Friday, April 20

Resuscitation, Can you perform a task and still run the code?

The short answer is YES.

The long answer is also YES.

A quote running around the interwebs today I first saw in my feed from Sam Ghali @EM_RESUS on Twitter.

I get the gist of the message, that we need a team approach to Resus and every team needs a leader who can stand back and run things without getting tunnel vision on any one task.

I also don't believe the statement to be accurate that "If you're running a resuscitation while performing a procedure you're likely doing neither very well."  Multitasking has been proven to reduce the attention given to each task, so don't try to burn me there, but there are tasks at a resus our rural friends are well familiar with.
Back in the day (it was a Thursday) we ran codes with 3 people.  2 EMTs and 1 Paramedic.  Sometimes one of the EMTs was an intermediate and we could throw them on the access task.

Now that I'm in the urban setting we have plenty of people to run a code effectively.  Eventually.

There have been a number of times I have been running the recus while performing a task.  Usually access.  It's muscle memory and can be accomplished rather quickly and easily while still monitoring CPR quality, BVM usage and the rhythm on the monitor.  I'll grab the sharp and run a BGL, open the airway kit and place it next to the head as they set up the BVM, there are a number of tasks and skills that can be done effectively by the team leader.  If I don't get involved and we delay access, are we helping?  Not really.

There is a big push for us to focus on the Pit Crew method, or High Performance Method, or whatever it will be called next week and I understand why.  It helps.

Sam's statement was meant to provoke thought and challenge the old ways, not to establish new policy in our systems and I understand that, but we also need to be realistic about the ability of EMS providers to complete one task while monitoring others.  I'm not going to BVM and try to get access at the same time, but I may need to BVM and run the code at the same time until more help arrives.  And that's OK.

Challenge the norms, find the weaknesses, address them, learn from near misses and apply sound judgement.

Wednesday, April 18

FDIC - Let's Do This!

Pack your bags and get ready for a full conference next week as we once again take over Inianapolis, IN for FDIC!

This year I'll be bringing back Engine Company: First Strike MCI, a class focused on the Engine Company being first in on an MCI.  We discuss pre-planning, setting expectations of your Company and how to make the first 90 seconds go smoothly.

Leave your vests, tarps and fancy tags for later, this is the nitty gritty of MCI Initial Operations.

Crowd estimation, what it means to transmit "Business as usual," tasks for your engine driver...all this and more will be covered!  Hope to see you there!  Thursday, 3:30 PM, Room 120-122!


Monday, April 16

Happy Medic on the Code 3 Podcast - Visiting a Firehouse Without Being a Jerk




Awhile back I was contacted by Scott Orr, award winning journalist and host of the Code 3 Podcast, the Firefighters podcast."  He wanted to ask me about an article I wrote about how to visit a firehouse without being a jerk.

The article got a wide array of comments, as you can imagine, but Scott just wanted to find out how to visit a firehouse without being "that guy."
From the podcast page:

If you’re like most firefighters, when you go on vacation, you like to stop by firehouses and say hello, check out the apparatus, the gear…
But sometimes, firefighters make the worst guests. They just don’t seem to know the rules.
As a guide, Justin Schorr wrote a column for FireRescue1.com on how to visit a firehouse without being a jerk. He was a guest on this episode of Code 3 to explain the hows and whys of being a guest.


It was fun to be on, go have a listen!

Friday, April 13

the Crossover Podcast - ep 150 - Listener Takes Exception to the "Three Disciplines"

In this episode, HM and MC get called out on their bullshit! “Three disciplines, indeed,” says listener and The Crossover Show supporter, Art.
Well, “Art”…if that’s your real name…jokes on you! Just when the guys started hashing out Art’s complaint, they realize Art made a crucial error.

In other news, a former Missouri medic is in a wee bit o’ trouble after stealing some meds.
How did he get away with it?
Simple answer: Shitty Bookkeeping.
Cue Happy Medic losing his mind about the quality of Kansas City Fire’s management of inventory and record keeping.

BOLO

US Cryotherapy – Walnut Creek
Paddle Your Own Canoe by Nick Offerman
Build Stuff with Wood by Asa Christiana
Instructables.com
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Friday, April 6

the Crossover Podcast - Ep 149 - Death and Taxes and Beer

In this episode, HM and MC have a special in-studio guest, Kim from KMS Tax Prep…better known as Mrs. HM.

