Sep 22, 2015

My trip to Las Vegas for EMS World EXPO 2015 was my eleventh consecutive trip to a major EMS conference.  I feel like I have had a front row seat to see the direction that conferences like EMS World EXPO and EMS Today have taken on a number of different levels.  The crowd certainly has changed.  You still have your big names that show up year after year and those faithful attendees who come year after year and take classes.  Many products stay the same, while many “new and great ideas” are here one year, and gone the next.  Ambulance design shows the continued utter lack of advancement particularly from a provider safety stand point, which I continue to find alarming.  My car today looks nothing like the 1987 Volkswagen Jetta that was my first car in high school, so why does the back of my ambulance look exactly the same as the 1984 box truck that I first road in back in 1993? It is interesting the direction that conferences in general have taken.  For a few years there seemed to be a bevy of new content mixed in with the usual trauma, mass casualty and pediatric classes that always seem to populate the convention schedule.  We used to learn about how ultrasounds were going to be the next big thing, and now Mobile Integrated Healthcare has taken yet another conference by storm.  It’s important information about the future of our industry but come on, folks, it’s time to see something new. To JEMS and EMS World, I beg of you, step outside of your comfort zones.  Let’s move away from the same speakers that present year after year, regardless of how many awards that they have won, or how many articles that they have published.  We need some fresh new ideas and fresh new presenters.  I know that might ruffle the feathers of a few people out there who do not like being turned down, in fact I know of one in particular who has already said he is not submitting to a certain conference anymore because they did not want him this time around, but the time has come.  We are...

Last month I headed down to Baltimore for an afternoon to visit the exhibit hall at Firehouse Expo.  While I was there I had the chance to sit in on a class about leadership on the fireground that raised some interesting questions for me about the safety of responders and more specifically our regard for that safety. The instructor took a considerable amount of time out of the class to question the “culture of safety” that we operate with feeling that you need to be willing to sacrifice more to save more, likening his battlefield experience in an extremely admirable and heroic military career to his time on the fireground.  To sum up what I, as an attendee in the class saw as his message, you need to be willing to sacrifice more to save more.  He was saying that many were too cautious by putting the concept of “at the end of the day, everybody goes home” above the mission of the department which generally is to save as many lives and as much property as possible.  He disagreed with the “nothing is worth your life” concept of the culture of safety. Now, let me start off by once again stating, as I have many times before, that I have zero experience in firefighting.  My personal participation on a fire scene consists of me standing around, waiting for a patient to be delivered to me, or handing out Gatorade and water in an attempt to keep those on the fireground from not becoming my next patient.  What goes on inside that house is something that I have no knowledge about. What I do have, however, is a great respect for those who do put their lives on the line in those situations.  The angle of this class that I want to discuss is the bleed over from the fire side to the EMS side of the profession since in many communities the two are so closely tied.  Some firefighters might sit in on a class such as this and receive and honor the message that “when you’re on the engine, you need to be willing to risk it all.”  Then, the very next...

Mar 2, 2015

Last week I spent Wednesday thru Saturday in Baltimore, Maryland attending EMS Today.  It was my tenth major EMS conference that I have been to since 2010.  I am starting to feel like somewhat of a veteran.  I have seen a lot of people come and go.  I have seen good years, and I have seen bad years.  In 2012, I barely made it out of Connecticut before Hurricane Sandy shut down the northeast. For the first two or three years, there was a certain buzz at the conferences.  Twitter personalities and bloggers were everywhere.  The podcast studio was a constant revolving door of people coming in and out to see who was there and who was going to be on during the next time slot.  Classes were full of innovation.  New speakers were sharing new ideas.  Lines outside of certain doors were so long that you knew which classes were going to be standing room only. In 2013, the conference world seemed to slow down a bit.  JEMS decided to move EMS Today to Washington, DC.  Some bloggers started families.  Others just did not have the money or time to take off of work.  Classes seemed to be the same thing that we had seen the year before.  Sure, the huge push for Community Paramedical education had started but even that seemed to be starting to repeat itself.  It was almost as if we were hitting an educational plateau. From a personal stand point, I had opportunities to take more classes thanks to winning a free registration from JEMS and the generosity of the team at MedicEd who provided me with free registrations in Nashville and Baltimore this year.  Prior to this past week, while I felt like I was getting some knowledge out of class it seemed to be more of a reinforcement of what I had heard in previous years rather than some new innovation. The exhibit hall moved in the same direction.  2011 was filled with speculation of what ultrasound was going to do for prehospital care.  There were new devices everywhere that you turned.  Through the end of 2014 though, not much seemed to change.  The atmosphere this past...

