Editor’s Note: With this story now being five years old, I have removed the names of those involved.  I do, however, feel that there are a lot of lessons that we can learn from this situation. Late last week Kyle David Bates posted an article from a New York State college paper about a New Jersey EMT from the Newton First Aid and Rescue Squad in Newton, NJ.  In the article this EMT describes such events as “driving over 100 MPH” in an attempt to beat the “golden hour” and being covered in a variety of patients’ bodily fluids.  The outcry and comments on the from EMTs, some of whom know this person personally, are mostly filled with disdain for the way the article painted EMS professionals as a group as an unprofessional group of adrenaline junkies more concerned about what they are able to accomplish with a heavy right foot than the outcome of their patients. The response of the Newton First Aid and Rescue squad was to post a message on the department’s Facebook page denouncing the article, stating that the EMT had been suspended and disciplinary action was being taken effectively hanging him out to dry to take full blame for the statements and quotes within the article.  It stated that the article was written “without the consent of the squad and its officers.”  The only problem with that is, as KDB so aptly points out, the squad’s 2nd Lieutenant was quoted in the article as well. The entire course of events is a real comedy of errors, the fallout of which is far reaching.  Not only have personal reputations been effected, but the squad’s integrity has been brought into question and potentially the values of EMTs everywhere could be brought into question. 1.  The Newton First Aid and Rescue Squad – First of all, a full admission of what knowledge of the article prior to its publishing needs to be explored and put into public record.  I am basing this off of the squad’s swift stroke of the virtual pen in putting the entire burden on the shoulders of an 18 year old kid. Also, it would be wise for the First Aid Squad to take...

No, this is not an article in favor of bringing back the Super Size to McDonald’s.  What I am talking about is creating a strong base for an EMS organization. What does it mean for someone to grow within their career?  In EMS, for the most part, that refers to any upward movement that someone might have.  For a field provider, that mostly means that they will end up in one of two places: supervision and leadership, or clinical services.  We either lead or we teach.  But is there enough for people who have no interest in doing either of those?  And because we lack options, are we losing people to other professions?  I’ve heard it before: when someone gets that rocker on their shoulder that says “paramedic” the immediate reaction is “I’ve made it.”  Well, why should being a field paramedic be the be all end all for someone who does not aspire for a life with any more upward movement.  It is not a glass ceiling that is holding us back in EMS, its glass walls. Some services have done a great job of developing what Skip Kirkwood refers to as horizontal employment opportunities.  That is to say: there are other opportunities for employees to use their skill at their level that does not require upward movement.  Down at Wake County EMS, they do a large number of standbys for some of the colleges in the area, and offer other options such as bike teams, tactical EMS, an increase in HAZMAT training among other things.  The hope is that it keeps things fresh and new for their field providers and keeps them from becoming stagnant in their current position in the organization. With these horizontal opportunities comes a chance to obtain continuing education credits on topics that were previously not available thus helping to solve the current often point and click or wink and nod status of many (not all) EMS educational opportunities.  Most of all, there is an opportunity to try something new and different.  It promotes growth, outwardly, much like the nursing field does.  Not every RN works in a nursing home, an emergency room, or a doctor’s office.  They...

On my first night in Baltimore, I had a chance to talk to Dr Ray Fowler the medical director for the Dallas Fire Department.  First of all, let me say that it was an honor.  This guy is so smart, and has so many great thoughts about EMS.  The topic was CPR, and compression rates.  Dr. Fowler told me that he read a study (which I am still trying to get a hold of) that discovered two facts: 1.  a rate of compressions in CPR greater than 140/minute increases mortality.  2.  The majority of people cannot tell the difference between 120 and 140 compressions per minute. Dr Fowler suggested that a more effective range to shoot for would be 100 beats per minute, or maybe even 110.  But how do we determine that?  I went on YouTube and found these kick drum metronome clips.  Take a listen to these two: 140 Beats per Minute 120 Beats per Minute Could you tell the difference?  Neither could I.  Now, take a listen to this: 100 Beats per Minute I find 100 beats to be a little more distinguishable.  This made me wonder: would the use of a metronome on a cardiac arrest improve outcomes?  Imagine, while doing compressions, your monitor would be beating right along with you, setting the rate at 110 or 120 or whatever is the final decision that produced the best outcome.  Just with setting that rate and sticking with it would not just potentially improve recoil, depth of compressions and of course rate, but it would also help signal when the compressor is tired and needs to be swapped out.  When the person running the code noticed that Joe was not keeping the beat, he could swap him out with someone else. Now, I fully admit, I lack a considerable amount of rhythm.  Anyone who has ever seen me attempt to dance can attest to that.  But I even think that I could keep up with a set metronome, pushing rhythmically. I am thinking about experimenting with this a bit, and I will definitely report back.  In the meantime, what does everyone else think? Special mention to JCox98 on YouTube for the...

