Thursday, March 31

Ambulance Safety - A discussion with Greg Friese


At last year's EMS Expo I was invited to interview a number of folks for EMS1.com.  Among them was Greg Friese, noted blogger and educator, but did you know he has a background in passenger vehicle safety?  Have a look.


 


Oh, and wear your gorram seat belt.


 


Thank you.


 


 

Wednesday, March 30

Adding to the DCFEMS "Patient Bill of Rights"

DC FEMS Abulance from Daquela manera on flickrJust saw this on Facebook and I'm sure the blogosphere will jump all over this in the coming weeks but I wanted to do some editing of my own first.  My additions are in BOLD.


This was downloaded from the DCFEMS website and is in the public domain.  And like most "Bill of Rights" they clearly come from a long history of trouble situations.


 



As our patient, you have the right to expect competent and compassionate service from us. This is kind of a given, isn't it?  That the people I call for help will know what they're doing and care?  But, I guess we do need to start on a high note, so good job there.




If you have any questions, comments, compliments, or complaints about our service you are encouraged
to call the Office of the Fire & EMS Chief at 202-673-3320, or email us at director.fems@dc.gov.  Nice


You may expect: You may also expect the clerk at the store to know how to use the cash register I'd prefer somethign along the lines of "We will do our best :"


1. To receive timely and appropriate medical services without regard to age, race, religion, gender, sexual orientation, national origin, disability, or any other protected class. No brainer


2. To be transported in a clean and properly maintained ambulance to an appropriate medical facility. We may not be able to take you to the hospital of your choice. GOLD! Get that out there now! Well Done!


3. That we will never refuse to transport you and we will never use any method to discourage you from receiving medical treatment or transportation. You forgot "when appropriate."  Is #4 to add taxi strips to the vans?


4. To have your vital signs checked and documented whether or not you are transported to a hospital. No brainer


5. To have your past medical history, medications and your current complaint of illness or injury, along with the assessment, interventions and treatment performed by our emergency personnel, thoroughly and truthfully documented on your patient care report. No brainer


6. That your patient care report and protected health information will be securely retained and stored, remain confidential and be available for your review, as required by law. This is already on the HIPAA form we're required to have them sign, right?


7. That you can refuse drugs, treatment, procedures or transportation offered to the extent permitted by law, and to be informed of the potential consequences of the refusal of any drugs, treatment, procedures or transportation. OK, but this reads as if they can order MONA ala cart, then blame us later.


8. That all of our personnel who come to help you will be clean, neat, dressed in the appropriate uniforms, and looking professional. Now I have to comb my hair and chew gum at 3AM?  This is more of a Department rule, rather than a patient "right."


9. That our personnel will explain to you or your family what is being done to assist you, and we will answer any questions you may have about your treatment. If you speak another language, assistance will be provided so you can make informed health care decisions.  No brainer


10. That all of our personnel will be polite, compassionate, considerate, empathetic, respectful and wellmannered.
Any employee will furnish their unit number and Fire/EMS Department ID number upon request. I like this one actually.


11. That your privacy, modesty and comfort will be our concern.  No brainer


12. To receive, upon request, a reasonable explanation of any charges for emergency medical care provided by us.  WHOA! Hang on there a minute! Are we going to carry billing sheets with different charges?  Perhaps in menu form?  "I'd like a BLS transport with bandaging...but...Ooooh! Is that a special on splinting?!?!"


You have the responsibility:
1. To cooperate with our personnel so we can provide the best and correct type of care for you.  That's it? Really?  This is the end of the document, so I guess the patient responsibilities need to be filled in by me.



 


Continued as ammended by yours truly:



2. To not lie, coerse, misinform or make false claims to the persons caring for you.


3. To make every effort to have non-emergent conditions addressed during normal business hours and within 24 hours of the onset of symptoms.


4.  To, when appropriate, make child care arrangements prior to transport rather than suddenly realizing our rescuers have no car seats.


5.  To remove all weapons, elicit medications and evidence of crimes before calling for a non-related issue.


6.  To understand you are responsible for payment for services rendered, regardless of insurance status or government program status.


