Kilted to Kick Cancer continues to turn heads and open conversations with total strangers about male specific cancers.  More so than either myself, Motocop or the starter of all this TOTWTYTR could have imagined I’m sure.

A random woman in her “early 60′s” (had I seen her at work I would have guessed 70′s) asked about the kilt in an airport food vendor line.  I mentioned the campaign and our intent for men to get checked.  Suddenly, after having known me for less than 60 seconds, has mentioned her husband sometimes has blood in his semen.  He told her it happens to “men of a certain age.”  NEGATIVE GHOSTRIDER!  I told her to call her husband from the airport to schedule an appointment with his doctor ASAP.

This is the exact mindset that likely has this man past the intervention stage if he does in fact have prostate issues.  If only she could have bumped into a kilted man 30 years ago.

And that is the point here folks.  We need to raise awareness so that when the generation staring at facebook is old enough they know what needs to get checked.  Heck, how many folks go overdue on their oil change on the car, let alone keeping up with their own health and that of those around them.

Visit the links, share them with important men in your life and if you can spare a few bucks to help research, click the links below the Kilted to Kick Cancer logo there in the sidebar.  Next month everything will turn pink for breast cancer and the kilts will go back on the hangers (not for too long though, details on that soon), but the fact remains that this cancer is killing almost as many men as breast cancer kills women and we’ve only scratched the surface on even researching it.  Like Motorcop says, cancer is like a giant domino game.  Once one falls, the rest are sure to follow.

Kilt up, and if you don’t have a kilt, support a blogger who does!

From my childhood comes a fear so concrete, so engrained in my being that even as an adult in a well lit room I would be confronted by this fear and turn into the 6 year old I was when I first experienced it.

Goosebumps, anxiety, a desire to run…fast.  Fear is a powerful thing and overcoming it isn’t easy.

Those of you who attended the EMS World Expo HollyWood Nights party recently know exactly what, and who, I’m referring to.

I have a friend who is deathly afraid of clowns.  Any kind of clown, from cute to scary and he tries to punch his way out.  One year we thought we’d interrupt a Halloween party by having a clown ride through the party on a little clown bike.  That didn’t go so well.  He didn’t confront his fear and the clown recovered after a few days.

I don’t mind clowns in general, just the one.

The clown from Poltergeist.  In the film a clown doll comes to life trying to kill a little boy who was my age at the time.  It laughed, it hid under the bed, it’s arms grew, all the things clowns don’t usually do.  That scene, which we all know I saw too young, burned itself into every synapse in my brain and every time that movie would come on I’d be fine until the clown scene.  Even a few weeks ago I tried to watch it on a warm sunny afternoon.

Nope, the fear was too intense.  I had to turn off the TV and go outside.  Like I said before, fear is a powerful thing.

At the party this last week there was a variety of movie memorabilia, props and the like from a number of films scattered about the restaurant.  Over in one corner was the gun prop from Escape from New York, over there a bit from here and over here a bit from there, you get the idea.  At the bar enjoying a drink I mentioned all the neat memorabilia around us when someone pointed out the prop not 3 feet from me the entire time.

The clown.

My fear response was intense, I’m told there is video, and I’m immediately trying to get to the door.  That clown will start laughing, break out of the glass he’s in and try to kill me, that’s what he’s done all my life.  My friends built a wall and pushed me forward telling me I had to face me fear.

Reluctant is a word you could use.  Still squirming to get out of this confrontation my mind is telling me it is only wood and fabric, created by a prop guy.  The 6 year old in me is peeing his pants.  The fear was so intense I can barely describe it and before this encounter would never have been able to even write this much on the subject, let alone think it.

But this is where I tried to step up tall and face the clown who so permeated my fears.

I heard someone nearby say, “Look! He’s not even wearing a kilt!”  I was, as many others were, and suddenly I was able to catch a breath, a half a breath at least and took that sliver of a window of opportunity and reluctantly reached out and touched the glass.  It suddenly, without explanation, looked different.  It was a neat looking clown toy, with little white bloomers and a clearly well carved wooden face in a classic clown design.  I appreciated the workmanship of the prop master and how the magic of the movies made him come to life.

And just like that, my fear was gone.  The rest of the evening I kept looking over at the clown in the glass and wondering if the 6 year old inside would think this had all been a dream and suddenly awake to see the clown at the foot of his bed.  But when I listened I heard him laughing at the clown. “You’re wearing bloomers, you’re wearing bloomers.”

Inspired in part by Motorcop and his hatred for the confusion between jail and prison I too would like to clear a few things up for the general public.  Nearly everything you have ever seen on TV about fire, police and EMS is false, yet you assume it to be accurate.  Especially all the medical dramas…I get that you watched season 3 of Grey’s last night and know what abdominal pain could be, but listen, it was probably the 4 packages of TGIFridays jalapeno poppers, not an AAA, so sit down before you hurt yourself and actually need an ambulance.