Nov 6, 2014

This week I started what is essentially my first real true vacation since my trip to New Orleans for EMS Expo 2012.  I’ve had time off, however most of it has been because of swaps.  This time around though, I burned enough vacation time to put me out of work until the 22nd of November.  It’s an exciting break to say the least. No fall break would be complete without a trip to EMS World’s annual EMS conference being held this year in Nashville, Tennessee.  For those of you who have never been to a national conference I ask you again, what are you waiting for?  If you want to see the latest products, or have a chance to rub elbows with some of the most brilliant thinkers in this industry then conferences like EMS Expo or EMS Today are for you.  This trip marks my 9th consecutive major conference.  I’ve made some great friends, amazing professional contacts, and I have always walked away with a little different view of our field and where we are heading. I am sure that many of you are wondering what happened to the podcast.  Well, it’s not dead.  Not even close.  The last couple of months has been taken up by a lot of extra work, extra teaching and side projects which have taken time away from my social media existence, particularly the development of the podcast.  Schedules clash, ideas need to be saved until the right people are available to talk about them, and some ideas just never seem to fully develop.  We will be recording an episode of the show on the exhibit hall floor thanks to Jamie Davis and the crew at the ProMed Network.  They have always been so good to me, and continue to be supportive. Furthermore, I hope to get together with some people down there to actually have a chance to schedule some upcoming shows.  So the podcast is not even close to being a dead project.  I have invested in it, and plan on getting back to it in Nashville and in the coming months.  In the meantime, check out the already recorded episodes here. Tomorrow I hop on...

May 26, 2014

On this week’s episode of EMS in the New Decade, Scott Kier and Ben Neal talk about an inspirational conversation they were part of while sharing a few Happy Hour drinks at a bar called Huck Finn’s in New Orleans at the tail end of EMS Expo 2012.  What started out as a group of medics swapping war stories turned quickly into a conversation about pit crew CPR led by Tom Bouthillet from EMS 12 Lead and Code STEMI that was the jumping off point for some major changes in Ben’s EMS system. So crack open a beer, sit back, and enjoy a night at Huck Finn’s with Scott and Ben. To download this week’s podcast, click this link!  Otherwise, use the player...

This past weekend I had an opportunity to speak at my first national conference.  A few months ago I submitted and was accepted to present at that National Collegiate Conference which brings together campus based EMS systems and EMTs from around the country.  This year’s gathering was in Boston, so I headed back up to New England for the weekend.  First of all, let me start out by saying that as of late I have become a fan of the train, but i was persuaded by a friend to fly up.  What a great decision.  Fifty five minutes in the air, and I was on the ground at Logan.  It was well worth it. But i digress. . . I was amazed at the number of people who attended this conference.  From what I was told there were over 1,100 collegiate EMTs who had come from as far away as Arizona.  They were probably the group that I felt the worst for.  Sometimes I wonder if they actually sell clothes in Arizona that are capable of handling thirteen degree weather. The conference itself had about 110 presentations over the course of three days, an aggressive undertaking for even the most polished conference, but it was handled well.  Each block had five or six presentations dealing with everything from MCI response to toxicology, and over to career related ones like mine, and ones on administrating and running collegiate based EMS services and developing best practices for them.  To me, it was also a training session for these kids (and I use that term loosely) for how they should perform and what they should be ready for should they head off to EMS Today or EMS Expo in the future. The collegiate audience presents an interesting one.  Personally, I feel that there are two kinds of conferences that we attend.  The first is to just put credits in our bank so that we can re-up our cards.  People sit back with folded arms, sighing and looking at their watches waiting for the next break, and asking questions like “Are we going to go all the way to 5pm today?”  Those are not as much fun to...

Now that I got my charger fixed for my Netbook I can finally share this post that I wrote on my train ride back from EMS Today 2014.  Enjoy!! Here I sit on the train ready to head back home after another series of adventures at EMS Today.  Although the vibe at this year’s conference was different than years passed, the one factor that remains constant is there are a number of people who are extremely motivated to do more than just spend their 40 hours on a truck, collect a paycheck, and go home.  For the most part, the people who attend these conferences are doing so in the hopes that they become better clinicians both for themselves as well as their patients. Lines were drawn in the sand at this year’s EMS Today conference and the goals and direction was apparent from the get go.  The major focus of many of the classes was what some call community paramedicine which others have termed mobile integrated healthcare.  There were  a number of classes about branding, data, attitudes, and expectations that should be important to a service as well as a paramedic as they prepare themselves to provide care outside of the traditional “emergency” environment so many of us are active in today.  While the classes and churiculum are great, however, I want more. This year’s conference marked the 8th major one that I have attended dating back to EMS World EXPO in Dallas in 2010.  I have seen a number of fads come and go.  I remember just a few years ago when the exhibit hall was full of venders looking to sell everyone on the importance of their products when it came to prehospital ultrasound, something that a lot of us thought might have a practical use in the field.  For the past two or three conferences, community paramedicine has been showing up more and more.  I remember last year, when NAEMT’s EMS on the Hill Day was canceled, Chris and Anne Montera (then known as Anne Robinson) along with a team from MedSTAR in Texas lead by Matt Zavadsky held a half day workshop for the NAEMT delegates to talk about...

