the Chronicles of EMS

Mile High Opportunity

Right smack dab in the middle of my crazy 30 days was an opportunity to come here to Zoll Summit and present the first position argument for EMS 2.0.

As much as it has been pulled apart, scrutinized and criticized, the core message of looking at why we do what we do was very well accepted by the audience here in Denver.  Supervisors, Chiefs, practitioners, designers and marketers all sat down and listened to that crazy blog guy and his UK buddy explain what EMS 2.0 means and why it has a chance to work this time.

Mark did a great job relating social media to the mission of improving EMS and the discussion that followed ended with one of the attendees asking where they could find a “user guide” on how to approach social media policies for departments.  Mark and I shared a “Well, duh…that’s a great idea!” moment and went on.

Soon after our session and the discussion we commandeered the main ballroom and it’s twin 25′ screens to fire up the first episode of the Chronicles.  It was after the last session so not too many folks turned out, but many times it isn’t the quantity, but the quality.

Soon after the show and a quick look at A Seat at the Table (thanks for the reminder Mic Gunderson) we found ourselves face to face with CEO of Zoll Rick Packer, our sponsor.  Fearing a “I never approved this” moment, we were welcomed with a warm smile and a hand shake, followed by a long discussion of the concepts we discussed in the show.

Zoll has been more than gracious in helping us spread the word of EMS 2.0 and Chronicles, even if I should be back in the room studying for the promotional exam.

This week has seen us debating EMS systems allocation with friends, Chris Montera and Steve Witehead to name a few, and sharing the idea of improving EMS.

Later today Mark and I will be attending a networking event where we hope to share the message even more.  Sorry for so few updates, we’re working on it!

HM

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109 thoughts on “Mile High Opportunity”

  1. “”user guide”on how to approach social media policies for departments.”

    Why isn't such a guide on the CoEMS site? When are you EMS 2.0ers going to stop talking and actually get stuff done? It shouldn't take 40 years to make a one page get to the point social media policy.

    In my mind there are 3 big problems to solve: frequent flyers, low pay, and the disrespect culture. I'm convinced these problems could have been solved long before the advent of Twitter, Blogger, WordPress, Facebook, podcasts, and JEMS Connect. The IAFF sure wasn't founded in the information age.

    Here's the thing I see a lot of people all off on their different blogs chatting about. What I haven't seen is people coming together to write a one page document about what they want. I don't see any group planing an “EMS 2.0″ labor union to do something about the low salaries.

    As long as EMS 2.0 is nothing more than blogs, videos, and presentations it will remain a joke.

  2. “”user guide”on how to approach social media policies for departments.”

    Why isn’t such a guide on the CoEMS site? When are you EMS 2.0ers going to stop talking and actually get stuff done? It shouldn’t take 40 years to make a one page get to the point social media policy.

    In my mind there are 3 big problems to solve: frequent flyers, low pay, and the disrespect culture. I’m convinced these problems could have been solved long before the advent of Twitter, Blogger, WordPress, Facebook, podcasts, and JEMS Connect. The IAFF sure wasn’t founded in the information age.

    Here’s the thing I see a lot of people all off on their different blogs chatting about. What I haven’t seen is people coming together to write a one page document about what they want. I don’t see any group planing an “EMS 2.0″ labor union to do something about the low salaries.

    As long as EMS 2.0 is nothing more than blogs, videos, and presentations it will remain a joke.

    1. I kept reading this, hoping for a happy face or something to indicate Tim didn’t mean to be as disrespectful as this sounded. I didn’t find it. “As long as EMS 2.0 is nothing more than blogs, videos, and presentations it will remain a joke.” So, you think that a small group of firefighters and EMS people that have come together basically in less than a year should have been able to change problems that have been around since the beginning of EMS? That’s pretty unrealistic. Might I remind you that they (we) are people that recognize that changes need to be made in EMS and are spending a lot of their time away from their jobs and families, often at their own expense, to try and grow awareness of this through social media. It’s through that awareness that the right people with the right power might be inspired to try and make those changes. EMS 2.0 and Chronicles of EMS is anything but a joke. Justin, Ted, Mark and the others can be sitting in their stations and bitching about the issues instead of trying to do something about it. I really would like to know, Tim, how you think this small group of “boots on the ground” people are supposed to (immediately) change long term issues like frequent flyers, low pay and disrespect. Maybe you should start with showing a little respect to the people that are trying to do something positive. BTW, what have YOU done to make positive changes in the state of EMS???

      1. “Tim, how you think this small group of “boots on the ground” people are supposed to (immediately) change long term issues like frequent flyers, low pay and disrespect.”

        By creating a formal group that has one message. These 3 big problems have already been solved, just not on a grand scale. DC Fire has sort of solved the frequent flyer problem by sending 3 paramedics and 1 nurse practitioner out to check up on the patients who call 9-1-1 a lot. An EMS 2.0 web site with the message of the EMS 2.0 community and how these big problems have already been solved and how any agency can implement these solutions would not be a joke.

        “BTW, what have YOU done to make positive changes in the state of EMS???”

        I’m creating EMS Compare which will allow anyone anywhere anytime to see how any EMS agency is performing and what is going on at a larger scale. Medicare’s Hospital Compare website has encouraged hospitals to improve their door to balloon times because those times are publicly available and comparable. I hope EMS Compare will do something similar. Thanks to Myers Benchmarks EMS is moving away from just measuring performance based on response times and cardiac arrest. The site might actually make it easier to get public support because they’ll see how well EMS is already performing.

