Wednesday, November 17, 2010

We Need Change

So have you read anything about that EMS 2.0? Beep, Beep.  Rats
Don't go that way, too may trucks.  Have you tried that place to eat?
So what's the deal on that EMS thing?  These guys are trying to make things better for us and the patients.  We don't need a another union.  It's not a union.  Siren and lights, pull to the right idiot!  Where'd they say the call was?  Keep going.  OK, so there could be options other than taking patients to the ER.  I'd like to take them to jail.  I'm in. OK command we're two minutes out.  How many helicopters are coming?  Maybe we could be trusted to determine if the patient really needed an ER.  Like when they get that miracle drug D50? Yeah, like that only better.  Better start slowing down.  Not hauling people has to cut down on my paperwork.  It's your turn in back by the way.  Do we have any help coming?  Ten and second due ALS.  We're lookin' at two priority ones.  Split up.  No one riding with him I'm back to help you.  Like that 2.0 thing?  Yeah Cap, just lay the board here and we can use some help rolling him on to it.  Head, right arm and leg, pelvis.  Next time take a plane when you fly.  It's not the flight it's the landing.  Thanks everybody, OK let's go.  Does EMS 2.0 get me out of the nursing homes?  Not entirely. Someone still has to go and assess.  But if the patient slid from her wheelchair to the floor and told you she did maybe she doesn't have bilateral hip fractures just because the CNA says she does.  Helicopter is two minutes they want a report.  SUCTION!  OK, now pass off to fly boys.  Jeez, I can't take you anywhere.  What did you do roll in it?  Somebody has to do your work.  Is that what EMS 2.0 is for?  No the work is still there, we just get choices and so do the patients.  It's kind of anti-dumping.  When you get a say in things usually it works out to everyone's satisfaction.  Hey let's get you clean and go for two brownies with peanut butter icing.  Let's go back to the station and I can show you EMS 2.0 on  I'd be a happy medic if I could have a brownie.  Beep Beep.  Rats.  2.0 here we go!

Wednesday, November 10, 2010


As I was re-reading my company SOPs it occurred to me that no where in them does it say proceed to the call disregarding all traffic regulations, rules of nature, and common sense; while maintaining speed generally associated with requirements for flying an F-16 in a Dog Fight.  Only one EMS promulgation even allows speed at no greater than ten MPH above the posted speed limit.  But are you ready for this?  All edicts stipulate seatbelt use in moving vehicles and the EMS papers don't mention when not doing patient care.

Is every call an emergency?  Risk a lot to save a lot.  Risk little to save little.  Don't risk anything if you can plan ahead.  Seat belts and speed are both under our command.  Keep them under control.  Yeah, I think my kids would miss me.  Thanks to Firefighter Close Calls for the pictures.

Wednesday, November 3, 2010

You Are What You Read

In between discipline, training, planning, and WOW actual calls it occurs to me that we have some down time that we could responsibly fill with knowledge enhancement activities.  Do you like that?  A new acronym KEA.  Yeah, what the heck does that mean?  Let's call it reading.

It doesn't make a difference if it's printed matter, blogs (thank you dear reader), or internet news.  It counts as reading.  Watching fireman vs. policeman is NOT reading and hence not a KEA.  Posting pithy retorts on your or someone else's FaceBook page is not KEA, although it sometimes requires reading between the lines.  So what is it?

Let me share my monthly Fire and EMS reading with you.
Daily: Statter911, Firegeezer, Firehouse Zen, Raising, The Fire PIO, Three Mouse Clicks From Disaster, Pink, Warm, and Dry, Street Watch, Future Ditch Doctor, Happy Medic, No Ambition But One, The Boogie Man Is My Friend.
Weekly:, Fire, Dr. Grumpy,
Monthly: Firehouse Magazine, Fire Engineering Magazine, The PA Fireman, EMS, Fire Rescue.
For fun: B-Shifter, Rescue Men, When the Bronx Burned, Alex Cross

OK, you get it.  The list can sometimes become overwhelming.  But there is literally something for everyone.  Cruise the blogs, catch up on the news sites, and yeah, even read a book or magazine.  In fact how many of us read a book more than once?  Start a station library and bring in some of your lightly read books or magazines.  I think you'd be surprised what others will pick up once they see someone else is doing it.

So your homework today: focus on KEA and let's avoid the KIA (killed In Action).

Monday, November 1, 2010

An Oldie, But a Goodie

Possible CVA my ambulance is due.  OK, look up the address, cross street, note that ALS is not available, tell new guy I'll drive, and we're off.  New guy and I get along pretty well.  He can't stop asking questions whenever he is with another human being but as an adjunct instructor for the community college where he is paying to take his EMT/Paramedic/LPN/RN/MD I feel obligated to give him well thought out and correct answers.  OK he's only getting his EMT there but because of all the questions it seems like he is studying for his nursing boards or medical degree.

Why are we going this way?  Because there are designated emergency corridors we use when we respond.
Why don't we use the lights and siren?  Because it's Sunday and I don't want to cause ten "Sunday Driver" accidents on the way to our nothing call.
How can you be sure about the call?  Well statistically 75% of ALS calls don't merit ALS.  50% of BLS calls could safely be driven to the doctor's office for an appointment tomorrow.  Oh, and I hauled this patient's mom from the same address about a dozen times.
On Scene.
"Hi, I'm Newly Minted EMT can I help you?"  I secretly wish, just for a whimsical moment, that I still had the deep caring attitude of my partner.  But I also place a mental side bet that within six, no three months we'll have him working on the dark side with the rest of us.  Let the games begin!
"It's my son, he had a stroke and can't move his right side. OPQRST.  Patient blinks and stares as mom answers questions.  Other reviews that I really don't pay much attention to, something's not right here.  Mouth doesn't droop, no drooling, follows us with eyes where ever we go.  Hmmmmmm.

OK now my OPQRST, Opportunity to Preempt or Quit Resultant Stroke Treatment.
OK Newly Minted, let's load him.  "Yes, we need to get him to the hospital."  Cue crying by mom.  Haul patient out to ambulance.  Get his oxygen ready and I will start filling out paperwork.  Cue odd look by Newly Minted.  He already knows I hate all paperwork.  Catching on? Nah, not yet.

Me to Newly, OK this Medical Assistance paperwork, I think I have it all filled out.  Now in order for the patient to not be billed they have to sign for the trip right?  I cut off his answer and say Mr. Patient, can you sign here?  Mr. Patient grabs pen, signs name, and lays back down.  Oh, did I forget to say that he is obviously right handed?  As I thank him and move to get out of the back of the ambulance I note the extra bright 200 watt light bulb that just lit up above Newly's head.  Yeah, he got it now.

I think I heard him curse under his breath as he was filling out page two of the narrative...I't's going to be a shorter walk to the dark side.