Calculated Risk and Letters in the Files

Before you get too excited to hear what I think about the politician and the ambulance company at the shooting scene, close the door and take a seat.
Before you go ripping into scene safety and how this guy has no idea what it is we do, take a deep breath.

Because half of you are hypocrites.

How many of you race lights and sirens without wearing your seat belts? According to NIOSH studies and reviews of fatal and non fatal ambulance accidents…HALF. Yes, half.
Half of you are not wearing your seat belts in your ambulance.

So when you complain that some politician thinks you are invincible and should go racing into an unsafe scene, I almost gag knowing full well HALF of you already do that on a daily basis. And for even more minor incidents than the one in the press.

Yes, this is a letter in YOUR file. Those of you not wearing your seat belts in the cab of the ambulance. Patient care in the back does not even enter into this or the data I’m finding, this is only about in the cab.

So many were so fast to jump on the politician, yet how many of you really pay attention to yourselves on a daily basis?
Worried about a wrinkled shirt? Can’t reach the radio? Go ahead, try to give an excuse for not wearing your seat belt, the same thing you preach about to unrestrained drivers at wreck scenes. You can’t. There is no excuse for not wearing your seat belt in the cab of the ambulance. None.

Then why is not wearing one killing so many EMS responders?

We’re not a stupid group, stubborn perhaps, but we seem to understand kinematics and mechanism of injury, at least to the point it guides our treatment, but to not apply those standards to our own flesh and blood is insane.

Stop shaking your head and muttering that you already do wear it. Half of you are lying. Lying to yourselves.

I’ve had enough. You have made me unHappy.

Buckle up. I’m getting annoyed reading these studies about line of duty deaths and the lack of a simple click that could have made a difference. And if you are a LODD from not wearing a seat belt, should it really be a Line of Duty Death or should it be renamed Lack of Due Diligence?

Letters in the files are flying today

It’s been awhile since I had to fire up the typewriter and find carbon paper for these letters, but something very close to home has happened and we need to nip this all in the bud.

First letter in the file-

A Letter in the FileJason Brown, Colleton County Firefighter Paramedic, was released from duty last week after posting a cartoon video to his facebook page which featured harsh language and an exchange between a firefighter character and a doctor character.  We all remember Fireman Mike’s suggestions about when to call 911, and the language in that video wasn’t PG, but it lacked the confrontation shown in Jason’s video.  In a perfect world we would all watch this cartoon and laugh because I have had a similar conversation 100s of times in clinics and medical offices wondering just where these folks went to medical school.

But the end of the video is the only part I have an issue with – “We’re going to pretend this conversation never happened…” this implies that the fireman cartoon in the video is going to ignore the complaint and leave.  THAT is the reason this letter is going in your file, for a questionable ending to a cartoon video on the internet.

Second letter should not need to be written, but your knee jerked so hard so fast it went right up and kicked you in the face.

A Letter in the FileColleton County Fire-Rescue Director Barry McRoy.  In your termination letter to FF/PM Brown you mention “This video has created an embarrassing situation for this department, our public image and the cooperative relationship we enjoy with Colleton Medical Center. It reflects poorly on you and Colleton County.”

No, Sir, you and your Department made this an embarrassing situation for the department.  Ask Brown to remove the video and make a training film if so inclined to make movies keeps this in house and solves all the problems.

I can only assume your fear of the rest of the country finding out the working relationships your service might really have has scared you into firing anyone who tries to express themselves.

Was it the video, the characters or the fact the world saw it on his facebook page?  I can only assume he is like me on facebook, friends, family and coworkers following along.  When he posts the video maybe 100-200 people see it, maybe half that amount watch it.  That is how social media works. It isn’t put up on every single fire and EMS website for all to see…

…until you fired him for it.  You took an easily fixable in house “choice of words” situation and exploded it into a National example of a public safety agency afraid of social media.  Because of the way you handled this situation I and now my readers are reading about Colleton, whereas last week I did not even know the agency existed.

