Wednesday, March 31

Happy Trails Happy

Our beloved ever smiling mascot here at HMHQ, the Original Happy Medic has arrived for his last shift.

But, like we do it here, the new guy is standing by to step in so Happy doesn't have to take any runs he doesn't want to.  He'll also cover dinner so HM can enjoy one last uninterrupted meal before heading off into retirement.

Our mascot was born of necessity, some of you early readers remember the pre-Happy days when a blog called emsfun appeared on blogspot.  No names, no logos, no ads, no BS, just me and my thoughts.  The therapy experiment worked well and caught a following as I was catching onto other fire and paramedic blogs and websites.

When EMS United, Firefighter Nation and JEMS Connect started to really grow about a year ago, I needed a unique avatar to use and Happy was it.  From there he just started taking over.

Twitter...use Happy.

Facebook...use Happy.

Zazzle...Use Happy.

It just grew and grew and through it all he was there, always smiling.

We changed his jacket, his helmet, his T-shirt, ditched the unibrow, kept the nose and whitened the teeth and he stayed.  Few would go through such heavy changes, but he was and will always be a champ.  So come on down Happy, off the banner and take a break.  Enjoy your last shift, we've got the new kid starting in the morning and you'll be up to the Angry Captain's in no time tomorrow, relaxing with a Jack and Diet Coke and swapping tales of the days of open cabs and hip boots.

You will be missed.

[caption id="attachment_1854" align="alignleft" width="171" caption="Happy Medic New Hire Photo"]Happy Medic New Hire Photo[/caption]

[caption id="attachment_508" align="alignleft" width="154" caption="Happy Medic Today"]Happy Medic Today[/caption]

All the King's men


That's what we could have done differently.

"Witnessed arrest" is something you never get used to.

You can move quicker out the door, they could have called sooner, but when you get that gut feeling that the final moments have already started all you can do is anticipate the next 5-10 minutes.

All the while hoping the watching family understands why their loved one was alive when you got there and not when you left.

Then explaining to the ER docs that they were indeed conscious and talking in between the 40 breaths a minute, then lost visual focus and you watched the monitor go from 130 to 40, then to nothing.  Nothing at all.

Between the responders caring for this imaginary person there were over 70 years of ALS experience and duplicate state of the art tools and medications, procedures and techniques.

It happens, only when you least expect it.  So expect it.  It makes it easier to explain to the BLS members why your salary, fancy education and expensive equipment was useless to intervene in time.

Be safe.

Tuesday, March 30

Peek a boo I see you

blog engineOne of my 101 things your Fire Department wishes you knew widget is one about lying to me.  I do this all day long, I have seen it all and what you're saying isn't stirring the kool aid.

Oh how I love to have these kinds of conversations with my clients.


Just like you saw in Episode 1 of CoEMS, Chest pain at the pay phone.


Although our company is most often in quarters when the bells ring, we were on our way home from shopping this particular morning and it was raining.

When the call came in we were amazed we were not only a block away, but could see the pay phone in question.  But alas, there is no one at the phone to receive my assessment.  But he saw us alright.

You see, the pay phone does not have shelter from the rain, but the gas station across the street does and he's running as fast as his little legs can get him, almost getting hit by cars as he goes, and dives into the dirt and bushes near the edge of the gas station, amidst a number of recyclables.

We pull up and exit, wondering why he ran, but knowing why.

"Sir! Sir, did you call 911 just now?" I ask.

He remains still, curled up into the fetal position and holding his eyes shut tightly.

"We saw you run from the phone to here, we know you're awake."


At least we're not in the rain.  I suggest to the officer that we better have the police dog come by and make sure this man is alright, something I've always wanted to try, but the opportunity never presented itself.

Knowing how I think the Officer lifted the radio to his mouth, but didn't key the mic.

"Yeah control, we need the K9 unit at this location,"

"NO DOGS!" He's awake and shouting at us.

"Hi there, did you call 911 from that pay phone?" I ask noting he is in no distress I can see.

"I need my medications, they were st-I took them all.  All at once, I need a psych hold." His mouth is racing faster than his mind and all the magic words come flying out in one quick blurb.


He refuses the free ride to a shelter we provide and also refuses to tell me where he is from, "Here" is how I know him to be lying, and he insists he took all his medicine at once in an attempt to hurt himself.  But this is when a good practitioner goes down that road, because you never really know.

"What did you take?"

"Morphine, a lot of morphine."

"How much is a lot?" Comes the voice of the transport unit, now approaching from over his shoulder, listening to the conversation.

"1600 milligrams."

I would be lying if I said we all kept a straight face.

"I'm sorry, I didn't get that.  Could you repeat it please?"

"I took 23 60 milligram capsules, I could drop dead any minute."

Gathering my composure, and watching the others do the same, I asked him when he took all these super morphine capsules and his answer will not surprise you.


After 5 minutes of trying to convince him to get into a shelter, the transport unit decided there was no way to rule out the ingestion so away they went.

We gathered our things and went back in service just in time to catch a run for someone who needed ALS interventions right away.  And that's no lie.

Monday, March 29

A retirement...of sorts

Your pal Happy has reached a point in his career that many a firefighter and paramedic dreams of.  He has reached retirement.

No, not ME.  Him.  That little cartoon fellow that adorns my avatars, logos, banners and the like.  He was photoshopped long ago when I needed an anonymous face to go with the blog of old.

He has changed a lot since his days as a probie, first appearing in a crude version of a new header at the old blog site.

Happy Birthday Happy Medic

From there he was tweaked and changed, colored and altered into the image you see now all over the interwebs.  The same image my daughters have grown up with, often at the top of whatever web page daddy is looking at while ignoring them.

Happy Birthday Happy Medic

He was me for a good long while.  Through times when I didn't, couldn't, let you know who or where I was.  Happy, with his overly expressed smile and shiny lid, went a long way in conveying my emotions when I think about the job I do and the joy and therapy I get from writing these posts.

He has smiled back at me from a lonely screen in the computer room of a busy firehouse, a laptop in the early morning hours after my youngest was born and recently he adorned the business card I gave to the Chief of FDNY EMS.

Happy has always been there for me, and always will be, but I regret to inform you his time has come and gone.

Soon, Happy will retire and go to live with the Angry Captain.  He is not gone, only passing along what he knows to the new guy.

Oh yes, there is a new guy.

You see, long ago I wanted a Happy Medic that reflected who I really was and how I really feel, but never had the means or the reason to do so.  The Happy you all know now came along because of a creative internet search and some even more creative photo shop work.  He was never mine.  He was never me. He was hired because some new forums were starting and I needed a brand, and fast, and he fit the job description.

Keep in mind that the life of an internet mascot is not unlike the years of a dog.  They pass faster than our own and we miss them when they're gone.  Terribly.  I have given this retirement long and hard thought and more than a few pints and know it is for the best.

