Aug 14, 2014

Since the blog is 4 and a half years old, I felt like it was time for a change.  As I mentioned in my announcement about the lack of a podcast post for this week, the site got a makeover.  For the last couple of days, I have been tweaking and moving, and playing around with all of the new settings on the new WordPress theme that I downloaded.  I know it might sound boring, but actually it is kind of fun! There will be more changes on the back end which will probably be less noticeable to those of you who read the blog regularly already.  I am currently playing around with a few different search engine optimization plugins that Go Daddy! offers. Also, I feel like this is a good time to mention the direction that this blog has taken over the past couple of months. As many of you know already, I moved my blog off of the First Responders Network of blogs.  This is in no way a reflection on my relationship with Ted or any of the other folks over at FRN it is a great organization that I am still affiliated with.  The truth of the matter though is the blog started to outgrow the capabilities of what could be offered to me on the hosting side of things.  My move to self-hosting the blog and running it through Go Daddy! was a tough decision to make but it was vital to the future of MedicSBK.com. The fact is, if it was not for Ted Setla, I would probably still be writing over at the little Blogspot site where I got my start four and a half years ago.  He believed in me, he got me started, and he gave me a soapbox to stand on for more than four years. So take a look around the site!  If you notice something that is not working, or a link that is dead, please feel free to report it to me.  There is still plenty of fine tuning and tweaking that will take place here over the next couple of weeks, but all in all, I feel like the...

There has been a topic that has been bothering me for quite a while now, and I feel it is time for me to weigh in on it. One of my favorite shows that has ever been on TV was HBO’s miniseries A Band of Brothers, based on Stephen Ambrose’s book of the same name about Easy Company of the 506th Parachute Infantry Regiment in World War II.  In one of the show’s best episodes, the company’s medic is forced to ration medications and supplies so as to provide as best he can for The result is him having to hoard morphine for the more severely injured soldiers and carefully consider his treatments and who gets them and who does not.  I have watched that particular episode many times and thought to myself that I could never imagine having to make those decisions.  I always felt that in medicine, everyone deserved the same care, whether it be in the form of life saving medications, supplies, or pain management. Now, here I am, almost 70 years later, and I am on the verge of being forced to stare at a drug bag with expiring medications that cannot be replaced, and having to choose between morphine and the far superior fentanyl based on what I feel my patient’s needs are.  But who really is to blame? One of the greatest tragedies in this country is the profit machine that is health care.  It exists on every level from insurance companies to hospitals to manufacturers of medical equipment to the big bad drug companies and even to prehospital ambulance services.  In fact, I am not a fan of any ambulance service being referred to as “for profit.”  The fact is whether an ambulance service is privately owned, classified as a non-profit, fire based, third service, or any other model that sends out a bill they are, in fact, in the EMS business to make some sort of profit.  But I digress. Some drug manufacturers have decided to stop producing certain medications because regulations and quality controls have become so strict that without a significant price increase, the profit that they can make from these drugs becomes little...

This one is for you.  That’s right: this quarter’s addition of Intervetions was written just for you, the EMT, the paramedic, the field provider.  Inside, you will find stories about training, the importance of communication, and my contribution all about stress management. Even though this is a quarterly magazine, there is a lot of work that goes into it.  The goal of the Interventions team is to give you, the reader, as much quality content as we can.  Personally, I think we have once again accomplished that. Thanks to the entire Interventions team for all of their hard work.  And especially, a big thanks goes out to Justin Schorr for his creativity with the magazine’s layout. Without further delay, I’d like to present to you this quarter’s Interventions Magazine.   Up next: The Interventions team will educate those who make the legal decisions that govern what we do: the...

This past Monday, issue number 2 of EMS INterventions went “live” on the internet.  Comprised of articles and videos put together by the team at the First Responders Network, the magazine offers a look at what we want from our Medical Directors and what they can do to help us achieve that reboot of EMS, that EMS 2.0 that we so desperately need. I would like to invite you to check out the edition and please share any comments that you might have either on our respective blogs or at [email protected].  Additionally, I welcome you to download and print out the PDF version of the magazine and share it with your colleagues and medical directors.  This is where you, the reader comes in.  Help us spread the word, and help us put EMS 2.0 on the tip of everyone’s tongue. I am very proud of what we have put together, and would like to thank everyone involved in creating the publication for their hard work, dedication, and spectacular content that was contributed.  We look forward to putting together Issue 3, due for release sometime around EMS Today in Baltimore.  Stay tuned for updates in the weeks and months to...

