Tag Archives: Ems

Reply to “For EMS’ers, Is PA School Just the Next Thing to Do?”

December 27, 2012 9:04 pm | 14 Comments |

Bob Sullivan at EMS Patient Perspective posted on one of my favorite topics today; brain drain in EMS.  What happens to great paramedics who get bored doing “vitals, oxygen, monitor, IV, transport” to the Nth degree for a few years?  They leave EMS!

If you haven’t read the original post, go check out ”For EMS’ers, Is PA School Just the Next Thing to Do?”  Leave a comment or “Recommend” the post, then hurry on back here.  I’ll leave the light on for you.

Already back?  Good!

First, I agree that PA is a great goal for EMS providers, but it might be a pipe dream for the average paramedic with 5 years of street experience at McAmbulance. Here’s where I see obstacles for most:

1. Many will get tripped-up with the PA school entrance requirement of having a 4-year degree. It’s a damn costly endeavor. I’m still paying off mine, and will be for a while. Few McAmbulance operations are giving tuition reimbursement for employees to pursue a degree beyond the Associate’s degree they probably already earned with their paramedic courses.

2. Even if your employer pays for your 4-year degree, it will be a benefit to full-time employment only.  Ever try keeping your full-time job, family, and personal health together for several years while maintaining an “A” or “B” in Organic Chemistry and a handful of other prerequisite courses?  It’s something I’ve seen done, but only by a few high performers.  And I mean truly gifted people.

All that being said…
Going from paramedic to PA is entirely possible.
I’ve watched others do it.
They are very happy now.
You can do it, but it will be very challenging.
Here are a few tips. 

Second, there’s a bigger issue that needs to be addressed here.  That issue is our collective lack of career development.  As Skip Kirkwood so often points out in his writing, our law enforcement and fire/rescue peers have a dozen different career paths to take within their departments.  Since 2008, he’s been preaching that we need to develop career breadth for medics whose aspirations may not involve supervision.

Too many talented people leave EMS because we give them a job (something to do for a while) but fail to offer them a profession (something to pursue for decades).  As Bob Sullivan suggests, maybe they leave to become PA’s. Perhaps they depart to become RN’s or MD’s.  Regardless, they’re leaving and we need to address that.

Posted in: Uncategorized | Tagged: , , ,

EMS Book Review: “Silent Siren: Memoirs of a Life-saving Mortician” by Matthew Sias

December 21, 2012 6:05 pm | Leave a Comment |

My EMS Book Review for December is Silent Siren: Memoirs of a Life-saving Mortician by Matthew Sias. The book is a chronological progression along his unique career in emergency services.

 Sias’ story is uncommon with respect to his career development.  It’s normal for some new EMT’s to follow a non-EMS trajectory and eventually become career law enforcement, firefighters, nurses, PA’s, or doctors.  Less common are the EMT’s who become coroners or morticians.  Out of my hundreds of emergency service friends, I know of only two who pursued that path.

Going into the book, I had the preconceived notion of it being a collection of morbid stories that would depress even seasoned EMS providers. Despite the darkness of the cover and title, this isn’t the case.  Sias weaves together several dozen short memoirs with a light and humorous writing style that engages readers to follow him through his pursuit of providing for a patient or family’s needs.

 I enjoyed reading this book and even had the opportunity to talk with Sias on Medical Author Chat with Greg Friese.  Be sure to check out that interview and pick up the book!

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EMS Book Review: “You Called 9-1-1 For What?” by Dave Konig

December 1, 2012 12:16 am | 5 Comments |

My EMS Book Review for November is another great offering from The Social Medic in You Called 9-1-1 For What? by Dave Konig. 

 True to Social Medic form, he’s published this gem solely in e-book format.  Not only does this give the reader universal accessibility when using the free Kindle Cloud Reader, but it also offers the dynamic content of hyperlinks to some of these hilarious 9-1-1 calls.

 Many of the calls are related to law enforcement, with a few medical issues thrown in for good measure.  Reading about these asinine requests made of law enforcement made me thankful for my career choice of EMS.  Selfishly, I wanted to read mostly about Fire & EMS “emergency” calls, but that may be something he’s saving for Part 2.

 This humorous compilation is the perfect companion for your next posting assignment on the corner of Boring St. and My Back’s Killing Me Ave.  The icing on this sweet offering is that it’s only a buck on Amazon.  OMG, BBQ!

Posted in: Book Review | Tagged: , , ,

EMS Book Review: “The Official Guide to Blogging for EMS” by Dave Konig

October 29, 2012 9:45 pm | 1 Comment |

My EMS Book Review for October is The Official Guide to Blogging for EMS by Dave Konig.  Although the title implies it being a “guide,” this book is in a class of its own in an industry steeped in guides and manuals.