So raise a glass and toast the retirement of the little cartoon you know as the Happy Medic and wish him well in his retirement.

His last shift is Wednesday March 31st and the new guy will be along shortly thereafter.

Where is the new guy from, you ask?  Oh, if you follow this forum you already know the answer to that.

Take care, Happy.

[caption id="attachment_508" align="aligncenter" width="185" caption="the First Happy Medic 2008-2010"]the Happy Medic[/caption]

You Make the Call...Day Off...What Happened

ymtk-140x200It figures.  Finally a day away and the job finds you.  Well, at least everyone evacuated, that's a plus, but when no notification appears to have been made to the Fire Department, soemthing should be done...but what and by whom?

First, let's walk this back a few Departments and talk to the young kid who was an Explorer scout in a sub-urban system:

  • I can't do anything because 1) I have no gear with me and 2) all the payphones are inside, so I can't call it in.  Maybe someone here has a car phone they can use.  Keep everyone outside until help arrives.

Thanks kid, and this is likely the most common response aside from pulling out the cell phone and calling 911 these days which, to my surprise no one was doing this particular day.  One bicyclist stops to fix a flat and 5 people report him unconscious but 1000 people listening to a fire alarm do nothing.

Now skip to the rural volunteer firefighter of old and let's see what he does:

  • My pager is on my belt, but my radio and gear is always in the truck.  I'm on the radio calling in the whole South region of the County and getting bunkered up and to the head of the museum to investigate the panel, then radio ahead my findings.  Since there is only a paid driver on the engines around here I'll be able to get an airpack no problem.

Again, a go getter that guy, recently dropped out of college to get more "street time."  We'll see how that goes for him.  But a fair response in a volunteer district.  No point running back to the car, driving to the firehouse, then returning.

And now to the paid guy in the public safety system, let's see how he handles it.

  • I don't carry my radio or gear off duty, but we're a small community, so I'm getting my badge out and asking what is going on.  Judging by the delay in response the cross staffed engine is likely out of service transporting someone into town in their ambulance.  It happens.  If I can I'll find out what is going on.

Not a bad solution, at least for peace of mind, see if they'll tell you what's happening.

So, you ask, what did Happy do?

  • The first 15 minutes were annoying to say the least.  Even the 3rd due on a 3rd alarm would have made it by then and the alarm was still ringing which meant only one thing: They couldn't reset it alone.  I grabbed my handy iphone and called the non emergency dispatch number and asked if they had received an alarm bell at the museum.  He checked the board and found no incident and asked if I wanted it rung out.

  • Just as he asked the strobes stopped and the bells went silent.  I told him to hold off, I'll find out what's going on.

  • ID came out of the wallet and with phone to ear I identified myself and asked if they had an emergency.

  • "No, it was a smoke detector in the kitchen, just a false alarm."

What do we say here at the Happy Medic when we get answers like that?


Radio, in my other ear, was asking me to confirm what he heard, that a fire alarm was activated by a smoke detector that was triggered by smoke and the location asked the alarm company to cancel the fire department.

The woman who called herself the manager indeed confirmed that information and I simply advised dispatch.  It was just then there was a tug at my pant leg and the 4 year old needed the restroom and folks were already being let back in.

Radio advised me they would have a supervisor come by and speak to the staff about when to and not to cancel a fire alarm activation.

Reasons to cancel it: "I saw that guy pull the alarm by mistake thinking it was the elevator button."

There are no other reasons.

If you said find out what is going on and relay when necessary, you made the right call.

Sunday, March 28

Sunday Fun - Getting Mugged

I carried it on the plane.

I carried it in the pocket of my heavy winter coat, or what they call in Baltimore a "wind breaker."

I had a permanent marker ready as well.

In the booth at EMS Today I had it proudly displayed.

When on the EMS Garage show I had it with me.

Why you ask?

So that if I run into Mike "Fossil Medic" Ward or the Firegeezer I can get the world's first autographed Firegeezer mug.

Yup, Fanboi Alert.

Mark Glencorse caught this shot just as I handed Mike Ward the mug and the pen.mike ward

Thanks Fire Critic for capturing this shot of me and Bill Schumm, the Firegeezer himself.

And so the mug takes it's place amongst my other Fire treasures.  I'll have to order another one to actually drink out of because I am so not washing that one.  Ever.


Friday, March 26

You Make the Call...Day Off

ymtk-140x200Ah... a nice day off with the family.

Today you've decided to grab the kids and head into the City for some time at the Museum.  The crowds are thick on a beautiful spring morning and you navigate them with the skills of someone who has been through worse.

As you stand in line with another 250 patrons, wouldn't you know it, the fire alarm  begins to sound.


Grabbing the little ones you make way with the others towards the exits and are rather impressed with the way folks are actually leaving the building.  On the way out, your little one asks if the fire trucks are coming.  Doing the quick math and having responded to an alarm at this particular building, you know the first due engine is only minutes away so you hurry along to the front of the building.

Outside everyone is asking everyone else what they think caused the alarm.

"Some kid playing with the alarm" someone says.

"What if they just needed to evacuate the building?" someone else asks.

Looking at your watch you realize the first due engine is past due and the alarm bell is still ringing.

10 minutes pass.

Then 15 minutes pass.

No sirens, no engine and everyone is still outside.

Do you step forward and if so, what do you say/do?  This is your response area on your days on duty and something isn't right, but you have the family in tow.

What do you do?

You make the call.

Wednesday, March 24

Rose by any other name...

Recently I was given an invitation to become a contributor to paramedicine 101 a great blog resource that I read often, but never linked to in the sidebar for reasons only my alien abductors can tell you (sorry, watched The 4th Kind at the firehouse last night).

So I finally get to start a post this way...

Also posted at Paramedicine101

The title is not a typographical error or omission, I meant it to play on the line from Romeo and Juliet.

In the Shakespeare play, Romeo proclaims that his love for Juliet transcends their family names and political differences by saying

"...That which we call a rose
By any other name would smell as sweet."

And this line certainly conveys that feeling, as does the rest of their exchange, but try calling Rose, your 78 year old patient, by another name and let's see if she stays as sweet.

It can not be repeated enough so I will keep repeating it until I either snap and become un-Happy or until I stop hearing certain words at the scenes of emergency responses.

If you choose to use profanity I have issues with you.

If you use inappropriate terms to describe ethnic groups, I have issues with you.

If you can't learn and use your patient's name then we not only have issues, but you are lazy.

Things I have heard on scenes throughout my travels are terms like Pal, Buddy, Honey, Sweetie and my least favorite, Dear.

