Sunday, February 28

the Telephone Game

I can only assume everyone played this game as a kid, but as rescuers, we play it everyday.
For those not familiar, you and your friends sit in a circle and one person whispers a sentence to the person to their right and so on and so on. The gist of the game is to see how much the sentence changes from person to person either by forgetting the exact words, or rewording it for whatever reason.

Funny thing is, I get to see each step of the game as it goes. This was brought to mind one morning when I got another one of my blog starting runs when I asked, "You called 911...for this?"

The game started when the client (See Glossary of Terms) had a sore throat and went to the doctor yesterday. Our story should end there, but this is managed care, so of course there is more.
This morning, 10 hours after starting the course of antibiotics, our citizen phones the expensive private health care nursing advice line. According to her, she told the nurse, "My throat still hurts, can I use a throat spray to eat? It hurts to swallow."
The nurse told her to "...hang up, call 911 and tell them you need an ambulance."

Our client calls 911 and, in clear words, tells the call taker she needs an ambulance for a sore throat.
Call taker follows instructions coding the call as a 26A25, Non-emergent sore throat. It worries me the 911 system even recognizes this, but...
The dispatcher changed the call to a 11D2, choking with difficulty breathing.
The notes on the MDT state she is unable to swallow.
As we arrive code 3 as instructed, we are met by a young woman with a diagnosed and medicated case of strep throat.

"Did you call your doctor today?" I ask after checking all vitals without disturbing findings.
"No, the office said he was too busy, they had me call the nurse line." She hands me the card.
"What did the nurse say?" I can't wait to hear this.
"To call 911 for an ambulance." She says with a small laugh.

After a small conversation I discovered she didn't feel different, just wanted advice on a throat spray so she could have breakfast. Her throat hurt, but no more than yesterday.

We went full circle in the telephone game this time, where the sentence was the same at the beginning and end, but it was all the junk in the middle that got messed up.

Maybe folks should be able to call us directly in the ambulance for advice since the dial-a-nurse seems to default to us most of the time anyways.

Saturday, February 27

That's just Bitchin'

You have never seen anything cuter than THIS.

And if you have, just keep it to yourself.

Thursday, February 25

You Make the Call...Ladder Drill

You Make the CallYou're the boss on the ladder company today and have decided to run the troops through their paces.  The large extension ladder is raised in front of the firehouse.

You've sent the young guy up to practice working off the side and locking in when a woman with a clip board casually strolls up and begins to talk to you.

Even though all your member are in their PPE with helmets in place, she refuses to stand back as she makes notes on a sheet on her clip board.

"I notice your ladder is not secured at the top," she tells you.

"Well No, Ma'am, it's not, we're practicing a situation where that doesn't happen, that's why this fellow here is holding the ladder," you tell her while pointing to your foot man holding the ladder as he always does.

She presents credentials from the local occupational safety department and orders your member off the ladder.  She then demands to speak to your supervisor for a violation of safety laws.

What do you tell her?  You make the call.

Wednesday, February 24

Was that a critical call?

Got a message from my Paramedic mentor a little while back about the title of this post.  He was asking what makes a call critical?

The definitions include "at or of a point at which a property or phenomenon suffers an abrupt change especially having enough mass to sustain a chain reaction; characterized by careful evaluation and judgment; urgently needed; absolutely necessary; forming or having the nature of a turning point or crisis; being in or verging on a state of crisis or emergency;"

But what does it mean to an EMT or Medic in the street he wonders.

Is it the presentation?

The required interventions?

Is it a feeling we get either before or after?


What makes a "critical call" in our book?

Behold! A Meetup of epic proportions!

It's being billed as

The Largest Fire/EMS Blog meet up of all time

and it is in Baltimore March 5th, 8pm.

Bloggers from the FireEMSBlogs network will be there and not just Mark and myself.

If you are a blogger and will be there, leave your info in the comments and I'll add you to my list.

All are welcome, bloggers, readers, fans, stalkers, ex-wives (only odd numbered ones), industry reps (if you're buying), Chiefs in uniform (so we can drink in front of you), small woodland creatures (so cute), #TeamHappy, anyone from the 1996 Eden Prarie Varsity Lacrosse Team, Firefighters, Paramedics, EMTs, conference goers, Instructors, Destructors (OK, not really destructors), my Mom (Hi MA!), retired members, volunteers, paid, paid/call...

...if I left you out you're invited.

