The Flawed Logic of EMT Before Paramedic

Tweet This morning I caught Chris Cebollero debate Kelly Grayson on the Inside EMS podcast about whether experience as an EMT should be required before entry into paramedic school.   Chris’s position is that it should be required, and is necessary to have experience interacting with patients before paramedic school.  Kelly believes it does not, and […]

How Many Words Does It Take to Describe How Your System Works?

Tweet For my master’s thesis, I spent a great deal of time figuring out how to explain the EMS system in my area  in a language that would be understood by non-EMS people.  It took 227 words: Ambulances in the study are staffed exclusively at the BLS level. They are operated and overseen by 21 […]

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 […]