Many Fire Departments have strenuous and extensive requirements to make their rescue squad.

In NBC’s new show Chicago Fire, apparently all you have to do is have worked as an EMT in San Francisco.

Taylor Kinney as SFFD EMS EMT Probie Glenn Morris in Trauma

Taylor Kinney as Lieutenant Kelly Severide on NBC’s new show Chicago Fire

Not bad, SFFD EMT to CFD Lieutenant in 3 short years.

Also interesting that both Departments seem to have such lax rules regarding rugged facial hair.

After this show is cancelled what do you think Kelly will return as?

Our good pal Dylan, noted BlogStalker, childhood Explorer Scout friend and Chief Programmer at GasdaSoftware got a surprise while out back the other day:

CalFire was responding to a slow moving fire that proved difficult to access on Sept 3rd.  It was on site of the Concord Naval Weapons Station, a deactivated WWII munitions depot primed for development if anyone can figure out how to remove all the ordinance. While we could smell the smoke at HMHQ Dylan, from Gasda Software, had a far better vantage point.  I’d be curious to hear the pilot’s thoughts about all the kids at the edge of the pond.

And yes, that’s a separate helicopter.

Thanks for the video Dylan!

Tomorrow morning (Monday) our buddy Motorcop is taking the sarg…the seargean…the saarg…well, he’s looking to promote.   In an effort to help him out I was able to pull some strings and get some of the exam questions.

I hope these help!

Vehicle 1 is parked facing south 22 feet from a stop sign in a 25MPH zone with hazard lights activated.  Vehicle 2 is traveling south at a speed of 35 MPH wit ha driver holding a cell phone to his head.  If vehicle 2 impacts vehicle 1 after applying the brake pedal for 20 feet, how far away is the Starbucks?

A male has been witnessed peeking into windows at the local yoga studio.  When you arrive on scene do you,

A) Detain the man in the london fog coat looking into the window.

B) Question the man in the london fog coat looking into the window.

C) Tazer the man in the london fog coat looking into the window.

D) Point out to the studio owner that their window faces a public street, the blinds are open and it’s daylight.

One of your patrol officers fails to report for duty.  Phoning his residence there is no answer, but he answers his cell phone.  He states he is sick and notified the night Sergeant, but in the background you hear an airport announcement.  Do you,

A) Notify him he is in violation of Dept regulations and begin suspension paperwork.

B) Accept his statement and place him off sick, then call in a cover.

C) Call the night Sgt to confirm the story.

D)  WTF guys? Am I not invited on the camping trip again this year?

CVC 21100 addresses _______________________________

A) The size and location of mud flaps on commercial vehicles.

B) The allowable length of overhang of an object protruding from a vehicle before it needs to be flagged and lighted.

C) Electric vehicles on sidewalks

D) No one is ever going to look it up, just pick something random.

And the question weighted most heavily on the exam:

Responding to a reported man down you arrive to find the local town drunk an inebriated fellow.  Do you,

A) Dismount bike in manly fashion making sure all civilians see the stripes.

B) Assess the situation after growing a bad ass mustache.

C) Ensure the man down is breathing and if not, begin life saving efforts

D) Stand over him, hands on belt and shout “Stay down! The heroes are coming!” after calling for an ambulance.

Good luck MC, we’re all rooting for you!

Parking in San Francisco is not a nightmare, but more of a craps shoot.  When Mrs HM and I lived in the City we only had one car and it was a small car at that.  When trying to find parking there was a rule:

3 blocks 6 times or 6 blocks 3 times.

This meant that if you went around the 3 nearest blocks in all directions 6 times you were not going to find a spot and should just find a shady spot maybe no one would see you.  But you had to be careful.  Handicap spots and the little ramps in the sidewalks were big tickets and I would never block a plug (hydrant).  Parking in a driveway or blocking a garage not your own was a guaranteed tow, so sneaking into a half spot was generally attempted, sometimes with success, other times that little white envelope would be waiting for you in the morning.

Unless of course you forgot which day of the week street cleaning was.  Then you’ve got another ticket for that too.

The Department of Parking and Traffic wanders the City in little 3 wheeled bikes and are almost like locusts swarming through the neighborhoods looking for places to earn revenue.  It’s a thankless job and when I see their little trucks parked on a plug and they’re no where in sight I call them in as illegally parked.

But I’ve gotten a bit off topic.

Point is, when you would be sitting at a sidewalk cafe and see a DPT bike go by, you suddenly sprang up and sprinted to the clearly expired meter and gave it another 25 cents for another 4 minutes without a $65 ticket.

But since 2008 the DPT officers aren’t looking around as often.

Listen to KRON 4′s Gabe Slate and Stanley Roberts Team up to look at how transit buses are issuing parking tickets just by driving down the street.