Not everyone in EMS has their own blog, and that’s okay.  Even if a provider doesn’t write for the masses, he or she can still benefit from this book.  We all read EMS literature in some form, and this book helps sets standards for what is “good” or “not so good” in our reading diet.

Konig is a New York City based EMS provider working in the field since 1994. He has worked in the private sector, as a 911 provider, and as a volunteer.  Additionally, he has been heavily involved in all aspects of social media since 2005.  He is currently the founder and administrator of the well-known EMS Blogs Network.  When it comes to EMS blogging, he is THE subject matter expert.

I enjoyed this book because it is both authoritative and immediately useful.  Konig not only writes with the authority of a blog network administrator, but he also offers specific examples (with links) for each topic he discusses.  Being immediately useful is also an essential attribute for any EMS “guide.”  EMS folks don’t have time to meditate on complex pathophysiology theories while managing emergencies, so throughout the book Konig goes straight to the point for new (or experienced) EMS bloggers looking to improve.

Every EMS provider has a voice and shares part of the responsibility for moving us ahead as a profession.  If you’ve ever thought that your voice and ideas could help the next person down the line, maybe this is the year you give EMS blogging a try.  Pick up Konig’s book and get to it!

Posted in: Book Review | Tagged: , , ,

EMS Book Review: “Paramedic to the Prince” by Patrick (Tom) Notestine

October 4, 2012 11:42 pm | Leave a Comment |

Have you ever seen the ads in EMS and Fire magazines telling readers about employment opportunities overseas?  Years ago when I was a young, single paramedic, I gave some thought to what it would be like to work in another country.  Sure, the culture would be different, but medicine is medicine.  Right?    

In the book Paramedic to the Prince by Patrick (Tom) Notestine, we learn that isn’t always true.  In Saudi Arabia, medical school and physician jobs are reserved for those with wassta (connections and influence).  Diagnosis and prognosis are not conversation topics to be had with patients, either.  Instead, providers should tell patients that they will get better, Inshallah (God willing).  These are just a few of the many differences Notestine encountered during his work in Saudi Arabia.  

Notestine’s literary work stands out among other books by EMS authors.  Not only is it well written, but it offers a detailed account of how even the most basic patient care changes from one culture to another.  I recommend this book to anyone, regardless of their medical knowledge or experience.    

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Part II – CCW on duty… and the conversation we SHOULD be having

September 16, 2012 7:44 pm | 16 Comments |

The responses from my post, “Part I – CCW on duty… and the conversation we SHOULD be having” prompted me to reflect further on the CCW on duty issue.  

First, and most shocking to me, is that people read my blog.  Lots of people.  According to Google Analytics, that post tripled my previous record for daily visits.  This means people outside of my peer group and immediate family visited my blog!  Shocking!  This also means that readers find guns more interesting than the book reviews I’ve been doing.  Not so shocking.

Second, several readers suggested that EMS/Fire responders be issued tasers. 

@medic60 via Twitter, “Hey I am ok with Tasers for simple assaults. We have a protocol for removing taser probes. Might as well use it.”

cltmedicman via WordPress, “Screw CCW just give me a taser ;-)“

My friends, I have something even better!  It is EduMedic’s EMS Taser.  Why settle for a regular taser when you can have one specifically for healthcare workers?  The prototype is still being reviewed by the FDA, but I’m sure they’ll love it.  For now, go ahead and send me $10K and I’ll add your name to the list.

Third, a reader believed that the Use-of-Force Continuum was irrelevant to the conversation.

Robert via WordPress, “We are not law enforcement, user of force continuum doesn’t apply to us.”

I respectfully disagree, Robert.  As I said in Part I, This is about the conversation we SHOULD be having, not just the mandates.  Consider this…

We are not anesthesiologists, yet we learn airway management from them.

We are not lawyers, but we learn documentation best practices from them.

We are not law enforcement, but we can learn from them.

EMS/Fire responders advocating for CCW on duty will be more successful in engaging their employers on this issue if they started the conversation from this perspective.  Also remember that a CCW class won’t address evasion and defense of the most common “empty hand” threats. 

Are we, as EMS/Fire responders, required to follow the Use-of-Force Continuum?  Nope.

Can we benefit by learning from law enforcement about tactics within the Use-of-Force Continuum?  You bet your Beretta, we can.

 

Posted in: Clinical Considerations | Tagged: , ,

Part I – CCW on duty… and the conversation we SHOULD be having

September 15, 2012 10:40 pm | 19 Comments |

Kip Teitsort of DT4EMS.com uses this poster to express a brilliant analogy on arming EMS/Fire providers.