Nepotism is alive and well at #TheCrossoverShow, friends!
Regardless, it is indeed tax season and Kim is here to give you some tax tips! You may not like taxes, but they are, as the show title intimates, inevitable. So, pay attention!
Kim and the boys discuss, amongst other things:
  • Do you need a CPA to prepare your taxes?
  • Can you write-off your meals/haircut/etc.?
  • Why aren’t your taxes due on April 15th this year?
  • And much more…
Listen, friends, taxes are unavoidable. You can be smart with your money and be prepared or you can choose to half-ass your hard-earned cash and wonder what happened when the IRS repossesses your life. Don’t be a sucker…get you a certified tax preparer.
You know…like KMS Tax Prep!
BOLO
The Final Day by William Forstchen
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Tuesday, March 20

the Crossover Podcast - Ep 146 - Chillin.

Chillin' as in just hanging out?  No.  Chillin' as in 170 degrees below zero.

In this epsiode, the guys chill…to the extreme. MC and HM take a little sojourn to MC’s newest obsession: Cryotherapy.
Cool, right?
Beyond machine gun-like puns, the guys talk to the proprietor of US Cyrotherapy – Walnut Creek, Tim Fitzgerald, about exactly what “Cryo” (that’s the lingo, I’m told) is and what it can do for you. Beyond simply being really friggin’ cold, the facility at US Cryotherapy offers an array of services including:
  • Red light therapy
  • Hydro-massage
  • Infrared sauna
  • Normatech sleeves
  • Localized cryotherapy for troublesome spots
Stiff or sore after a long shift? Cryo can help mitigate that problem.
Got joint issues from carrying God knows how much weight on your belt, back, vest for countless years? Cryo can help relieve that pain.
Want ten minutes to yourself and get a wee-bit pampered at the same time? Cryo, baby.
If you’re local to Walnut Creek, stop in at US Cryotherapy and tell them you heard about them from Motorcop and, if you’re a first responder (to include ER docs/nurses and military), you can choose from three services and get them for free on your first visit. If you’re a civvie, they’ll give you the first visit for only $37 (that’s $10 off!)
Supporters of The Crossover Show (over at Patreon.com/TCS) also get a bonus…video of MC and HM experiencing HM’s first-ever cryo session. (HE’S NOT WEARING A SHIRT, Y’ALL!)

Quick aside from me a week later: When you go in for these treatments or any others make sure you are 100% honest with yourself and the proprietors.  I went in feeling less than 100% under an intense amount of self administered stress about work.  My hopes were to see if the treatments helped.  The resulting intensity overwhelmed my body and made me very sick.  I have since recovered, mostly, but wish I had been honest with myself and said "You've stressed yourself to the edge of sickness, don't give your body more than it can handle."

It does not turn me off from possibly visiting US Cryotherapy again, but I first must get healthy in the brain hole.  Not an easy task, as many of you know.
-HM

BOLO
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Sunday, March 4

The Frequent Frequent Flier Flier

It happened. Gorram it, Mal, it finally happened.

I got a return customer who's a frequent flier!  Airport humor...it takes a minute.

THE EMERGENCY

Aircraft inbound with a woman experiencing dizziness and nausea.

THE ACTION

After the steak chili we just downed for lunch at the firehouse I'm experiencing the same symptoms.  The flight number sounds familiar and the City of origin sounds familiar as well.  You see, while the rest of the EMS world gets and address, I get a story...

"Medical Emergency reported, TWA flight 101, inbound from Taipei ETA one five minutes (no one says multiple digit numbers at the airport, it's the coolest thing!) to gate G55, female in seat 27Alpha, Blue shirt, black shoes, oversized pink roller bag with a kitten on the tag...unknown medical."

No, seriously, sometimes they give us the most insane details about the person, except for the reason we're heading over there.  A few moment later we get the update that she feels like I do and before I can burp the aircraft pulls up to the gate and the doors open and...wait...did they say "pink roller bag with a kitten?"  Is this dejavu?

There she is.

The same woman I saw yesterday for the same symptoms.  Already returned from her stint overseas because, please note the quotes, "I'm too sick to fly."