    2. Timothy,

      You have a knack for sticking yourself into a discussion without reference and creating a lot of animosity. Until you come to me with any shred of decency and respect about what has been accomplished in the very short time we have been doing this, your comments represent the very nieve nature of your experience. I have three kids, wife and inlaws I have to support while building the brand of CoEMS and all technical aspects of the site and more. Let me be very direct and say that I appreciate your donation to the CoEMS team and it shows that you are heading in the right direction, but your comments here are not only hurtful, they are without a doubt poison to our whole mission and I publicly don’t condone this. You don’t support a cause by blasting what they haven’t done, you suggest it.

      Learn from this Timothy or you will be ousted by the whole EMS community.

      1. What you accomplished is overnight fund-raising and permission for a 20 minute video showing issues around frequent flyers. Pretty cool. You did a bunch of video taped discussions with paramedics and administrators. Pretty cool. But guess what none of it matters. What matters is agencies like DC Fire have solved significant problems. They solved those problems before CoEMS showed up.

        I have tried repeatably to help you and your cause before and after criticizing you, but you don’t want my help, so I’ll just keep criticizing you and your mission. You care more about the fact that I’m not an EMT then you do about the fact I’m a guy with a lot of free time, a lot of interest, and the ability to look stuff up, write code, etc. You can put an end to this bashing simply by sending me an email with how I can help you.

        1. Timothy,

          You have single handedly dug your own grave with regards to support. Not only will I never ask you for help, you have disrespected me and my colleagues and changed how I feel about your lack of experience. I once thought I would just wait to see what your true colors were, well today you made that clear.

          I will support everyone else who appears to not have EMS experience and wants to help, but my requirement is respect. Respect those in the community, respect those who care enough to bring about change, respect where we came from, you have done none of this.

          Sad timothy, sad… you almost had me convinced that you were worth spending time to grow and use in our campaign.

          Now next topic… moving EMS forward with respect…

    3. I just recently checked your site and found no link to a labor organization, a one page document on social media usage for agencies, pretty much everything you have mentioned I am not doing.
      Perhaps you’ve been missing the parts where this movement is catching the attention of industry leaders, being heard on a level and respectful playing field and gaining acceptance as a legitimate concept.
      I would love to speak more to this topic but I have to go meet with the Deputy Chief of an organization that is using technology to the benefit of their patients and see how I can share that with everyone.
      I apologize very deeply that we haven’t changed 35 year old problems in the 1 year since I dealt with the situation that spawned this incarnation of a movement to change EMS.
      I look forward to your white paper on how to do all this.

      1. First of all I’m solving the problem that matters to me. The problem is I can’t find out the names of the EMS agencies in a given area yet alone performance info.

        “I just recently checked your site and found no link to a labor organization, a one page document on social media usage for agencies, pretty much everything you have mentioned I am not doing.”

        OK I get on doing that right now.

  3. “”user guide”on how to approach social media policies for departments.”

    Why isn't such a guide on the CoEMS site? When are you EMS 2.0ers going to stop talking and actually get stuff done? It shouldn't take 40 years to make a one page get to the point social media policy.

    In my mind there are 3 big problems to solve: frequent flyers, low pay, and the disrespect culture. I'm convinced these problems could have been solved long before the advent of Twitter, Blogger, WordPress, Facebook, podcasts, and JEMS Connect. The IAFF sure wasn't founded in the information age.

    Here's the thing I see a lot of people all off on their different blogs chatting about. What I haven't seen is people coming together to write a one page document about what they want. I don't see any group planing an “EMS 2.0″ labor union to do something about the low salaries.

    As long as EMS 2.0 is nothing more than blogs, videos, and presentations it will remain a joke.

  4. Well said, Sam. The only thing that is truly a joke here is Tim’s comments. Change and evolution takes time, especially in a field where such changes have never been attempted. We can come out guns blazing, and making rash statements, and make ourselves look like some over eager jackasses who will never get the respect we deserve, or we can act as professionals, and show the world what we are able to do.

    Its sad, really, Sam. Tim will never understand this unless you can find some sort of clinical study that shows it. He knows nothing about what we do, and only bases his views off of what he sees immediately around him. The “my system works best, hands down” attitude is what we are all trying to get away from anyway.

    In reality, we should all be proud of what was accomplished over the last couple of weeks. I got to sit and watch Ted and Justin speak at the SFPA. I didnt want their presentation to end, and clearly neither did the group they were speaking in front of.

    And then, this week, we have Mark flying back across the Atlantic to stand up for US and our beliefs. Clearly, from what I read on Twitter, and on the blogs a lot was accomplished.

    Thanks, Justin, Ted, Mark, and everyone else who was in Denver working on turning this profession that I love so much into something more. Its going to take some baby steps, but we WILL get there.

    1. “Its sad, really, Sam. Tim will never understand this unless you can find some sort of clinical study that shows it. He knows nothing about what we do, and only bases his views off of what he sees immediately around him. The “my system works best, hands down” attitude is what we are all trying to get away from anyway.”

      DC Fire is kicking King County’s butt when it comes to dealing with frequent flyers. King County could also improve it’s two-tier system by doing what Boston does and simply have the first-tier responder also be the transport crews. Now if an agency wants to achieve 49% survival for bystander witnessed VF (cardiac eitology) then King County, Rochester, Minnesota, Wake County, Rock County, Wisconsin, Boston are the places to study. It’s pretty simple high bystander cpr rate (50%) combined with BLS on scene within 5 minutes of 9-1-1 call 90% of the time.

      1. You know, Tim, save it. Ted is exactly right. We all have families to support, mortgages to pay, and jobs to do in addition to the EMS 2.0 movement. Do you think life for Mark just stops when he wants to hop on a plane to Denver? Do you think Ted and Mark’s employers just let them run wild and take paid time off at their leisure? The people who are standing behind this are doing so because they believe in it, and not because they have any potential financial gain. We write our blogs, we spend time reading and reflecting on each other, and we spread the word to those around us on our own time and for the benefit of the greater good.