7.  That those who respond to help you are not your employees, nor are they required to follow your every request, especially those involving moving furniture, shopping for groceries or picking up friends enroute to the hospital.


8.  To remain at the destination facility until evaluated by a physician.


9.  To act on the recommendations of said physician so as to not endanger your clearly fragile health condition and demanding transport 12 hours from now.


10.  To stop smoking.


11. To exercise more.


12.  To eat healthier.



I think that about covers it.  More in depth analysis of the pros and cons no doubt to come online today, but I am, more or less, in favor of what it says, but like mandatory seatbelt policies, it should not be necessary.


 

Tuesday, March 29

Moving In

Well hi there!  You seem to have found the future new home of the Happy Medic!  Please pardon the dust as we're getting things ready for you.  Elements moving, text changing sizes, heck the entire theme may change.

 

Just stay calm, there will be word when we're ready to bring all your favorite content over.

 

So sit back and relax, grab a fresh home brew, put your feet up and wait for the word.

 

-Justin

AmboDriver, ideas from the future

Ambulance from gwire on flickrOur pal Kelly has some great ideas to improve equipment in the EMS setting.


 


Pop on over and have a gander, leave your ideas.

Monday, March 28

You Make the Call - MotorDoc - What Happened

I was hoping the word kidnapping would come into play on THIS scenario from Friday.


 


The Doc doesn't want a trip to the trauma center, even though he meets the criteria that he helped create for us sad, lonely medics who can't use our own judgment.


He was separated from the bike after hitting the side of a truck somewhere a bit less than 30mph, or so he says, and there is no gray area on this one for my system.


He meets trauma criteria wether or not I think he should go.  Such is the state of EMS in my system at the present time.  Even though he presents alert and oriented, he himself would be the first one down our throats about how the clavicle is a distracting injury and hitting his flank could also have injured his pelvis and abdomen.


We could go on for years about wether he is or isn't injured, but there is no need.  There is also only one way I can transport him to another facility outside our protocols.


Direct Medical Control.


You see, regardless of where your patient WANTS to go, it is your responsibility to make every effort to take them where they NEED to go.  If Erma having the CVA demands a hospital without a scanner, call ahead and have them divert you.  Taking her to the wrong place based on her request is worse than "kidnapping" I'd argue it's downright neglectful.


Imagine we take Mr MotorDoc to Saint Farthest, per his request, documenting in quotations everything he says, heck, even get a photocopy of his ID for the report.  All those items will look really good blown up at the trial after his injuries turn out to be more than you thought and he cites you violated clear cut trauma protocols.


This is not a matter of Kaiser vs a Blue Shield participating Hospital, this is a matter of getting a patient to difinitive care.


 


So, back to MotorDoc.  A simple phone call to the attending Medical Control Physician explaining our situation got the intended response.  MotorDoc had to explain his injuries and his reasoning to the attending to get permission to deviate from protocol and be seen at Saint Farthest.  At that point it is the Physician's responsibility should the injuries turn out to be more than we thought.


And the best part of the story?  The attending wanted him to come into the trauma center and from what we could tell did everything we had already done to convince him to do so.


Destination protocols are a necessary tool to keep track of which hospitals in your area can be the best resource to your patients.  Keep in mind they may not know their requested hospital can not help them and it is your responsibility to make sure they get the care they need.


 


If you said kick the decision upstairs, you made my call.

Friday, March 25

You Make the Call - MotorDoc

You are dispatched to a reported motorcycle down in a trouble area in your district.  On arrival you find a single motorcycle has impacted the side of a big rig tractor which was turning in front of him.  He is laying supine, helmet removed prior to your arrival and is alert and oriented.


The rider states he was travelling at 20-30 mph and pulled the brakes when he realized he was not going to make it around the truck.  The skid marks leading up to the truck match that story and you begin your assessment.


Deformity to the left clavicle, self splinted and pain on palpation to the left flank are noted with no flail segment noticible on palpation or observation.  No other trauma is noted and the helmet is pristine.


As you begin to cut the leather jacket, after convincing him it will not be a good idea to pull it off considering the injury, he pulls rank.


"Ease up kid, I'm a Doctor.  Just do what I say and I'll be fine."


