Last weekend, I went back to my old stomping grounds in New Jersey to enjoy some good beer, BBQ food, and some great times at the annual Summerbrew in Island Heights, NJ, the town I grew up in.  In a town of roughly a thousand year round residents, the fire department hosted brew fest is a pretty popular event. The event brings out an interesting cross section of people for me personally.  I get to catch up with people that I grew up with from my town, but I also get to see a number of people from the fire and EMS community that was such a huge part of my life through high school and college.  As the years go by, we shake our heads and think back to what we considered to be “the good old days” that always keep me saying, “I miss my volunteer time, but I miss it back then, not now.” Fifteen years ago, I was an excited 18 year old EMT, just three years into my career.  There was no where that I felt more comfortable or confident than running a call.  When the tones dropped, I was all business, and back in the best days of Squad 21, I was surrounded by some of the best providers I’ve ever encountered.  We had experienced people who were patient and had a passion for what they did.  They were problem solvers, and clinicians.  Any challenge that was thrown at us was one that we would overcome together.  When you moved beyond patient care, the compassion that my squadmates showed for the people they encountered was incredible.  The patients always came first.  It was the way it should have been. Back then, respect was earned, it wasn’t expected.  The volunteers worked twice as hard to prove themselves to the medics that intercepted them day after day.  Every blood pressure was dead on, every splinting job was second to none, and every hand was held.  Dispatchers knew who they could count on, and we all looked out for each other.  It always put a smile on my face to hear “Good afternoon, Scott.” when I’d sign on the radio for...

One of the biggest challenges of working in EMS is there’s never truly a day off.  There’s no reason to put locks on the doors of our industry because someone is always there.  If there’s not a call going on, there’s the potential that call is going to happen.  There can never be a lapse in coverage when it comes to providing EMS in the field, and when making the transition to management, we need to not lose sight of that. The “normal” world exists on a typical 9-5 schedule Monday thru Friday with holidays and weekends off, and managers in EMS seem to stick to that schedule as well.  There is a lot to be done behind the scene to keep things operating smoothly.  There are budgets to manage, capital purchases to make, people to hire, and meetings to attend with stake holders and customers alike.  Additionally though there are people to manage, and those other sixteen hours of the day should not be overlooked. A forty hour a week manager is only there for about a quarter of their company’s work week.  They are missing three quarters of the work week, and as a result potentially missing two thirds to three quarters of their work force.  Evening and overnight crews can feel neglected, and even run the risk of missing out on employee appreciation functions due to an unwillingness to come in off the clock for such events. Keeping a presence in the field is a positive thing as well.  A manager never has to put on a set of gloves or lay hands on a patient, but imagine how you would feel if you walked out of an ER to find your boss cleaning the back of your truck, or they carried your oxygen bag out of a house for you.  Its small gestures like that which will make people’s days easier. Normally, I look to a lot of EMS leaders for advice and guidance.  Now, it’s my turn, as a mid-level manager to share some with them. 1.  Remember, the work doesn’t stop when you stop working — Things keep going when you’re at home.  Whether it’s the evenings, the...

I’ve seen a number of changes since I first stepped on an ambulance at the age of 15.  Some of them have been good, and some of them not so good.  In this edition of EMS in the New Decade, I want to point out what I feel has been the best piece of equipment and the best treatment that I have seen added to my toolbox mainly in my last eleven years as a paramedic. 1.  The LP 12 Monitor — When I was in paramedic school at Springfield College, I was trained on an LP-10.  We had no way of doing 12-leads besides that old trick of moving that single electrode around the chest to get the pictures that we wanted.  We could look at the inferior leads with the old “hold down the print button” function on the LP-10 to put it in diagnostic mode, but without a little bit of work, we couldn’t get the monitor to do a lot on its own. Don’t get me wrong, I loved my LP-10, but it was dated, and it was evident to me from the start of my paramedic career that as an industry we had moved past it.  In fact, for the last two years of my career in New Jersey when I was in paramedic school in Massachusetts every LIFE EMS unit that intercepted my BLS ambulance had an LP-12 on it.  I was a bit behind the curve on reading 12-leads due to my inexperience with them, and my trips home brought that glaringly to the forefront. Adding an LP-12 to my truck somewhere around 2003 when Massachusetts made them a requirement was a huge step in the right direction.  Not only was I able to do 12-leads but I had an O2 Sat machine build into the monitor, and I was able to measure end title CO2 not only on intubated patients but also via a nasal cannula-like detector.  That was technology that our emergency room didn’t have.  In fact, our larger ER still relies on breath sounds and a color metric device. My scene times may have gotten longer after I packed my LP-10 away, but I...