In my book, you Sir, are the one who should be fired for creating “…an embarrassing situation for this department, our public image and the cooperative relationship we enjoy with Colleton Medical Center. It reflects poorly on … Colleton County.”  Sound familiar?

Both of you need to sit down and TALK about this, face to face.  If the offended Doctor who likely asked you to fire Brown wants to join in, all the better.  Have a talk about the proper way to use social media to move the agency, EMS and medicine forward.

This is a sticky spot to be in for sure.  I’m sure if you look hard enough into my musings there is a reason Colleton would fire me too, and every other EMS and Fire blogger.

But think of it this way:

What if Brown had drawn his video cartoon and had it published in a national EMS magazine instead?  Perhaps a single panel cartoon showing a Paramedic and an MD disagreeing in an entertaining manner for all to enjoy?

Would that be OK?

Should Brown be fired?  I say no.  Reprimanded…perhaps, spoken to for sure, but firing him first thing shows fear.

That is not all.

Editor’s note: No the link to the video is not broken, it is not here.  Best part of all this is that you can find it all over the internet now, I don’t need to link to it here.

Great job, now stop!

Recently, I was able to take part in a unique rescue.

Dispatched just after 1 AM to a report of a person in the water, we are the first engine at the scene. Responding behind us are the truck company, ambulance, chief and paramedic supervisor as well as our heavy rescue units. The heavy rescue units are specially trained swimmers and divers but are at least 10 minutes behind us.

We spot her clinging to a thin cable, 15 feet below us along the dock about 10 feet from a large party boat.

Police have arrived and are moving a gang plank to the boat to gain access to the water level. We’ve deployed a flotation device but the victim is either too tired or too confused to grab onto it. Using ladders and hooks we are unable to reach the victim, despite multiple attempts. the water is cold and dangerous for those of us not properly trained or equipped.

We are able to arrange a staging area on the boat to remove the wet clothes and assess injury just as the heavy rescue team arrives, fully wetsuited and ready to work.
They are quick to the water and work safely and efficiently, attaching a rescue device and removing the victim from the water almost without visible effort. They made it look like nothing.
A tip of the helmet to those of you who were involved in the like clockwork water rescue. You delivered me a patient from a place I could not go.

And that’s where the praise ends and your letter begins.

When you removed the victim from the water, you were directed to the awaiting backboard and blankets so I and the awaiting ambulance crew to begin our assessment.
The victim was placed on the board and the straps tightened despite our requests to the contrary. Everyone began shouting to get her off the boat quickly and into the awaiting ambulance.
We asked you to wait. Your part was down, it was time for us to do our thing.
But despite our requests there were more of you than us and away you carried the wet, dripping, cold victim to the ambulance where the wet clothes saturated the floor making working dangerous.
3 minutes it took to get her up the narrow stairs, gangplank and across the parking lot on the pier. All that time the medics are hustling to complete an airway assessment.

Luckily the victim’s airway and major vitals are intact, but she is cold. We removed the clothes and try to contain the amount of water coming from the cot, but there is no stopping the flow from the many layers.

You are experts at what you do. I know that, you know that. You proved it putting yourself into a situation I would not.
Please let me do my job. I didn’t tell you how to get into the water or what to do when you got there, please let me do what I am trained to do.

You get them, I treat them.
That is all.

2 Letters, one for the EMT and one for the MD

Dear Medical Doctor,

You went to college a full 4 years longer than I and I can only assume in that 4 extra years you got wicked smart.

Test question, then.

An admitted child murderer should or should not be eligible to serve as an EMT on an ambulance?

Should? You fail.

Firegeezer reported recently about one of the cracks in the EMS system, the complete reliance on Medical Directors to do everything. Policy, protocols, certifications, perhaps they even decide when to mop the floors at their agency buildings.

But first, the true evil.

First letter is to Jessie Thrush who until recently, was just an ex-Sheriffs Deputy trying to make his way as an EMT. When Mr Thrush filled out his EMT certification application in San Diego, CA, he checked the box next to “Have you been convicted of a misdermeanor or felony in this state or any other…” YES.

