The Podcast

Podcast Episode 17: The Medicast

Posted by on Sep 9, 2014

We took the week off last weeks or Labor Day and this week the podcast is back with a short interview that I did on Jamie Davis’ The Medicast where we talk about the show and what it is all about.  Regular shows will be back next week!  Enjoy! To download the show in MP3 format, follow this link!  Otherwise check the show out below:  ...

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For Leadership

The Ambulance of the Future

Posted by on May 12, 2017

Roughly twelve years ago, AMR and AEV’s Safety Concept Vehicle made its way to Springfield for us to take a look at.  It included a number of interesting features like an expanded harness setup to allow providers to move a little more freely around the box while still being anchored.  There were mounting brackets for cardiac monitors, and video cameras to monitor both the rear of the truck for backing up, and the passenger side to check for traffic before opening the curbside door. The vehicle itself contained a lot of positives that have been adopted over the years.  I see more cameras used in emergency vehicles and I’m a a fan of the checkered or striped patterns on the backs of trucks to make them more visible to oncoming traffic.  I have also seen a few more monitor brackets.  But where is everything else?  When is that ambulance of the future going to get here? Year after year at conference after conference, there will undoubtedly be some ambulance parked on the exhibit hall floor touting itself as the “ambulance of...

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For the Field

The EMS Bill of Rights

Posted by on Jun 22, 2017

There has been a lot of buzz over the past week about California’s EMS Bill of Rights.  Dave Konig has a great take on it over at The Social Medic that I encourage you to read.  American Medical Response has even launched a counter campaign to it complete with the hashtag #LivesBeforeLunch.  While that makes me cringe a bit, I want to touch on one line of AMR’s response to the bill that stuck with me. “As written, AB 263 is an unprecedented political power grab, and will heavily penalize private – but not public – employers of EMTs and paramedics.” When I look back at my career with AMR that spanned more than twelve years, I had a lot of ups and downs.  Had busy shifts and I had slow shifts.  I found myself mandated to work despite being sick, or just needing a day off.  Through the highlights and the lowlights of working in a busy 9-1-1 system that amassed roughly 40,000 calls per year, the instances where my 12 hour shifts hit double digits were rare when compared...

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Lessons to Learn

The Same Old Words, The Same Old Playbook

Posted by on Jun 5, 2017

Any time I peruse the pages of EMS related articles I will inevitably come across some service that is trying to take over another service’s area.  Diving deeper into those articles usually reveals the same usual arguments.  Imagine my surprise when I clicked on an article about the East Longmeadow Fire Department’s move to take over EMS response in the town of East Longmeadow. I should first point out that what I am about to write is meant to represent my own personal views on the state of the industry.  I have not inquired about anything having to do with the current staffing of ambulances and volume.  What I am reflecting on is the article and just the article coupled with my years of experience in the greater Springfield area. Just to give a little bit of background here, I used to have a dog in this fight.  As many of you know, I was a 12-year employee of American Medical Response, the last seven of which as a supervisor.  I participated in contract bids for the town, and saw service...

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Recent Posts

Conference Preparedness

This past September, I attended my first “real” EMS Conference. Sure, I’ve been to a few small ones out in my side of Massachusetts, but I had never seen anything quite like what I experienced down in Dallas. It was amazing, and I was completely overwhelmed. Now, as I prepare to head off to Baltimore for EMS Today in just a couple of weeks, I think its time to share with you some of the lessons I learned at EMS Expo. 1. Wear comfortable shoes! – You are going to be on your feet and walking around a lot. A large conference isn’t the place for flip flops (I’m looking at you, April) or brand new shoes that haven’t been broken in yet. I was able to find some inserts down there that they were selling on the conference floor that made a huge difference, but I definitely wasn’t prepared for all of the walking that I had to do. 2. Carry a spare wall charger for your phone — I’m a social media addict. There were many times where I was chomping at the bit to get my phone charged, but my charger, of course, was on my desk in my hotel room. It would have been great if I had a wall charger with me that I could have plugged into an outlet somewhere to just get myself a little more juice. 3. Get a business card made up — You never know who you’re going to meet when you go to a conference, and having some way to identify yourself, and making a lasting impression after the fact is great. Conferences aren’t just about education, they’re also terrific networking opportunities. Not only did I make and strengthen some great friendships in Dallas, I met some people who have been valuable resources for helping to improve the place I work in. 4. Pack a couple of resumes — As I said, conferences aren’t just about education. You’re going to find services and recruiters there too. If you see someone you like, tossing a resume their way might not be a bad idea. You never know where it might take you. 5. Leave...

EMS Today Meetup

Are you going to be in Baltimore on Wednesday March 2nd? Are you looking to meet up with folks from the EMS Social Media community? Do you like beer? Well, here’s your first chance. Russell Stine from Hybridmedic and I are putting together a Meetup which will be starting at the Pratt St Ale House across the street from the Convention Center at 206 West Pratt St. There is also a very good chance that we might have a sponsor for this event, but I don’t want to attach anyone’s name to it. We should be starting up at around 7:30 or 8pm after the first round of classes is out. It will be a very informal, fun way to meet other f0lks in the community, and if its anything like the EMS Expo Meetup at the House of Blues in Dallas, it will prove to be a great time. EMS Today is just two weeks away! Are you ready? I...