Uno Pizzeria Harborplace- Pratt Street Pavilion, 2nd Floor
201 East Pratt Street
Baltimore, MD 21202

Sponsored by George Washington University, JEMS and

Special thanks to Chris Kaiser

Walk / Don't Walk

don't walkI had no idea that walking patients to the ambulance was such a risque thing to do.

Since the debut of Chronicles of EMS I have been seeing posts and getting emails about how folks are glad they saw me walking patients to the ambulance because it proves I'm willing to show the cameras what's really happening.

Well, news flash - I walk patients to the ambulance all the time.

When their condition permits, of course.

But when Bubba Fishbiscuit calls because he is out of "brain pills" again, or sprains his wrist guess what folks, he walks if he wants to.

I have even been known to walk patients INTO the ER! AAAAAAAHHHHHHHHH!

My question to you is, why aren't you?

If your patient doesn't need the cot, or want it, why are you "required" to use it? And the stair chair too?

I dug through my County Guidelines, Department Protocols and even Department rules and regulations and found nothign about folks not being able to use their good legs when they want to.

Forcing people to make you carry them is insulting.

"No Ma'am, we have to for liability reasons" is the exact opposite of what you're doing. By letting them walk they are responsible for their actions. When you carry and drop them, well, that was your call.

So why is it that so many Paramedics and EMTs were taken aback when I allowed people who were walking around when they called me and walking still when I arrived to walk into the ambulance?

can't billIs it billing?

Is it?

Is the ability to be reimbursed for the transport more important than the patient? If you are required to carry or cot everyone no matter what, then yes.

Ask your Medical Director about walking patients to the rig who have non life threatening injuries or who are stable per their history and protocols and request to walk on their own, watch what they say.

Now go ask your billing department how hard it is to get Medicare to reimburse when you start your narrative with "Pt ambulated without assistance to Medic99." Watch their eyes catch fire.

Your protocols should outweigh your policies because your policies cover you and your protocols your patients and we've covered more than once in this forum that this thing isn't about us, it's about them.

If Bubba's had a few too many, he gets carried. If he's going to reach out on the stairwell and twist in the chair causing my knee to go out, who's fault is that? Bubba's for reaching out or mine for not helping him down the stairs in the first place.

Have a serious talk with your system administrators if you are not permitted to let your patients walk to the ambulance. Show them the Chronicles episode and show them that I do it all the time and, gasp, no one dies.

But, and I hate that I have to add this, follow your established policies and protocols until otherwise advised by those who have the power to change things.

Monday, February 22


Sunday Fun - Get MotivatedIn my opinion the most important person on a hoseline is the layout man.

Some departments staff 3 to an engine, meaning there is no layout man unless the Officer goes back down the line to make things right.

Not mine.

We run 4 to an engine and for good reason: You need 4 people to mount an effective primary fire attack.

Driver/Engineer: Operates fire apparatus, engages and monitors pump and water supply.  Good so far, we have a way of getting water into the hoses, that's a plus.

Officer: In command of the team. Calls for type, length of hose and where it is to be deployed.

Nozzleman: Operates the valve at the end of the hose, points it at the fire.  Really more complicated then that, I know, but than again, so is...

Layout: Ensure the hose is properly deployed from the apparatus and unkinked entering the building.  Follow the attack team around corners, untangling and advancing line as needed.  Block open doors and move furniture so that when the line is charged it isn't trapped under something.  Stay back from the firefight to pull line back so the nozzle team can redeploy to another location without standing on a load of spaghetti in the hallway.  And, possibly THE most important role of the layout position is to slow additional responding companies if conditions are unsafe ahead of you.

Even though the Officer has a good view of the seat of the fire, and a good officer knows the conditions around them, they can't see what the layout person sees.  From a safe distance, possibly at a corner, ready to pull hose while the nozzle gets the "glory," the layout can scout conditions in other rooms and maybe even get some ceiling fall on them when the truck cuts a nice hole.

The layout knows all the trouble spots that line may encounter if it needs to move through that area again.  The first two folks through had their attentions elsewhere.

The layout is also the one who will be assisting the nozzle team should the conditions warrant an evacuation.  From that position you know where the exits are, not just where the line goes out, but also rooms of refuge, should they be needed.

When the fire is out and overhaul continues, the layout man needs to make sure that line is still available to knock down hot spots in the ceiling and walls by looping it into an unburnt room and placing the nozzle, with nozzleman still attached in a position to redeploy if necessary.

