able to provide. What a great thing for someone to do for a community.  Thank you, Johnny April. Credit the news clip to 22 News at...

Read the original post and the comments it generated: Bad Publicity and Saving Face In my two years of blogging, I have seen what I considered to be a few “big” days.  A post goes up, it generates some buzz, and I get a decent amount of hits, usually a few hundred.  This past Monday though, any previous numbers I had seen were blown out the window.  In the first 24 hours that my post about Joshua Couce and the Newton First Aid Squad was up, I saw almost 4,000 visits to my site.   I received a number of comments about this post, and I thought that I would take some time to highlight some of them for you. First of all, I would like to share with you a few comments from Newton FAS members: Member of 15 years: “It is an unfortunate situation that has come about by someone that has been mentored by some of the finest EMT’s around, yes I am a member of the NFAS and I have to say yes Josh made a bad decision by over indulging in the truth, I believe that youth plays a big role in his decision making process. I am in NO WAY CONDONING his behavior or how he portrayed himself and the squad however there is not one person out there that has not made a bad decision weather it be in the professional sense or the personal sense, and unless your back yard is completely clean maybe people should reach out to Mr. Couce and help him grow and mature within the EMS community rather then hanging him out to dry along with the rest of the squad.” Debora Baldwin Phillips: “Mr Kier, I thank you for your insightful post. Some of the points you address are valid. We, as the squad are aware of them. I will not address them in a public forum. However, I, as Captain of the squad, assure you, and anybody else concerned the issues are being addressed. Deborah Phillips, CT1” Thanks to both of you for sharing your thoughts, especially you, Captain Phillips.  Believe it or not, I wish you well in your future...

Recently, Austin Travis County started hiring EMT Basics to work with their paramedics in order to create more units in the system and reduce what is commonly referred to as “skill dilution.”  But what is skill dilution?  Does it even exist, and should we worry about it? I started my career in suburban NJ, a state that, at the time, mandated that every paramedic unit in the state be staffed by two paramedics, operating out of a hospital or under a hospital’s license as an intercept unit.  In my county there were five paramedic units which grew to six, and eventually seven during the summer months.  Seven units staffed for the entire population of the county.  The medics on the truck would commonly take turns tech’ing calls, splitting the work down the middle.  I must say, and I’m sure many would agree, the paramedics that I saw working over the years for LIFE EMS out of Community Medical Center in Toms River, New Jersey were some of the most skilled providers I have ever seen. As time has progressed though, and I have been exposed to different systems, I see paramedic/EMT trucks more and more.  Call them what you like: P/B; 1-and-1; Medic/EMT, but it is all done with a few ideals in mind: to expand coverage, and to give them more chances at patient contacts.  I wonder sometimes though if it really truly makes a difference, and I also wonder about the consequences. For example: if patient contacts are so important to the ability of a paramedic to be able to provide care, then does that mean that urban paramedics who may see as many as ten times the patients that a rural paramedic sees in a given year as superior providers? And what about burnout?  Those of us who work P/B often have had those days when 75% or even 100% of the patients require a paramedic’s care.  When those days turn into weeks, and the overtime mounts up, those borderline BLS/ALS patients can slip through the cracks.  Running P/P trucks gives a system the chance to have a paramedic at a patient’s side from contact to turnover on every call.  If...