Category Archives: Mutual Aid News

Happy Awards 2011 – Best New Blog

EMS blogs pop up all the time, write a few posts, then suddenly nothing.  Maybe they got caught, maybe they got bored, maybe they forgot.  One day I read a post from a new blogger calling their site Captain Chair Confessions.  The style was right up my alley and the stories were so familiar I felt an immediate connection with the author.

The frustration, the angst, the sheer hair pulling insanity that can only come from being in EMS for more than 20 minutes in a system or with a partner or in a place that just doesn’t get it.  It’s there.

Also there, if you read carefully, is the withdrawing of a burn out in progress.

I think CCC, as they call themselves for short, has been saved by this amazing therapy experiment called blogging.  Even though the political stuff can get heavy from time to time, it is CCC’s forum and I can skip a post from time to time, but rarely do.

CCC, thanks for making me smile this year and good luck in the future!  I’ll be reading!

MOI oh MOI!

Rogue Medic is in a great mood as of late and this article about the complete joke that is Mechanism of Injury (MOI) hits the nail on the head.  I recently had to triage a car over a patient because of strict trauma guidelines, luckily finding the always available “Paramedic Judgement” to wiggle my way out of it.

 

The simple point is this: Mechanism needs to be a symbol on a map, not the destination.  With cars designed to crumple around our patients, what if it does take 30 minutes to get them out but they are unharmed?  And the pedestrian clipped by the mirror on the arm by a passing car at 40MPH?  Why are they on a board and in a collar?

 

Because 30 years ago when this Profession was still trying to figure itself out we bought into some crazy ideas, that’s why.  Now that we’re actually starting to study some of these ideas and finding them hurting more patients than they are supposed to help, we need to start revamping a number of our “standards of care” which actually should read “That’s what everyone else does…”

Whenever I have to document damage to a vehicle (mainly for my recollection of the run later on, just in case) I try to use some basic terms that at least remain consistent in my own description of vehicles.  Those are:

Light truck, truck, large truck, coupe, sedan, wagon, van and commercial vehicle.

Then I go and describe the damage using 3 terms, light, moderate and considerable.

Those are mine and can be widely interpreted.  Maybe I’ll get Motorcop to jump in on this but…A coupe hitting a brick wall at 40MPH will look differently than a van that hits another van at 25MPH.  One is a trauma, the other not by protocol, even though one may indeed have carried far more force.

And even if I do mention light damage to the front of the vehicle, what does that mean? What kind of car? What kind of impact? Against what? Did the vehicle’s protection systems discharge properly?  If the driver was able to self extricate and has no chief complaint, why am I chasing him down with a C-Collar? Because the folks who wrote the policy are in a committee long ago and far away.

MOI is important as far as it gives us an idea of POSSIBLE injuries to consider.  I consider it as a part of the Past Medical History and weigh it just as heavily.  If it does not apply to the patient’s presentation it will be considered, but not relied upon.

One rollover will have a 17 year old girl sitting on the curb completely unharmed while a minor damage collision could yield significant injuries to the passengers.  We won’t know until we assess them.

I remember long ago in far off new Mexico, some medics would launch the helicopter just based on dispatch information of the reported damage.  And we’re back to the telephone game of one person’s “Oh my God! They’re trapped!” and another’s “She’s just not getting out, but looks fine.”

Assess.  Use MOI as a tool, not a guide.  We always look inside the passenger compartment for deformity, blood, marks, bent steering column etc, but we should not be basing a transport on the vehicle.

 

Then again, try documenting that you let a driver refuse transport who had moderate damage after a head on collision into a guardrail, deploying front airbags with a non-complete recollection of events.

Now if I tell you they hit the guardrail head on after sideswiping another vehicle at 40MPH and spinning around, coming to rest in the slow lane and is avoiding telling the police they cut across 6 lanes of traffic to make an exit…now can I let them go home?  Or should I be chasing him down with a collar?  We all know the answer to that one.

 

Looking forward to more, Rogue!

On Not Liking People

New EMS Blogs writer CCC from Captain Chair Confessional posted recently that he does not like people and the post got me thinking.

Have a read for yourself.

 

I left a brief comment but wanted to expand on it here.  I too hate people.  We all do to a certain extent.  There are those who would like us to believe that having a large circle of friends somehow makes us better, or that loving everyone equally is the norm.  Some think that my political leanings dictate I love everyone no matter what.  The truth could not be farther from the truth.  That doesn’t sound bad out loud.  Try it.

CCC’s post is more about hating the BS floating around these days and I have to agree there is plenty.

