I had someone very close to me point out that sometimes I have the ability to get rather negative, as of late, about where I came from.  Looking back at some posts and some Tweets, I couldn’t help but see what she was talking about.  I don’t know exactly why that manifests itself.  Some of it is frustration, some of it is my own pride.  While 2012 posed a lot of crossroads for me that led to my inevitable departure from Springfield, I count my blessings every day for the experiences I had and the friends that I made in my twelve years working there. I learned many lessons from many, many different people: patients, doctors, professors, EMTs that I worked with, supervisors who both supervised me and supervised with me, paramedics who reported to me. . . the list goes on and on.  I had a long way to go to be good at my job when I started in Springfield and without those experiences, without those calls that I did both with good and bad outcomes I would not be the person or the paramedic that I am today. I left for a number of reasons, the culmination of it all contributing to the fact that I was not happy.  Part of it was issues with the local direction of my company, part of it was the major changes happening way above my head that I had absolutely no control over.  I wanted and needed a change, and that is exactly what I got.  None of that took away from the fact that I had some amazing supervisors that I got to work with, and two hundred plus EMT’s and paramedics who I was proud to work in the street with. Now that I am almost four months out from my departure, I just wanted to once again share that with everyone.  I have written a lot in the last month about the team at AMR Springfield because I believe in them and I believe that no one could do a better job for the people in Springfield.  I believe in the EMTs, the paramedics, the dispatchers, and the team that leads...

Tuesday afternoon at 3:30pm, there will be a meeting held at Springfield City Hall to discuss American Medical Response and their ability to provide prehospital care to the citizens of Springfield.  Below is something I would like to share with the City Councilors who will be in attendance Tuesday. City Councilors of Springfield, Despite the favorable findings of WGGB in their investigation on emergency response, you have decided to hold a forum to discuss potential short comings of the current EMS provider to the City of Springfield.  Yes, that is right, I said it was favorable.  Although the ebb and flow of the story might not have showed it, all of the information provided shows that AMR exceeds the expectations set for it.  But maybe you should dig a little deeper.  Prior to walking in the door to Tuesday’s meeting, I would like to urge you to do a little research and maybe expand your vocabulary a bit. For instance, for just a second, let’s forget about response times.  They don’t nearly matter as much as you might think.  Try researching what a ROSC rate is, or how CPAP has reduced the mortality of shortness of breath patients, particularly in Springfield.  Ask Baystate Medical Center about the success of their ST-Elevation Myocardial Infarction program (STEMI for short) and ask them how many of those patients are delivered by AMR. Still not convinced?  Why not take a good hard look at other communities around the country and see for yourself how good you have it in Springfield.  An ambulance is on scene in a preset amount of time or less 97% of the time.  How do you think that compares to communities like Detroit, Washington DC, or Philadelphia just to name a few? Or how about closer to home?  Ask around to some of the neighboring more rural communities and see what their response times are like.  I guarantee that some will be longer than the average time publicized by AMR in WGGB’s article, but the patient outcomes will still be favorable. Just like with in-hospital medicine, perfection will never be obtained in prehospital medicine.  Errors are going to happen because not only are the...

I have been wracking my brain for the last week as to what to put up for my 200th post.  Yes, folks, this is it.  Number 200.  It has taken almost three years, but it is quite an accomplishment if you ask me. As I take a look at my current career, I cannot help but reflect back on where I have been.  2013 is a year of new experiences for me.  I’m in a new service with new protocols, and new opportunities.  It took me a while to figure out where I wanted to land, and if you had asked me a year ago, I would have told you I was content with where I was.  I might not have been overwhelmingly thrilled with it, but I was content.  The last six months though was like writing on the wall for me that it was time to move on. Fifteen years ago in January of 1998, I tested for my second EMT card.  I had gotten my New Jersey certification a few years prior, and the fall of 1997 found me enrolled in my second EMT class.  I decided to retake the class to refresh myself, because I had the option of trying to get reciprocity and testing out.  By February of 1998, I got that envelope in the mail, the big envelope. In the state of Massachusetts, when a person gets certified as an EMT they are given their own certification number that will travel with them for their career, barring them doing something like forgetting to recertify.  The number on the card that I got in the mail that day was 848810.  Two and a half years later when I got my paramedic card in the mail, it had the same number, 848810. The recertification process in Massachusetts is not an easy one.  Well, from the provider side of things it is not too bad.  A paramedic needs to do 24 hours of continuing education and a 48 hour approved refresher class every two years, and then send all of their recertification in along with a check made out for way too much money via US mail (certified mail if you’re...