Let me assure you I have fallen victim to the occasional frustrated or suddenly confused Buddy or Dear comments, but constantly using such terms only proves you don't care enough to even learn their name.

And another point of clarification, while we're on the topic of names, your patients are not expected to remember yours. Notice I said remember, not learn, because of course we are introducing ourselves to our patients, then using the names they tell us to address them.

Aren't we?

When entering a scene keep in mind what you look like. Uniformed, carrying bags, wearing gloves, possibly even a mask and asking questions. Not to mention all that ruckus outside. That's scary. Not just for the kiddos, but everyone.
Now imagine the confusion when I come racing up the stairs in full turnouts fresh from a fire call doing the same thing.

So when you approach these folks, put them at ease from the first words out of your mouth.
I prefer a simple phrase like, "Hi there" or "Good (afternoon, evening, morning)" just to remind them I'm a human being too.

Now to the tricky stuff that comes from experience, the introduction.
"What's wrong?" is a poor opening line,
"What happened?" can lead down roads not concerning the present Chief Complaint, and
"Why did you call 911?" often leads to people looking away and saying "um..."

Start by offering a hand and simply saying hello, then your name. When they reach to shake in introduction not only do you have an ABC assessment complete, but you make them smile and feel at ease.

Now remember the name they give you.

Repeat it to them.
"Hi Jessica, how did you end up on the floor today?"
Write it on your glove if you must, but remember it. Use it. Call them by it.

If Jessica introduces herself as Mrs Johnson, you call her Mrs Johnson until she tells you otherwise. Not Jessica and certainly not Dear or Sweetie.

Not using a patient's name when speaking to them shows not only disinterest in your patient but disinterest in your profession.
If you lose the trust of your patient then all you are is an expensive ride.
Earn their trust and do it from the beginning with a smile, an offer of a hand, a hello and referring to them by their name.
It's a little step that goes a long way and will not get you noticed when you do it, but will stand out glaringly if you don't.

Imagine if Juliet showed Romeo the amount of interest many in EMS do and called out,
"Buddy, Guy, oh where for art thou Pal?"

I think Romeo would have turned tail and found someone that could at least remember his name.

EDIT - 3/26 - A fellow writer posted a comment about his thoughts on this topic 2 days earlier, which addresses some interesting "rules" in the UK pertaining to addressing clients, citizens and patients.  Read it HERE

Tuesday, March 23

Where'd who go?

blog medicBehold the car into the tree.  Behold the car full of teenaged girls saying something about a motorcycle.  Alas we found the bike.  Where'd the rider go?


Units are responding to a reported major MVA, entrapment, car vs tree.


And as usual, the tree won.  But this isn't a straight forward tale of a car accident, extrication and treatment.  No, no my friends, you all know this forum is about the unusual, so follow along as we piece together what happened.

Tonight the girls are out to have a good time, cruising towards the club district, jamming the tunes as the kids say, when they enter an intersection at a decent speed.

Something impacts the car causing it to veer onto the sidewalk and come to rest, rather violently, around a tree 40 yards down the road.

The responding engine approaches from the side the car was going to, not coming from and has radioed for assistance while they begin assessment.

Me and my ride are coming from the other direction, the same as the girls were traveling.  Not one to get tunnel vision I always make it a point to scan the road before an accident for skid marks, body parts, you name it, and that is how I spotted the motorcycle.

We stopped for a brief moment and looked for a rider to accompany the bike since there was a trail of fluid from the intersection to the bike it had not simply been knocked over.  I see no one and the buildings are so close to the street that had he hit one, we'd see him.

So we choose to approach slowly, looking with the spotlights for the mysterious rider, but have no luck so make contact with the crews at the car.  It is here where we hear multiple stories from the emotional passengers about the man on the hood of the car.

Hoping I had not missed something so obvious I take a quick peek and, thankfully, no one there.  But my brain starts to process the distance from the intersection and the likely speed of the car into the tree and it occurs to me.

He was ejected from the hood.

Sure enough, 30 yards back the way the engine had come, partially wrapped around a sign post is our bike rider, helmet now off, relaxing up on one arm.

"I was wondering if you guys saw me, I'm pretty sure me leg is busted." he tells me as if mentioning my shoe was untied.

He had some significant trauma and we took full precautions, even so far as removing his now almost useless re-enforced riding jacket in one piece, per his request.

We landed the helicopter a few blocks down and got him out fast.

I found out later from the nurse who took him in that he was hit by the car and felt a searing pain in his leg, then found himself trapped on the hood of the car as the girls began to scream and the driver lost control.  Had he been even 1 foot in either direction he would have been pinned against the tree or ejected and likely run over.

In the end he was lucky to have been hit the way he had.  But it still makes me smile when I think about the police officer/EMT holding the collar who, when asked where the man on the hood went, responded,

"Where'd WHO go?"

Monday, March 22

Chronicles Schedule

chroniclesblogUpdates for April are up at Chronicles of EMS

Have a look.

The PD to FD Translation Book

A little while ago I told you about the hidden meanings when PD talks to Fire. Now for the flip side.

When Fire says:
"We need this road closed!"

What they really mean:
"Would you mind blocking those cars with your body instead of mine?"

When Fire says:
"Can someone hold this IV?"

What they really mean:
"If you're going to gawk over my shoulder at least be useful."

When Fire says:
"Advise when the scene is safe."

What they really mean:
"The MDT says psych patient and we just showered after PT. We're not in the mood to wrestle."

When Fire says:
"There is no medical merit here."

What they really mean:
"I have other emergencies to attend to, so if you can do all the paper work on this one, that's be nice."

When Fire says:
"Is he in your custody?"

What they really mean:

"There's no reason for him to go to the hospital, he can stay in jail."

When Fire says:

"Can you relocate your cruiser to the north and close the road?"

What they really mean:

"That little thing your car is parked in front of is where we get the water to fight the fire.  Could you move it? kthxbai."

You Make the Call...Stairway...What Happened

ymtk-140x200We had a patient very similar to THIS not long ago, or I didn't, depends on your interpretation of the legal nightmare that is HIPAA, but since we're learning here, I claim the education exemption.

He fell down the granite stairs, as evidenced by the drops of blood as we came up.  Why is it folks refuse to stay put when they might actually be injured but are held down by bystanders when nothing is wrong?

Up the narrow stairs we find a man in his 80's with a head injury and a flail section. Double whammy.  In real life we had room to get the board around him and lay him down for the journey.  It was not easy and the issue of placing the board uphill or downhill was a quick learning moment for our EMT student ride along.

But when we returned to the firehouse, I wondered aloud what we would have done if we had not been able to fit the board.

Some possible answers included:

  • Walking him back to the point of injury with C-collar in place.  No, not a good idea.

  • Using the stairchair and buckling him in. Could work, and quick.