There is an order to things.  When this order is disrupted it causes after effects, ripples.  That is why there is traffic on a road where everyone is going the same direction.  Someone who does not understand this order or who can not see it in their lives is doomed to disrupt it.  As I said in my comment over at CCC’s place, this isn’t some kind of “God’s plan” order, or some other deity of choice, or even some love-in touchy feely new age crap.

I’m talking about the beams.

I read Steven King’s Dark Tower series when going through an interesting part of my life: My OCD.

OCD is not just washing your hands 30 times or touching every lamp post, but has many manifestations.  OCD had penetrated my life and lifestyle to the point that when I got frustrated that I could not manipulate my environment to make things work better anxiety and depressions were not far behind.  When confronted by a stack of magazines at the dentist’s office, I had to straighten the pile.  HAD to.  No matter what else was happening.  Crooked pictures got straightened, things out of center got centered.  Water rings on tables at restaurants had to either overlap to create only one or make a pattern.  Salt shakers, chairs, store displays anything and everything that was out of it’s optimal place HAD to be manipulated to meet my specifications.  Funny thing was, I had no idea I was doing it.

This irrational behaviour (miss you Mark) led to a deep disgust of people who did not understand the way things were supposed to go.  People who cut in line without thinking about those now behind them, all inconvenienced because of one person.  The guy at Costco who clogs the main isle getting a sample of pulled pork salsa, then gives you a dirty look when you move his cart out of the way.  I disliked more people than I liked.  When it came time for a shift at work however, everything seemed to change.  It wasn’t until later on, with the help of therapy to understand what I was doing and why, I learned that EMS is a form of OCD all it’s own.

Not to say that CCC’s not liking people is obviously a nervous disorder, or even maybe, just that reading that post was like looking into my own past.

Not liking people is not a bad thing.  I hate some people.  I have said on multiple occasions I do not carry a firearm because of my opinion of many person’s driving abilities.  Liking people or not liking people, I think, means you need to find some new people.

Many of you in the business of helping others will relate to CCC’s post and likely agree that you too hate people.

But I would ask each of you to stop and think WHY you have these emotions towards certain people and if, perhaps, there is something in your past or present that is filtering what you see.

As was mentioned above, for years I had no idea that what I was experiencing was any different than anyone else until someone commented how funny it was that I was arranging the colored sugar packets at the table while inside I was hating whoever had left them that way.

The things that bothered me before that I was compelled to fix still catch my eye and I can control the impulses to alter my environment but it took a long time to realize my own hatred for most people was because they did not jive with my path.

 

Magnum Boot Blog and Giveaway

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.

Lt Morse and my toilet

Well, now that I have your attention, Lt Morse from Rescuing Providence is sending along a chain letter of sorts and I can’t turn him down.

He was tagged by another blogger who was tagged by another and so on and so on until I was chosen.  He has been asked to share what reading material awaits when he visits his “office.”  And he did, then tagged me along with 4 other bloggers.  So I will do the same and wow you with the expansive reading material awaiting me.

Brace yourselves.

  • Parenting Magazine
  • A JC Penney Catalog
  • Firehouse Magazine
  • the wife’s word puzzle magazine

So there you have it, another of life’s nagging questions answered.

Now for the tagging.  I think I’ll choose a few folks who may actually have something neat to share.

MEDIC 22

EPIJUNKY

FRUGAL FAMILY

MOTORCOP

MSPARAMEDIC

2nd Alarm Addition

Traveling the interwebs machine on a study break I found a blog post that was titled The SFFD is Stalking me.

So of course I had to.

Kent Firefighter Gary Lane runs the blog Coffee Talk Around the Tailboard and it contains a great mix of personal thoughts (He’s anti-triple load), embarrassing co-worker photos, and a fair bit of tips and tricks at the company level.  Take this video for example:

Not a bad company drill, right?

Now go over to the blog and dig back to the first day he started building that prop and you too can have these kinds of drills.

So welcome to the 2nd Alarm Board Mr Lane, I’m a follower.

Burned Out?

Ying, meet Yang.

New Mutual Aid Company: Burned Out Medic.

He dropped a comment on a recent post and I just spent an hour reading through some great posts of his.  Have a look and imagine the voice of Charlie Brown reading the stories of EMS we all tell.

*Good Grief*

Is that tactical in your pants?

…No, I’m always Happy to see you.

As it is these days with blogs, websites, social media accounts, emails and every other conceivable way to link to these here pages of EMS and Fire fun, there always seems to be something new and interesting out there.  My analytics recently showed a site called tactical pants.