We should never leave the engine without a tool of some kind, but as the layout we need full flexibility so a sheathed axe can really get in the way.  A pump can can also get in the way but makes an excellent door chock and point of no return doorway device.  That little can can keep an advancing fire from getting through a doorway if teams are retreating behind you for at least 2-3 minutes when used properly.  So what to bring?

Depends on construction, location of fire and your Department's SOPs.  A cop out answer I know, but the truth.

So next time someone else "grabs" the nozzle, remember that they have it easy, now you've got the most important spot on the hose line.  If the fire goes out you did your job right.

Now get those kinks out and feed line up to the third floor!

Friday, February 19

Blink. Blink.

After racing lights and sirens for a first party unconscious person, up three flights of stairs and into an open apartment:

"Did you report a life or death emergency?"

Blank stare from occupant with coat and bag.

"No, I called 911."

Tuesday, February 16

Well, isn't that what you paid for?

blog engineSometimes when I feel like everything is going right in the universe my clients pull me back down to earth kicking and screaming.  I never doubt what they tell me, good heavens no, but I always wonder...if they purposely seek out, pay for/barter, then ingest "speed," what did they think was going to happen?  Sleep?


First job of the morning has us responding to a reported shortness of breath at a restaurant.


Anaphalaxis, my first thought too.  I had only just checked the jump bag, knew I had 4 good doses and three needles ready to go.  Benadryl also at the ready, we park in front of the somewhat questionable eatery and are waved to the rear entrance.


A few twists and turns into the kitchen and I'm asking my usual questions,

"Did you report a life or death emergency?"

No response, only a wave to follow.

"Did you call? What's going on?"

Come on, come on, over here, over here he waves.  It would have been cooler if he went to one knee and did some of that cool Navy Seal hand gesture stuff.  I totally would have done the same.

"Employee or customer?"

"Is no employee no customer, he come running in."

And it is then we find our client wearing a new hole in the carpet running back and forth ringing his hands together.

"Are you alright Sir?" i ask trying to slow him down enough to assess him.

"I can't, can't, breath, I'm going to die." He tells me in clear, yet quick breaths.  The decision is made to guide our almost olympic sprinter towards the cool morning air.

Outside he's grabbing onto my jacket arm asking me to help him.  With our almost embrace I can see his pulse racing at the carotid, easily over 150.

Finally giving him something else to grab onto, a dumpster nearby, so I can actually assess him properly.  It's then that the lies start to fly.

"I'm dying." He screams.

"When was the last time this happened to you?" I ask while listening to clear lung sounds and making a safe assumption (educated guess).

His eyes shot to mine with a hint of anger and more than enough embarrassment.

"What? Um, never.  What do you mean?" He's scrambling, looking all around trying to think of something to explain away his condition.

"When did you take it?  About 20 minutes ago is my guess.  Slow down your breathing, you're going to be just fine." I turn him to me, man to man, and try to show him how to take deep breaths.  That so rarely works, but I always try.

"Yesterday." He suddenly speaks slowly, relaxing.

Turning his shoulders back towards me I call him on it.

"How about just before you ran into the restaurant?  Yeah?" Was my response, then I just let him wonder how I knew.

The ambulance arrived shortly after our discussion and he of course requested transport to discover what on earth could have caused his heart to suddenly race, nay, hurry, no, speed.

Gee, I wonder.

Sunday, February 14

What a Weekend

What a weekend indeed. As our regular readers are aware, it appears those 26 exhausting days back in November were worth it after all. Even though only the first half of our Project was turned into the Chronicles of EMS, the entire experience has changed the way I view my system.

This screen shot will take you where you can watch the show.

This past Friday saw the World Premiere of the Chronicles of EMS Reality Series in San Francisco. Mark and I arrived a bit early at the request of Producer/Director Thaddeus Setla and were quickly aware of the extensive set up on site. Multiple large TVs are linked to laptops and cameras, all relying on a tiny ethernet cable to stream it all live around the world.
The chat room got a bit colorful at times but we did notice those of you out there reminding visitors to keep things clean, even if they refused.
Before we knew what was happening, Mark and I were at a table talking with magazine reporters, investors, friends and readers, all excited to see the first episode.
Although we had a really nifty schedule of events, technical troubles and the wave of people in the Hotel Frank made that schedule difficult to keep.

Keep in mind this is all being put together by Paramedics, not professional live streaming folks. We can't afford them yet.

