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...

May 21, 2017

EMS Week 2017 is upon us and as always there are a lot of positives that need to be pointed out.  Its a time to recognize the little things that people do, and more importantly the people behind the uniform.  It is the week of the year that should be about us, because the other 51 weeks out of the year should be about the patients that we serve.  With taking all of that into consideration though, this is not going to be one of those positive posts. Last week, there was a call for articles and posts related to the tagline “EMS Strong: Always in Service” for this week’s message to providers.  It asked for people to talk about what it means to them.  Well, here you go. I grew up in a heavily volunteer driven community.  When I started EMS, every BLS unit on the street was staffed by people dedicating their time.  Much like myself, many went through their day to day activities with a Minitor II pager strapped to their hip, waiting to hear that rhythmic beeping that still gives me palpitations more than 20 years later.  Day or night, weekend or weekday, on school vacations or snow days, it did not matter.  I was always in service. At the time, I was a young, naive teenage EMT.  I was happier on the ambulance than I was on the high school basketball court.  I did not care if I got home from my summer job at 2am, if the pager went off at 3, I was going.  I did not have a care in the world.  EMS was what mattered to me.  I was always in service. In college, I sacrificed many Friday or Saturday nights where my college friends would be out drinking and partying to throw on a uniform, turn on the radio and go trucking out of my dorm to take care of the sick, vomiting, and ETOH students of Springfield College.  I cleaned vomit off of my boots.  I cared for people that I might see in my economics class come Monday morning.  I was ready to go at a second’s notice.  I was always in...

Apr 11, 2017

Last week, the Asbury Park Press posted a letter to the editor entitled “Letter: Emergency response teams must have volunteers.”  The piece was written by John Bendel, a town councilman from Island Heights, NJ; the same Island Heights, NJ where I got my start in EMS more than twenty years ago.  John’s letter is a reply to an editorial done earlier in the week called “EMS system deadly hodgepodge” which addressed several the shortcomings of New Jersey’s EMS system, many of which were identified more than ten years earlier by a study done about the state’s slowly dying prehospital care system. To say the least, Mr. Bendel’s letter sparked a fire in my belly.  I wanted to address some of the points that he attempted to make here. “Sure, it would be nice if every Emergency Medical Technician (EMT) were as qualified as the legislation you endorse would mandate.  But if they were, far more would be paid professionals than volunteers.  In America where health care still bankrupts families, that’s a big deal.  We need volunteers.” Let’s address the semantics of this statement first.  “Health care” is not bankrupting families.  Many have begun pointing out that it is health insurance that is doing this.  Skip Kirkwood has taken to frequently correcting people telling them that what they are seeing is attempts at health insurance reform, and not health care reform.  He’s right. Now, on to the meat and potatoes of this statement.  First, what is the issue with creating more jobs, and putting more money, and insured individuals, into society?  Why is it so bad that some would like to see people compensated for the hundreds of initial training and numerous hours of refresher and continuing educational training that EMTs are required to do?  Career EMS providers (because professionals can be paid or unpaid) guarantee that someone is going to be there when the tones drop.  Volunteers cannot always make that same assertion. And let’s talk, for a second, about the chain of survival that drives health care.  With the exception of bystanders, every other link in that chain is staffed with employed, compensated individuals.  Nurses, doctors, dispatchers, people who work in rehab centers,...

Apr 10, 2017

Or better put, I guess, I’m back. It has been quite some time since I put anything up on this website.  I’ve spent the last year or so setting up and running a site about Drexel University Men’s Basketball called Always A Dragon which has been a nice diversion from EMS in general.  Writing about sports is very, very different and it has helped sharpen my skills in a lot of ways, but I think that its high time that I get back to writing about my passion: EMS. I have noticed a lot of things in myself recently.  I’ve been frustrated by a number of things going on immediately around me, as well as in the industry.  Social media, something that previously opened a lot of doors for collaboration and change in EMS has largely descended into a hodge podge of name calling and “my service is better than yours” debates.  Publications have turned to some providers and former providers who might not always be what they seem at the surface, and leave a lot to be desired for the direction that they are leading our younger generation in.  Health care, or rather health insurance, in our country is in shambles.  Our country as a whole, in fact, is in shambles for many different reasons, depending on who you ask.  Things just are not good right now. For me, writing on these pages has always been rather cathartic.  Finishing up a post and pressing “PUBLISH” for me has always put a smile on my face, and I need that.  Hopefully some of that enthusiasm can spread to those of you who are taking the time to read what I have to say. Tomorrow, we hit the ground running.  We are going to start where I started: Island Heights, NJ and a letter to the editor submitted by a councilman in the town that I called home for the first 19 years of my life.  From there, who knows where we will go...