You pause a moment and consider his statement.  After the first try to move his arm ends in screams, he reluctantly agrees to cut just only the area needed.


As C-spine precautions are applied he bats them away and adds another gem, "I'm not going to Regional Trauma, take me to Saint Farthest."


Saint Farthest is a local ER, most often staffed with a general practitioner doing their rotation.  They have no surgical capabilities and the last time you took a patient there with a decent laceration there was an argument.


 


The patient identifies himself as a trauma doc and doesn't want to bother his co-workers.


He'll agree to the collar and board if you agree to take him to St Farthest.


What do you do?


You make the call.


Read through the comments, the click HERE to see what call I made.

Wednesday, March 23

List of threes

I have another three lists of three things for you.


 


3 Things that don't belong on pizza:


1.  Fish


2.  Fowl


3.  Fruit


 


3 Things I love to hear on the radio:


1.  Working fire


2.  It's a girl


3.  The San Francisco Fire Department would like to congratulate and thank (insert name here) for 30 years of service on today, thier last shift.


 


3 things I should be doing instea of blogging:


1.  Working out at the gym


2.  Playing with the kids


3.  Working on the house

Tuesday, March 22

Thoughts on ETI

Recent discussions in EMS circles have revolved around the idea of removing endotracheal intubation from our standard of care because we seem to not be very good at it or don't do it often enough to remain proficient.


Kelly Greyson's recent article at EMS1.com added fuel to my fire when he discussed the number of intubations medics are asked to get prior to being released into the field.


My program required 10 in the OR and I remembered thinking that was far to few. 


Far too few to be proficient at an airway that was not at comfortable waist height.


Or an airway that didn't have a comfortable chair and clean place to rest my equipment.


Or an airway that hasn't been fasting for a day incase there is vomit.


Or even an airway that started out just fine, then got worse on the stairs while carrying them downstairs in the dark.


We are GROSSLY undertrained compared to our nursing and medical friends and it is directly related to our being considered a trade.  We are put on the bottom of the pile for live intubations, not because we aren't good at it, or do it seldomly, but because we are seen as kids, unskilled laborers with lights and sirens.  In some programs I'm told instructors are having to beg to get OR time for their students.


When I went through the OR for my tubes, I recall having to get permission from the patients and being scared to ask.  Then the Anesthesiologist grabbed the form and took it to each patient and explained to them that if I didn't learn there, with him watching, how would I be able to do it to them in their bedroom in the middle of the night.


Every person signed, even the young lady whom I knew from school.


The Doc understood that of all the folks who need training on ETI, the first ones in the door should be given first shot, because if not now, when?


Did my 10 tubes that day make me a good airway manager? - No.  But it got me over the initial fear of inserting a blade into a living person and looking for real cords.


We are reminded that the gold standard of airway management is not the endotracheal tube, but adequate gas exchange at the cellular level.  A perfect example of this in practice is CPAP.  With this tool we can assist a patient towards a positive outcome without shoving a piece of plastic into their throat, just onto their face.


 


But the more I consider my last few intubation attempts I am constantly distracted by the basketball games on TV.  So and so is 17 for 32 and having a great game.


17/32?


I'm 4/5 on my last few tubes I can recall and felt like a failure.  We shouldn't be "missing a tube" in the field and delivering it to the ER (or the ME in some cases) but using stats like these to take away a tool is insane.


Imagine if a police officer who shot at 5 suspects only hit 4.  Would we be considering taking away his weapon or sending him to the range for more training?


The firefighter who puts out 4 of 5 room and content fires isn't stripped of his hoseline and told to leave firefighting to the insurance company, we train more.


Mailcarrier delivering to the wrong house, bus driver missing a stop, kid at the Starbucks screwing up my order.  Lose the mail van?  Take away the bus?  Take coffee away?  All insane options, but for some reason when we make mistakes the first answer is to take away a vital tool I need available.  For what?  I don't know, but when I need it and it's gone, what will I do then?


We need more training.  We all know it, but no one is going to come by the station and give it to us.