But when the show went live, the room got quiet and I went to the back of the crowd to gauge reactions. And the were 100% positive.

Thank you all so much for taking your own time and money to help us show the world what we did and what we learned.

The following morning Ted loaded up the cameras, Mark and got a few folks from out of town we usually talk to over skype or email to sit down and talk with us.  We fired up the cameras and filmed a sister show, A Seat at the Table.

It was more fun to film than I expected and we talked about a lot of issues. You can watch the show link for information on future table discussions and how you can join them live, each show has a laptop open to the chat room which has it's own place at the table.

Whenever we travel with the Chronicles team, we hope to gather folks around the table and open the dialogue even more.

Thank you again for all your positive comments about the show, we hope to live up to your high standards in the future.

Saturday, February 13

Caption Contest Winner

The internet's most popular caption contest ended with a thud and a lack of fanfare.  I was meant to tell you who's caption made me happiest at the Chronicles of EMS Premiere, but alas I couldn't get to the camera.

So, the winner of the Chronicles of EMS T-Shirt is...

...drum roll please...


"She's got HUGE...tracks of land, Boy!" from reader cjordan.

He may have cheated since he knew me long ago, but knowing I'm a python fan came through in the end.  So Mr cjordan, if that is your real name, send me an email with your T-shirt size and soon in the mail to you will be your very own Chronicles of EMS T-shirt.

Thanks everyone for commenting and even more for your support in our endeavors with the Chronicles.

Wednesday, February 10

From the Archives...Bubba's Bad Temper Pt II

The pre-Chronicles retrospect of favorite posts continues with part 2 of the 3 part posts about a patient who didn't exactly behave himself.  My partner on this job recently went light duty and pulled strings to let me keep her spot warm while she's gone.

Originally Published June 25th, 2009

blog medicRound 1 seemed normal enough, at least as normal as things get in the big scary City some nights.

Round 2 begins as I'm assisting Bubba down the stairs and he decides an elbow to my face would make his night better.
Luckily, I watch a lot of movies. Not fighting movies or martial arts movies, Happy is a lover, not a fighter, but I enjoy a good strategy and tactics film when I can.

I had 3 options as Bubba took his first of many swings.
Option 1 - Let him hit me. Um, no.
Option 2 - Try to duck or dodge out of the way. I'm not one for choosing the direction of an assault and I figured I had a 1 in 3 chance of moving the correct way.
Option 3 - Close the range to target.

What came to my mind in a flash was the Hunt for Red October. When he turns into the path of the torpedo before it can arm itself. My reasoning after the fact seems perfect, in the moment I just needed him to chill.

The bottom of the stairs had along it's side a large wrought iron ornamental security gate, the kind we have to force open most days.

As Bubba moved with the elbow, I forced my shoulder into his, jamming him into the gate. My right leg got up under him to throw him off balance while my left hand dropped the computer and squeezed Bubba against that gate. I knew if he got me off balance and I went to the ground I was going to get hurt.

My partner was already on the radio screaming for police assistance. She had to scream to be heard over the screaming of, in ascending order of volume, Me, Bubba, the girlfriend:and mom, who's voice had found new heights.

Bubba was my height and had at least 20 pounds on me. I was tired and sober, he was drunk and rested. My only hope was to keep him against that gate until the cavalry arrived. All I wanted to hear was the screaming of the police sirens.

I was able to get his right hand into mine and forced behind his back, now near my waist. His left arm, the one that swung the first time was pinned between him and the gate, not moving for now.

The scene from Pulp Fiction when Julius is telling Honey Bunny to be cool was playing over and over in my head and I'm sure lines from the scene were coming out of my mouth. All I remember is wanting to keep his 230 pound frame off balance and against the gate which was almost more than my one leg could do.

After what seemed like hours of holding him he began to calm and still no sirens filling the night air, only screaming. He promised he was "OK,"and I reminded him that I had no problem keeping him there all night if I had to, a thought my leg would most certainly disagree with.

I decided, possibly foolishly, to let him back down to the ground, partly for a rest and partly because he had indeed calmed. I kept his right hand behind him and made a reach for the left wrist, controlling both rather well considering the circumstances, I thought, and we slowly made the drunken, angry stumble towards the ambulance, feeling him squirming and trying to get free the whole time.

There in the middle of the street, mother still screaming and us now screaming at her to go back inside, Bubba sees an opportunity to try knocking me down again. He's got one leg up on the rear step of the ambulance and one hand on the rail to climb in when, I'm told later by my partner, Bubba takes a swing. All I recall was seeing him shift his weight and losing my cheerful disposition.