        Rome wasn’t built in a day, and EMS will not be changed in a year. Accomplishments like the ones that were had in Denver are huge steps forward for an industry where many just roll with the punches and dont take the time to ask why, or try to make a change from the street level. As things progress, and as these EMS leaders buy into what we are trying to sell them, then you will start seeing things really start going in the direction that we want them to.

        You always seem to start some sort of controversy. My advise to you: sit back, read and learn. There are a lot of extremely intelligent people around you who could teach you a lot about what our industry does, and you will learn more than you ever could reading about bystander CPR rates, and going over response times…

        1. “Rome wasn’t built in a day, and EMS will not be changed in a year. Accomplishments like the ones that were had in Denver are huge steps forward for an industry where many just roll with the punches and dont take the time to ask why, or try to make a change from the street level.”

          Justin is actually DOING something. Only problem is most people have no idea he’s doing it. He’s working to create an ALS rapid response program in San Francisco. If that happens it will be a huge accomplishment.

          “You always seem to start some sort of controversy. My advise to you: sit back, read and learn. There are a lot of extremely intelligent people around you who could teach you a lot about what our industry does, and you will learn more than you ever could reading about bystander CPR rates, and going over response times…”

          My whole interest is in questions that no one for sure knows the answer to such as “Do cities with populations between 400,000 and 800,000 that have tiered-response (ALS only to certain calls) have more endotracheal intubations per medic than those with single-tier (ALS personnel make all patient contacts) systems? And do the tiered systems have higher ETI success rates?”

      2. Tim, you seem to have the passion, have acquired a lot of facts and come up with some potential solutions. Better you should work with other people that have the same goals, rather than rant against them because their process may be different. If you can find a way to take all your good ideas, have them appreciated, approved, and funded, more power to you. In the meantime, appreciate that others are trying to make a difference in their own way.

        1. “In the meantime, appreciate that others are trying to make a difference in their own way.”

          Like DC Fire. They had a problem like most systems do with frequent fliers so they solved that problem. I only appreciate other people’s attempts to make the world a better place when it actually works or was very interesting. Ideas are cheap. Execution isn’t.

  5. Justin,

    Was good to finally meet you and Mark when our paths finally crossed in Denver this week.

    I’m glad that the connection with ZOLL has been working out so well. Blake Cerullo is another person at ZOLL that I know was working in background and was absolutely instrumental in getting this going on their end.

    Looking forward to helping CoEMS in whatever way I can and collaborating on future projects of mutual interest.

    — Mic

    Mic Gunderson, President, IPS

  6. I kept reading this, hoping for a happy face or something to indicate Tim didn't mean to be as disrespectful as this sounded. I didn't find it. “As long as EMS 2.0 is nothing more than blogs, videos, and presentations it will remain a joke.” So, you think that a small group of firefighters and EMS people that have come together basically in less than a year should have been able to change problems that have been around since the beginning of EMS? That's pretty unrealistic. Might I remind you that they (we) are people that recognize that changes need to be made in EMS and are spending a lot of their time away from their jobs and families, often at their own expense, to try and grow awareness of this through social media. It's through that awareness that the right people with the right power might be inspired to try and make those changes. EMS 2.0 and Chronicles of EMS is anything but a joke. Justin, Ted, Mark and the others can be sitting in their stations and bitching about the issues instead of trying to do something about it. I really would like to know, Tim, how you think this small group of “boots on the ground” people are supposed to (immediately) change long term issues like frequent flyers, low pay and disrespect. Maybe you should start with showing a little respect to the people that are trying to do something positive. BTW, what have YOU done to make positive changes in the state of EMS???

  7. Timothy,

    You have a knack for sticking yourself into a discussion without reference and creating a lot of animosity. Until you come to me with any shred of decency and respect about what has been accomplished in the very short time we have been doing this, your comments represent the very nieve nature of your experience. I have three kids, wife and inlaws I have to support while building the brand of CoEMS and all technical aspects of the site and more. Let me be very direct and say that I appreciate your donation to the CoEMS team and it shows that you are heading in the right direction, but your comments here are not only hurtful, they are without a doubt poison to our whole mission and I publicly don't condone this. You don't support a cause by blasting what they haven't done, you suggest it.

    Learn from this Timothy or you will be ousted by the whole EMS community.

  8. “Tim, how you think this small group of “boots on the ground” people are supposed to (immediately) change long term issues like frequent flyers, low pay and disrespect.”

    By creating a formal group that has one message. These 3 big problems have already been solved, just not on a grand scale. DC Fire has sort of solved the frequent flyer problem by sending 3 paramedics and 1 nurse practitioner out to check up on the patients who call 9-1-1 a lot. An EMS 2.0 web site with the message of the EMS 2.0 community and how these big problems have already been solved and how any agency can implement these solutions would not be a joke.

    “BTW, what have YOU done to make positive changes in the state of EMS???”

    I'm creating EMS Compare which will allow anyone anywhere anytime to see how any EMS agency is performing and what is going on at a larger scale. Medicare's Hospital Compare website has encouraged hospitals to improve their door to balloon times because those times are publicly available and comparable. I hope EMS Compare will do something similar. Thanks to Myers Benchmarks EMS is moving away from just measuring performance based on response times and cardiac arrest. The site might actually make it easier to get public support because they'll see how well EMS is already performing.