FNG.  If you work in the field, you know what it means.  Personally, I’ve never been happier to be called something in my life.  Being the new guy here isn’t that tough, especially with the group I am lucky enough to work with. It’s been a month in my new system, and although some things have been a struggle, I have really enjoyed myself.  Some people have referred to things as being like “riding a bike” you kind of never forget.  Moving to a new system as a paramedic though is nothing like that.  I like to think that it is more like driving a car. In a different country. Where you sit on the opposite side of the car. And drive on the other side of the road. And the pedals are reversed. The end point is the same.  We all want to provide good patient care, and turn our patients over to the hospital feeling the same, or better, than when we picked them up wherever we found them.  How we all get there though is different.  Protocols are different, and treatment can be more regressive or (preferably) progressive and sometimes taking those old habits, and those old protocols and completely dismissing them can be incredibly difficult, especially when they’ve been part of your everyday life for a number of years, in my case twelve of them. I’m not going to sit here and try to reinvent the wheel and tell anyone that I know the best way to solve this portability problem because I don’t, short of nationally set protocols that everyone follows, but as long as we are all in our own little sandboxes, that will never happen.  Truth is though, I really like the way things are done where I am now.  Treatment modalities are aggressive, and pretty straight forward allowing a medic to do what they feel is best and all of this with the blessing of our medical director. With each tour, I am feeling more and more comfortable.  Sometimes I feel like I’m all thumbs with two left feet, and a brain that is a step behind, but as I slowly settle back into a comfort...

As 2012 wraps up, I spent a little time looking back at my posts from this year.  It was a turbulent year for me, and although real life tore me away from the blog a bit more than I wanted it to, I still did my best to keep it active, and I think I had some great posts in there. This was a year of change for me.  The working environment that I was in changed drastically, life changed drastically, and I decided that in order to best respond to that I needed to find a new place to call home, and a service that was a bit more in line with what I believed in as a paramedic and more importantly, as a person.  While certain aspects of my life are still working themselves out, I still feel that mission was successful.  Anyway, on to the posts. “Bad Publicity and Saving Face” – No post that I made in 2012 stirred things up more than this one.  I saw more than 6,000 visits to my page as a result of it, and got a number of comments both on the blog and over on Facebook.  It is all about a controversial article that, of all places, was written in a college newspaper.  It is a gut check for everyone out there who has ever told someone what being an EMT is all about, and it is a reminder that our profession follows us into each and every social circle that we put ourselves in.  Check it out, and see what everyone had to say about it.  Then, read the follow up to the article here. “What Would You Do?” – Sparked by a conversation that we had in the office at my part time job, this post was about a sticky situation involving a DNR, and a patient who did not want to be around anymore.  Legally, morally, and ethically, each opinion might differ from the one before it.  There are some great comments in this post. “Officer Gene Cassidy” – Everyday, police officers, fire fighters and paramedics make sacrifices.  This past June, an officer in the city I used to work...

My career at AMR in Springfield came to an end this past Monday night.  I was going to put up a post about my last shift, trying to take all of you through my night step by step, but it was a pretty “ordinary” night for the most part.  There were a few goodbyes sent, a few coffees shared, but all in all, the only thing that made it memorable for me was the fact that it was my “swan song.”  My twelve year career came to a close at 6:30am when I punched out for the last time, took a deep breath, and walked out the door. The rest of my week was spent catching up with friends both new and old to say one last goodbye.  I was humbled and overwhelmed by the turnout at our local watering hole of people who showed up to say one last goodbye and share a beer or two.  Or three.  Or maybe four. I have to say that if anyone is ever in Western Massachusetts and you’re looking to enjoy a beer, O’Brien’s Corner in Springfield is the only place to go.  I’ve had many a beer, a lot of breakfasts and some great memories that were created just by pulling up a stool to the bar. Thursday night was my time to say “see you soon” to some folks from my part time job.  They gave me this great picture as a going away present.  I don’t normally work through the fall so I have not been present for many of the group pictures that they’ve taken from year to year.  Their response was to photoshop me into the picture.  Well done guys! The house was completely loaded into a UHaul Thursday night, and Friday I made the move south to my new “headquarters.”  The unpacking was done, a stop was made in New Jersey, and right now I am in my dad’s car typing away as we roll across the Tapanzee Bridge about two hours away from Springfield.  I’ll make one last stop there, pick up some precious cargo (the cat) and head back south for my four hour trek.  Monday I start...

Okay, so my absence lately has been more than noticeable but there IS a reason behind it, I swear.  And despite what the title of this blog might imply, no I am not closing the blog down, quite the contrary, actually. At the end of last week I did something I never imagined doing, I gave my 2 week’s notice to my current employer.  After twelve years, I am moving on.  It has been quite the ride for me, and I am taking many, many lessons and memories with me, but a move to a high performance EMS system that can offer me more of a future is a must at this point. As I start my career as a twelve year FNG, I am sure I will have plenty more to share. Right now though my focus is on my final five shifts.  Next Monday is my last day.  I’ll have plenty more to say between now and then!...