On November 1, at 12:01am Pacific time, Paramedics Plus took over 9-1-1 coverage in Alameda County marking the end of a lengthy service by American Medical Response.  I, however, cannot help but feel like AMR got the short end of the stick in the deal. I have read through both of the bids quite extensively, and I must say that from the perspective of Alameda County, they had a strong grasp of what they were looking for, and released a rather detailed document spelling out what EMS means to the county.  Both replies were lengthy and well put together, and in my opinion far exceeded the expectations that were set.  In the end though, the bid came down to one thing: the all mighty dollar. The last piece of the bid called for both companies to submit what they planned to charge for their patients for their services.  Paramedics Plus came in lower than AMR giving them the points they needed to push themselves over the top, and ultimately win them the contract.  Kudos to Alameda County for looking out for the wallets of their tax payers, but I feel like there was too much weight put on this stat.  While most services harp on response times, ALCO shifted that focus to financials.  Their response time criteria was still very strict, and they did a lot to further the quality of patient care provided in the county, but a lot of that feels disregarded to me when I see the weight that patient charges, most of which an insured person would never see, are figured into the equation. It must be understood though that I am a little biased.  I owe a lot to Mike Taigman and his team in Alameda County.  Level Zero was the project that opened my eyes up to EMS on the internet.  A profile of a few of the providers in the county, having seen the movie I was even more excited to hit the streets in ALCO when I had the chance hoping I’d just have the opportunity to run into someone I might already know a bit about.  While I only saw one “cast” member from afar,...

“The Genisis for change is Awareness.” – Michael Angier That quote was shared with me by a colleague of mine the other day, and it inspired me to write this blog. . . There has been lots of talk about what needs to change about EMS for EMS 2.0 to take effect, and be accepted. Ideas have to change, Medical Directors have to adapt to different ways of thinking. I think that what we need first is we need to develop strategies for the movement at the street level. More people need to be aware of the ideas and thoughts that are out there. I’ve taken it upon myself to take some steps to help make that happen. As I’ve mentioned in previous blogs, some of us here in my company have started putting a bug in people’s ears at the earliest stage: when the new EMT walks through our doors. Level Zero: The Movie has become an official part of our New Employee Academy. The instructor that showed the movie and the class loved it. Along with the movie, a series of handouts were put together by our Lead Supervisor (who is also an EMS 2.0 advocate) that revolved around professionalism, and how to handle one’s self. I’ve taken that a step further. As I’ve found different blog posts and articles that I like, I’ve printed them out, and left a stack in our Deployment Office for people to take and read. Additionally, I usually carry some of them with me as well, and I’ll hand them out to interested folks when I run into them on the street. One prime example of this was an article written by Chris Kaiser of Life Under the Lights last week called “What Difference Does EMS Make? Choose Your Own Ending.” The article itself had a profound effect on me. Chris a terrific writer, and the message he conveys about how our job effects those around us, and the personal pride that we should take to “become the best EMS Provider (we) can” played over and over again in my head. I handed out this article to one employee in particular who seemed very interested in...

When the movie Level Zero came out last year, I was extremely excited. I think everyone who operates in this medium and in our field can agree that there is a complete and total lacking of positive press, and realistic examples of what we do as a profession. It did not take me long at all to email the Level Zero Link to everyone that I knew, whether they were in the field or not. I loved the viewpoints of those featured in the movie, and thought that they had a lot to say about what we did. Little did I know, but a little more than a year later, I would have a chance to experience the streets featured in Level Zero first hand. I got a call at the beginning of December from a colleague of mine who needed my assistance. There were some computer systems out in Alameda County that needed some tweaking, and some additional education that went with it. I was offered an all expenses paid trip out to ALCO, where I would get to spend 40 hours or there about riding along on the streets of Oakland and its surrounding communities. How could I say no? I had a great experience that week. It was really eye opening. Every truck I got on had a crew that welcomed me, was willing to answer questions about their system, and had plenty of questions about my system and where I came from. I’ll be honest, this trip was more than just a “Help the company” opportunity for me. I walked away with many ideas about system design, system status management, and crew attitude and motivation that I could take back with me to where I worked and improve the quality of my service. I feel like I sound like a broken record sometimes. The words “when I was in California” come out of my mouth more times than I can count. The topic of Level Zero the Movie came up with one of the crews I was with, and they were quick to explain to me the concept of Chronicles of EMS. Could it be? A chance to view more...