  9. I just recently checked your site and found no link to a labor organization, a one page document on social media usage for agencies, pretty much everything you have mentioned I am not doing.
    Perhaps you've been missing the parts where this movement is catching the attention of industry leaders, being heard on a level and respectful playing field and gaining acceptance as a legitimate concept.
    I would love to speak more to this topic but I have to go meet with the Deputy Chief of an organization that is using technology to the benefit of their patients and see how I can share that with everyone.
    I apologize very deeply that we haven't changed 35 year old problems in the 1 year since I dealt with the situation that spawned this incarnation of a movement to change EMS.
    I look forward to your white paper on how to do all this.

  10. First of all I'm solving the problem that matters to me. The problem is I can't find out the names of the EMS agencies in a given area yet alone performance info.

    “I just recently checked your site and found no link to a labor organization, a one page document on social media usage for agencies, pretty much everything you have mentioned I am not doing.”

    OK I get on doing that right now.

  11. Well said, Sam. The only thing that is truly a joke here is Tim's comments. Change and evolution takes time, especially in a field where such changes have never been attempted. We can come out guns blazing, and making rash statements, and make ourselves look like some over eager jackasses who will never get the respect we deserve, or we can act as professionals, and show the world what we are able to do.

    Its sad, really, Sam. Tim will never understand this unless you can find some sort of clinical study that shows it. He knows nothing about what we do, and only bases his views off of what he sees immediately around him. The “my system works best, hands down” attitude is what we are all trying to get away from anyway.

    In reality, we should all be proud of what was accomplished over the last couple of weeks. I got to sit and watch Ted and Justin speak at the SFPA. I didnt want their presentation to end, and clearly neither did the group they were speaking in front of.

    And then, this week, we have Mark flying back across the Atlantic to stand up for US and our beliefs. Clearly, from what I read on Twitter, and on the blogs a lot was accomplished.

    Thanks, Justin, Ted, Mark, and everyone else who was in Denver working on turning this profession that I love so much into something more. Its going to take some baby steps, but we WILL get there.

  12. Justin,

    Was good to finally meet you and Mark when our paths finally crossed in Denver this week.

    I'm glad that the connection with ZOLL has been working out so well. Blake Cerullo is another person at ZOLL that I know was working in background and was absolutely instrumental in getting this going on their end.

    Looking forward to helping CoEMS in whatever way I can and collaborating on future projects of mutual interest.

    — Mic

    Mic Gunderson, President, IPS

  13. “Its sad, really, Sam. Tim will never understand this unless you can find some sort of clinical study that shows it. He knows nothing about what we do, and only bases his views off of what he sees immediately around him. The “my system works best, hands down” attitude is what we are all trying to get away from anyway.”

    DC Fire is kicking King County's butt when it comes to dealing with frequent flyers. King County could also improve it's two-tier system by doing what Boston does and simply have the first-tier responder also be the transport crews. Now if an agency wants to achieve 49% survival for bystander witnessed VF (cardiac eitology) then King County, Rochester, Minnesota, Wake County, Rock County, Wisconsin, Boston are the places to study. It's pretty simple high bystander cpr rate (50%) combined with BLS on scene within 5 minutes of 9-1-1 call 90% of the time.

  14. You know, Tim, save it. Ted is exactly right. We all have families to support, mortgages to pay, and jobs to do in addition to the EMS 2.0 movement. Do you think life for Mark just stops when he wants to hop on a plane to Denver? Do you think Ted and Mark's employers just let them run wild and take paid time off at their leisure? The people who are standing behind this are doing so because they believe in it, and not because they have any potential financial gain. We write our blogs, we spend time reading and reflecting on each other, and we spread the word to those around us on our own time and for the benefit of the greater good.

    Rome wasn't built in a day, and EMS will not be changed in a year. Accomplishments like the ones that were had in Denver are huge steps forward for an industry where many just roll with the punches and dont take the time to ask why, or try to make a change from the street level. As things progress, and as these EMS leaders buy into what we are trying to sell them, then you will start seeing things really start going in the direction that we want them to.

    You always seem to start some sort of controversy. My advise to you: sit back, read and learn. There are a lot of extremely intelligent people around you who could teach you a lot about what our industry does, and you will learn more than you ever could reading about bystander CPR rates, and going over response times…

  15. Tim, you seem to have the passion, have acquired a lot of facts and come up with some potential solutions. Better you should work with other people that have the same goals, rather than rant against them because their process may be different. If you can find a way to take all your good ideas, have them appreciated, approved, and funded, more power to you. In the meantime, appreciate that others are trying to make a difference in their own way.

  16. Timothy -

    Like you, I am the type of person who has to learn things the hard way. One thing I have that you don’t is the benefit of an additional 19 years of life experience.

    It would be interesting for me to see how things turn out for you. Good luck with your demons.

    Tom

    1. Thank you for that very nice message. I respect you a lot. We’ve had some good discussions about cardiac arrest. My favorite post of yours is the interview of Dr. Keith Lurie.

      What were some of the things you had to learn the hard way?

      1. That it’s more important to be influential than right. That you can alienate people and entrench them in their position when you’re overbearing. That all things have a place, a time, and a season. That you can’t accomplish large goals by yourself. That you need other people, and they are human beings with unique perspectives that you can learn from. That you should say, “I’m sorry” when you offend good people, because it’s the first step in repairing the relationship. I think you have a lot of potential, but if you’re not careful you will become your own worst enemy.

        Tom

      2. That it’s more important to be influential than right. That you can alienate people and entrench them in their position when you’re overbearing. That all things have a place, a time, and a season. That you can’t accomplish large goals by yourself. That you need other people, and they are human beings with unique perspectives that you can learn from. That you should say, “I’m sorry” when you offend good people, because it’s the first step in repairing the relationship. I think you have a lot of potential, but if you’re not careful you will become your own worst enemy.