Enter tacticalpants.com.  Now before you get all Motorcop on me and discuss the merits on how many pockets your duty pants should have (Mark’s jumpsuit has billions, I prefer a standard 5) take a look in the bottom right hand corner of their site and hidden rather carefully is a title labeled Tactical Pants Blog.

I know, right?  I thought the same thing.  Kind of like seeing that my toothpaste has a website, how interesting could it really be?

Well, I had a click and started to read not only posts about law enforcement, but links to some of my favorite blogs as well.  They even interviewed AD a little while ago, but not too much about his pants, more about being a Medic, blogger, author and role model.

So I’m trying to decide where to add Tactical Pants in my blogroll between PD Evals and Continuing Education.  For now they will reside in the PD Evals section just because of the hilarious Cop LOLCats feature they did.  Go on, take a look.  It’s right near the AD piece.  Coincidence?  HMMMMM?

Waiting for the bells to ring,

HM

If you get stopped…

The Po-po with the Mo-mo, the Po-po a Go-go is back on the streets after welcoming Baby MC and starts off in a car due to pouring rain. Poor guy didn’t even get to fire up the Honda and bust some fools on his first day back? We at HMHQ think that is just a travesty.

Welcome back Motor Cop, we missed you and your matter of fact style. We always enjoy reading from our Law Enforcement friends, but you are after all our brother from another mother here in blogger land.

Stay Safe MC and see you in the report room for cocktails.

HM

(Oh yeah I did)

The power of the Blog

Mark has chimed in about an update to the Project, the Trans-Atlantic Paramedic exchange I’m always reminding you of. Pop over and read his post, answer his question, then come back for my thoughts on whether blogs are bad.

It seems that the powers that be on both sides of the pond are still nervous about the reality of patient confidentiality laws, and rightly so. It is understandable to be worried about litigation if one of your people is blogging, facebooking/Myspacing or tweeting the address of a patient, a patient’s name, history, likeness or scene photo, but what about those of us trying to make an impact on the Profession of EMS?

These same supervisors who are nervous about Mark’s blog being perceived as NHS driven and my supervisors to even allow me to tell you my name, surely sit down with other professionals and share tales of “the big one” or “the call that went wrong.” Are those violations of privacy rights?

What about ACLS scenarios? Each time we enter the classroom we are encouraged to share stories of patient outcomes and interventions. Are those violations of privacy rights?

Many of you may be shaking your heads and saying, “That’s different, it’s not in the public realm,” I say sure it is. I go home, tell the wife about a rough call or scenario in class, she tells a friend, etc etc.

We share information all the time, and mostly even more details than have even been shared in this arena. Privacy is so private that people will scream for help on a busy sidewalk, then refuse to give their name because they don’t want a bill. Will rail on and on about their medical history, in front of dozens of strangers, then I have to get a form signed saying I promise not to share their information with anyone outside of our billing system. That’s makes sense, right?

I took this opportunity to re-read the Health Insurance Privacy and Portability Act (HIPPA) and find out once and for all if what I’ve been doing is allowed. Here’s a shocker…yes.

From the text of HIPPA:

What Information is Protected

Protected Health Information. The Privacy Rule protects all “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).”12

“Individually identifiable health information” is information, including demographic data, that relates to:

  • the individual’s past, present or future physical or mental health or condition,
  • the provision of health care to the individual, or
  • the past, present, or future payment for the provision of health care to the individual,

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.13 Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

The Privacy Rule excludes from protected health information employment records that a covered entity maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act, 20 U.S.C. §1232g.

De-Identified Health Information. There are no restrictions on the use or disclosure of de-identified health information.14 De-identified health information neither identifies nor provides a reasonable basis to identify an individual. There are two ways to de-identify information; either: (1) a formal determination by a qualified statistician; or (2) the removal of specified identifiers of the individual and of the individual’s relatives, household members, and employers is required, and is adequate only if the covered entity has no actual knowledge that the remaining information could be used to identify the individual.15

Take note of the “and” following the bullet points under Protected Health Information. If I post about someone who, even if I change all the information, can still be identified by someone not there at the time, it becomes questionable.

I understand the reason for privacy rights, believe me, but I also understand how sharing information of a non-sensitive manner can help move our understanding of this Profession forward by leaps and bounds.

I don’t know what privacy laws are relevant in the UK, but I’m sure Mark is well aware of his limitations, as evidenced in his post.

Blogging can do harm Mark, when done recklessly and without respect to our patients, clients, employers and co-workers.
But when done following the intent AND letter of the law, it can only help.

I’ll explain more when you pick me up from the airport in Newcastle during our blog born EMS exchange to advance patient care. But keep that private, OK?