Jun 12, 2015

I’ve been thinking about writing this post for a week or so.  It’s a tough decision to make, but I feel that its something that I need to do. I started this blog about five and a half years ago on a whim to see if I could get myself back into writing which is something that I have always enjoyed since childhood.  Now, here I am almost 400 posts later, and still going strong.  Anybody who reads what I write regularly knows that there has been a bit of a slowdown as of late.  That is mainly due to the amount of stuff that I currently have going on in my life outside of the blog.  EMS Compass, a part time job, teaching, my full time job, traveling, a social life.  Most of my “EMS related” time ends up pretty tied up leaving less and less time for writing. As far as internet age goes, five and a half years is pretty old.  Most of the blogs that I pick up and read seem to have a shelf life of six months or less.  People get into writing, put 110% into it and then just grind to a halt mostly due to a lack of material.  Somehow, I pushed through that and found that comfortable balance between having things to write about and posting them in moderation so that I could stay ahead or at least keep up with my posting schedule.  Its not easy to do, and for anybody looking to start a blog that is the biggest tip that I can give you. What it comes down to is I think that it is time for me to take a short break from writing here at EMS in the New Decade.  The blog is not going away by any means.  Instead, I am simply going to take a few months off and start fresh in September.  This will give me time to get reorganized, deal with what is shaping up to be a very busy summer, work on some other side projects, and just do some writing in moderation so that when I do come back in September I have lots...

Feb 13, 2015

For the last forty years Hollywood and EMS dramas have not mixed.  When it comes to creating a drama that relatively, not even accurately, portrays the daily lives of EMTs and paramedics, many of us in the field have viewed attempt after attempt with high hopes only to walk away disappointed.  Trauma.  Rescue 77.  Even Third Watch.  None of these shows have even remotely captured what my life is like on the truck or off. Reality TV has not done much better.  Paramedics on TLC back in the 2000’s came close however the show was so poorly edited that I don’t think that they had anybody with an EMT card in their back pocket in the cutting room with the power to say “this doesn’t look right.” While I was excited for its premier, I am sure you can understand my reservations when A&E announced their new series Nightwatch which was set to follow the EMS, police, and fire personnel working the 8pm-4am shift in New Orleans, Louisiana.  My interest was piqued after seeing the trailers though.  I was excited to see that Dick Wolf, creator of  Law & Order had a hand in it, and I was even more excited that it was following one of my favorite reality TV shows ever to be on television: The First 48. The EMS/fire ratio One of the first things that struck me about the show was how the cast was introduced in the premier’s first fifteen or twenty minutes.  Two medic units care for a shooting victim as he circles the drain.  The police officers portrayed in the show search for a shooting suspect.  Then we cut to the fire house where the guys of Squirt 27 are debating what they are going to have for dinner.  I chuckled because that’s how it usually goes in urban EMS.  EMS spends their time in mobile offices with fire department units landing back in a station. Please do not take that as a dig at the fire service.  I have a ton of respect for the men and women who do a job that I have zero desire to do, however, as the show progresses through the...