 


More importantly, we need to back away from the airway kit when the BVM is working.  I'm a firm believer in the "start simple" school of airway management, which states that if gas exchange at the cellular level is adequate for tissue perfusion, keep doing what you're doing.  Reassess and act as needed.


If the industry wants to solve the ETI stats by taking the tubes away I can then guarantee a success rate of ZERO.  Instead, let's apply the same metric to IV starts, medication errors and just disband EMS all together, because if you take one tool because we misuse it and don't remediate the provider, the problem will spread.


The problem IS NOT the ability to intubate the trachea, it is poorly trained practitioners using a tool they do not completely understand in a manner that may not even be necessary.


If an MD needs 200 tubes to be considered proficient, then misses repeatedly in the ER, can I take his tubes away if I can sweep in and get it first try with only 10 under my belt in training?


 


Of course not, because if they need that tool another time I want them to have it available.  Now offer me the same consideration and perhaps we can all move forward.

Monday, March 21

the Crossover - Episode 11 - Captain Daddy

In this episode, we introduce a special guest that had a major influence in MC's life...CaptainDaddy! Happy picks his brain about getting out of the job "whole". We also chat about retirement systems, budgets and whether drivers of emergency vehicles should be referred to as such.



Episode 11

Sunday, March 20

The evolving call

Often our patients and clients tell 3 stories.  The one to get dispatch to send us as fast as possible, the version on scene is never as exotic, then they pepper in a completely new history and chief complaint at triage.

When very lucky, we get a call that evolves in front of our eyes from the mundane to the exotic.  In this case it was because of a bystander.

THE EMERGENCY

The caller states her husband has twisted his ankle and is unable to stand.

THE ACTION

Lights and sirens through the pouring rain and we discover the neighborhood parking attendant jumping up and down in the middle of the street waving his arms as if we were the first airplane to fly near his island in years.  Conveniently enough he's in front of the reported address so we pull over and go to work.

The injury is straight forward enough and I begin my secondary assessment.  He's sitting at the base of a couple of old steep steps and I almost made a big mistake by assuming the steps were the culprit.

"How did this happen?" I ask as the EMT begins to splint the ankle.

"Oh, I lost my balance." He responds, clearly distracted by the discomfort of the splinting efforts.

"Were you dizzy, did the world start to spin?" Now there is a whole new window of concern opening, and quickly.

"Not until after the fall was I dizzy." Or patient answers, occasionally wincing with pain.

"He felt better after he threw up." Says a woman holding an umbrella just out of our little treatment circle.

When I asked about the vomiting he confirmed that soon before the fall down the steps he did indeed vomit, felt dizzy and had to catch his breath.

Needless to say my spider sense was tingling.  I was missing something and it was bothering me.

On further questioning we were finally able to patch together what had happened.  Are you sitting down?

In the backyard, under a tarp was a table saw.  Trying to finish a project before the worst of the storm passes through, our patient failed to use proper precautions against wood resting between the fence and the blade.  As the blade spins against the wood, there is a tendency for the wood to stick or kick back.  When a small piece of wood became stuck between the fence and the spinning blade he reached for it using a push stick, a god idea, but approached it head on.

The 2" x 4" by about 3" piece of wood struck him square in the chest traveling at least 50mph, knocking the wind out of him.  Disoriented and in pain, he stumbled around the front of the house and vomited on the sidewalk, seen by our umbrella lady.  Then he tried to get in the side door to call for help, but lost his balance and twisted his ankle.

Then we were called.

He never showed signs of a traumatic injure to his chest, but there it was.  And we almost missed it.  Imagine THAT triage story coming out at the local ER instead of the regional trauma center.

Friday, March 18

This is a remarkably long title and likely not to be used on a daily basis

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Thursday, March 17

New Text MSG - CPR Needed

We all know about the San Ramon Valley Fire Department's revolutionary citizen dispatching system for cardiac arrests, or iphone CPR app called "Fire Department."

What we didn't know until the cameras started rolling at Station 7 yesterday was that the San Francisco Fire Department will also be joining in releasing the Fire Department app (firedepartment.mobi) to assist in getting bystander CPR on scene quicker.