        Tom

  17. What you accomplished is overnight fund-raising and permission for a 20 minute video showing issues around frequent flyers. Pretty cool. You did a bunch of video taped discussions with paramedics and administrators. Pretty cool. But guess what none of it matters. What matters is agencies like DC Fire have solved significant problems. They solved those problems before CoEMS showed up.

    I have tried repeatably to help you and your cause before and after criticizing you, but you don't want my help, so I'll just keep criticizing you and your mission. You care more about the fact that I'm not an EMT then you do about the fact I'm a guy with a lot of free time, a lot of interest, and the ability to look stuff up, write code, etc. You can put an end to this bashing simply by sending me an email with how I can help you.

  18. “In the meantime, appreciate that others are trying to make a difference in their own way.”

    Like DC Fire. They had a problem like most systems do with frequent fliers so they solved that problem. I only appreciate other people's attempts to make the world a better place when it actually works or was very interesting. Ideas are cheap. Execution isn't.

  19. Timothy,

    You have single handedly dug your own grave with regards to support. Not only will I never ask you for help, you have disrespected me and my colleagues and changed how I feel about your lack of experience. I once thought I would just wait to see what your true colors were, well today you made that clear.

    I will support everyone else who appears to not have EMS experience and wants to help, but my requirement is respect. Respect those in the community, respect those who care enough to bring about change, respect where we came from, you have done none of this.

    Sad timothy, sad… you almost had me convinced that you were worth spending time to grow and use in our campaign.

    Now next topic… moving EMS forward with respect…

    1. As a representative of our generation and what we bring to the healthcare movement, let me say this, Tim. I can research all day, I can run calls all day and night. My boots get bloody and muddy just like Justin’s, Mark’s, Montera’s, Sam’s and Setla’s- night after night. What makes them different is experience. Sure, I’ve done CPR a dozen times or more, I’ve read about it and researched studies, but to my 3 years, these people have 10…15…20 years of these experiences. This is why they’re leading the way. I place my full trust in the direction they are leading us. I respect your enthusiasm and passion, Tim. If only every new EMT had this much drive to see change… but you can’t come into a war and expect to take over for the general when you’re just a private. You know I heart ya, buddy… but cutting down the generals never get us Privates anywhere.

      And Sam- I truly appreciate the contributions you’ve made to EMS. You did help write my Paramedic text, after all… so by proxy you were my teacher.

      Setla, Justin, Mark- you boys are so dedicated to this movement it inspires me. You have families, and full time jobs, yet you find time to change our industry. Yes, change. You know it, I know it… no matter what anyone else says. You always have my full support. I love you guys.

    2. As a representative of our generation and what we bring to the healthcare movement, let me say this, Tim. I can research all day, I can run calls all day and night. My boots get bloody and muddy just like Justin’s, Mark’s, Montera’s, Sam’s and Setla’s- night after night. What makes them different is experience. Sure, I’ve done CPR a dozen times or more, I’ve read about it and researched studies, but to my 3 years, these people have 10…15…20 years of these experiences. This is why they’re leading the way. I place my full trust in the direction they are leading us. I respect your enthusiasm and passion, Tim. If only every new EMT had this much drive to see change… but you can’t come into a war and expect to take over for the general when you’re just a private. You know I heart ya, buddy… but cutting down the generals never get us Privates anywhere.

      And Sam- I truly appreciate the contributions you’ve made to EMS. You did help write my Paramedic text, after all… so by proxy you were my teacher.

      Setla, Justin, Mark- you boys are so dedicated to this movement it inspires me. You have families, and full time jobs, yet you find time to change our industry. Yes, change. You know it, I know it… no matter what anyone else says. You always have my full support. I love you guys.

  20. There will be no appreciation for your efforts, your work or your passion. From now on you have to earn that.

  21. “Rome wasn't built in a day, and EMS will not be changed in a year. Accomplishments like the ones that were had in Denver are huge steps forward for an industry where many just roll with the punches and dont take the time to ask why, or try to make a change from the street level.”

    Justin is actually DOING something. Only problem is most people have no idea he's doing it. He's working to create an ALS rapid response program in San Francisco. If that happens it will be a huge accomplishment.

    “You always seem to start some sort of controversy. My advise to you: sit back, read and learn. There are a lot of extremely intelligent people around you who could teach you a lot about what our industry does, and you will learn more than you ever could reading about bystander CPR rates, and going over response times…”

    My whole interest is in questions that no one for sure knows the answer to such as “Do cities with populations between 400,000 and 800,000 that have tiered-response (ALS only to certain calls) have more endotracheal intubations per medic than those with single-tier (ALS personnel make all patient contacts) systems? And do the tiered systems have higher ETI success rates?”

  22. As a person who photographs the LAFD and LACOFD I am proud that the word is getting out to those who don’t understand the world of EMS.. It is not easy for these men and women to do what they do day in and day out. I commend you men for everything that has been said and done. Keep up the good work..

    P.S. I learned a long time ago that when you have HATERS, that means you are doing something right…..

    1. “P.S. I learned a long time ago that when you have HATERS, that means you are doing something right…..”

      I was all set to prove you wrong but thanks to a Google search I found this:
      “When I hate, I realize that I’m just jealous someone else is doing something I wish I was doing”

    2. “P.S. I learned a long time ago that when you have HATERS, that means you are doing something right…..”

      I was all set to prove you wrong but thanks to a Google search I found this:
      “When I hate, I realize that I’m just jealous someone else is doing something I wish I was doing”

  23. As a person who photographs the LAFD and LACOFD I am proud that the word is getting out to those who don’t understand the world of EMS.. It is not easy for these men and women to do what they do day in and day out. I commend you men for everything that has been said and done. Keep up the good work..