“Nothing stops an organization faster than people who believe that the way you worked yesterday is the best way to work tomorrow.” — John Madonna Patrick, one of my colleagues here in Massachusetts shared that quote with me one night when we were having one of our nightly conversations about where our service is, and where it is heading.  John Madonna’s words describe many people that I’ve encountered in EMS.  They fear and are resistant to change, and they really shouldn’t be.  They need to learn how to embrace it, and be comfortable with change, and view it not as “change” but as evolution. I’ll paraphrase Patrick’s thoughts that followed: “We could call this the ‘Dinosaur Mindset.’  Extinction thinking.  We must grow, learn, evolve, become, and always improve ourselves and our ability to serve the world.  All the while not changing or letting go of the core principles, truths, and values that should never change.  If we waver from our course, we will just find another way to become extinct and irrelevant.” Every generation has seen change in EMS.  Otherwise, we’d still be driving around in Cadlillacs that doubled as hearses.  We wouldn’t be doing 12-Lead EKGs, and CPAP would just be some silly thing that respiratory therapists apply in the hospital. If you’re one of those people that’s not really comfortable with change, that’s fine, but don’t fear it.   Don’t hold it back.  Throw the phrase “That’ll never work” from your vocabulary, and right next to it, file the phrase “well, 5 (or 10, or 15) years ago, we didn’t do it that way.”  Be patient, and let evolution take its course.  It might not be comfortable at first, but with time, change becomes easy, and often can be beneficial. Be willing to try old tricks but with a new twist.  Just because something hasn’t worked in the past doesn’t mean it can’t be made to work now.  Finally, learn from what goes on around you.  If you want to change, don’t be set on reinventing the wheel.  The best answer might not be within your organization, or even within the industry.  Be willing to take that extra time, and make the...

Did anyone else see the story that came across EMS1 yesterday about Dennis Leary producing a pilot for an EMS show?  After what I’ve seen him do with Rescue Me, I must say, I am excited, but I’m also reserved.  I’ve been burned one too many times. Maybe its because we compare every show that comes out to Emergency! or maybe its because we compare them to our everyday experiences.  Regardless, there are some bad ones that have been out there. Need I list the complete failures of EMS shows that I’ve seen in my time? Let’s face it. . . It’d be a short blog post if I didn’t. Rescue 77 — This one came out in 1999.  I was a few years into my EMS career, and excited to watch something a little more modern that Emergency! which was a show that I loved.  Well, I couldn’t be more disappointed.  This was filled with unrealistic scenarios, people doing handstands on patients so they didn’t have to defibrillate someone in water, and a doctor reducing a patient’s intercranial pressure in the field with a Black & Decker drill after being begged to “think like a medic!”  It’s a shame the producers couldn’t do the same thing.  This one was dead after 8 episodes. Third Watch — This was a favorite of a lot of people, and I will probably take some flack for mentioning it, but boy this show just didn’t do it for me.  It was too much adrenaline, and went a bit too far at times.  From the EMS side, there really weren’t any likeable characters for me either. Trauma — Um Hello?  Do I really need to say anything about this one?  There are really only two cool things this show gave us: The term Captain Versed, and the Halloween costume associated with it created by Ms. Paramedic. Paramedics — Okay, so it was a reality series.  Great, right?  Sure.  It had a lot of redeeming qualities, but it failed me due to poor editing.  Treatments were out of sequence, and to anyone who had a trained eye, it was easy to notice. Saved — This one was the best...