Misconception #1: You call for an ambulance.

When your kid cuts his finger, when your cough won’t go away or when your neighbor seems to be walking funny and the Today Show says it could be a stroke, you do not call an ambulance.

You call for help.

The help that arrives is what you want, don’t look at me funny when you report your kid’s laceration won’t stop bleeding and I arrive 4 minutes later in a big red truck.  Don’t get testy when I tell you the ambulance is coming but that he doesn’t need it.  I’m the expert, I’m going to talk for a few minutes and you’re going to do what I say.

OK, not really, the law makes YOU in charge of this emergency, what was I thinking?

In your extensive medical wisdom you’ve decided junior’s finger needs the ER, despite my assurances to the contrary and your ambulance has arrived.  We aren’t doing anything for him because, aside from the self adhesive bandage I have already applied, there is nothing more we, or the ER, can do.  “But because we go in with you, we’ll get seen quicker, right?”

Misconception #2: Arriving by ambulance will get you seen quicker.

No, no no my friend.  When you arrive by car and go inside and wait in line, then the person behind the desk asks you to fill out all the info and they let you see a nurse real quick, then sit and wait, that is called triage.

Triage is a word that means to sort.  We take the sickest people first.  Well, the ER does, I have to take every Tom Dick and Harry who asks, completely ruining what could be a proper working system, but that’s another blog entirely.  Well…not really, but we’re off track now.  See what you’ve done?

When we bring you in by ambulance, no lights and sirens, stopping for every red light, we’re traveling no faster than you could be.  Then we arrive to a little nurse’s station where they collect your info and the SAME NURSE checks you out real quick.  Now guess what happens.  If you’re not sick enough to be seen right away, we take you off the cot and walk you to the chairs in the waiting room.  Then we make sure we have your billing address correct and say good day.

Misconception #3: The ER fills and refills prescriptions.

Cough been keeping you awake all night?  Too bad you never got that prescription filled.  You see, when a Doctor examines and diagnoses you, they may write a prescription for medication.  This little form lists your medication, dose and instructions and is the Doctor’s way of healing you, but you have to go just a might further on your own.  Goto the local Walmart and go back to that cool little office in the back and hand them the piece of paper the Doctor gave you.  You’re going to have to wait a few minutes, so go wander the tackle isle and wait for your name to be called.

Take the medicine home, read the instructions and follow them.  Oddly, your health will improve.  I know, weird.

Calling 911 at 4 in the morning and handing me the prescription will not help.  I do not dispense medications,  I administer them when indicated.  The ER does not have a pharmacy that dispenses medicines, just one that facilitates administration.  The ER will look at the prescription form and point you in the direction of the nearest 24 hour pharmacy.  I tried that, but you wouldn’t listen to reason and do the right thing, you demanded transport.  When you get home in 45 minutes, don’t call back.

Misconception #4: Your Doctor will be at the hospital.

Hate to break it to you Erma, but Dr Johnson is NOT at St Farthest today, it’s Sunday and he’s an endocrinologist.  He works for the same corporation as your hospital, cubbied into a group for billing purposes and is allowed access to your insurance corporation’s network of specialists and tests, but he is not there.  He will not be there, nor will I call him to let him know you’re going in again.  He will be notified should your condition warrant review by someone of his specialty.

Only once in my career have I seen a primary care race to the ER to meet a patient and she had more money than God, which gets you that kind of attention.  But still only gets her me in a City ambulance.  Figure that one out.

There it is, a quick list of some of the most common misconceptions in modern Emergency Medical Service.  If you ever wonder why it’s taking so long for an ambulance, chances are we’re taking care of someone who wants it, but doesn’t need it.

For someone called the Happy Medic I do seem to complain a lot.  A recent discussion with a trusted Fire Service friend who introduces himself as ” A Basic for life” circled back to why EMS folks are always complaining.

We complain about money, hours, crappy bosses, Medical Directors who don’t get it, patients who don’t need it and other agencies who aren’t doing exactly what we want them to be doing.

When he rattled off that list I couldn’t help but stifle a chuckle and agree, “Yup, that’s EMS in a nutshell.”

We in EMS love to be abused and have had plenty of chances to jump off this roller coaster but never do.  We come back over and over again not to complain and bitch and moan about it, which we love to do, but because we love to do this thing called EMS.  For every crappy call I make a difference on 2 others.  For every MD who has no clue what we do another steps forward and smiles when they see the compassion and care we give our patients.

The positives are out there and we see them, we even secretly think back to the times we were instrumental in making someone’s bad day just a hint better even if it was just for bringing them a blanket or putting their little dog in the back room before we left for the hospital.