    P.S. I learned a long time ago that when you have HATERS, that means you are doing something right…..

  24. Timothy -

    Like you, I am the type of person who has to learn things the hard way. One thing I have that you don't is the benefit of an additional 19 years of life experience.

    It would be interesting for me to see how things turn out for you. Good luck with your demons.

    Tom

  25. Thank you for that very nice message. I respect you a lot. We've had some good discussions about cardiac arrest. My favorite post of yours is the interview of Dr. Keith Lurie.

    What were some of the things you had to learn the hard way?

  26. timothy,

    Remember this… People will forget what you say, people will forget what you have done, but they will never forget how you make them feel…

    ~May Angelou

  27. Timothy, Timothy, Timothy…….*Sigh…*
    Im sure that we had this conversation a few weeks ago, did we not?
    Im also sure that at that time you thanked me for my advice and said I was right. So, what happened?
    I have tried to show some compassion and guidance to you in the past, tried to shape the way you approach conflicting ideas so that we can all hear your voice without immediately rebelling against it. I tried to get you to appreciate those of us who are trying to do stuff, and have you engage with us.
    We are not so naive to think that we know all of the answers.That is what this whole thing is about, learning from others and sharing to effect change.
    How on earth do you expect senior decision makers to just jump on board what they see as a new, radical and sometimes risky way of effecting change. You think that if we publish a one page document then it will all be fine and dandy?
    Anything new needs time to bed in. It needs time to slowly permeate through to those who have previously had concerns about it. It will never work to have a loud shouting voice without any reasoning behind it trying to put their own views across without having any realisation about the wider picture.
    I can see that you appear to have listened to sense with Toms advice again, but you appear to be setting a trend here. You come in to stir up controversy, you come in to disrespect so many of our community and you provide no value to your input into our community.
    Now im not saying that you always will not have value, but up till now, the proof is in the writing.
    Im sorry that you have done this again, and to be honest, your apologies are difficult to accept because this could just be a ‘copy’, ‘paste’ of the last time this happened and the apology you made then.
    You have lost my respect, which is a shame, as I am probably one of the most tolerant of us here.
    Good luck Sir!

  28. Timothy, Timothy, Timothy…….*Sigh…*
    Im sure that we had this conversation a few weeks ago, did we not?
    Im also sure that at that time you thanked me for my advice and said I was right. So, what happened?
    I have tried to show some compassion and guidance to you in the past, tried to shape the way you approach conflicting ideas so that we can all hear your voice without immediately rebelling against it. I tried to get you to appreciate those of us who are trying to do stuff, and have you engage with us.
    We are not so naive to think that we know all of the answers.That is what this whole thing is about, learning from others and sharing to effect change.
    How on earth do you expect senior decision makers to just jump on board what they see as a new, radical and sometimes risky way of effecting change. You think that if we publish a one page document then it will all be fine and dandy?
    Anything new needs time to bed in. It needs time to slowly permeate through to those who have previously had concerns about it. It will never work to have a loud shouting voice without any reasoning behind it trying to put their own views across without having any realisation about the wider picture.
    I can see that you appear to have listened to sense with Toms advice again, but you appear to be setting a trend here. You come in to stir up controversy, you come in to disrespect so many of our community and you provide no value to your input into our community.
    Now im not saying that you always will not have value, but up till now, the proof is in the writing.
    Im sorry that you have done this again, and to be honest, your apologies are difficult to accept because this could just be a ‘copy’, ‘paste’ of the last time this happened and the apology you made then.
    You have lost my respect, which is a shame, as I am probably one of the most tolerant of us here.
    Good luck Sir!

    1. Something I did not realize until 40 minutes ago is I’m jealous of all the attention you, Justin, and Ted are getting. What I understand now is that if I want the attention you get then I’m going to have to put in the time you put in. You did what I haven’t namely become a paramedic, understand the system, and then recommend improvements. I have been doing the exact opposite.

      “How on earth do you expect senior decision makers to just jump on board what they see as a new, radical and sometimes risky way of effecting change. You think that if we publish a one page document then it will all be fine and dandy?”

      The page document comment was made in regards to social media policy. In my opinion having a well-thought out but simple document on the web anyone can download and adapt for their organization would be a major accomplishment. I think such a document could be produced and adopted by partnering with the National EMS Managers Association and other similar organizations.

      “Im sorry that you have done this again, and to be honest, your apologies are difficult to accept because this could just be a ‘copy’, ‘paste’ of the last time this happened and the apology you made then.”

      As time goes on we’ll see if this apology was just words written down or a real change in how I interact with others. I know personal change is very difficult, but I know difficult things can be accomplished.

    2. Something I did not realize until 40 minutes ago is I’m jealous of all the attention you, Justin, and Ted are getting. What I understand now is that if I want the attention you get then I’m going to have to put in the time you put in. You did what I haven’t namely become a paramedic, understand the system, and then recommend improvements. I have been doing the exact opposite.

      “How on earth do you expect senior decision makers to just jump on board what they see as a new, radical and sometimes risky way of effecting change. You think that if we publish a one page document then it will all be fine and dandy?”

      The page document comment was made in regards to social media policy. In my opinion having a well-thought out but simple document on the web anyone can download and adapt for their organization would be a major accomplishment. I think such a document could be produced and adopted by partnering with the National EMS Managers Association and other similar organizations.

      “Im sorry that you have done this again, and to be honest, your apologies are difficult to accept because this could just be a ‘copy’, ‘paste’ of the last time this happened and the apology you made then.”

      As time goes on we’ll see if this apology was just words written down or a real change in how I interact with others. I know personal change is very difficult, but I know difficult things can be accomplished.