He quickly found himself flat on the cot as I tackled him into the ambulance, landing one leg on his hip and one arm on his chest. I'm not entirely sure it was one maneuver but I would have loved to see the video.

As we're struggling now in the ambulance, as if by stealth, a sea of blue rushes the back and there are no less than 3 boys in blue saying and doing things that I can not. They have him four pointed and are able to clearly shout over the rest of the commotion outside where I can make out at lest 2 more officers dealing with mom and the girlfriend.

I look at my partner and share a look of, "Holy s*it, did that just happen?”

I took off my duty jacket and took a deep breath throwing it to the bench seat in frustration, suddenly feeling the strain in my shoulders and legs from holding him for what turned out to be 4 minutes against that gate.

The officer looked to me and told me he was impressed I didn't fight back. What I had taken as staggering towards the ambulance, they had seen from afar as him struggling and swinging elbows, all while I'm walking behind him.

The final part of our tale, Round 3, will be covered tomorrow morning, Friday as a perfect You Make the Call.

Tuesday, February 9

From the Archives...Bubba's Bad Temper

Another co-worker recently reminded me of when she and I met Bubba one night, leg wrapped in a towel, tied with twine and an attitude.

Originally published June 25th, 2009

The next 3 posts will cover 3 distinct parts of a rather interesting job.

Round 1 - Tblog mediche Dispatch

1:15 AM and the MDT tells me you've cut your hand. It also tells me you're in your twenties. It doesn't tell me if you're seriously calling 911 for this. I assume you know more than I do about who needs an ambulance and away we go.


A man has accidentally cut his hand.


This was a perfect storm of mystery, intrigue, alcohol and lies. The building is older and has a large partial S staircase leading from the street level to the first floor door. So when we start our trek up the dark staircase, the front door is out of our sight above us and to the right. I stood there at the bottom of the stairs, tired already from the first 16 hours of the shift, waving my arms at the motion sensor light that, apparently, has yet to be installed. Warning flag #1.

The door is open and I hear high pitched voices speaking, nay shouting, in a language I do not understand. As is habit I scanned the floor for blood. I see none. In the next room is Bubba. (See Glossary of Terms)

Bubba has his pants half way down and has a towel tied to his thigh with twine.

"Hi there."I say, hesitant to put anything down quite yet.
He mumbles in response. Even just this slight mumble sends a waft of alcohol breath my way that would have caused me to fail the brethalyzer right then and there.

He's telling a story about opening a can of oysters and missing, hitting his leg. Then, after a few questions he tells a different story about how he got cut. All the while I'm telling him I know he is lying. And all the while the mother and the girlfriend are shouting and won't leave the room until my associate for the day finally convinces them to give us peace and quiet.

His leg is cut, not his hand:warning flag #2.

Using my Happy Medic skills we've convinced Bubba to come to the hospital to have the 5cm wide 2-3 cm deep wound from the chef's knife examined.
Oh, did I skip that part? After arguing with the landlord Bubba thought it would be a good idea to get wasted drunk, grab a couple of knives from the kitchen and wave them around like a child demanding more dinner. Darn it if those things are sharp when you get a little too animated.

His mother and his girlfriend, who hovered over my discussion with Bubba in the room are still shrieking in their native tongue and Bubba is trying to shout back at them as I'm guiding him towards the front door and down the stairs.
Quick aside, the wound is wrapped, not bleeding and he flat out got angry when we tried the chair. Warning flag #3.

Halfway down the dark stairs I have my hand under his arm to help him balance, as I offer to everyone I treat. I have Bubba in my right hand, one step ahead of him and the electronic PCR in my left. I looked away to check the bottom steps. When I looked back up:warning flag #4, a swinging elbow coming my way.

Coming soon - Round 2 - the Struggle

A Seat at the Table

Buried within all the excitement of the premiere of the Chronicles of EMS Reality Series is another premiere I'm proud to be a part of.

Over the years EMS has been serving their communities we seem to be finding ourselves out in the cold when budgets are doled out or reimbursement tables adjusted.  The practitioners on the street, in the patient's bathroom, bedroom, living room, deepest darkest days are largely ignored when industry heads meet to discuss where the trade may go.