EMS bloggers are notoriously negative because sharing the good moments isn’t as therapeutic as letting the bad ones out.  Griping about how much I hate little rat dogs (Nothing but love, MsP) relieves far more stress than a post about how nice it is that the elderly can keep pets better these days.  See, rat dog tirade beats observation about Granny any day.

From the outside my blog is a collection of complaints, gripes, wishes and dreams with very few shimmers of hope.  Well, that’s how it is on the inside as well, but if I came to this little wordpress screen and began to tell you all the good things about my chosen profession I would spend 22 hours on it instead of just the 2 I do complaining.

This is still my therapy experiment, shouting into this room of mine that used to be empty, but somewhere you and I connected on something, be it good or bad, inspiring or deplorable and each of you reading this likely has a different reason for stopping by again and again.

The Google tells me most of you like a good misuse of 911 story or a letter in the file of some EMT or Paramedic doing something stupid and I can see that, but keep in mind I have a smile on my face most days because this therapy experiment lets me get those emotions out here and not on scene.

And when we can side step burnout simply by venting, we extend a job into a career, and that’s what I’m here for.

Thanks for reading,

HM

A recent article in a major EMS publication has me second guessing how I communicate.  Regular readers may want to sit down before reading this.

Imagine that instead of thinking through a thought, concept or comment a person could simply spout it out, anonymously, for anyone who wanted to listen?  And not in a public arena, but from the comfort of their own home.

Gone are the days of decorum and civilized discussion when a person took out a pen and paper and wrote a letter to the editor.  Replacing that honorable tradition is this new technology promising to let us communicate instantly with anyone in the world, at a moment’s notice, to say anything about anything, not knowing who may be party to the conversation.

Privacy is gone.

When I speak my mind, where does it go? Into the ether to be collected on the other side, surely, but what of the intermediate?  Where is it before it gets to it’s destination?  We’ll never know who or what is there, listening in, watching for us, taking notes just in case.

No longer can correspondence be between two people when a third party could be a part of it at any moment, without notice.

This is unprecedented in world history and I can not be blind to it any more.  Where is our honor?  Where is our respect for our fellow man?  When did we decide that communicating instantly was more important than communicating well?

I imagine next we will stop referring to one another by our names but instead use the letters and numbers that define where we are in relation to this so called “new frontier” of social interaction.

Well, I’m out.  I have seen the dangers, read actual accounts of persons who have fallen out of good public standing because of someone reporting what was recorded and I am not going to take the chance that this technology comes between me and a meaningful relationship with my friends and colleagues.

I am giving up the telephone.

-HM

Rip Shear RS-1

A few weeks back I received a care package from the folks at Rip Shears.  Inside was quite the interesting little device, a removable dual blade cutter that can be attached to any standard 7 1/4″ trauma shear. From there you simply start a cut with the shears, then flip and rip. Take a look at this short YouTUBE video from Rip Shears:

This at first had me nervous.  Do I really need an open blade on my shears?  I wear a pair of shears on my duty and turnout belts and adding something so seemingly dangerous had me concerned I’d be replacing belt loops and turnout straps.

This was not the case at all.  I’ll get to the 2 issues I have with the product after I tell you why I’ll always be carrying one with me in the field from now on.

The Rip Shear seems like a simple device and it really is.  The fact that it is small and detachable means I can move it from shears to shears as needed instead of some giant device.  It also fits nearly perfectly into my existing leather pouch, since the shears fit as well.  I don’t wear BDU pants but did have a chance to test the shears snapped into a pair of Perfection pants supplied by Chronicles of EMS uniform supplier ALLMED.

AllMED Perfection EMT Pant

As you can see the gear does not hamper the ability to wear it, but the pocket just barely covers the blade, enough to likely get caught once or twice.

Drawback #1: The blades in the upward position.

When showing this tool around the ambulance yard one morning, one of the EMTs loved it.  He removed his regular shears from a lateral behind the back pouch and inserted the military green shears.  To show how easily they would deploy he pulled them out, not noticing his shirt got caught, and cut a clean rip in his shirt.  From this experience we chose to reverse the blade direction using only a screwdriver and voila, problem solved.

(l) as shipped (r)inverted

I now carry my own rip shear with the blades oriented down, took 45 seconds to switch.  There are no special tools required to remove and replace the Rip Shears, simply use a phillips screwdriver to remove the three screws, remove the blade unit and the guide unit, done.  The setup of the screws and hardware allows for the inverting of the blade and for attaching it to almost anything.

This far outweighs a single use tool that does not already incorporate itself into gear you already have.  Space in the bags and in my pouch is at a premium these days, so this little guy is more than welcome.

Another early concern was that the open blade would catch a finger.  I have to admit I was scared to handle these at first, but as shown in the photo, even little 5 year old fingers are safe from wandering into the blade area on the Rip Shears.  Fear not my thin fingered friends, you’re safe.

