Well, its July, and its my turn to host The Handover.I’ve done a lot of thinking over the last couple of weeks after I was given this task, and I feel like I’ve come up with a good topic. Throughout my schooling to become an EMT and a Paramedic, I received a lot of education and information about treating strokes, and traumas, and MI’s.I’ve learned how to read 12 leads, and I’ve tubed and cannulated my fair share of patients.There have been times though in my career where I might go a rotation without dealing with a critical patient.There is one patient that always has seemed to be present in my EMS Career as a Paramedic, and coincidentally, it’s a class of patient that was not touched upon as much by my Paramedic and EMT instructors: The Crisis Patient. These patients come in all shapes and sizes.Some are as young as 5 or 6, and some as old as 70 or 80.They all present differently.Some are suicidal, some homicidal, and some depressed.Some of them are very cooperative, many show passive resistance, and others, unfortunately, insist on being difficult. Recently in my system, because of a few incidents, techniques for dealing with these patients has been a hot button topic.Some crews are reluctant to go into scenes without the Police Department or a Supervisor present.Instead of blindly pushing people through the door of a residence, I’d like a chance to take from you, my esteemed, intelligent colleagues, some of the techniques that you use to deal with these crisis patients.So I was wondering: – How do you approach these patients?How conscious are you of your body language around these people – When a patient is resistant or reluctant to receive treatment and transport, how do you like to handle that? – In your time with these patients, how much do you dig into their history, and reasons for feeling depressed, suicidal or just “not right?” – Finally, when it comes down to it, what techniques do you use for subduing and restraining a patient? So how do you contribute? Just post a link to your blog as a comment to this post, and I will...

I’ve had a lot of blog ideas for this week’s edition of EMS in the New Decade kicking around my head: Health Care and EMS, the ongoing Massachusetts EMT scandal, and a few others, but I feel it more appropriate for right now to put those on the backburner and say goodbye to a colleague, and a pioneer who has played a huge part in the movement to make my job better: As many of you know, Mark Glencorse has decided to close down his 999 Medic blog.I understand and sympathize with him for his main reason for doing this: family comes first, but that doesn’t mean I’m not going to miss his posts. When it comes to Blogging Age, I’m still a young’n.My blogging career didn’t get started until March, which is nothing compared to Mark’s 18 months and more than 450 posts.Heck, I remember my first night on Twitter when I got to join Justin and Ted on their limo ride intoBaltimorevia UStream, and later reading about Mark’s experiences at EMS Today. That gradually evolved to where I had my plane tickets on standby to fly toDenverjust to spend the evening with the poor guy and share a beer or two because of some silly volcano that had stranded him state-side. This is my chance to say thank you, Mark.Thank you for everything that you have done.Thank you for being a leader in the Chronicles of EMS movement.Thanks for pointing us in a positive direction to help fix our struggling nationalEMSsystem.Thanks for your fun comments on all of our blogs, and thanks for all of your posts over the last 18 months.Most of all, Thanks for being willing to take time away from your family to come and share your knowledge with us.I can only imagine what a huge sacrifice it must have been for you and it means more to many of us than you could imagine. Now it is time for the rest of us to carry the torch, and pick up where Mark is leaving off.I’m sure there will be many occasions when we will all say “remember what Mark said?”And share all of those words of wisdom.The wisdom...