  • KED and carry, not much room there unless we include the stairchair. Could help the flail section as well.

  • Load and go, don't spend time packaging, he needs definitive care.

All certainly good options and faced with a unique presentation we need unique answers.

But let's not spend too much time in the stairway throwing out suggestions.  Find a solution and go with it.

If you said take precautions any way you know how, you made the right call.

Sunday, March 21

Sunday Fun - The Art of Paul Combs

The name is familiar and when you see his cartoons in the pages of Fire Engineering Magazine, they make you sit back and really think about your job and how you do it.

I have always enjoyed Paul's no nonsense approaches to fireground safety, seat belt use and wearing your equipment.

But it was this image that caught my attention in a different way:

Please take a moment to browse the amazing images at Art Studio Seven, from the Fire Service Political Cartoons, to the illustrations and drawings.

But when you look at the cartoons don't just read the words but take a few moments to explore the entire panel.  There is so much more every time I go through.

Thanks for sharing your talent, Illustrator Paul Combs.

And if the Chief wanders by while you're reading this Sunday Fun, show him the site, he'll recognize that signature with the big "O."  Now you guys have something else in common.

Friday, March 19

The light bulb moment

The light bub moment, when a face goes from confusion, then slack, then completely changes into a smile with a slight nod.

You see it in Paramedic classes usually 6 weeks into cardiology when they finally connect the ECG lines to physical electrical conduction.

It is seen on the faces of our youth as they learn to kick a ball, roll over or tie their shoes.

I saw it recently on the face of a triage nurse at Saint Closest, and all thanks to one of those controversial make-your-own movie cartoons.

The details are unimportant so I'll just tell you that I had accompanied one of our ambulances to the trauma center and was milling about waiting for the engine company to come by and collect me.

While chatting in the triage area, @Chrismedic wandered in and we shared a hello and a quick photo before telling the staff all about CoEMS.  it was then one of the nurses mentioned a video they had seen online about a nurse and doctor having a back and forth only a nurse could appreciate.

It was then she mentioned she thinks she knows who made it since the maker of the film was called St Farthest, a common name for the botique hospitals on the outskirts of town.

The triage nurse had not been part of the conversation until she suddenly went expressionless saying, "Wait a minute.  just wait a minute.  Saint Farthest...Saint Closest...Oh."

Then the light bulb moment struck as we all watched nodding slowly in a "you can do it, come on" motion.

"I get it!" Her face lit up.  "That's just silly."

You Make the Call...Man Hole Fire...My Call

You Make the CallWell, shoot. When I first got hired our training Captain put up a shot of the Tokyo gas attacks and asked us the two best ways to handle such an incident.  People were running everywhere, others lying in the street.

He let us think about it for a few minutes, then let us in on the secrets to dealing with large incidents.

Option #1 is to reach over the center console while pulling out of the station, grab the steering wheel and pull.  The rig hits the door and you're out of service in quarters, send someone else.

Option #2, if you forgot #1 and found yourself on the scene, was to calmly remove your coat and helmet and blend in with the crowd.

All kidding aside, this is a situation many firefighters will not encounter.  In my area we have large underground electrical vaults that serve as relay points for the City's electrical systems.  More than once these have failed, caught fire, exploded etc.  hey, it's electricity, a thousand different things could happen.

The important question, and the reason I shared this photo of an actual vault fire, was to get us all thinking about that first radio report and request for resources that can establish the tone and response over the next 30 minutes.  they say the first 3 minutes of a large incident can dictate the next 3 hours and I believe it.

My Department also has resources specifically designed and staffed to handle these incidents so I simply have to relay to the Battalion Chief that I have a vault fire and the system does what it has to do.

But, here would be my initial actions if that was not the case:

"Control, this is Engine 99, we are on the scene of what appears to be an underground fire, smoke showing.  We are staging upwind at 5th and Main, establishing 5th Street Command.  Strike a full first alarm and have them respond from the south to 5th and Main."

You get the idea.  The point is to convey what you can without getting too wordy, but get resources rolling, including higher ranks to co-ordinate further response.

I would use the PA to get bystanders away and set up a perimeter, stretching a line part way there to protect persons who wander in if something happens.

That's my call.

You Make the Call - Stairway


The call was simple when it came in, a man has fallen and is bleeding.

As you climb the granite steps, they are narrow and steep and so far each one is covered in spots of bright red blood.  As you step carefully around the spots and up to the third switch back you find your patient standing in the corner, head laceration over the right eye, slurred speech and a wicked flail chest.  He's 83.

He's grasping onto the railings at a turn in the stairs, barely enough room for you to pass by and survey from above.

Similar to this photo from a hotel somewhere, the fellow with the red spot on his face is your patient, just imagine him standing straight up in the corner.  The stairs down around the corner are just as steep and narrow as the stairs here.

How will you deal with C-Spine precautions, if at all?

You make the call.

Thursday, March 18

He got lucky

The following tale is of a guy who got lucky, but not for the reason you think.


Don't you just love when your dinner is interrupted at work?  I do, especially when your bells are preceded by dispatch calling out for units on the air to stand by for a fire dispatch. "Stand by for the box!"


It is the evening and we are first due with the truck close behind.  On arrival we have light smoke showing from the alley between two 5+ story type 5 apartment buildings, this is going to be tricky.

As we pack up the truck is already stopped and I hear the PTO kick in as the officer calls for a ready line and I pull it down and onto the nozzleman's (woman tonight) shoulder.

She advances as I follow laying the line out, irons in my other hand.

The sound of the aerial going up is just below the shouts of people down the alley shouting and pointing at a rear garden apartment with heavy white smoke coming out.

As we set the line for entry we can see it was a small kitchen fire which has been extinguished with a small dry chem can which is now sitting in the doorway.

The doors and windows are opened up to ventilate the chemical and the offending pan is removed to the alley.

As we down shift from working fire to PR mode I notice two folks in their late teens or early twenties who appear to have been hastily dressed.  Hair tossled, faces red.

When the Battalion Chief asked them what happened there was the embarrassed smile and a look at each other.

"I should have waited to start the oil." He says and smiles to the now dozen firefighters cleaning up and helping to open windows.

"Tough way to learn that lesson," the Chief remarks later.

Back at the dinner table we discussed various comments that may have been made in the other room while the kitchen began to burn.

Everyone got out safe and they were able to stay there that night.  The lucky part of all of this was that their smoke detector did not go battery.  Lucky guy indeed.

Wednesday, March 17

You Make the Call - Man Hole Fire

You Make the CallIt's been a quite day at the big house in your Department.  You are assigned to the busy engine and were ready for one hell of a day.  Today it will be quality, not quantity that gets you.