Jan 16, 2015

What makes somebody qualified to teach an EMT or paramedic class?  I took my first EMT class back in 1995 at night while I went to high school during the day.  I knew every single one of my instructors either personally, or more likely by reputation.  They were sage-like legends in the field of EMS.  They were the old guard.  And it was their job to educate the young, motivated naive students such as myself. Fast forward to college and it was much of the same.  For the most part, the people who taught my second EMT class and my paramedic class already had twenty to thirty years in the field.  They lived and breathed EMS and would share story after story about what they encountered over the years.  They talked about the first time that they had to tie an ankle hitch because the one provided with the HARE had been lost under the bench seat, and that was why it was so important for me to learn how to do the same. In May of this year, I will celebrate my fifteenth anniversary of getting a paycheck for working on the ambulance but my life in EMS extends a couple of years past that.  I got my start in the back end of what was the successful days of volunteer EMS.  We covered our calls, did not understand what a ROSC rate was, and were happy to get a CPR save pin every year at our department’s installation dinner.  Daytime ambulances were staffed by mothers who put their kids on the school bus and then turned the pager on, people who worked nights, or some of those legendary EMS providers who taught at night and were otherwise retired.  They donated their time which is something that does not happen very often anymore for a number of reasons some of them cultural, and others financial.  Any way you cut it though, volunteerism in EMS is all but done in most of the country. So here we sit now, half way through this decade, and we need to figure out who takes the reins.  Many of those EMS legends are in the twilight of...

Oct 22, 2014

In the first part of this series, we took a look at the disease of Ebola itself.  In the second installment we looked at the disease’s signs and symptoms, and took at look at how we as prehospital providers could be put at risk.  In this final part we take a look at the role EMS will be paying in the battle against Ebola. The EMS Response to Ebola In a recent EMS1 article, Dr. Alex Garza took a look at Ebola and how it will affect EMS responders.  One of the first things that he pointed out was the need for specialized air ambulances to transport these patients.  Personally, I feel that we need specialized responders as well.  Dealing with highly infectious diseases such as Ebola requires specialized training and treatment for the patients.  The infection control training that EMTs and paramedics receive is usually focused on “universal precautions and Body Substance Isolation” heck, if you don’t say that at the start of every National Registry station, you’re most likely going to have to retest, but I digress. . . Much like we have specialized HazMat technicians in many systems, and SWAT medics maybe we need specially trained medics and EMTs to handle specifically the interfacility transport of potentially contagious patients. I also spend a lot of time reading the National EMS Management Association (NEMSMA) ListServ on Google.  There has been a lot of talk over the past couple of weeks about different services developing policies and procedures for dealing with patients who possibly have contracted Ebola.  If your department releases anything, read it.  Memorize it.  Make sure you know what your point of entry plan is.  Is one hospital being designated as an Ebola receiving facility?  Who do you have to notify if you have a possibly infected patient?  Are there any radio codes that you need to be aware of?  Also do not be afraid to ask your leadership for answers to any of these questions.  If they don’t have them, suggest that they might be important.  If they’re resistant go higher up the chain if you have to, or at least as high as you are comfortable going. The Center...

Oct 21, 2014

In the first of this three part series about the Ebola virus, we talked about the history of the disease, and a little about the pathophysiology of it.  Now that we have a little background about it, let’s look at its signs, symptoms, and talk a little about the treatment of Ebola. How Does a Person Catch Ebola? As we touched on in part 1, Ebola is transmitted through direct contact with body fluids of a living or deceased infected person or animal.  The list of fluids that traces of the Ebola virus have been found in it not a surprising one, and includes saliva, mucus, vomit, sweat, tears, breast milk, urine, feces, and semen.  According to the Center for Disease Control and Prevention (CDC) the virus can live in body fluids for “several days” at room temperature, which brings up some serious conundrums when it comes to the pronouncement of patients with obvious signs of death that are encountered in the field. This is why we need to stress the importance of universal precautions with every single patient that we encounter.  The CDC tells us that transmission occurs through “direct contact” with bodily fluids.  Direct contact means that “body fluids from an infected person have touched someone’s eyes, nose, or mouth or an open cut, wound, or abrasion.”  While alarming, contact of body fluids with unbroken skin is at a very low risk for transmission of the disease. The big concern right now that is being fueled by the mainstream media is the prospect of the Ebola virus becoming airborne.  While it is known that it has not currently taken on that characteristic, as previously stated, traces of the virus has been found in saliva and mucus.  While coughing and sneezing are not a commonly found with Ebola patients, should a patient with Ebola cough in the face of another individual, there is a risk that the disease could be transmitted. What are the Symptoms? Now that we know how the disease is transmitted, how can we tell if somebody has it?  The alarming thing about Ebola is the symptoms that you will see in patients infected with the virus are quite familiar:...