They've talked of minimizing standards to maintain a constant flow of low paying jobs and EMTs eager to step on the gas and run the lights and sirens.  Study after study showing one way is wrong so another can get a bigger market share.  All the while our pagers are going off and alarm bells are ringing.

If we're lucky enough to have a voice in the discussion, we are looked at as an afterthought.  A nod and a smile greets our suggestions for improvement, often with a "we tried that before, it didn't work" which is the EMS version of a pat on the head.

Various committees and organizations sprung up with a spot for us, among dozens of others, making sure we had no chance to be heard.  EMTs and Paramedics were never given a seat at the table.

So we made our own.

Social media has us sharing ideas and concepts in a way they never saw coming.  Research can be done from home instead of at a far off conference of owners and Chiefs all striving to prove themselves as having the best system.  We can now call their bluffs, and they can call ours.

A Seat at the Table takes one element we discovered while filming the Chronicles of EMS Reality series and expands it into a format rare in our industry: Video.  This element was the civil discussion of differences by street level EMS personnel who took the time to comment about what Mark and I were learning from one another.

There are plenty of EMS videos available for viewing online and by purchase, but never before has a filmmaker with a vision and a background in EMS taken up the challenge to document what we're talking about.

Take a look at this snippet Ted Setla and I shot to explain to investors the power of Chronicles of EMS:

Chronicles of EMS - The purpose from Thaddeus Setla on Vimeo.

The Chronicles of EMS:A Seat at the Table is a table top discussion program filmed in the round and is scheduled to include as many people involved in the future of EMS as we can find.

Each time the Chronicles team travels, A Seat at the Table will be close behind to take advantage of the unique people we might meet and want to hear from.

Not only will we be sharing ideas, but getting answers to questions from those in charge of where we're all going.  Mark Glencorse and I will be there but you will be as well, following each episode as it is filmed HERE in the ustream chat room (scroll to the bottom). When you listen live to the filming, Mark and I will be monitoring your comments and questions for the panel and including them in where the show goes.

That chair you're sitting in will now be at the table, a voice in where our young profession leads.

Watch the Chronicles page for updates about filming in your area and if you want to be in studio with us, let me know.

Bookmark the link to the Seat at the Table page as upcoming episodes, topics and guest lists could change suddenly as we're sent all over the world exploring how EMS systems operate.

See you there.

From the Archives...for the heart attack...

With the Chronicles of EMS premiere racing towards me I find myself distracted in my writings of late, so I wanted to share some of my favorite posts with some of you newer readers.

This one comes from the very early days of my writings and still is a bit edgy, but I see the partner I had on this run a lot now and we still laugh about it.

Originally published August 3rd, 2008

You called 911...for the heart attack...?

blog medic

Another run in the middle of the night to a local residence hotel. You know the kind of place. Seedy part of town, lobby looks like a garbage sorting station, complete with dirty employees. We rarely carry equipment without a plan on never putting it down and cringe about having to clean our boots afterwords. We're met in the lobby by a rather clean gentleman wearing headphones who waves us over like he knew we were coming. I can tell by his almost new shoes he is not a resident, nor has he been in town long.

"My heart is just beating away."Usually a comment from a citizen like this elicits my compassionate response of, "Can you be more specific?"but on this morning at 3:30 and on our 20th run of the 24 hour shift, I had lost my cheerful disposition. In response to the comment, "My heart is beating away"I responded, "Mine too. Do you have an emergency?""I can't sleep,"he responded after a slight pause.”Me neither,"I shoot back getting annoyed. Not annoyed so much at the fellow who called us, but that this conversation is occurring in the lobby of the garbage station like residence hotel. But be careful, if you get these folks outside, they think they automatically get a ride, so keep them on defense. After his, "I can't sleep"complaint crashed on take-off, he asked why I was so mean. I explained that there could be a baby choking or someone being shot who needs us but if he can tell me what the emergency is I can let him know how I can help. "I need some food, man, I'm broke.""I have a job,"I reply, "You need to come up with something better. Maybe this line works where you're from but not here.""How did you know I'm not from here?"He wondered out loud while I moved towards the door. "Wait, can you give me a ride to the bus station or a shelter or something?"I moved towards the heavily fortified Manager's window in the lobby of the residence hotel we were in and knocked on the window. A sleepy man who may have been speaking a form of English I'm not aware of became visible.”This guy needs a room, how much?"I ask. "Him stay 1 hour? or more to day? $10."I look over to the fellow who called us and motion towards the window. "You can get a room for the rest of the morning or keep that money in your pocket and call whoever you left behind wherever it is you're from and beg forgiveness and go home.”