The bells ring and you have been dispatched as a single engine resource to a reported man hole fire in the City Center.  This area has heavy commercial, light industrial and some high occupancy buildings.  You have smoke showing from the firehouse as you pull out.  Convinced there is no way a 60+ foot column of smoke is your job, you are silent on the air at first.

As you arrive on the scene the wind is still, temps in the mid 60s and it is the early afternoon.  Turning the corner what you see is similar to this photo.

Obviously since you are first on the scene the responders in the photo have yet to even be dispatched.  Your driver is uphill and upwind, mainly because he's that good and your crew is still in their seats.

What is your initial report for this incident and what resources will you request, if any? You make the call.

Monday, March 15

Chronicles of EMS: Episode 2

Also posted at Chronicles of EMS .com HERE

This is mainly to get everyone to stop sending me emails on how to watch Episode 2 of the Chronicles of EMS.

We haven't made it yet.

That isn't to say there isn't one, but keep in mind it costs nearly $10,000 to film an episode and Setla Films put together a knockout punch premiere for far less than that.

We have a ton of footage of me and Mark in the fire station, riding the engine and having in depth conversations about calls we showed you.  So in essence, if we put together a second episode from the SF adventure and held it to the same standards I would have to go back into the studio and re-record a lot of voice over to cover set ups and explanations of what was happening, otherwise it would be the Justin and mark interview show, which is currently under the name A Seat at the Table.

You have all been so wonderful in your acceptance and spreading of the first episode and it was indeed an amazing experience to make it, help prepare it and then release and share it with the world.

To put things in perspective, you are all the happy first time parents of this baby, the Chronicles of EMS, and we just rolled over for the first time.

You're excited, the calendar has been marked and you're calling all your friends to tell them what just happened.

Do you want to see us roll over again or start to crawl?

Crawl or walk?

Walk or run?

Run or race?

This is the beginning of a lot of firsts for us and for you the audience.  Feel free to keep emailing your thoughts and concerns to me ( and to Mark(  We not only welcome your comments but demand them because, after all, this is about community above all else.

We made 2000 facebook fans in 3 days while filming and the ning site is still gaining members.

Keep the word spreading and when the next episode comes out you won't have to help us spread the word, just sit back, relax and enjoy.

So, in summation, we're rolling over, you like it and we're doing more and more every day. (Wait until you see what we're trying to do for EMS Expo! I've said too much already)

If you want to see a new episode sooner, get on the phone to your ambulance salesman, equipment supplier and union rep to get in touch with us about sponsoring a trip to your system or a system you want to see.  You'd be amazed what magazines are charging these days for an ad that gets looked at once, then put away.  We offer a part in the future of EMS, all they have to do is think like Pepsi.

...and always very curious

Relaxing with a cup of coffee and the HM juniors this morning, their favorite monkey Curious George came on, got into his usual hijinks and was whisked away holding onto a kite.

When the man in the yellow hat saw him flying away he called out to a nearby child,

"Call the Fire Department!"

The kid raised his shoulders and asked the age old question (which is asked less and less these days),


"They seem to know how to do everything!" And he runs off, gets in his hang glider and rescues George all on his own.

Meanwhile Light Task Force 3 was responding for a high angle rescue along with Engines 1,16 and 43, Trucks 1 and 8, Battalion 1, EMS 1 and Medic 99.

Well, not really, but that is what my mind pictured.  How curious...

Saturday, March 13

Disaster Plan - The last letters you will ever write

LODD LetterIt has indeed been almost 6 months since I last gave you instructions on our Family Disaster Plan.  if this is the first you are reading of it, click on the Disaster Plan tab at the top of the page and get caught up.

Today's step is an important one, but in no way, shape or form should it be your first.

Tonight you are going to write a Line of Duty Death instructions sheet to your spouse and loved ones to read and follow only in the event of your death, at work.

This is different than your living will, which you all have now, right?

This is also different than any funeral arrangements you may have made or hope to make.

In the back of the Family Disaster Plan are two important sets of instructions.  The first is the Line of Duty Injury instructions sheet.

This gives my wife a list of phone numbers at Headquarters as well as who to ask for at the firehouse, "the Captain" and "Daywatch" to get someone who can tell her more about what may have happened to me if she is indeed notified that I am injured on the job.

The last time I got hurt no one called her because I was treated and released so quickly.  But if it happens again and she gets a phone call in the middle of the night, she knows to take a deep breath and relax.  I know because that is how the instructions start.

Here is just a snippet to get you thinking about what to write in yours-

"Well, you got the phone call you've been dreading.  I understand you are upset.  If I got hurt I was in the wrong place at the wrong time.  We'll worry about all that later, I need you to start thinking three hours ahead.  Each decision you make between now and this time tomorrow will set the pace for the coming week.  Take a deep breath and calm down.

I'll wait.


Goto the closet and get one of my work T-Shirts or sweatshirts and wear it when you come to see me.  Be honest if folks ask if you need anything.  Take their help.  They need to help as much as you need it."

It will get emotional when you prepare them for what they might see when a firefighter is injured in the line of duty.  Be honest.  If you dance around topics now it will only create confusion at the most improper time.  End the letter by reminding them that even though you are hurt, it could be worse.

Now, while an emotional wreck, excuse yourself and be alone for a bit and HAND WRITE the next letter - Line of Duty Death Instructions.

This letter is the one they will keep and read over and over and over after you are gone.  Tell them about why you did what you did or chose this job, profession, occupation, place to volunteer.  Sign it, seal it in an envelope and put it in the back of the Disaster Plan.

On the same day, make plans to open the letter the day after your retirement.  Perhaps someplace tropical.

Do it now or regret it later, your choice.


Wednesday, March 10

Having a bad shift?

Let it go, this too shall pass

He looked OK to me...

Words that can get you fired. Others include,

She said she was fine;

His lead II was unremarkable and has had heartburn in the past;

Your anxiety can come from nowhere and leave you tachy, lady of 55 who's mother died of an MI recently;

Damage like this happens all the time, that bruise is normal;

A little smoke inhalation won't kill you, look at me;

Asthma is not going to kill you, go find your inhaler;

The Doc signed off on the AMA so I'm golden;

Babies sleep all the time;

The snow was too heavy;

It was too hot;

I was tired;

I read in a blog that doing that was alright;

Have you seen this funny youtube cartoon?

Point being that there are a lot of rumors, stories and opinions flying about what happens in our business and it can be very hard to find the truth in a situation with 3 correct versions, one wrong version and 15,000 who have parts right.
I have been known to join the fray when it comes to EMS and Fire Departments who do something I like (Tip of the Helmet) and things I don't (Letter in the File) but drawing conclusions from a single source is a bad idea.
Have an issue with a story you read part of on facebook? Before you lay it on thick you may want to finish reading the story, then seek out at least 2 more sources to confirm the facts. If you can not get the facts, use the google to find out who to call to get the facts.

