The Adrenaline Rush Is a Bonus

Tweet Last week I got a email from an author who is writing a book about career options.  She asked if she could speak to me about career or volunteer opportunities in EMS.  I wrote back and we chatted for about 20 minutes later that day.  One of her questions was what kind of qualities […]

Enter the No IAFF Spin Zone

Tweet The issue of DC hiring single-role paramedics has been in the news recently, where a lot of opinions have been presented as facts in the media.  Following up on the All Hazards Myth, most of those opinions are Fire-Service Based EMS Advocates talking points.  With a dwindling number of fires and increasing number of […]

The All-Hazards Myth

Tweet Yesterday the D.C. Fire and EMS Department announced that it will hire a group of single-role paramedics instead, reversing its policy of only hiring cross-trained firefighter/paramedics.  This comes five years after the department moved its separate-but-equal EMT’s and paramedics into a “fully integrated, all hazards agency,”  amid daily headlines of long response times, staffing […]

Expanded BLS: Better Than Nothing, But Not Good Enough

Tweet Following up on Rural Patients Deserve the Same EMS Care as Urban Ones is the issue of expanding the BLS skill set.     The line between an ALS and BLS procedures used to be one that required a needle, drug, tube, or electricity. Improvements in technology and risk/benefit analyses have blurred this line.  Expanded […]

A Culture of Silence Is A Two-Way Street, Dr. Baehren

Tweet In the latest American College of Emergency Physicians News, Dr. David Baehren writes about how paramedics have become less receptive to negative feedback since 9/11.  You can read his article, Culture of Silence, here. Skip Kirkwood wrote a response that appears on Mike Ward’s Firegeezer.  Skip describes issues with data exchange, bad protocols, and […]

Rural Patients Deserve the Same EMS Care As Urban Ones

Tweet In June’s issue of EMS World, I wrote an article describing what communities deserve from their EMS system.   My position is that every call should have someone capable of administering a 12-lead EKG, CPAP, nebulized bronchodilators, pain medication, and chemical sedation.  This requires an ALS provider on every call, which sparked some discussion about responses in rural areas.  Here […]

A Patient-Centered EMS Manifesto

Tweet In the June, 2013 issue of EMS World, I wrote an article titled Things Your System Should Deliver.  It is a description of what I believe our patients deserve from their EMS system.  Each item is based on evidence, and systems fail when they do not deliver them to eligible patients. I have always […]

Narc Policies that Make it Hard to Do the Right Thing

Tweet Several ALS procedures, such as intubation, IV fluids for trauma,  and ACLS drugs  have not been proven to make a difference or have been shown to cause harm.  Pain management, however, is one procedure that we positive does help. Consider this excerpt from a 2000 Journal of the Royal Army Medical Care article that Peter Canning […]

Who Will the Community Paramedics Be?

Tweet Last week I was in Washington DC for EMS on the Hill Day.  Unfortunately the meetings with our representatives were cancelled because a predicted but unrealized snow storm.  NAEMT anticipated that the government may close, and offered presentations about how healthcare reform will affect EMS reimbursement and the development of two Community Paramedic programs.  […]

Somewhere Between 8 Minutes and Whenever We Get There: That’s Our Problem

Tweet My friend and recently new coworker Scott “Medic SBK” Keir wrote about a pseudo-controversy from where he used to work about long response times.  In AMR’s contract with Springfield, MA, they must arrive within 10 minutes to priority 1 calls 95% of the time.  After one 17-minute respone time to a shooting, a reporter discovered that AMR […]