I admit it, I’ve slipped and stumbled.  My blog has been reduced nearly to the occasional urban tumbleweed (read: plastic bag) that kind of blows through every so often.  With high hopes for content, I have not nearly been putting out as much as I would have liked, and you know what?  It’s my fault.  It’s all my fault. While I was expecting big things for 2012, and I seemed to start off on the right track, the last few months have not been quite as fruitful for a number of different reasons, many of which will become more clear in the coming months. One thing is for sure though: I need to get back to what is important. I have been reminded a lot of why I really enjoy this online community lately, and why I am so passionate about EMS.  I had a chance to speak to the guy who made this all possible for me: the one who set me up in Oakland that opened my eyes to the Chronicles of EMS.  I have talked to a few people who I truly respect about the direction of my career and my potential future and have gotten nothing but support.  To those people: you know who you are, and I thank you. Above all else, I need to get to what is important to me: writing, being a good paramedic, a good supervisor, and a strong advocate for the industry and frankly, there is no better time than now for me to get cranking on that.  I am in a holding pattern at the moment, treading water if you will.  The NREMT-P card is in my pocket along with my PALS, PHTLS, and a new ACLS card.  It took a lot of hard work, and I am ready to put forth that sort of effort here among other places. I think that getting everything back on track is just what medical control ordered.   To all of you who have been faithful readers during the last year and a half, I am sorry I have neglected you.  I will tell you that I plan on continuing to write this blog for myself,...

Nothing seems more satisfying than when hard work pays off.  I set the bar high for July.  I knew I had some work to do, and I had to make sure everything was done, and everything was in order.  That meant getting my PHTLS recertified, taking PALS again, updating my ACLS, and obtaining my National Registry certification.  While that just seems like four classes, it is a lot harder than one might think. The first thing that I realized was PHTLS classes are very hard to come by.  I did, however, luck out and find one class down in Connecticut at the end of the month.  That would be the last piece of the puzzle, but it was scheduled.  PALS was the easiest of the group.  I found a class pretty quickly and got that squared away.  ACLS?  They’re a dime a dozen.  Scheduled, and done.  No problem. Then there was my National Registry paramedic certification.  That’s right: the Quest for the Disco Patch.  This was the one that terrified me the most.  Being twelve years out from any EMS related exam that I had taken, and eleven years since I took any standardized test, I was a touch nervous.  Add to that the fact that I felt the pressure of actually being a provider, and I was then really nervous.  I scheduled the written first, followed by the practical more towards the end of the month. I studied almost every day for three weeks.  I would take practice exams, then study what I got wrong, and then take another one trying to absorb as much of that supressed information as I could.  When the test day came, I was a wreck.  I sat down on a Thursday afternoon and fired up the computer that I was put in front of and cranked through 87 questions.  Yes, that’s right, just 87.  I got there, and it shut me down.  “You have completed this exam, and will get the results in two to three business days.” Headache number one was gone by Friday afternoon.  NREMT was quick to get me my results, and I knew my written was all set.  Then it was on to...

Twelve years ago I walked out of my state KED station declaring to everyone who would listen that “I hope I never have to do that again.”  I passed my state practicals the first time around which really was the bigger piece that worried me.  The written would come as I was a pretty good test taker but the hands on stuff needed to be done correctly on the first pass.  There was no passing by a skill and coming back to it if I was not sure about it. In August I plan on heading up to New Hampshire and taking my practical station for National Registry and I have to revisit all of this again.  My practical day for both my EMT and paramedic exams were pretty anxiety filled.  I wanted to get it done and never look back and that is really what I did.  Now I have twelve years of bad habits to put aside for one day of testing. Still though, even after all these years my paramedic instrutor Gary Childs, or GAC as he was known back then, standing over me reminding me to “rip the tape” on my IV station or stressing the importance of that first rhythm interperatation on a quick look.  I was well educated in paramedic school and for that I am extremely greatful. Paramedic school was extremely fun but challenging all at the same time.  I had a great group of classmates and we were close.  Some of us were college students who had entered a small four year program together while others were from fire departments, private services, and the community.  Regardless of our background we all bonded quickly and even today when I see any of them it is always nice to catch up on the old times and figure out where everyone is today.  Having them around helped surpress a lot of that anxiety that I had.  I always knew that if I had a problem that an insturctor did not point out to me one of them would share it with me. When it came time for state testing though I was on my own.  I had no partner...