The gentleman considered my words, put his headphones back on and stopped talking to us, just standing amongst the trash, waiting for something to happen. I asked if he wanted an ambulance to take him to the hospital and he gave me the universal one finger signal for "Go away.”

Friday, February 5

Fire and Rescue, UK style

My EMS adventures in Newcastle upon Tyne had come to an end and I had but one full day left in England.  Swalwell Station Manager Peter Mudie has arranged for me and Mark to take a bit of a tour of the capabilities of the Tyne and Wear Fire and Rescue Service, so we're up early and he's taken us for a road safety class.

Not for me, thank goodness, but for a group of young drivers to impress upon them the importance of not drinking and driving.

Many of us have been to these presentations before.  A middle aged expert prepares what to them appears to be a hip multi-media presentation and the attendees seem less than interested.  I was the same way at 16, we all were.

Enter the Happy Medic and UKMedic999 and the class is now wondering what just happened.

The presentation was actually one of the best I've seen including some racy videos that in the end have a message about driving safely.  The kids were really paying attention then.  Mark and I had a chance to impress upon the gathered youth the importance of seat belts and driving safely. I think my "accent" kept their attention more than my content.

[caption id="" align="alignright" width="334" caption="Even the locals were cold. Mrs HM knit me two hats, so I shared."][/caption]

Then it was off to the yard behind the station for an extrication drill to show the new drivers what happens when cars collide.

Set up down the hill were two cars and two students were chosen to be the victims.

To say it was "balls cold", as one student put it, would be an understatement.  I'm a 6th generation Californian, 50 is cold for me.  This yard was cold.  Wind blowing, snow falling and me with no gloves.

The kids watched as their friends shivered in the cold while the fire appliances pulled up and began their task.  I mentioned in passing to the instructor that I would have let the kids go back inside and he suddenly had a point to make to the youth suddenly more interested in each other than the hydraulic tools freeing their friends.

"AYE!" He shouted to the huddled, hooded forms, "You're here wearing your coats and gloves, hats and whatnot, but what if you were heading back from your mate's place and were wearing only a shirt and crashed?" He was moving around in front of them, almost pacing like a drill sergeant, "Laying in the snow, cold, tired and hurt?  You wouldn't last very long would you?"

He had their attention the rest of the morning.

The extrication was straight forward with the only difference being the use of the smaller ladders to brace the car on it's side.

After a lunch cooked by the station's french chef (Yes, the chef is not a firefighter) it was off to Tyne and Wear Fire Headquarters.

What an impressive building and training ground they have!

A grand foyer greets the visitor and many small groups of men are sitting in plain clothes discussing this and that.  One of them, the only one wearing a shirt and tie sees my SFFD Firefighter/Paramedic jacket and does a double take.

As I surveyed the enormous complex I would assume candidates are intimidated when they enter to get their employment packets.  Peter led Mark and I on a brief tour of the lower level and the man in the tie wandered over and said hello.  Just a casual greeting, he seemed like a regular guy in a sea of white embroidered uniforms and street clothes.

[caption id="" align="aligncenter" width="552" caption="Chief Bathgate, Yours Truly, Peter Mudie"][/caption]

The man in the tie wandering the lobby is none other than Iain Bathgate - Chief Fire Officer for Tyne and Wear.

blink. blink.

He offered a hand and I shook it.  There I was in my uniform shirt, but buried under a sweatshirt and a jacket.  Had I known I was going to meet the Chief I would have at least donned my cap and tie to show respect.

Turns out he was more interested in the back of my jacket than what wasn't around my neck.

"You do both then?" he asked me.

"Not often at once, but yes, I am proficient in both skills" I replied, wondering if I should go into further explanation.  As we spoke the other men were taking interest in the fellow with two titles on his jacket their Chief was talking to.  He immediately suggested a tour of the training grounds, something his face glowed about, he was proud of it.

Through the main lobby and out another set of large glass doors was their training facility, easily 5 acres and including a wide variety of props.

11towerThere was a standard training tower that, since once at the top one could peer over to the automobile manufacturer test track next door, was rotated and modified to keep wandering eyes away.


Next to that was a high voltage power line tower prop for high angle rope drills.  Under construction nearby was a large two story collapse house that can be dropped and rebuilt quickly to simulate rescues.