If they call you back, great. If not, then you have to go with what you have, but the impulse to post something you may regret will have passed.

If you are the one facing termination for doing something you knew in the moment was wrong, see ya. If you find yourself on job 21 in 24 hours and know that not writing a chart will get you home sooner, keep in mind that not writing the chart could get you home a lot. As in unemployed.

If just yelling at the guy to wake up instead of checking his blood sugar and other vital signs to confirm it's just Reuben again after another $3 bottle of wine, you yourself could be the one budgeting for the cheap stuff while on unemployment.

Backed the ambulance into another car near end of shift and drove away? Might as well keep driving into the sunset.

We all make mistakes. I make them all the time, but I make sure I'm doing what I'm supposed to be doing for my patients based on the information I have and how that information fits within the laws, protocols and policies I have sworn to uphold. Have I not charted patients? Of course, when it is not indicated. Have I omitted vital signs on my charts? Yes, it happens when you get back and can't recall the BP, so instead of lying I write nothing.

Being able to defend your actions or inactions with cited policy and protocols in front of you goes a long way to easing stress and the impact on your employment status.

In the end we all need to take a deep breath and find the facts about stories we read, especially in the internet age, when opinion can be mistaken as fact on a regular basis.

"Mr Happy Medic is there a reason you did not awaken the man lying in the street who was later found to be in cardiac arrest?"
"He looked OK to me..."
I'd be fired for sure, and for good reason.

Tuesday, March 9

EMS 2.0? Well, yes it is a dream.

In a number of emails I have been asked for an outline or "thesis" about what EMS 2.0 is. There was talk awhile back about a national EMS 2.0 organization to begin lobbying for the changes we all want to see. Others asked me for my suggested education requirements and how I expected a volunteer Paramedic already working two jobs to go back to school to keep doing what they want to do.

I have no answers to those questions.

Sometimes when asked I reply that I have all the answers, I just haven't sorted out what questions they go to yet.

I used the phrase EMS 2.0, and I think Mr Chris Kaiser did as well, because it brings up the image of a reboot, or upgrade.
Many of the Windows 7 features I got are neat, but most of it is based on the same things I liked about Windows 3.1, sure it is full of random errors and can be frustrating, but the system is slowly updating itself.

A few years ago I had had it with my operating system and all the limitations I saw in it and jumped into Linux.
I was under the impression I was savvy enough to make code changes to effect the entire operating capacity of the system. And since I had only a basic understanding of the features I so desperately wanted, I was unable to have the comfortable computing experience I expected. The adventure ended months later with a partitioned hard drive and having to choose an operating system each time it started. Drove me nuts. But those who know how to make it work love it and it works fine.

So when I speak of EMS 2.0, I am indeed aware of the pros and cons of an "upgrade."

Another list of questions I get is about the comparison to Web 2.0, the movement that led to the communities and user submitted content we call the internet today. I recall the early days of FTP file searching by tree late into the night in college, having the entire internet text based as a few html sites began to sprout up. I compare searching roots and file trees then and the "Web 2.0" experience we have now and realize that it is the inter-activity of the internet that has made it a community rather than just a marketplace.

There is an element there I can identify with when it comes to EMS. One of the Medical Directors who came by the booth in Baltimore asked me how he could use blogs to get his Paramedics to accept changing their protocols. I told him he should listen to what the patients his Paramedics encounter need and let that guide protocol changes. Then I asked if his medics had any way of approaching him about changes and he looked as if no one had ever suggested a medic could ever suggest a policy change, let alone present evidence in support.
"An open door and an honest opinion goes a long way in folks feeling like you care about what they're doing," I told him.
"No, I need them to do what I say." he replied and I couldn't speak against that because I am not an MD, nor in his system, understanding his troubles and challenges.

So where does this all fit into the EMS 2.0 landscape?

I dunno.

We need change, we need a new re-thinking of EMS, what it is, what we're doing and why, how, where, everything needs to be re-examined and reformed based on new research, response models, patient presentations and care taker abilities.
How that can happen on a National level all at once is something I would love to see happen, but we all know here are far too many feifdoms, unions, politicians, companies and providers who will fight tooth and nail to maintain the status quo, regardless of the benefits.
There are those who will not move forward no matter what they are shown or told. And not all of them are the old salt medics. Some of the new kids on the EMS block feel they have made it and will just sleep through their refresher every two years and keep drawing the pay check.
Departments will fight to keep licensing requirements low so as not to have to pay their people to seek out education, possibly because the higher educated can draw a premium at the next service over.

From my lofty perch here with my education and high paying EMS job you may think me a dreamer with all this CoEMS and EMS 2.0 talk and you'd be right.
But the Chronicles was a dream a year ago and now we're set to travel the world doing exactly what we want to do, explore what EMS means.
So I'm going to keep dreaming about EMS 2.0 and hope one day I can meet a crew from a department somewhere who both have an advanced education and operate under protocols or guidelines that give them the flexibility to treat, transport or transfer citizens, clients and patients based on what they need, not what they or some future lawsuit want.
I think we can all agree on that.

But how do we get there? We all get there in different ways at different times, hence the trouble in explaining EMS 2.0 to people at different levels of different systems.

There can't really be an EMS 2.0 "thesis" or guide, but more of a mission statement, and that I am thinking about.
So far three main principles come to mind and how to expand on them will be up to you. They will certainly mean different things to different people, and that is one of the things I love about it.

My EMS 2.0 is based on three main concepts.

Using technology to improve our ability to assess and treat,
Advancing our educational levels to not only learn more about our patients and communities, but teach them what we can and can't do.
We have to earn the trust of those who give us the power to do what we do in order to do more.

In short I need some expensive gear, a pricey college education and then let me go do what I've learned and proven competent to do. Exactly what that is will depend on your community.

The future is coming and we as a Profession have a chance to not only make ourselves a respected part of the health care system, but excel in providing care in an innovative manner that can release the burdens the current system is collapsing under.

It is a dream. But it had to start somewhere and if that is all it is for now, I'll take it, but something is happening out there and I want to be ready if my Chief asks my, "What do you think we should do?"

What are the three concepts your EMS 2.0 platform would fight for? Let me know.

Sunday, March 7

Haaaaaave you met Ted?

I apologize in advance for the formatting on this post, I worte it on the plane and wordpress's HTML coding sucks so in the interest of spending more time with my now 4 year old, I give it to you raw.

"Have you met UK Paramedic Mark Glencorse?"

"Have you met Ted Setla?"

I have never before tried so hard to talk to people about something other than getting in the ambulance. It's not easy to be a barker at these conventions.

Paul, who's last name I am either forgetting or omitting for my own safety, from Zoll was the leader of the demonstration of the Zoll Rescue net system, who's presentation was before Mark's and my own.