You see, Mr Thrush admittedly shook his girlfriends daughter to death. A felony. He KILLED another human being. A letter in your file for three reasons.

1. Killing

2. You have uncontrolled temper

3. Thinking you can hide on an ambulance “doing good” to make up for what you did.

But really, the man who signed off on Mr Thrush’s certification has a HELL of a lot of explaining to do.

As the Medical Director for San Diego County, Dr Bruce Haynes is the one who’s name is on each County certification card, advising prospective employers that the candidate does in fact meet the qualifications to serve as an EMT.

Did this one “slip through the cracks” Doc? Busy out there in San Diego? Too busy to see if any of your “EMT”s are child killers?

I get nervous wondering if a traffic stop will delay my license and you’re rubber stamping whoever wanders in the door?

Here’s the problem everyone. Medical Directors who look out over their ivory walls and put their hands in everything. You have an MD, I do not. I respect the levels of education you have received and the skills you posess, but unless you served in the field or maintain a valid National Registry Paramedic License (more common thank God) I believe you have no business as an EMS Medical Director in any agency.

I’m sure Dr Haynes doesn’t see every single application that comes across his desk, but at what point does that application fee to the county EMS agency kick in?

Each County in California appears to have it’s own EMS accredidation process, staff and fees. Why?

So each little feifdom can pretend they’re doing something special.

We’ve arrived at the point where experienced Paramedics have more patient care time than the physicians “overseeing” the system.

So why are MD’s even still in the loop? The law still requires we act under a Physician’s license. Because back when this whole thing started, the MD’s knew more about field care than we did.

We need to move away from the “Base Hospital” system folks, many states already have and they have progressive, adaptive systems.

So long as any ol’ MD can wander in and certify admitted child killers as OK to enter your home and treat your child, we have a problem. An isolated one? I seriously doubt it.

A letter in your file, Dr Haynes. That degree on your wall says you’re smarter than this.

A Letter in the File of the Attending Physician

A Letter in the file of the Attending Physician at the Riverbend Urgent Care in Springfield, Oregon.

Firegeezer, my first read every morning, brings a tale of a Doctor who sent a man from the clinic in one corner of the hospital to the ER in the same complex. LINK over to Firegeezer for the report and video, then come back.

The gentleman in the story was informed by the clinic staff he should be seen in the ER and when he asked if he should walk or get taken over in a wheelchair the Doctor tells him, “We’ll call you an ambulance.”

Put yourselves in the shoes of the crew that arrives. If the layout is as described,(remember the video) would you load the man in your rig? Would you wheelchair him to the ER? Would you laugh out loud and tell the Doctor he’s part of the problem? Or would the private ambulance crew be reprimanded for not putting the patient in the ambulance to generate a bill for transport?

This Doctor was clearly so afraid of being liable should something happen in the moments between locations, it clouded his judgment as to what was best for the patient.

Best for the patient is a calm transfer from location A to location B.

Time after time our service gets called to the office side of a hospital campus to transfer folks to the ER, often from a 911 activation. When we arrive we find a stable patient who needs “tests and x-rays.” Unfortunately this building has no physical attachment to the ER, so away we go. It’s so close that I have to give my 1 minute ETA radio call prior to loading the patient. It gets especially awkward when the patient’s condition calls for cannulation and I have to delay transport or transfer to do the Doctor’s job before I hand the patient off to another Doctor.

This is all hindsight, I understand that, but you can’t tell me there was no staff available in the clinic to wheel this particular man to the ER, within the same building complex.

Isn’t that what they keep raising our premiums for? For patient care? Or is it for all that advertising at the local baseball park?

Doctor, you screwed up on this one, and every other one you’ve sent from urgent care to ER by ambulance. You clearly have no understanding of the abilities of the modern ambulance compared to the advancements in wheelchairs.
And another thing, the hospital complex looks fairly new. Perhaps they might have considered putting the urgent care near the emergency care. If I can figure that one out what are all you high paid folks doing all day long?
At my local medical complex the elderly and pediatrics have to walk all the way around the building to get in, but the dental offices are front and center. Way to think that one through giant insurance company.