Let's do the math.  14.5 hours here...deported for forged documents (claimed nausea, asked for Paramedics), 14.5 hours home, time to forge new documents and book another flight, then the next flight back, another 14.5 hours.

Woman has stamina.  And nausea.  And requests to be taken to the hospital as fast as possible before she gets sent back again.

Saturday, February 24

the Crossover Podcast Ep 143 - Take Your Physical Game to the Next Level

In this episode, MC and HM raise the bar (pun intended) and bring in Dr. John Jaquish to talk about his revolutionary gear, the X3 Bar.

Is it possible to triple your gains in a fraction of the time? Does this sound like hooey?
Seems the answers are “Yes”…and yet the guys think that second question/answer is up for debate.
As a matter of fact, MC is taking the X3 challenge. Follow MC’s progress over at his YouTube channel. There, MC will be documenting his experience with the X3 and will give you an unfiltered and transparent look at the gains he has made.  HM is taking no such challenge, he is a lover, not a fighter.  If that makes no sense, just wait...it will.

Physical health is something that is largely ignored in the Three Disciplines…despite all those calendars you see. Most cops, medics, and fire personnel aren’t in the best of shape. If they are to get the most out of the retirement, it’s time to find something that is easy, sustainable, and effective.  It may just be that the X3 is part of the equation.

BOLO 
X3Bar.com (Use the code “motorcop” for $50 off!!)  Yes, this podcast could be worth $50 to you.
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Wednesday, February 21

42 Years of Experience

I was recently given the opportunity to speak with a nurse of 42 years.

You see where this is going, don't you?

THE EMERGENCY

A woman in her 60s is semi conscious, difficulty breathing.

THE ACTION

When we arrive to the scene we are met with the waving of arms and frantic pointing.  Sitting in a chair is a woman in her 60s, vomiting into an air sickness bag.  We call those ground sickness bags when used that way, but I digress.

She says she feels horrible, aches and chills for a few days, running a steady 101 F fever for just as long...cough, runny nose.

"Well, it sounds to me like..." I start but never get a chance to finish.
"Excuse me, I can give a report to whoever is in charge. I'm a nurse of 42 years."

She went on to explain how the patient was semi-conscious on the plane, then walked to baggage claim, sat down and began to feel ill.  When asked why we weren't summoned to the plane she told me, "It didn't seem like an emergency then, but then she started to vomit, so I activated 911."

I look over at teh crew assessing her and everything is coming back normal, they're already turning the form over to the refusal signature page.
"Oh, no, you have to take her in, she'll need blood draws. I'm a nurse of 42 years, I know these things."

Sigh...

Monday, February 12

A Tax Benefit you never knew you didn't get

As Firefighters and Paramedics the tax laws gave us certain benefits when purchasing equipment, uniforms, mileage between stations and all sorts of other little perks we could deduct when tax time rolled around.
Heck I made a spreadsheet with the mileages from each firehouse to each other firehouse (we have 42) and each January the wife would make me print out my work history and plot all my details to other stations.  Turned out that mileage was deductible that year.

That's all changing this year because of the new tax laws, but I wanted to focus on a deduction many firefighters have been taking for years and not realizing they can't:

Meals.

We've all been there at the dinner table and had someone spout out about how, because we aren't given breaks the meals are deductible.  Nope.

There's also the guys who live more than 50 miles away who read the tax law and said, "Well, I'm 50 miles from home and it says we can deduct meals that far from home!"  Nope.

Still more will argue they are allowed to take a certain percentage of the per diem rate published by the IRS because they are on a work related task.  Nope.

Believe me, I used to be all 3 of those guys.  Then I got a tax pro who set me straight on the law.

Here's an article that can explain more about deducting meals on duty.  The short answer is no, you can't.

If you have been doing so you need to get in touch with a tax professional ASAP.  That link above (full disclosure) goes to my tax preparer, who actually knows their stuff.

Lots is changing this year as to what we can deduct, if anything at all, so you'll not only need a hand with this year's filing, but perhaps the last couple of years and set a plan for next tax season.

We don't listen to the divorced guys when they try to give us relationship advice, why listen to them about taxes.  Get a pro.