He had great one liners and provoking questions that made passersby stop and wonder what the guy in the blue shirt was talking about. That was nice.

Just wandering the aisles at a trade show can seem awkward I've learned. As you wander, the folks from all the booths seem to come at you, quickly reading your name badge and asking you some strange question you'd rather not answer.

"What C-Collar does your system use?”

"Well, shoot, it seems to change all the time, why?"and they've got you. And they're good at it, that's why they're there.

At EMS Today Baltimore, the Chronicles of EMS team was invited by Zoll to speak about the reality series and where the movement might go.

Charlotte, our Zoll contact, had arranged for a large amount of T-Shirts to be available to conference goers and they were a big draw. Trouble was we didn't have a space in the booth, or any booth for that matter. Not sure exactly what we were, how we were to interact or what to do, we did what all Paramedics do, improvise and adapt.

A false wall curtain moved, literature stored and a quick ironing of a half dozen shirts up on hangers and POOF! Chronicles of EMS "booth.”

We were in front of the previously hidden storage room for the Zoll folks and they were constantly coming in to get more handouts and materials as they were quite popular.

So Mark and I took position in front of the 5' wide gap in Zoll products and readied ourselves for the storm.

And this is where the really great part of social media comes in.

As faces approached we tried not to look at the name badges, but just introduce ourselves with a simple "Have you seen the Chronicles of EMS, the new EMS reality series?”

Surprisingly, most folks who wandered by said they had heard of it, or seen something about it, and not in that "Oh, sure I'd LOVE to see pictures of your great grand children"way, but in a "Finally someone can explain this to me"way.

So right there in the booth Mark Glencorse had wrangled a power source and extra monitor to show the episode on a loop. And folks took a look and asked more about it.

A 17 year old EMT student from New York State saw it.

His father, a retired Firefighter and social media skeptic saw it.

And they both wanted to learn more about it.

That is huge.

What else was huge, in my book at least, was the number of bloggers who made the travels to gather in Baltimore for the largest Fire and EMS Blogger meet up in the history of man.

At one point a familiar face wandered over and extended a hand and I shook it. The voice that came with it was none other than Ambulance Driver. Before I had a chance to express my joy in meeting a true beacon in EMS blogging he stepped aside and introduced me to another beacon, Too Old to Work, Too Young To Retire (TOTWTYTR or TOTW). My jaw was on the floor. Having my face all over the show makes me rather easy to spot, but some of the most closely kept secret identities in blogging came forward and said hello. It was amazing.

Even more amazing though was how they stepped back when folks would approach Mark and I and say "I read all the blogs and meeting you guys is so cool." Mark and I shared an inside glance, then looked 10 feet back and wanted to say "Do you know who is standing right behind you? TOTW and Ambo Driver! Look quick!”

On the morning of the second day I was hurrying through the lobby of the hotel on my way to meet Mark to head for a full day of wrangling folks into the "booth"and share Chronicles. Coming my way through the throngs of high school students gathering for the Model UN Conference was the internet's Red Headed EMS Stepchild, Chris Kaiser. As I said hello to him an oddly familiar face appeared behind him.

And something happened that would happen over and over again that day:

The second introduction.

You see, we really do live double lives. As I looked to the beautiful (and tall) woman I suddenly realized I was introducing myself to an old friend, Epijunky from PinkWarmandDry. We shared a smile and a hug as if we had not seen each other in years even though we had never met.

Friendships were not made here, they were experienced on a different level.

I offered a hand to a fellow approaching the booth with purpose, another man close behind. It was Fire Critic and Fire Daily, themselves having only met face to face after months of co-hosting a radio show together.

NateEMTB from twitter stopped by to say hello, as did MyrtLife and literally dozens of others who introduced themselves first with their names, then their identities. The names got a polite smiles, the identities a welcoming embrace.

Yes Mrs999 and MrsHappy, we did a lot of hugging. It comes with the territory.

But then there were the other folks stopping by the spot we carved out of the convention floor, a space not even big enough for 3 people to stand, so we stood in the aisle.

It was in this aisle that I had the first of many "Are you freaking kidding me?"moments.

"Hi Justin, Hi Mark. I really like what you guys are doing"said the brown haired man in the striped shirt.

"I'm Bryan Bledsoe.”

I've said it in this forum a good deal of times, but this truly was a



And I was a fanboy all week. Dr Bledsoe wandered by a number of times during our stay and always had a smile and a handshake to say hello.

It may be a bit late, but if you hate name dropping and fanboyism, you should go read Motorcop because I am about to go 14 year old on you.

I carried my Firegeezer mug on the plane so the baggage handlers wouldn't damage it. I carried it and a red permanent pen each and everyday on the off chance I would bump into Mike Ward or the Fire Geezer himself to get it autographed. And I did. Both of them. Yup, I'm THAT kind of fan.

Throughout the show, we met people involved in all aspects of EMS and each level seemed interested in what we were doing, both in the show, with the blogs, EMS 2.0 and just saying hello and talking to folks.

I can not select a single moment that was my favorite but I have collected a few that stand out from EMS Today in Baltimore:

Meeting the inventor of the KED, over a beer.

Introducing myself to the Chief of EMS for FDNY who replies, "Yeah I know you guys.”

Talking systems allocation theory with an 18 year old EMT student from New Jersey (I forgot your name but if you read this email me, our talk is not over!)

Being interviewed by THE Dave Statter of who refuses to put me on channel 9.

When a twitter friend, 2 of them actually, accompanied other new friends to an Irish bar in the cold night air near closing time and then not letting me buy them a drink (I owe you squirrel and NJ)

Watching vendors realize the power social media has.

I can't wait until Denver in April.


Thursday, March 4

I'm one of the lucky ones

I have finally had the opportunity to become one of the folks I mentioned in the trailer of Chronicles of EMS. I am now one of the lucky ones who can travel across the country to visit other providers at a trade show.

As I've been reminding you, Zoll invited Mark and I out to EMSToday in Baltimore, Maryland.

And oh boy did we almost not make it on time.

When I was growing up we always got to the airport early. Always. Sometimes by hours. So that just became my normal plan. Get there early.

With two little ones and a just over one hour commute home from work, then turning around and racing to the airport I got there 1 hour ahead of the flight, a nail biter in my world.

Mr Setla was relaxing after a calm lunch and I was frazzled to find our flight not only delayed, but now not even arriving at our destination.

The airline, for whatever reason, saw fit to take the same plane we were on before and reroute it. Not through a different connection, since the same plane continued on to Baltimore, but to send us an hour out of the way to DC.

Despite multiple questions as to the reasoning we were no longer able to land at our purchased airport, we were assured the two airports were not far away from one another at all.

I should have known better.