Doc, I can only hope you’re getting a financial kickback from the ambulance company because if this was your idea of a working system, we’re in trouble. If it was up to me you’d be assigned to an ambulance for 48 hours to see exactly the impact your little calls are having on your community and just how little the ambulance crew can do in a minute and a half crossing a parking lot.
But you’ve designed the system in such a way that all I can do is yell at the clouds.

A Letter in the File of Richard Poplawski

Motorcop passes along this story of another multiple murder carried out by a wing nut lunatic kid (23) who believes in some kind of “Gun ban coming” as a result of the new President.
What a coward.

He’s only giving those who wish to ban aggressive weapons a reason to do so. If you support the Constitution and all the amendments within it you must come out against this murdering coward and all those like him.

Those of you who respect firearms and the underlying culture must support gun rights by removing those from your organizations who are not stable.

I personally do not agree with Mr. Poplawski’s aparent views on gun rights, but when the last President suspended Habeus Corpus, I didn’t murder anybody.
When my guy lost 2 elections, I didn’t take anyone hostage and kill them and 13 of their friends.

In the coming weeks I hope Mr Poplawski is given a fair and speedy trial, as all Americans are entitled to. Too bad he made this decision in a death penalty state.
Had he waited until Utah he could have faced his beloved guns in the firing squad.

This letter goes in your file Mr Poplowski and may your God show you the mercy you extended to the fallen officers, you murdering coward.

A Letter in the File

Heroism. What does it mean to you? Webster’s lists many definitions, most notably, “showing extreme courage; especially of actions courageously undertaken in desperation as a last resort.”

At my department there are occasions when certain persons meet this definition and they are recognized with an award for heroism.
These are often the result of a rescue at the scene of the fire.

But what about when you are not the hero, but just happened to be at the top of the stairs at the right time?

A few years back an engine company made a fantastic lead down a narrow hallway on the second floor encountering heavy smoke and immense heat. They found the seat of the fire and began attacking it when they came across a woman and a young child, alive, in an adjacent room, both unconscious. Many companies may have withdrawn and made the rescue, leaving the fire to expand, but these heroes chose to remove the victims one at a time.

The last man on the line pulled the child back along the hose line to the stairs where he encountered another team making their way to the fire floor. There were no words to exchange in the heavy smoke as one firefighter handed the limp body to the next who quickly turned back down the stairs and carried the boy out. By the time the confusion in the stairwell had become clear, that there was an active rescue in progress, the original company, still eating heat at the seat of the fire had now removed an elderly woman to the stairwell to be removed by another member of that team in the hallway. Both victims survived.

You may be saying to yourself, “Happy, sounds like a great story of true heroism, what’s the problem?”

The guys fighting the fire, the ones who effected the removal of the victims from a life threatening hazard, all the while still fighting the fire and as a result saving the other floors from involvement, weren’t recognized by the award.

The team on the stairs not only was nominated for the award, but accepted it. It sits on the wall at their station. I know the real story because I relieved the company that fought that fire the next day and you could see the light in their eyes when they talked about how good it felt to drag the victims out to a safer area, then get back to work. I knew these men well and trust what they say.

When what really happened came to light the engine company was given a certificate of bravery from the Mayor’s office…by mail.

The reason I’m putting this letter in their files now is because last week, at the dinner table, someone from the stairway team at that fire told a yarn about how he had been the one to remove the victims, not the engine. When pressed for details on what room they were in he changed the subject.

It’s not about awards in this business. If you need a shiny plaque to replace your own feelings of inadequacy or feel the need to lie in order to sound “cool,” quit now before you get someone killed actually trying these things on your own.

That is all.

A Letter in the File of Lannie Haszard

A Letter in the File to the bad apples in the barrel. Amid all the stories about EMS and Fire having to cut budgets, the last thing I wanted to read this morning was the following online article:

“In Portland, paramedic Lannie Haszard was sentenced to five years in prison in August after pleading guilty to five counts of attempted sexual abuse. Haszard, 62, was charged with inappropriately touching four female patients while they were being taken by ambulance to hospitals.” more here

Just because Larry Hagman’s character in Mother Juggs and Speed tried it out doesn’t give you permission to abuse your position of trust. I can only hope my next female patient having an MI didn’t read this. I’d really like to get leads 3-6 placed for the 12-lead, but Brain Dead there might have ruined it.