      1. This is my last comment on this subject and I am moving on. As direct as I can be Respect is a word that most kids don’t understand until it is too late, I am teaching that to my kids now and I find that I have patience for them, not you. There is nothing for me to apologize to you for and I will not expect one from you either. The day you graduate from EMT school or Paramedic school call me and I will welcome you back into my circle.

        1. I posted above earlier an apology to you: “Thank you for that quote. I’m sorry I hurt you. It was wrong of me. I will stop criticizing you.”

          “The day you graduate from EMT school or Paramedic school call me and I will welcome you back into my circle.”

          OK except a phone call from me in January. I won’t have my cert due to the affiliation requirement, but I will have hopefully passed the fall EMT class.

        2. I posted above earlier an apology to you: “Thank you for that quote. I’m sorry I hurt you. It was wrong of me. I will stop criticizing you.”

          “The day you graduate from EMT school or Paramedic school call me and I will welcome you back into my circle.”

          OK except a phone call from me in January. I won’t have my cert due to the affiliation requirement, but I will have hopefully passed the fall EMT class.

          1. What changed your mind? Last month you told us all how you would never in a million years do our job.

            Research might be for you, Tim, but maybe EMS isnt.

          2. What changed your mind? Last month you told us all how you would never in a million years do our job.

            Research might be for you, Tim, but maybe EMS isnt.

      2. This is my last comment on this subject and I am moving on. As direct as I can be Respect is a word that most kids don’t understand until it is too late, I am teaching that to my kids now and I find that I have patience for them, not you. There is nothing for me to apologize to you for and I will not expect one from you either. The day you graduate from EMT school or Paramedic school call me and I will welcome you back into my circle.

      3. Timothy-

        I used to be one who liked to “stir the pot”. But I found that I grew a lot more once I started being one who focused on how to make things better, vs. focusing on what was wrong. If I could make a suggestion for the future- buy and read “How to Win Friends And Influence People” by Dale Carnegie. It changed my life, and I cannot praise it enough. Use the techniques in that book for your debates, and I guarantee you at least half a fighting chance of gaining some semblance of respect back from these industry leaders. If you’re even halfway serious about your future career, trust me, it will be worth the investment.

      4. Timothy-

        I used to be one who liked to “stir the pot”. But I found that I grew a lot more once I started being one who focused on how to make things better, vs. focusing on what was wrong. If I could make a suggestion for the future- buy and read “How to Win Friends And Influence People” by Dale Carnegie. It changed my life, and I cannot praise it enough. Use the techniques in that book for your debates, and I guarantee you at least half a fighting chance of gaining some semblance of respect back from these industry leaders. If you’re even halfway serious about your future career, trust me, it will be worth the investment.

  29. That it's more important to be influential than right. That you can alienate people and entrench them in their position when you're overbearing. That all things have a place, a time, and a season. That you can't accomplish large goals by yourself. That you need other people, and they are human beings with unique perspectives that you can learn from. That you should say, “I'm sorry” when you offend good people, because it's the first step in repairing the relationship. I think you have a lot of potential, but if you're not careful you will become your own worst enemy.

    Tom

  30. As a representative of our generation and what we bring to the healthcare movement, let me say this, Tim. I can research all day, I can run calls all day and night. My boots get bloody and muddy just like Justin's, Mark's, Montera's, Sam's and Setla's- night after night. What makes them different is experience. Sure, I've done CPR a dozen times or more, I've read about it and researched studies, but to my 3 years, these people have 10…15…20 years of these experiences. This is why they're leading the way. I place my full trust in the direction they are leading us. I respect your enthusiasm and passion, Tim. If only every new EMT had this much drive to see change… but you can't come into a war and expect to take over for the general when you're just a private. You know I heart ya, buddy… but cutting down the generals never get us Privates anywhere.

    And Sam- I truly appreciate the contributions you've made to EMS. You did help write my Paramedic text, after all… so by proxy you were my teacher.

    Setla, Justin, Mark- you boys are so dedicated to this movement it inspires me. You have families, and full time jobs, yet you find time to change our industry. Yes, change. You know it, I know it… no matter what anyone else says. You always have my full support. I love you guys.

  31. As a person who photographs the LAFD and LACOFD I am proud that the word is getting out to those who don't understand the world of EMS.. It is not easy for these men and women to do what they do day in and day out. I commend you men for everything that has been said and done. Keep up the good work..

    P.S. I learned a long time ago that when you have HATERS, that means you are doing something right…..

  32. “P.S. I learned a long time ago that when you have HATERS, that means you are doing something right…..”

    I was all set to prove you wrong but thanks to a Google search I found this:
    “When I hate, I realize that I’m just jealous someone else is doing something I wish I was doing”

  33. Timothy, Timothy, Timothy…….*Sigh…*
    Im sure that we had this conversation a few weeks ago, did we not?
    Im also sure that at that time you thanked me for my advice and said I was right. So, what happened?
    I have tried to show some compassion and guidance to you in the past, tried to shape the way you approach conflicting ideas so that we can all hear your voice without immediately rebelling against it. I tried to get you to appreciate those of us who are trying to do stuff, and have you engage with us.
    We are not so naive to think that we know all of the answers.That is what this whole thing is about, learning from others and sharing to effect change.
    How on earth do you expect senior decision makers to just jump on board what they see as a new, radical and sometimes risky way of effecting change. You think that if we publish a one page document then it will all be fine and dandy?
    Anything new needs time to bed in. It needs time to slowly permeate through to those who have previously had concerns about it. It will never work to have a loud shouting voice without any reasoning behind it trying to put their own views across without having any realisation about the wider picture.
    I can see that you appear to have listened to sense with Toms advice again, but you appear to be setting a trend here. You come in to stir up controversy, you come in to disrespect so many of our community and you provide no value to your input into our community.
    Now im not saying that you always will not have value, but up till now, the proof is in the writing.
    Im sorry that you have done this again, and to be honest, your apologies are difficult to accept because this could just be a ‘copy’, ‘paste’ of the last time this happened and the apology you made then.
    You have lost my respect, which is a shame, as I am probably one of the most tolerant of us here.
    Good luck Sir!

