Oct 17, 2019

The world of social media is full of experts on almost every topic, including prehospital medical care.  When I say experts, I guess I should really be saying “experts.”  There are a lot of people out there who know how we should perform our jobs, and how things should be done.  Let’s take a closer look at one such example that recently made its way on to my timeline. You’re a BLS provider.  A 70 year old male who is experiencing chest pain calls 911.  The patient and his wife tell you that he has a history of an MI which was treated in Philadelphia in the year prior.  They are requesting to go to a community hospital without interventional cardiac catheterization capabilities that is about 20 minutes away.  About 15 minutes past the community hospital is a larger hospital with an interventional cath lab.  The paramedics are on the way, and you have an opportunity to meet them on the highway.  The safest place to rendezvous with them is at a rest area just after you get on the highway. You pull over, and wait for the paramedics to arrive.  The wait is described as causing as long as a “15 minute delay” to perform a 12-lead EKG.  The EKG is done, it comes back as non-diagnostic for STEMI, and the transport to the community hospital is completed.  At the surface, with the theatrics of a storyteller aside, as an “expert” on EMS, it seems appropriate to me.  There was a decision to be made and a determination of what definitive care was for that patient.  If he was positive for a STEMI, an interventional cath lab becomes definitive care, not a community hospital without those capabilities. A husband and wife residing in Sea Isle City, New Jersey disagree with my view.  They felt the care was inappropriate and the delay was not warranted.  They took their concerns to the town council. Barbara Crowley told the city council that “If this delay had been the last time, I would have lost my husband.”  I can play the “what if” game too.  If this delay had happened last time, the patient would have had...

Oct 8, 2019

Last week I wrote about how I was blocked by the National Association of EMTs on Twitter.  I received a lot of positive, supportive outreach from friends and colleagues so to all of you, thank you for that!  Additionally, I received a comment from NAEMT President Matt Zavadsky who left a comment on the post that included his personal cell phone number, and another correspondence from an old college friend who is now on the NAEMT board.  I am going to discuss my talk with Matt here, as our interaction was “on the record.” First, I want to say that I have a ton of respect for Matt.  I’ve taken his classes at conferences, and I closely followed the cultural changes that he led down at MedStar in Fort Worth, Texas.  He has always been an EMS leader that I admire, and my dealings with NAEMT have not changed that.  It meant a lot that he reached out, and we had a chance to talk about a few different issues in the time that we were on the phone. Regarding the issue of advanced degrees, Matt said that the issue of advocating for advanced education in EMS is one that is very delicate for the organization.  With a large mix of fire-based providers, with the fire sector being the most vocally opposed to the movement, and rural paramedics who are already strapped for staffing, there were concerns.  Couple that with the current funding streams that many sectors of the profession are struggling with, and Matt said (and I am paraphrasing) that the organization needed to take a far more neutral approach to the topic.  While, personally, I would like to be part of an organization that continues to challenge me, and make my profession more competitive and marketable, I understand. Now, regarding the issue of my Twitter block, my position as compared to the organization’s, as conveyed to me by Matt, become a bit more divisive.  In his comment, Matt said, “we maintain social media platforms to allow our members to express their opinions on EMS issue and their opinions about NAEMT, even when those opinions are not positive. The only restrictions we place...

Oct 2, 2019

Yup, your eyes are not deceiving you.  I have been blocked by the NAEMT.  But before I get into what is going on right now, let me give you a bit of background. Back in 2010, I started this little blog as a free Blogspot website lamenting about issues that I felt were important in EMS.  I made friends.  I became part of the EMS 2.0 movement and I took an interest in the National Association of EMTs.  The big draw from me was the large-scale advocacy that they were doing in Washington DC for EMS on the Hill day. I attended three of those EMS on the Hill days while I was living in Massachusetts.  I even wrote an article on grassroots advocacy for the NAEMT newsletter.  I became a State Advocacy Coordinator for Massachusetts and I was even approached by officials from NAEMT asking me to run against and hopefully unseat a long-standing Regional Director in the Northeast.  I contemplated doing it, as I felt it was time for a change of representation in the region where I was living.  A few months later though, I decided to relocate to Delaware which would move me to a different region anyway, so I declined the offer to run. Once I moved out of Massachusetts, I worked with the Advocacy Coordinator in Delaware for a short time but had trouble cracking the tight knit group down here.  There were no issues or hard feelings, it just did not work out and that was fine.  I was acclimating myself to a new area and a new EMS system.  I eventually just let my NAEMT membership lapse. About four years ago I signed on to the EMS Compass project aimed at determining and utilizing different measures to try and try an quantify and qualify how good we are at this whole EMS thing.  It was an ambitious undertaking.  Very ambitious.  A few things became evident rather quickly.  There was a lot that needed to be done. There was even more that could be done.  And there would be people and organizations who would probably not like the results, and some opposed it. NAEMT was one of...

Sep 30, 2019

Well, I am back.  It has been nearly two and a half years since I knuckled down and wrote about this career that I am so passionate about, but I feel like its time for me to sit down in front of the keyboard and just let this happen again. I am sure that some of you are wondering where I have been.  My best answer is experiencing life.  I am still working the job that I left AMR for nearly seven years ago.  I am engaged to be married in just over a month, and I currently live with my fiancée and our two four legged furry children.  My proposal can best be described as “epic” having proposed just over a year ago in front of part of the cast of the hit NBC sitcom The Office.  It even earned us our 15 minutes of fame and about 20,000 up votes on reddit. We have been vacationing in Disney World annually, which is more addictive than I would have ever imagined.  I have also dusted off my golf clubs for the first time in years, and I am hitting the links again with some of my coworkers, something that we are looking to make a regular occurrence. My professional career has been great.  I’ve been able to participate in projects like NHTSA’s EMS Compass initiative a few years ago, I am a faculty member with the Delaware Resuscitation Academy, and I have been given the opportunity to perform quality assurance and improvement on my department’s CPR cases.  Those who know me outside of this blog, or those who knew me back in my AMR days probably will not be surprised by that.  I have always been happiest when I’ve had my hands in more than just field care. While I have not been writing about paramedicine and issues in EMS, that does not mean I have not been writing.  A few years ago, I became a season ticket holder at Drexel University with their men’s basketball program.  Drexel is my dad’s alma mater.  Along with a few other season ticket holders, I have been following and covering the team for their last four...

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 overall to my full body of work. I have friends who work in the “public” sector in some of the busiest EMS systems in the country.  One who works in a fire-based EMS system routinely does more than 20 calls in a shift.  In fact, the overwhelming majority of medic units in their system far surpass the volume run by their busiest suppression pieces, and you know what the response from some of his coworkers on the suppression side is?  “I know I occasionally get a full night’s sleep while you are out running, but you chose your career and I chose mine.”  They are under represented by their union and are the medics who really need protecting, not the EMS based paramedics and EMTs of the private sector, yet that is who this bill is targeted as. In all my years involved in EMS, AMR has never hidden what it is.  They are a for profit company.  They are a place for EMTs and paramedics to find a job, and rarely a career.  The higher that you go on the food chain,...