By now, the New York Times article from last week has made its rounds in the EMS online community.  If you have not read it, I will give you the short version.  Based on the response to the Boston Marathon as well as some other high priority incidents, Federal Emergency Management Agency released new guidelines this past September in regards to the response of first responders to active shooter incidents.  The new recommendations revolve around what FEMA’s fire administrator Ernest Mitchell Jr refers to as “risk a little to save a little, risk a lot to save a lot.”  According to FEMA, risking a lot means sending EMS responders into the “warm zone” of an incident to treat and extricate patients. Most of the article revolves around one particular paragraph of the seventeen page document: b. While the community-accepted practice has been staging assets at a safe distance (usually out of line-of-sight) until a perimeter is established and all threats are neutralized, considerations should be made for more aggressive EMS operations in areas of higher but mitigated risk to ensure casualties can be rapidly retrieved, triaged, treated and evacuated. Rapid triage and treatment are critical to survival. Rush in, keep your heads down, and get out safe.  They have not completely ignored our safety, however, adding a few lines later: d. If exposed to gunfire, explosions or threats, withdraw to a safe area. e. Consider/Investigate the use of apparatus’ solid parts such as motor, pump, water tank and wheels as cover in the hot zone. Understand the difference between cover (protection from direct fire) and concealment (protection from observation). f. Remove victims from the danger zone in a manner consistent with predetermined agency training and standards of practice. LE officers may bypass casualties in order to eliminate the threat. Recommendation “f” leaves me with some hope that there eventually will be more mandated training and education for EMS providers, but the document seems to largely ignore any mandation of this.  There are, however, recommendations made in regards to what FEMA feels should be addressed when planning, and developing standard operating procedures.  For example, much of the treatment modalities recommended revolve around tactical emergency casualty...

I spent my Friday and Saturday traveling through New Jersey, New York, Connecticut, and eventually to Massachusetts after a painful, traffic filled ride up Route 15, a ride that has rewarded me so many times with a much quicker travel than using 95, but I digress.  Friday, our travel framed a stop at Pulse Check, an EMS conference held just north of the New Jersey, New York boarder, and Saturday I spoke at the Massachusetts EMS Conference in Springfield where I spent the first twelve years of my career. Both conferences had some great topics however there was one thing that really summed up one of my major frustrations with EMS on a national scale.  It is something that I have seen at every conference that I have attended including the major ones like EMS World and EMS Today.  A speaker will be talking about his or her topic, and they will get to the treatment and management portion of the lecture.  For example, let’s say someone is presenting on chemically managing a combative patient.  The exchange will go something like this: Speaker: “In MY system, we are able to give the patient 5 mg of Haldol and 5 mg of Versed for sedation, and then we can call our doctors and ask for more.  How do you do it?” Student #1: “We don’t have orders, but we carry Ativan for seizures so if we can convince our doctor to ‘back door’ the protocols, we can give them some Ativan to sedate them” Student #2: “Well, in my system we have the protocol in place the same as yours, but I cannot even take the meds out of my bag unless my doctor says I can, and when I call the hospital I have to speak to a nurse and then ask them for a doctor.” Student #3: “What is chemical restraint?  Are you talking about when they get combative, I call for four more police officers to come and they pepper spray my patient on the stretcher so we can four point them?” So here we have four different experiences from four distinct, different systems dealing with the same problem in four completely...

Just when I thought all hope was lost, all the chips fall into place. . . I have not missed a major EMS conference (EMS Expo or EMS Today) since my first trip to Dallas in 2010.  Because of all of the life changes that have happened over the year, and my demotion to “FNG” at my new job, I thought that this year’s EMS World Expo in Las Vegas might just be the first one.  It was tough to listen to everyone making plans, and talking about classes, and realizing that I just might miss it because of my work schedule. It took a little bit of work and a lot of overtime, but thanks to the generosity of some of my new coworkers in the form of swaps and their vacation days that allowed me to work almost non-stop, I have booked my hotel room, and scheduled my flights.  I will be arriving in Las Vegas on Sunday September 8th in the morning for four days and three nights of quality time with some of the best friends a guy could ever ask for. Yup, that’s right: our semi annual “reunion” will happen again!  I really did not realize how much I would have missed it until I took the time to schedule the trip.  The excitement that I am overcome with now, just about a month away, is overwhelming.  There is no better place than those conferences, and its not because of their location, its because of the people that I get to see there. To those of you who will be joining us for Expo this year, I look forward to seeing you all and catching up with you!  For anyone who is missing it, you will sorely be missed.  And finally, if you have never been, what are you thinking?!  You have no idea what you are...