  34. Something I did not realize until 40 minutes ago is I'm jealous of all the attention you, Justin, and Ted are getting. What I understand now is that if I want the attention you get then I'm going to have to put in the time you put in. You did what I haven't namely become a paramedic, understand the system, and then recommend improvements. I have been doing the exact opposite.

    “How on earth do you expect senior decision makers to just jump on board what they see as a new, radical and sometimes risky way of effecting change. You think that if we publish a one page document then it will all be fine and dandy?”

    The page document comment was made in regards to social media policy. In my opinion having a well-thought out but simple document on the web anyone can download and adapt for their organization would be a major accomplishment. I think such a document could be produced and adopted by partnering with the National EMS Managers Association and other similar organizations.

    “Im sorry that you have done this again, and to be honest, your apologies are difficult to accept because this could just be a ‘copy’, ‘paste’ of the last time this happened and the apology you made then.”

    As time goes on we'll see if this apology was just words written down or a real change in how I interact with others. I know personal change is very difficult, but I know difficult things can be accomplished.

  35. This is my last comment on this subject and I am moving on. As direct as I can be Respect is a word that most kids don't understand until it is too late, I am teaching that to my kids now and I find that I have patience for them, not you. There is nothing for me to apologize to you for and I will not expect one from you either. The day you graduate from EMT school or Paramedic school call me and I will welcome you back into my circle.

  36. I posted above earlier an apology to you: “Thank you for that quote. I'm sorry I hurt you. It was wrong of me. I will stop criticizing you.”

    “The day you graduate from EMT school or Paramedic school call me and I will welcome you back into my circle.”

    OK except a phone call from me in January. I won't have my cert due to the affiliation requirement, but I will have hopefully passed the fall EMT class.

  37. What changed your mind? Last month you told us all how you would never in a million years do our job.

    Research might be for you, Tim, but maybe EMS isnt.

  38. Timothy-

    I used to be one who liked to “stir the pot”. But I found that I grew a lot more once I started being one who focused on how to make things better, vs. focusing on what was wrong. If I could make a suggestion for the future- buy and read “How to Win Friends And Influence People” by Dale Carnegie. It changed my life, and I cannot praise it enough. Use the techniques in that book for your debates, and I guarantee you at least half a fighting chance of gaining some semblance of respect back from these industry leaders. If you're even halfway serious about your future career, trust me, it will be worth the investment.

  39. Having medics and NPs in DC check in on frequent flyers certainly will not solve the problem lol. Its a wide spread, rampant issue. People will call weekly, people will have chronic legitimate and illegitimate issues constantly. It will rain and get cold, people will get hungry, and people will call an ambulance to come drive them to the ER where they will receive “3 hots and a cot”

    Everyone has their own ideas and inputs for solutions to the many problems we face. In my opinion, surely improvements can be made, but what it boils down to is this: We are public servants, we serve the people of the cities and counties that we provide for. They will always have the upper hand and we will always have some sort of problem. Educating them can definitely close the gap, however. And I commend those who are taking on this enormous battle. One step at a time… Changes take years, but the first steps have already been taken.

  40. Having medics and NPs in DC check in on frequent flyers certainly will not solve the problem lol. Its a wide spread, rampant issue. People will call weekly, people will have chronic legitimate and illegitimate issues constantly. It will rain and get cold, people will get hungry, and people will call an ambulance to come drive them to the ER where they will receive “3 hots and a cot”

    Everyone has their own ideas and inputs for solutions to the many problems we face. In my opinion, surely improvements can be made, but what it boils down to is this: We are public servants, we serve the people of the cities and counties that we provide for. They will always have the upper hand and we will always have some sort of problem. Educating them can definitely close the gap, however. And I commend those who are taking on this enormous battle. One step at a time… Changes take years, but the first steps have already been taken.

  41. Having medics and NPs in DC check in on frequent flyers certainly will not solve the problem lol. Its a wide spread, rampant issue. People will call weekly, people will have chronic legitimate and illegitimate issues constantly. It will rain and get cold, people will get hungry, and people will call an ambulance to come drive them to the ER where they will receive “3 hots and a cot”

    Everyone has their own ideas and inputs for solutions to the many problems we face. In my opinion, surely improvements can be made, but what it boils down to is this: We are public servants, we serve the people of the cities and counties that we provide for. They will always have the upper hand and we will always have some sort of problem. Educating them can definitely close the gap, however. And I commend those who are taking on this enormous battle. One step at a time… Changes take years, but the first steps have already been taken.

  42. Having medics and NPs in DC check in on frequent flyers certainly will not solve the problem lol. Its a wide spread, rampant issue. People will call weekly, people will have chronic legitimate and illegitimate issues constantly. It will rain and get cold, people will get hungry, and people will call an ambulance to come drive them to the ER where they will receive “3 hots and a cot”

    Everyone has their own ideas and inputs for solutions to the many problems we face. In my opinion, surely improvements can be made, but what it boils down to is this: We are public servants, we serve the people of the cities and counties that we provide for. They will always have the upper hand and we will always have some sort of problem. Educating them can definitely close the gap, however. And I commend those who are taking on this enormous battle. One step at a time… Changes take years, but the first steps have already been taken.

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