A number of burn buildings stood ready for recruits and in service crews alike, one of which was in service when we visited.

But the piece of equipment that caught my eye as special was their train rig.  Over behind the airplane prop and the piles of wood was a full size train car half in a man made tunnel. 11tunnelI wish we had one.

Half way through my tour, Mr Bathgate dismissed himself and went back to running what appeared to be a well funded and well respected organization.

Mark, Peter and I finished the tour and the Department had a photographer come down and snap a few pictures of us in front of some of the appliances.  then a few minutes later she rushed out with a stack of nice photos for me and Mark to remember our visit.

The only comments Mr Bathgate made regarding the wording on my jacket was, "Oh, we'll not be doing that here" which is something I'm not unused to hearing from the Big Red Machine.

Same System, Different Country.

I've got a few more posts worth of observations and anecdotes that I'll be saving until after the Chronicles of EMS premiere on February 12th.

Thursday, February 4

EMS Today in Baltimore

Thanks to the Chronicles of EMS, both Mark Glencorse and I will be attending the JEMS EMS Today Conference in Baltimore, Maryland, March 5th and 6th.

It's a big deal for us to be able to spread our message to as many people as we can and there is no better way to share ideas than face to face.  Even though we can communicate here in the internets machine, Mark and I didn't really see what each other meant until we stood shoulder to shoulder in each other's systems.

Since it will be a little while until we can get to everyone's systems and learn from everyone how best to deliver EMS, heck even what EMS means anymore, we'll travel as much as we can to meet you and keep the dialogue open.


That's where our sponsor ZOLL Medical comes in.

SFFD Zoll Rep Roy Kniveton was kind enough to give the Chronicles of EMS team a run down of things coming from Zoll and let us put the new E Series through some quick tests.  Not any of that scientific lab type stuff, but medics dragging it around a room type tests.  Roy even offered to let the 100' aerial ladder truck run over it to show it's durability.

The truck officer declined the request.

But aside from coming in and letting us see what was new, Roy actually listened when we told him about our growing following.  He was genuinely interested in the EMS 2.0 movement and did some quick searching to see what we were interested in getting from our equipment in the future.

We must have done something right because our near future included a generous sponsorship in our pilot episode and flying Mark and me to Baltimore for EMS Today.  We will be Zoll's guests at their booth and we're looking forward to meeting all of you and answering questions about the Chronicles show, new concepts coming in social media TV and anything else you want to talk about.

I've never had anyone fly me anywhere before.

And to EMS Today no less.  Check out the web page HERE and look for JEMS Editor in Chief AJ Heightman to wander in to give you the details on all the exciting things happening around me and Mark.  Yes, there will be more than us ruggedly handsome frumpydumple fellows.

If you get a chance to make the premiere of the Chronicles of EMS in San Francisco on Feb 12th, we'd love to have you, sign up to let us know you're coming HERE.  And a special thanks to and AAM Consulting (Randy Africano) for sponsoring the premiere event at the Hotel Frank.  More about them soon.

See you in SF.

See you in Baltimore.

Wednesday, February 3

For the Paramedic Students...

My name is John and I am 63.

In just over 3 years time I'm going to be driving through your jurisdiction just as you are sitting down to your first meal in 12 hours.  As your order hits the counter I will experience an odd tightness in my chest and dismiss it as gas.

When you take your first bite my wife of 35 years will watch me clutch my chest and stop the car on the side of the road.

Just as you begin to think your bad day is finally slowing down, the worst day of my life, and possibly the last, has just begun.

I've slumped over in the car, releasing the brake pedal and the car drifts into a signpost, discharging the airbags.

My wife is hit by the passenger side airbag as she is leaning over to help me, noticing my unconsciousness just prior to her own.

A passerby has stopped and is now describing a motor vehicle accident to your dispatcher.

Lunch is still warm in your hands when your radio alerts to the accident.

You are tired.

You are hungry.

The kids have been keeping you up late.

The rent is past due.

Big deal.  I'm about to die.  While you're cursing me walking to your rig, my MI is moving and my wife's head injury is complicating what is already going to be a difficult airway judging by the amount of teeth on the floorboards.

As your rig negotiates traffic, my respirations are rapid and shallow, my wife's now non-existent.

When you pull up to the scene I need your A game.  I need you trained to the point where what you are about to do comes as naturally as breathing, because we're having a bit of trouble in that department.

This is not about you.  It's about me.  It's about us.

So back to your studies, we'll meet again before you know it.