On most Christmas mornings that I can remember, in his collection of books my dad usually had one from Clive Cussler.  If you’ve never heard of him, he is quite the author.  Most of his stories involve the main character, a guy named Dirk Pitt who is an Indiana Jones-type character: a treasure hunter who seems to wear many different hats.  For those of you in the younger generation, the movie Sahara starring Matthew McConaughey and Penelope Crews was based on Clive’s novel of the same name. Excuse me while I shutter uncomfortably for a moment. . . I’m sure you’re asking yourself: “What does Clive Cussler have to do with EMS?”  Well, I got an email from my mom the other day telling me the story about one of their friends who shared with them an excerpt from Clive’s 2006 novel called Skeleton Coast that they thought I might find interesting: Sloane laughed.  “May I ask you a question?” “Fire away.” “If you weren’t captain of the Oregon what would you do?” The question didn’t veer into any dangerous territory, so Juan gave her an honest answer.  “I think I’d be a paramedic.” “Really?  Not a doctor?” “Most doctors I know treat patients like a commodity – something they have to work on if they want to get paid before returning to the golf course.  And they’re backed by a huge staff of nurses and technicians and millions of dollars’ worth of equipment.  But paramedics are different.  They are out there working in pairs with just their wits and a minimum of gear.  They have to make the first critical assessments and often perform the first life saving acts.  They’re there to tell you everything is going to be all right and make damn sure it is.  And once you get the person to the hospital you simply fade away.  No glory, no God complex, no ‘gee, doc, you saved my life.’  You just do your job and go on to the next.” “I like that,” Sloane said after a beat.  And you’re right.  My farther cut his leg really badly on a charter once and we had to radio for an ambulance...

April will mark the two year anniversary of the Kansas City Fire Department taking over primary ambulance response in Kansas City, Missouri and the disbanding of the Metropolitan Ambulance Trust, or MAST for short.  Needless to say, the reviews of Chief Smokey Dyer’s promises to the city have been less than spectacular. The Kansas City Fire Department performance has been riddled with broken promises of service improvements.  The guarantee of faster response times for the city’s residents have not been met which led Chief Dyer to back pedal a few months ago, stating that meeting those response times with his current staffing would be difficult at best.  Basing their response times on nationally set standards by health organizations and the National Fire Protection Agency, Chief Dyer guaranteed an ambulance to each scene 90% of the time in fewer than 9 minutes, a standard that during its years of existence MAST had trouble reaching at times, ultimately leading to its restructuring at one point. While KCFD’s performance has not been as bad as some other municipalities with their 87% response time compliance, the fact remains that a promise for “better service” was made because KCFD stated that they could get there faster than MAST could.  That along with a restructuring that could save the city money, and also save fire department jobs were good enough for the city council to believe the scenario that Chief Dyer had laid out for them.  Now, the Chief is facing the need to cut over $7 million from his budget, which might result in the loss of over a hundred jobs. In May of 2011, I was on the panel for EMS Garage Episode 133, “Dyer Need” where Brad Buck, RJ Stine and I joined Chris Montera to take a look at MAST a year later.  I encourage you to listen to it and get a feeling for where the service was ten months ago, and where we saw it headed. The saddest part of MAST’s demise is it happened because of a false promise: KCFD stated that better response times would mean better service.  When will we realize that in actuality, better patient care means better service?  Far...