We all have those calls that push us to our breaking point.It might not be one type of call, but we will all find that one specific call that gets to us and sticks with us. Last Fall, I was working a busy Friday night.While listening to the police radio, I heard a “shots fired” call come in.This is not anything uncommon for the city I work in, but I noticed the street name was a street where a friend of mine lived.A few minutes later, I heard an officer who is normally very calm, cool and collected, come over the radio screaming (literally) for an ambulance on that street, and stating that they need to expedite. I started down that way, racking my brain for the entire 5 minute ride for my friend’s house number, but I couldn’t remember it.When I pulled up, there were five or six police cars already on scene, their blue light bars lighting up the street.I went up the steps and turned the corner to find my friend, who incidentally is a PA Student and EMT, doing CPR on a 16 year old girl with a gunshot wound to the head.She was kneeling in a pool of this girl’s blood, and had probably ruined her sweatshirt as well already. We found at that point that this girl still had a pulse, so when my ambulance got there a minute or two later, we loaded her up and sent them on their way.At that point, the focus of my care turned to my EMT friend. “Are you okay?”I asked her, as we stood on her front porch, across the street from what had now become a crime scene. “Yeah, I’m good.”She told me, and then relayed the story of what had happened.She was studying for a pretty big test, and had heard the gunshots come from across the street, followed by the girl’s mother screaming that her daughter had been shot.She waited impatiently for the appearance of a police car, and when the first one arrived, she grabbed her bag and headed across the street with little regard for her own safety. I listened to what she had to...

Before I host my edition of The Handover next month, I felt the need to contribute first. Tactical Pants wants to know what we do with our Downtime. You know, Downtime. Those precious few hours (minutes?) we have between each call. In the last 16 years that I’ve been involved in EMS, I’ve used my downtime in a variety of ways. It seems only fitting though that as I sit here writing this blog, I am enjoying some much needed “away time” which is a little different from downtime.Currently, I am sitting on an enclosed porch, full of burgers cooked up on the grill and fresh Jersey White Corn with a nice cool breeze blowing through the window.Boy, times are good right now. If it was six years ago, I’d probably be sitting in an ambulance parked on a street corner waiting for my next call, or more commonly, flying across the city lights and sirens to the next “emergency.”Personally though, I like tonight’s events much more. But I digress. Where were we? Oh yes… Downtime! When I was a volunteer EMT inOcean County,NJone of my more common crew chiefs and I would sit at the station passing the daily crossword puzzle back and forth.It was a great way to kill time and keep our minds sharp.There always seemed like there was lots of work to do during our downtime back then.We had trucks to check, paperwork to enter into our computer system, and supply orders to be tallied and submitted, but we always found time for our Crosswords. Thanks, Joey. When I moved on to Urban EMS, it was time for me to learn about mobile posting. We had a unique group working weekend overnights though. Our trucks would move around the city like a wagon train from common post to common post.We always had toys to keep ourselves occupied: Frisbees, hacky sacks, footballs, and even headrolls that we could play dodgeball with.On one particular night, I remember sitting out in lawn chairs in the darkest spot that we could find trying to get enough time away from the excitement of the city to watch a 3am meteor shower.I miss those days sometimes.It...

Is your service ready for “the big one?”You know what I’m talking about: that big call that we all dread, that MCI to beat all MCIs, the one that no matter how much you train for it, you never will be completely prepared.What can you do though to help make the day that your department is faced with a disaster you never expected?A lot of the steps are simple, but because of that, we might be more apt to overlook them. 1.Review your disaster protocols.If you’re on the streets that day, where will you fall in the chain of command?What will the Fire Department’s responsibility be?How about PD?You don’t need to know every move that everyone is supposed to make all the time, but knowing peoples rolls will let you know who to ask when you need something. 2.Make sure your vehicles start!I know this sounds silly, but imagine getting to that moment when someone tells you to “roll the MCI Truck,” and you go turn that key and . . . NOTHING.In my department, our MCI truck is constantly plugged in to keep it charged, but it’s lets face it, it’s a 12 year old ambulance with close to 200,000 miles on it.Once she gets going, she’ll go forever, but to help make sure that she can run, I try to start her at least once or twice a week. 3.What level of certification do you have in Incident Command?Everyone here is required to have 100 and 200, but because of my position, I have to take extra classes, assuming that I will be wearing a vest and hold some sort of authority if things ever went bad.Some might think of ICS classes as dry content, but if you ever need it, you’ll appreciate having taken the classes. 4.Run through scenarios in your head.At my part time job, we have a jar, and on the outside of it, it says “What if, right now?”When things are slow, we pull two different colored pieces of paper from the jar, and one of them will have a location, and the other a situation.An example would be pulling “Big Roller Coaster’s lift hill” and the other...