I had the opportunity to speak with Chief Price from San Ramon Valley Fire after a brief presentation about the app and it's history at a recent EMS Committee meeting far outside San Francisco.  The inspiration was perfect.

Out to lunch one afternoon with his IT folks, Chief Price heard, then saw an engine company roll up lights and sirens.  When he arose to see what was happening, he learned that literally inches away from him, in the store that shared a wall with his, was an SCA victim.  he has an AED in his company car.  He has a BVM in the car as well, yet there was no notification, no person running from store to store looking for help.

We now know that the sooner we can start compressions the better, but 4 minutes to code the call, send it out and respond is 4 minutes too long.

The Fire Department app may be poorly named (CPR app was already taken) but it also expands and allows local agencies to activate persons of specific experience and training, not by keeping a phone tree (sooooo 2008) but simply sending out a text that activates an app that tells your new citizen rescuers where to go and what to do.

Any department looking for community outreach and increasing SCA survival should really be looking into developing this.  The code is available, just contact them.

If you're the social media person in your department, download the app and take it into the Chief's office and show them.  I haven't made my appointment to go show it to Chief Hayes-White and now I know I don't have too.  I WILL however give credit for this to Thaddeus Setla and Mark Glencorse who sat down in her office in November of 2009 and spoke about the power of social media, twitter, facebook and building a community using mobile technology.  They may have just planted the seed that grew into what could be an amazing opportunity to mobilize a silent partner, the public.

You'd think this is the kind of thing the Department would ask social media folks about ahead of time.  Like those that work there?  I'll be submitting memo after memo trying to get on the team that steers this app.  Why the district attorney is involved is beyond me, I'll see if I can find out. EDIT - Just got an email from the DA's office.  THEY were the ones that saw the potential and took it to the Chief's office and that is why the DA is present.

If you are still entirely unsure what I'm talking about, visit this site for more info on the app, San Ramon Valley CA and keep a lookout for updates on when your service could begin dispatching citizens to start CPR before your rigs are even in drive.

Wednesday, March 16

Hello world!

Welcome to WordPress. This is your first post. Edit or delete it, then start blogging!

Yeah...what he said.

When was the last time you asked your waitress why she was scared to learn CPR?

My answer: last night.

At a last minute meetup, myself and Thaddeus Setla sat down with East Coaster and EMS 2.0 supporter William Random Ward to discuss EMS, social media, the state of emergency services and what we as providers can do to improve the state of our profession.

It occurred to me that we do need a lead Federal agency, we do need some really cool PSA's, but what we can't wait that long.

Random (Yes, his real name) stopped us mid conversation and asked us if we should ask our waitress if she knows about EMS.  We can't reach out to our regular circle of friends to see what the general public knows or doesn't know because they already are tainted by our experiences.

The waitress was slightly taken aback that three guys were asking what seemed like a set up for a date request, but we kept it simple.

"Do you know what EMS is?" - "Umm...no."

"Do you know what EMS stands for?  The letters?" - "No."

Then Random went into his dance.

I have often wondered what a young me inspired by more than a simple desire to be better might have looked like.  I only dream I had that level of inspiration and desire at 22.

Yes, he's only 22.  The definition of parapup, yet grounded in the realities of EMS and where we need to go both in the short term and the long term.  His ideas were simple.  Reach out to the community in any way we can to educate them about who we are and what we do.  Not in a grandiose way, not at first, but with simple conversations.

I asked our waitress if she knew CPR and the look on her face was similar to what I imagine her response would be to the question "Have you ever bungee jumped?"  She shook her head and told us no while feeling very awkward all of a sudden.  When we told her is was a less than 1 day class and there was no more mouth to mouth, she told us she'd look into it and walked away.

Assuming, like you are, that that was the end of it, she returned in a few moments to tell us she asked around her co-workers who knew CPR to find her manager and another employee stated yes and she was surprised.

I flashed to the scene in Fight Club when Tyler Durdin confronts the student behind the convenience store and threatens to kill him if he doesn't go back to school and chase his dreams.

Of course there was no intention of bodily harm, I had no gun and I'm not a dangerous manifestation of my own subconscious (as far as you know), but the spirit was the same.