I have never witnessed such horrible behavior and would not stand for it if I did/do. Are these fellas really so lonely and feel so worthless that they have to take advantage, not only of the women in peril, but of the trade so close to being recognized as a profession?

The public gave you its trust and you molested it. There is a special place where you just might get a taste of what you’ve been doling out.

Enjoy prison. If it was up to me I’d leave you in a room with those peoples family and call an ambulance when they were done with you. And the Paramedic in charge of your treatment? Well, do onto others…

And the headline: ‘Paramedic dream job for sex offender’ “It’s a dream job for a sexual predator,” said Greg Kafoury, a Portland, Ore., lawyer who represents three women who were groped by a paramedic.” Nice. I hope he never calls. We all know how the Happy Medic LOVES lawyers in EMS.

A letter in the file to Lannie Haszard, your pink slip is right underneath it.

A Letter in the File

Complacency kills.

Don’t get tunnel vision.

Fire in a type 5, 2 story residential. Heavy smoke and fire pushing from the entryway on first company arrival. You are assigned as an engine on the second alarm struck 10 minutes into the event.
As you are monitoring the radio enroute you ascertain that folks on the roof are reporting heavy fire in the second floor kitchen and need a hose line there. You also hear the transmission that a primary search is clear, and soon after that a secondary search is clear.
You arrive 18 minutes into the event and are assigned to ventilate the fire floor. As you arrive at the top of the stairs and decide to make a left to enter the rooms you saw from the street, who’s windows were still closed. You find 3 closed doors, burnt through with debris on the inside. It is clear as you enter the rooms, pushing doors open, that these rooms have not been entered since the fire started. You do your job opening windows and begin to pull ceilings. Out in the hallway you notice a bookshelf in front of another door. Moving it, you enter another room, untouched by fire. It appears the folks on the roof have cut their ventilation hole here. The one room without smoke or fire.
With your job completed you return to the command post and find that you were the fifth group of people into the building, including the group that “completed” the primary and secondary search. 2 of those rooms were bedrooms. This fire was early in the evening.

It is inexcusable to call a primary or secondary search clear without actually searching the area in question. We also found that every group into the building went straight to the seat of the fire and clogged the hallway.

Complacency kills my friends. If you are assigned to complete a search – DO IT. If your job is to knock down the fire – DO IT.
We were the only group that actually confirmed half of the building was clear of victims and fire spread. 18 minutes and 5 groups into the event.

Letters in the file of the members of those 5 groups who went right past were they were supposed to be and went for the “glory” of putting the fire out. The glory in this job is working as a team to save lives and minimize damage to property.
I need to grab a shower. When I cool off, the Happy Medic will be back.

Misleading Advertisers

A letter in the file to the political advertisers using Google’s Adsense to advertise on blogs across the internets. Even here at the EMSfun blog we hold certain “standards” even if they be as simple as upholding the constitution of the state and country in which we reside. Some of you I’m sure took an oath to that affect.

Certain advertisers disguised the intent of their messages by renaming the url of the sponsor to elude ad filters at google. Long story short, someone lied about an ad to get it onto pages that strictly requested the opposite. Most times we giggle at the content of the ads here at EMSfun, women’s clothing and nursing schools, but some recent ads just prior to election day were not appropriate for this site and, by the method they were placed, were not appropriate to be shown at all. Much the same way an internet predator slinks around pretending to be something they are not, political ads pretending to support basic rights prove deceitful and take up valuable (OK not here but other places I’m sure) space that could be used to remind folks to change their smoke detector batteries or warn citizens of weather conditions in their area.

So a letter in the file of political advertisers, and this will reflect on your promotional opportunities in the future.
If it was up to me you’d be busted back to the Tower to run PT drills for the Cadets.
That is all.