A 5 y/o's pinky finger does not fit

It took about 3-4 shifts to get used to having the slight extra height on my pouch and I now remove it to sit on furniture at work, mainly to discourage dirty looks when folks realize what’s on there.

The Rip Shear is available in black and a really neat glow-in-the-dark material that has been handy to have on a dark road on a night MVC.  Since EMTs can be excitable and use shears only to throw them away, I can easily track down my set and replace the Rip Shear onto another standard shear back at the station.

Drawback #2: The shears provided have a lip on the end too extreme to fit many pouches.  Again, easy fix here, just remove it and place it on a pair that does fit.  You can order your Rip Shear already attached to a set of shears, the website advises the manufacturer may change, so this may have simply been THAT particular supplier.  Yours may be different.

A perfect fit

The versatility of this product more than makes up for the out of the box issues we noticed.  When using the shears they worked exactly as advertised going through a few pairs of jeans in their time on my shears as well as the leather jacket of a very disagreeable clavicle fracture.  They cut like they look like they should.  No problems there.

I had hoped to grab an old pair of turnouts and use them to show how well they cut, but recent events here made it seem in poor taste.  Perhaps someone out there has an old set they would be willing to donate to Rip Shears?

Made in the USA and designed with Paramedic and EMT input I can’t think of a better addition to your kit for around $15.

Visit their website for more details and links to where to buy your own Rip Shears.

By way of new bloggers Magnum Boots and their BLDG4801 comes this find of the Chico PD PSA.

Atta Boy Chico! A Tip of the Helmet to ya!

Someone has been paying attention in class.
If your Bay Area Fire, Police or EMS agency wants to make a PSA, click over HERE, I know a guy.

The folks over at Magnum Boots have seen the power of social media and aside from maintaining twitter and facebook accounts that actually respond to followers, they’re going one step further and starting a blog.

BLDG4801 plans to feature:

• Insight on what’s happening at Magnum HQ
• In-depth interviews with key industry insiders
  
• Exclusive sneak peeks at new Magnum products
• Magnum contests and giveaways
• Field Tester, blogger and editorial reviews

As part of the blog launch they’re giving away $1,000 worth of Magnum gear to a lucky subscriber.  Check the site for details on how you can enter to win, and tell them FRNtv sent you!

We here at HMHQ wish them luck and hope to work with Magnum in the fall on a very special project.

screen capture of Season 3 Columbo

In 1968 a not yet crumpled rain coat wandered into a swanky flat where a murder had occurred carrying inside it a quiet young man who simply looked around.  The TV Movie “Prescription:Murder” was the debut of the world’s greatest homicide Detective Lt Columbo, played by Peter Falk.

Mr Falk died peacefully this morning in his home at the age of 83.

Lt Columbo always seemed to know more about the crime than he let on, the classic example of only asking questions you already know the answer to.  Rarely did he need all the fancy bells and whistles afforded to modern day Detectives, instead focusing on human nature and the fact that every criminal leaves clues, you just have to find them.  Each episode and every guest star was no match for the half chewed cigar and the signature rain coat with what inside seemed like a regular Joe Nobody.  Many a criminal dismissed him as incompetent but all knew that within 45 minutes we’d be hearing a full confession soon after Mr Falk delivered his signature Columbo line: “just one more thing…”

You will be missed Mr Falk.  I plan on watching “Prescription:Murder” again as soon as possible.

Thanks to the folks in the recent Santa Clara County Grand Jury, we now have positive proof that fire based EMS delivery using fire trucks is inefficient.

Phew.

I was worried we would never discover the problems draining tax payer dollars.  Did they know we’ve known this for nearly 20 years?  All they had to do was call me, or just google it even.  Instead tax dollars were used to show tax dollars are being used inefficiently.

I guess all the murders, robberies and other court cases are all finished there in Santa Clara.  Good thing they don’t have a baseball doping case to worry about.

What the grand jury failed to do, perhaps it is not in their interests, is look beyond the “retirement costs” and perhaps look at the system and how to deliver what our pal Chris Kaiser dubbed EMS based EMS.  Looks like Santa Clara needs to stop and rethink things, then start from scratch.  Someone suggested that once…but I digress.

This grand jury report will be cited by every union basher come election time in an effort to privatize public safety accounts and likely not lead to any changes in the delivery of first response EMS in Santa Clara County.

The report fails to mention that the local private provider does not have enough resources to completely cover the district for first response ALS.

So now what?

Oh, I covered this topic 2 years ago.  What, you missed it?

Top 10 New Responders without the Fire Department

and then

Top 10 New Responsibilities of the Fire Department

Poking fun at a serious topic for sure, but until we get away from a fee for transport model, this thing will never work guys.  Fire based, mailman based, if we base our service on what we can get paid instead of how best to serve the community, the system will never work properly.