"You're not off the hook.  Go learn CPR, you'll be glad you did." I said and she went back to serving her customers.

We should be doing the same.  Most of those who seek out EMS topics already do street interventions.  From "quit smoking' to "here's how to properly use your inhaler" and I recently used a crash course in CPR to get a man to go into the ER, but why are we not asking the barrista at the morning coffee place?  Or the lawyer cutting into the elevator in front of us on a run?  Or the mother of the 5 kids who insists her ankle prevents her from working?

While looking around for the person who is going to educate your community about you, look no further than the mirror my friends.

Have a look at what Mr Ward had to say

Tuesday, March 15

Weeding the yard

It's that time again.  Time to get out into the yard and deal with all the weeds that have snuck in over the winter.

But while out there, on the second day of clearing out the tiny back yard, I realize that this would have been a lot easier had I simply plucked each weed when I first saw it.  But I was busy with other things.

Our little garden in the back is visible from the kitchen, dining area and family room and we've put a lot of hours into it over the last few years.  But I spent so much time and effort on the fancier things I missed the obvious.  The weeds.

From a distance the weeds are nice.  A bright green spreads over what could have been grass, shading what I wanted originally and leaving a giant, prickly, hard to remove and on further inspection, ugly plant.  I didn't put it there, it found it's way in when I wasn't maintaining the grass properly.

So distracted with the BBQ area, patio and rocks, the grass went ignored even though it serves as the backbone of the yard.  The grass is a nice thing to look at from the bedroom window as the laundry dries on the line.  The kids play in the grass.  It cushions their landings from the slide and is nice to put your toes in on a hot afternoon.

But there's so much upkeep with grass.

I wish I could go back and tell myself that the extra time and effort in keeping the weeds out would be worth it in the long run.  These weeds are of all different sizes and shapes and are a pain to remove.

And now, with them gone, the yard looks horrible both up close and from a distance.  It won't be easy to fill the holes they left, dead grass underneath, but I know that with time, and tending, it will grow back strong and beautiful.

But still a part of me says it's easier to leave the weeds and look at the fancy things in the yard, ignoring the largest thing in the yard and the thing that brings us the most joy in the spring, summer and fall.

All the fountains, BBQs, rocks and other distractions can't hide a weed ridden yard, no matter how shiny or expensive they are.

Saturday, March 12

Emotion is good. Use it.

We are trained to exclude emotion in many situations, usually to our disadvantage.  I've found that the more I care...the more I seem to care.  It sounds odd and looks even more unusual in print, but I've found that those who build up an emotional wall completely are some of the first to crack.

But then again, those who engage completely break down even sooner.

The trick, I'm learning, is to know when to use that emotion to a desired result.

On a recent job we encountered an all too common condition that has a rather quick and easy remedy.  It was given and our patient awoke, rubbed his face, sat up and lit a cigarette as I'm sure he does every time he awakens to the sea of navy wool shirts with silver badges leaning over him.

His girlfriend, who found him unconscious, is in the hallway and in tears, crying so loudly we can barely hear each other talk during our treatments.  As we begin to realize the patient has no intention of going in to hospital, we do our best to convince him man to man.

When that fails we often take the Professional route.  My personal speech revolves around finding their trade, then making a fool of myself trying to explain it, then show them that they're in my comfort zone and should trust my judgment.

On the rare occasion our powers of persuasion have failed we can default to kicking the decision upstairs and getting an MD on the phone to speak to the patient.  With an adult man explaining in clear sentences that he will only be removed from his home by extreme force, the MD is reluctant to give a transport order (which is uncommon) and now we can get an autograph and go in service.  And by go in service I mean get a cup of coffee before she calls back after he's unconscious again after our treatments wear off.

Most times this is where my last ditch efforts are to literally beg, asking them to prove me wrong, daring them almost.  When the smoke was blown towards my face without a response and the crying in the hall continued I realized this man did not even see me there, just a uniform with a warm body in it.  A warm body who's job it is to medicate him from time to time, then go away.  There would never be the personal connection I need to convince him of his condition and what needed to be done.