Like a reanimated zombie you just can’t kill, the debate over EMS/Fire responders carrying concealed weapons (CCW) on duty is back on its feet.  Kelly Grayson weighed-in on the Virginia issue over at his blog, and EMS World picked up another story out of Ohio.

This debate annoys me as much as the political banter of an election year, and for the same reason.  Each side is so focused on their philosophical rants that they miss out on the conversation we should be having.  It starts with the simple question, “Will ______ issue or policy substantially change my everyday life?”

For the issue of concealed carry on duty, the clear answer is, “NO.”  Regardless of the CCW policy outcome in Virginia and Ohio, EMS/Fire providers will still face the largest likelihood of line of duty deaths (LODD) from cardiovascular disease and motor vehicle collisions.  We are our own worst enemies.

But what about all the assaults on providers?  We have to do SOMETHING!!

Absolutely.  Action must be taken on a national level to teach EMS providers how to evade and defend themselves from the most common healthcare-atmosphere assaults.  

Here’s where we can start the conversation that SHOULD be taking place.  Take a look at the EMS section of The Secret List and the “Assault on Staff” log in the DT4EMS forums.  You will find instances of providers being shot or stabbed.  CCW may or may not have changed those outcomes, we will never be sure.  

But you can be sure of something else.  CCW won’t change the fact that EMS/Fire personnel will continue to get physically assaulted.  Far more common are the “empty hand” assaults on providers who haven’t been trained in simple evasion and defense of said threats.  According to the Use-of-Force Continuum, these assaults should not be answered with lethal force on the part of the provider via CCW.  This may be a shock to some, but getting punched or kicked by a patient-turned-assailant doesn’t justify a lethal-force response.

The conversation needs to be directed toward first addressing the most common assaults.  Training like Defensive Tactics for EMS/Fire is the logical first step.  When we, as an industry, have taken steps to mitigate non-lethal assaults through basic training, then (and only then) we can begin having the lethal-force/CCW conversation that so many want to jump into today. 

 

Posted in: Clinical Considerations | Tagged: , , , ,

EMS Book Review: “Population: 485 – Meeting Your Neighbors One Siren at a Time” by Michael Perry

August 30, 2012 8:42 pm | Leave a Comment |

My EMS Book Review for August is Population: 485 – Meeting Your Neighbors One Siren at a Time by Michael Perry.  From the title alone, readers will recognize this as a commentary on rural EMS.  It’s a sharp contrast from many books in the EMS genre that are borne out of inner-city “knife and gun club” response areas.  

Perry is a skilled writer with the ability to pull readers into the action of a call, but his book goes beyond the sirens and wrecks.  He takes seriously the idea of “meeting your neighbors” implied in the subtitle.  His reflections are more than observations of patients and providers.  It is a commentary on community; the people, the places, and most importantly the relationships.

I would recommend this book to anyone, regardless of their involvement in EMS or Fire.  Perry also shares his thoughts with readers in a great interview on Medical Author Chat.  When you head out to grab your own copy, make sure to buy two.  You’ll want to share this one with your friends!

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A Glimpse into Conference Planning

August 23, 2012 4:04 pm | Leave a Comment |

I did a short piece for the Missouri EMS Association on the making of an EMS conference.  It can be viewed here:

http://memsa.org/posts/missouri-ems-and-expo-planning/

Posted in: Conference Review | Tagged: , , , ,

EMS Book Review: “Please Don’t Dance In My Ambulance” by Barry Bachenheimer

July 28, 2012 1:46 am | 2 Comments |

My EMS Book Review for July is Please Don’t Dance In My Ambulance by Barry Bachenheimer.  Readers of my reviews may be calling foul already.  Sure, reviewing an EMS children’s book is a sharp break from my regular reading regimen.  To be honest, I gave up caffeine this month and have subsequently dropped to a third-grade reading comprehension level!  Luckily, this book is a great purchase for readers of all levels.  I thought of two great uses for this book as I flipped through its colorful pages.

First, it’s a fun story for any EMS provider to share with the young children in their family.  The short, whimsical rhyming and cartoon illustrations will bring a Dr. Seuss feel to story time.

Second, this book would be a good tool to have on hand at EMS public relations events.  Young children are frequently apprehensive around ambulances, and this short story (perhaps read from the tailboard to a group of kids) would be perfect for decreasing their anxiety about ambulances.

There does come a point in the story where everyone gets to dance in the ambulance after their hard work is complete.  Bachenheimer discussed his hard work as an EMT and educator on an episode of Medical Author Chat last year.  Check out the interview, then grab the book to read for the young children in your life!

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