Recently, an article was posted about a group of Prince George County, MD firefighters who violated policy and transported a child in cardiac arrest to the hospital in their fire engine with what was described as “limited medical supplies” instead of waiting for an ambulance that was less than five minutes away.  The child, who was reportedly having an asthma attack, arrested in front of the crew.  The paramedic who was on scene made the decision to start transporting in their fire truck after getting what can only be assumed was an unacceptable ETA of five minutes.  According to the Prince George County Fire Department, the patient regained pulses prior to arrival at the emergency room. The firefighters who were involved were not suspended without pay.  Their medical control was not pulled.  They do not even appear to have been reprimanded by their department.  Instead, they have been given valor awards for their life saving actions that day. First, I do not want to overlook the miracle that took place on this call.  A life was saved albeit using very unconventional and potentially dangerous actions.  Effective CPR was done, and the girl lived, without any residual neurological deficits.  I give them credit for their care, but only to that extent.  This does not mean, however, that these firefighters should not stand and explain their actions. As I stated previously, the fire truck that was used on the call had limited medical equipment, and according to the press release, it was not one that was typically used for medical calls.  This leads me to believe that the life-saving actions taken by the paramedic that day was effective CPR which could have been done just as well, if not better, on the patient’s living room floor until a transport capable unit arrived. What about the large amount of departmental liability this crew put their employer under?  The girl had no neurological deficits but if she came out of this with so much as a limp or maybe slurred speech, her family could have owned the entire department, and potentially taken that paramedic for everything he had because of what would have only been described as “gross...

2011 was a big year for me and a big year for EMS in the New Decade.  Born from some ideas discussed over a few beers in Baltimore was The First Responders Blogging Network, and I was fortunate enough to be one of its first members which brought about my domain move from Blogspot to www.medicsbk.com. While as of late there were a few technical glitches, I saw a number of visits and got some great comments, so I decided to share with you the top five articles viewed by you, the reader.  For those new to the blog, I welcome you to check out content that you have not yet seen.  For the faithful readers that have been with me all year, I invite you revisit some of this year’s most viewed and share your thoughts on them. 5.  A Punch in the Gut – In July, the Baltimore Fire Department’s EMS Training Center was shut down.  Read my thoughts on that here. 4.  IntuBrite Laryngoscope Blades – As part of my involvement with the Podcasting Studio at EMS Expo in Las Vegas, I was able to choose what I felt was the most innovative product on the show floor.  Here is my selection. 3.  A Call to Volunteers – Over the course of the last year and a half, I have become quite vocal about the New Jersey State First Aid Council and their efforts to bust EMS in New Jersey back to the stone age.  Here is one of those articles. 2.  EMS in New Jersey – A Call for Action – Here is yet another view of EMS in New Jersey, this one dealing directly with NJ State Bill S-818 and my thoughts on it.  Again, this was a very hot topic this year, and I invite you to read this, especially if you are a New Jersey EMT. 1.  Goodnight, ALCO – On October 31st 2011, AMR Alameda County closed their doors.  A lot of great paramedics and EMTs were forced to find other work in different counties or hop on board with the county’s new provider.  I owe a lot to the folks out in ALCO.  This is...