Internal Quality Improvement

For the last couple of months, the term Personal Responsibility has become one of my favorites.I think it’s the answer to many of the questions that we ask day in and day out not only on the streets as we take care of our patients, but in life in general. I constantly struggle with how to provide effective QA/QI and where Chart Review falls into that whole mix.Now, I haven’t done a ton of Chart Review in my day, but I’ve read some truly bad ones, and I’m sure I’ve written my share of less than desirable charts in my day, but does it go without saying that a poorly written chart means substandard care was provided?I don’t think that is always the case.A strong argument could be made that the quality of the chart written can be a direct reflection of quality of care, just like the cleanliness and readiness of one’s ambulance could indicate the same, but ultimately, what is a Patient Care Report? That PCR isn’t just the picture that we paint for those that we turn care over to, or those that review our charts in the Chart Review process.Ask yourself this: Do you think James Patterson, Stephen King, or your favorite author could write an effective chart?I’d say they could probably paint a pretty clear picture of what happened.Does that mean they have the patient care to back it up?Absolutely not. Effective documentation shows a person’s ability to tell a story and craft words.Don’t let the term “Craft words” confuse you.I’m not saying that people are not truthful, because I have a lot of faith in the people that work in this field.I think that a majority of the time, what is documented is an accurate account of the call, but we need to start looking at patient care beyond the chart, and beyond the capacity that an English Professor, or a Math Teacher would look at it from. How do we do that?Well, that’s the difficult question.When practicing medicine in the pre-hospital setting, we often act alone, in the back of an ambulance, or with one other knowledgeable person present to help us.Random visits on calls by Supervisors,...

Breakfast with Skip (Part 2)

That morning in Dallas, I got to spend about two hours with Chief Skip Kirkwood from Wake County EMS, and boy did it fly by. The interview I posted in that previous post was a pretty good summary of what we covered in the more “formal” part of our talk. From there, the discussion turned to an exchange of ideas and thoughts on where we are at and where we are headed, and if you’re looking for inspiration, look no further than what you can learn from him, and his department in North Carolina. My admiration for Skip Kirkwood started about five years ago. I learned about the National EMS Management Association, and their list serv on Google, and I quickly signed up for both. If you don’t follow the NEMSMA List Serv, what are you waiting for? Its filled with some of the greatest minds in EMS who frequently share ideas and thoughts on the field, and Skip is one of their most frequent and well respected contributors. When he speaks (or in this case writes) people stop, take notice, and listen. I have actually saved many of his emails that I found to be useful, and I’ve shared them with those around me. I’ve closely followed the progress Wake County EMS has made over the years, and I even have a few friends from New Jersey who currently work in his system (who I am very jealous of). To me, Skip Kirkwood comes across as someone who is a fearless, confident leader who expects nothing but the best out of everyone around him, and I don’t see why simply his personality wouldn’t bring that out of people. He also projects himself as a very patient person, eager to share the life and professional lessons he’s gained over the years. I thought the most interesting moment in our interview was his response to the question “What lesson would you like to teach to a new EMT or Paramedic just getting their start in the field?” His response had nothing to do with anything clinical or even operational. It was about their personal well being. “Manage your finances,” he said, “don’t live outside of...

Breakfast with Skip (Part 1)

This is a blog post that I intended to put up months ago, but I never got around to finishing. Paraphrasing a sit down interview is something that I really struggled with, but I really feel that not sharing this information would major injustice to our time that we were able to spend with Skip Kirkwood, chief of Wake County EMS in Wake County, North Carolina. I hope you enjoy this two part post, and take as much from it as I did. A little over a month before EMS Expo in Dallas, I was speaking with April Saling (better known to the online community as Epi Junky, the author of Pink, Warm, and Dry) about our mutual admiration for Wake County EMS Chief Skip Kirkwood. We decided that since we were both going to be at EMS Expo in Dallas, and since Chief Kirkwood was also going to be at Expo, that we would contact him and attempt to arrange an interview with him for our blogs. Our hope was that Chief Kirkwood would be able to spare five or ten minutes out of a very busy schedule to sit and answer some questions for us about EMS over a cup of coffee. Well, much to our delight, Chief Kirkwood did one better by inviting us to join him for Breakfast on Thursday, the second morning of Expo. Skip got his start in EMS in 1973 when he was certified as a Hospital Corpsman. He then started his career in EMS and shortly after, he obtained his Paramedic Certification, By the Mid-80’s, he decided that there might not be much of a future in Emergency Medical Services, so he decided to look elsewhere for a career. He decided that the next step in his life should take him to law school, where he obtained his law degree and worked for a large Law Firm in Philadelphia for a few years. One day, while sitting in his office reading JEMS Magazine, Chief Kirkwood came across a Job Listing for the position of the Head of EMS for the State of Oregon. The recommended requirements were a Paramedic Certification and a knowledge of Law. He...