6 hours later we gather our luggage in DC's Reagan Airport and ask the locals the best route to Baltimore. Their suggested Super Shuttle was a moderately priced hassle, requiring us to sign in, buy a ticket and wait 20 minutes before getting in one of the half dozen waiting vans.

We were 2 hours later than expected and now an hour away from our hotel. It's 1130 PM and we're tired and hungry.

A taxi trip will run us almost $100, but get us there quickly.

Knowing a trip from Baltimore airport to the hotel runs about $40 (Thanks FireDaily for the heads up) our chosen method of transport made perfect sense.

Jay's Sedan Service is a family run business in the NY/DC/VA/MD area operating just a handful of cars driven by the owners and the care and attention to detail shows. We've all been in a leased car vs an owned car and the difference was clear.

Our driver, Jay, made us a deal over the phone and was curbside in less than 5 minutes. En route we started with idle chit chat until we learned Jay is on Facebook and Twitter (@jayssedansvc) with his business and we had to have fun with it.

Next thing you know Ted is ustreaming live video from the back of the Lincoln Town Car while Jay is laughing along with us.

After a touch of traffic we finally arrived at my hotel just after 1 AM local time. I say mine because Ted had been booked by a different group at a different hotel nearby.

Thank goodness for free late night food delivery.

So skip ahead to what my body thinks is 430 AM when my alarm goes off and I open the window to the beautiful brownstone Baltimore clock tower.

I can't wait to dive in to everything this weekend could create for me, my friends and EMS in general.

Monday, March 1

Rain Gutters

We moved into this house about 2 years ago and have been finding little problems here and there as most homeowners do.

Aside from mystery sprinklers (don't get me started), with recent storms I've found limitations on the capacity of my gutter system.

Sure it carries the water from the roof along the gutter to the downspout.  Sure it ties into an underground system that drains into the sewers, but there's all sorts of non water stuff getting in there.

At our old house we got new gutters installed and had a chance to install a really great, but expensive, product that blocks non water items from getting into the gutters.  With 2 large pepper trees overhead it made the next rainy season far easier to cope with.

But here we have a different problem and a different system.  It would appear that the underground drainage system that ties into the sewer has either failed or become clogged with debris, roots, small woodland creatures, something other than water for sure.

During one of our recent storms I spent hours out in the driving rain trying to flush what I thought was a simple clog only to find it was systemic on that one side of the house.

One side no problems at all, the other hopelessly clogged.

With water backing up against the foundation of the house I had to stop the immediate damage and climbed back up and clogged the downspout.  That sent the water in that gutter over to the other downspout near the front of the house.  My problem was not solved, only no longer an immediate problem.  But now water was backing up at another location, just not right against the foundation and in plain sight.

With the family driving the wife nuts inside (toddlers hate rainy days) and my hands cold I came inside hoping to tackle the problem another day.

When that day came I could only install a patch of the same system that was in place before, a tube running from the downspout off the side of the house towards the neighbor's yard. (He's never home, he won't notice.)  I unclogged the downspout and water rushed into the pipe I dug a trench for and away the water went.

Problem kinda dealt with but still not solved.  The other spout on that side of the house has o elevation where I can make a trench without digging up most of the yard.  Plus, now it's a huge mud puddle.

I'm not sure what the solution to my problems are, but I know what I have isn't working as well as it should on one side.  And I don't think breaking out the concrete on the other side of the house to improve a working system is a good idea either.

I'm researching other ways other folks are handling similar problems and hope to learn a little something that can help me with my troubles.

I just hope I can come up with something before the next storm rattles in and makes more trouble for me.

Thanks for letting me change gears,


Letters in the files are flying today

It's been awhile since I had to fire up the typewriter and find carbon paper for these letters, but something very close to home has happened and we need to nip this all in the bud.

First letter in the file-

A Letter in the FileJason Brown, Colleton County Firefighter Paramedic, was released from duty last week after posting a cartoon video to his facebook page which featured harsh language and an exchange between a firefighter character and a doctor character.  We all remember Fireman Mike's suggestions about when to call 911, and the language in that video wasn't PG, but it lacked the confrontation shown in Jason's video.  In a perfect world we would all watch this cartoon and laugh because I have had a similar conversation 100s of times in clinics and medical offices wondering just where these folks went to medical school.

But the end of the video is the only part I have an issue with - "We're going to pretend this conversation never happened..." this implies that the fireman cartoon in the video is going to ignore the complaint and leave.  THAT is the reason this letter is going in your file, for a questionable ending to a cartoon video on the internet.

Second letter should not need to be written, but your knee jerked so hard so fast it went right up and kicked you in the face.

A Letter in the FileColleton County Fire-Rescue Director Barry McRoy.  In your termination letter to FF/PM Brown you mention "This video has created an embarrassing situation for this department, our public image and the cooperative relationship we enjoy with Colleton Medical Center. It reflects poorly on you and Colleton County."

No, Sir, you and your Department made this an embarrassing situation for the department.  Ask Brown to remove the video and make a training film if so inclined to make movies keeps this in house and solves all the problems.

I can only assume your fear of the rest of the country finding out the working relationships your service might really have has scared you into firing anyone who tries to express themselves.

Was it the video, the characters or the fact the world saw it on his facebook page?  I can only assume he is like me on facebook, friends, family and coworkers following along.  When he posts the video maybe 100-200 people see it, maybe half that amount watch it.  That is how social media works. It isn't put up on every single fire and EMS website for all to see...

...until you fired him for it.  You took an easily fixable in house "choice of words" situation and exploded it into a National example of a public safety agency afraid of social media.  Because of the way you handled this situation I and now my readers are reading about Colleton, whereas last week I did not even know the agency existed.

In my book, you Sir, are the one who should be fired for creating " embarrassing situation for this department, our public image and the cooperative relationship we enjoy with Colleton Medical Center. It reflects poorly on ... Colleton County."  Sound familiar?

Both of you need to sit down and TALK about this, face to face.  If the offended Doctor who likely asked you to fire Brown wants to join in, all the better.  Have a talk about the proper way to use social media to move the agency, EMS and medicine forward.

This is a sticky spot to be in for sure.  I'm sure if you look hard enough into my musings there is a reason Colleton would fire me too, and every other EMS and Fire blogger.

But think of it this way:

What if Brown had drawn his video cartoon and had it published in a national EMS magazine instead?  Perhaps a single panel cartoon showing a Paramedic and an MD disagreeing in an entertaining manner for all to enjoy?

Would that be OK?

Should Brown be fired?  I say no.  Reprimanded...perhaps, spoken to for sure, but firing him first thing shows fear.

That is not all.

Editor's note: No the link to the video is not broken, it is not here.  Best part of all this is that you can find it all over the internet now, I don't need to link to it here.