You are dispatched to a single family house for a patient with abdominal pain.  Just like any other call, you pull up in front of the house, gather your gear and head up to the front door.  After ringing the doorbell, you are greeted by a gentleman n his mid-20’s who is holding a camcorder, filming you as the door opens.  “He’s over here.  I just want you to know, you’re being video and audio recorded.”  How would you react to this?  Would you demand that the man put the camera down?  Would you cite a violation of the patient’s HIPAA rights?  Maybe you would state that your own personal rights are being violated.  Ultimately though, I would like you to ask yourself one question: What’s the big deal? If you are doing the right thing, maintaining a professional demeanor, and delivering the best patient care you are able to, what is the big deal if someone is videotaping what is going on?  Realistically, nothing about what you would do for that patient should change.  The only difference is you have a captive audience. A search through YouTube will reveal what some people would describe as videos of patient neglect or people not being treated with the respect they deserve.  Take the recent video of the Houston FIre and police personnel taking pictures of the passed out woman while they stand around waiting for the ambulance to show up.  The fact is, more times than not, you won’t find the YouTube titles of “Police officer is perfectly respectful during traffic stop.”  Or “Watch this homeless person as they are taken care of by caring and compassionate EMTs” why?  Because there is no shock value to that.  No one wants to watch that boring video.  They want to be outraged and shocked with what they find on the internet. I fully admit that I frequently surf YouTube and religiously check out the CopBlock YouTube page.  Now, while I do not agree with the stance and opinions of many of its members, I like to see how the officers who are taped handle themselves when faced with an aggressive camera person and I have seen good...

To read all of my posts about the New Jersey State First Aid Council, and the struggles of EMS in New Jersey, just click here. For more information on the NJSFAC click here. Earlier this month, I had a friend from New Jersey send me the latest information sheet put out by the New Jersey State First Aid Council in regards to State Bills S818 and A2095.  While the bills are slowly gaining momentum with the current vote on Bill S-818 resulting in 21 “Yes” 15 “No” and 4 “Not Voting” as an official for the NJSFAC stated in a recent email, “The fight is not over.”  EMTs and paramedics that live and work in New Jersey need to understand the true fabric and importance of these bills. The First Aid Council’s intention was to share their views which are in the form of oppositions to many of the amendments that were recently made to the bills.  Here is my rebuttal to a few of their arguments.  Please take a good look at this, especially if you are a New Jersey EMT. FACT: The New Jersey State First Aid Council opposes the establishment of a new lead agency for EMS.  For some reason, the NJSFAC opposes this amendment because it would give “. . . complete control over and all facets of EMS in the state including some that are already overseen by other groups. . .”  My question to this is: what’s the issue? EMS is a fragmented profession, and New Jersey is no exception to this.  In fact, in many aspects the fragmentation of EMS is magnified in New Jersey.  In some states, differences exist in counties.  In New Jersey, the unique setup of each EMS system right down to staffing and equipment varies from town to town and squad to squad.  Rules and regulations vary depending on whether or not you are a volunteer ambulance service or a professional one.  In New Jersey, an ambulance is not an ambulance and an EMT is not an EMT. Establishment of a lead agency for the state would create one entity for everyone to answer about everything.  Standardization could be developed.  Studies could be...

Anyone who knows me or spends any time perusing this blog knows that I feel that scene safety and the wellbeing of those of us who work in this field is the most important thing there is.  As a supervisor, my first goal is to make sure every single one of my employees goes home to their families at the end of the day.  They might not go home on time all the time, but I need to make sure that they go home. This past week I had a chance to attend the EMS1 Street Survival seminar put on by EMS1 and Calibre Press.  The program itself was created from the principles developed as part of their law enforcement scene safety class.  Much to my excitement, the class was taught by Mike Taigman, someone who I have a great deal of respect for. Prior to the class, Mike conducted an online survey that revealed that a quarter of EMTs responding had been involved in a fight or violent altercation with a patient.  75%, however, reported that as a result of those violent altercations they were injured in some way.  These numbers are unacceptable, and the need for training and education is evident.  The focus on the class was not to teach a “rip ’em up, tear ’em up” fight with everyone mentality.  While physical resolution of a conflict was covered, first and foremost, avoiding such a conflict was the priority. Day one dealt with coordinating these scenes and acting as the eyes and ears while someone else makes patient contact.  The focus was awareness: be aware of who is there, be aware of how you got in to the scene (out doors or in doors) and being aware of how to get out of a scene.  The videos and photos, actually and staged, that were shared during this first day were geared towards being focused on those little details that one might encounter.  How would you approach a certain scene?  What windows need to be watched?  How should you enter a house to best appraise what sort of situation you are walking into. When it comes to verbal communication in an escalating situation,...