It was late and the entire building was awake, partly from our commotion, but mostly from the girlfriend crying in the hallway.  Wondering what would happen I brought her in, not to convince him to go or to have a heart to heart, but to teach her the basics of CPR and opening airways.

Cruel perhaps, but as I explained how to keep him alive later, after we had left, her hands were visibly shaking and she calmed down and listened carefully.  As our patient watched me teach her how to open his airway and keep him alive until we could arrive the next time, he saw what a burden he had been and would soon become.  As we explained hand position for chest compressions he rose, easily dwarfing my 6 foot 2 inch frame, and grabbed his jacket and shoes.

"Get your shoes, I'll go." he said as he put out his cigarette and walked towards me.

Half of me shreaked like my 5 year old and ran down the hall to survive.  The other half turned square, ready to defend my actions and took a breath in.

He brushed past me and into the hall, out the door and into the ambulance.

His girlfriend gave quick chase, grabbing a large bag on the way which rattled with a dozen pill bottles.

My emotional connection to this case was irrelevant, because no matter how much I invested in it, the results were not going to change.  But focusing on my patient's state of mind and emotion, I can manipulate the environment for their benefit.

Did I trick him into going?  Some could argue yes.  Will the transport and evaluation really have any effect on his repetitive condition?  We already know the answer is no as countless transports in the past have shown.  But maybe, just maybe, showing him how much he impacts those that matter to him, not just telling him, will be the start of something.

I can only hope.

Thursday, March 10

Police car driver recovering after accident

An accident between an ambulance and a police car left the police car driver in the hospital and the ambulance crew recovering from minor injuries.

The initial investigation shows they were responding to separate incidents and that the ambulance had the green light.  All those things aside, I'm glad everyone is OK, considering the police car driver had to be extricated.

Police car drivers are given training to respond with lights and sirens, as are EMS personnel, and if the investigation holds, I wonder if the police car driver will be cited with failure to yield to an emergency vehicle, as EMTs and Paramedics are from time to time when they are the ones at fault.

Likely not, but I hope all police car drivers take this story and also a deep breath when responding, as we all should, and come to a complete stop to break an intersection with red light and siren.

What?

Wat's that you say?

He's not a police car driver?  How's it feel to be referred to by only a portion of what you do? MC, I smell a crossover!

We have a tall hill to climb and perhaps we should start with some PSAs for the press.

"The ambulance drivers also were being treated at the hospital, Ramos said."


Oh, and this lovely nugget:

"Sorrick said the ambulance company is prevented by privacy regulations from providing the names of the injured medical personnel."


So here's a HIPAA quiz (Adding information, creating a new scenario) - Does HIPAA prevent the ambulance company from releasing the names of the injured employees if they were not patients?

-Justin Schorr

Fire engine driver / Ambulance driver

Wednesday, March 9

Epiosde 10 of the Crossover - Quit being stupid!

Happy and Motor are at it again, finally, and this time calling out some stupid things done by stupid people while representing EMS, fire and police. From the ambulance company who lost $1 million to the 27 year old DUI while driving a fire truck and a special comment from Motorcop about a narcotics officer in Happy's area caught stealing and selling narcotics. Quit being stupid!

EPISODE 10

Monday, March 7

Idiot

Another great conference comes to a close and the blogosphere is full of great reviews, so many that I have yet to read them all.

Some highlights for me included meeting new faces, like maddog medic and Shaolin Traumashere at meetups and in the Zoll booth.

The most inspirational moment for me came on the last day as things were winding down.  It wasn't someone inspired by our content or who writes blogs, or even someone who developed a new EMS system or program, but two sisters.

This was also the moment I realized the importance of being a person before being a blogger and how something so seemingly innocent can easily lead to disaster.

Zoll offers a CPR Challenge station so two people can do it side by side and compare their ability.  As I was sipping coffee in the booth, I looked over and saw two girls barely old enough to reach the CPR set up at the station doing their best, which was as good or better than I've seen sometimes in the field by "experienced rescuers."

It was inspirational!  Here were 2 kids barely old enough to spell Emergency, having fun applying the basics of CPR!  Forget teaching this in high schools, we need to move it forward.

Then I ruined the moment, and in an awkward way.  Being the person I am, I wanted to capture this amazing moment I was witnessing.  My hand went instinctively for my phone and before I knew what was happening I was framing up a photo.

Goosebumps were forming on my arms thinking about how the description of what I was seeing could be applied in so many ways to help rescuers and lay people alike take CPR seriously.

Through the viewfinder suddenly the mother of the children was sternly, and rightly, asking me who I was and why I was trying to photograph her children.

Now this moment was stained by my wanting to be a part of it.  The mother's interaction with me distracted the kids and the moment I had wanted to capture was gone and I felt like an idiot.  I never did snap the photo and offered my phone to her to prove it.  Apologies spilled from my mouth and I returned to the podium where my coffee was and reflected on what had just happened.

"Way to go" I thought to myself.  I could have simply watched, applauded when they were finished and had a perfect memory to use when convincing schools to add CPR classes.

I let my need to capture things digitally interfere with capturing the soul and emotion of what was happening. Something that, I now know, would have been far more powerful than a picture.

The rest of the day and our entire trip home that moment sank in and I began to second guess not getting the photo.

"Perhaps if I explained why?" The little angel on my shoulder offered.

"Oh, yeah sure, tell mom you're taking the picture to put on the internet, that'll go smoothly," responded the devil on the other side.

Now when I reflect on the moment that was, then was not, I realize there was quite the crowd gathering to watch what happened and I ruined it for them as well.

Idiot.

Thursday, March 3

EMS Today is...well...today

Twitter was aflutter with checkins from some of EMS's top bloggers as they made the opening ceremonies of JEMS EMSToday conference here in Baltimore.

Last night's Zoll Pre-Conference Blogger Bash was a resounding success and special thanks go out to Scott Kier (@MedicSBK) and Russel Stine (@HybridMedic) for arranging it and to Zoll for sponsoring it.  We had guests of all backgrounds, from a few gold badges we know, to some new faces, the older and the younger, all gathered to say hello again and get ready for a great conference.

I'm currently nestled in my corner here in the room while Mr Setla is editing hours and hours of footage from yesterday.  There was so much great conversation last night that we hope to share as much as we can as the show goes on.

There were some new faces in the crowd last night and I wanted to take just a moment and thank them for taking the leap of lifting their veil of secrecy ever so slightly.  MadDogMedic and Shaolin Traumashere were in attendance and introduced themselves as such and we had, as we are loving to see, the second introduction.  There is a comfort in knowing someone by their online presonality and then meeting them in person that is just awesome.

The show floor is open at 530 today and I'll be in the Zoll booth, which this year has a neat sign with a picture of me, Thaddeus and Mark Glencorse at one of the first filmings of Seat at the Table.  Very cool.

We went for a walk around the show floor earlier to give you an idea of the enormity of it and the wide variety of products, services and equipment on display.  If there is something you want us to tell you more about, get on twitter and include hash tag #CoEMS or #FRNtv and we'll do our best to find it and learn more about it.

After the floor closes we're off to the inner harbor for the FireEMSBlogs meetup at the Uno's.  If you need a map or details, come find me in booth #3707 and I'll get you a flyer.  the firsst 300 folks get a free drink, so if I'm #301, mind if I sneak ahead?  Last year the guys had a corner upstairs and we quickly overflowed.  Tonight we have the entire restaurant.  Yes, bloggers will be invading an entire restaurant.

No doubt there will be another flurry of updates starting around 8pm as folks assemble at the Uno's.

Updates here as I can get them up, follow the youtube channel for video updates from EMSToday 2011.

Wednesday, March 2

Baltimore Begins

[youtube]http://www.youtube.com/watch?v=li9RexCek7k[/youtube]

Tonight it's the JEMS EMS10 Awards dinner, look for me tweeting about it using hash tag #EMSToday and #EMS10, then off to the Zoll Pre-Conference Blogger Bash at the Pratt St Ale House at 8 pm.

We also had an opportunity to track down Charlotte Norton from Zoll to say thanks for all their continued support of Chronicles of EMS and First Responder's Network.tv.

[youtube]http://www.youtube.com/watch?v=i5low_sTQBw[/youtube]