Installed on select Municipal Transportation Buses (MUNI) are cameras that capture images of cars along the bus’s route.  Those videos are then screened by a DPT officer and offending vehicles are sent tickets in the mail.

Unlike static red light cameras, they are able to see if a vehicle is moving, blocking traffic, occupied etc.  However, Happy is not a fan.

Reason being that buses are buses and parking enforcement is parking enforcement.  In addition, I seriously doubt the MUNI drivers are being cited for all their traffic violations, including blocking multiple lanes, stopping blocking intersections, illegal turns etc.  Or perhaps the drivers are safer now that the cameras are installed?

Either way, the City sees some value to the service since over the next 15 months cameras will be installed on all 819 buses.  At a cost of $800,000 in a City facing cuts in Fire, Police, EMS, library, even MUNI is hard to justify.  But in 2010 they recovered almost 1/4 of that cost on only 30 buses.

You do the math.

Some will scream “Big Brother!” and I see that argument and raise you a “it’s breaking posted laws.”

I only hope that the trucks that double park 2 and 3 wide directly next to a clearly identified loading zone get fined as much as the drivers who don’t notice the 3 feet tall letters on the street “TAXI ONLY.”

Perhaps MC could speak to the validity of mounting a camera on the ambulances to capture traffic violations?  I think we could up that 2102 citations in a year in just a few months the way folks seem to go insane around an ambulance.

Do you think this program is a good idea?  Think it goes too far?

Or he…I dunno.

What I do know is that the Trayvon Martin George Zimmerman situation has got us right back at each other’s throats just in time for the weather to turn nice (sorry Kansas, I didn’t mean it that way).  With the release of some video of the suspect in the police station soon after the incident surfacing, suddenly everyone is a medical expert.  Trouble is, there is only one document that can solve this problem of “was his nose broken and head bleeding?”

The PCR.

According to reports the suspect sustained injuries and was given “first aid” in the back of the police car by paramedics.

Now, because it’s the “media machine’ we have to assume everything specific is actually vague, right?  So it may have been a BLS unit, a police officer/EMT or a full fledged ALS response unit.

Despite your preconceptions about the case, because you DO have one regardless of the facts, imagine yourself on this response: (I designed it this way, this isn’t how it happened)

PD requesting ALS unit code 3 for GSW victim.  On scene they advise the victim is DOA but another person, in the back of the police car in handcuffs, needs medical attention.  Your partner confirms the DOA while you attend to the person in the police car.

After assessing his injuries, what does your chart include?  That he is in the police car?  handcuffed?  Is he in custody?  Under arrest?  What about your physical assessment?  Is it any less complete because he’s sitting in the back of a police car at night?  Do you move him to the ambulance?  Do you bandage wounds?  Do you clean wounds?  Do you clean clothes?

After deciding a refusal of care or no indication for transport, how is this documented?  Refusal? AMA? It depends on the injuries, sure, but if the patient is handcuffed in the back of the police car, does your system have a cut and dry policy for who can sign for them?

All these questions of what happened when and to what severity are hinging on what could possibly be a poor chart.  A chart that will not only be seen in court, but the way things are going, will be plastered all over FOX News and MSNBC for years.

Writing your chart for CYA takes on a whole new meaning these days.  Do it right. Every time.  You never know when a seemingly straight forward case hangs a hard right turn and crashes into a wall.

I’ll leave comments open if they focus on the importance of documentation in an EMS reference.  If I start to see a “debate” of the race-baiting, racist, self defense, stand your ground law, gun nut, 2nd amendment hater BS this has turned into I’m closing comments.  Let’s talk EMS here folks, sheesh.

I got a strange voice mail from the Secretary of the Chief of Department asking if I could talk to a reporter about our advancements in cardiac arrest survival.

Um…yes please?

Laura Landro from the Wall Street Journal asked the kind of questions I wish more reporters asked.  Not just asking for our survival rate, but the more important question:

“Why is your number improving?”

We discussed continuous chest compressions, training the entire department to AHA standards and ensuring our BLS fleet can anticipate ALS interventions.  We discussed esophogeal airways, CPAP, see through CPR (from ZOLL), end tidal capnography, so many different tools that come together to make a 9% into a 23%.  And that was all before I got my job at HQ.  It’s nice to highlight the work of those who came before including Jeff Myers, Seb Wong, Brett Powell, Pete Howes.

Hopefully this is just the beginning of a conversation with the public about how EMS impacts their daily lives, not just when they, for lack of a better term, drop dead.

The Ultimate Lifesaver

My EMS career has been just over 12 years.

It has been a fantastic time and has changed me in ways that I would never have thought possible.

And it all ends in a little over 9 hours time.

Justin has kindly offered to let me have some space on his blog so that I can say my farewell to EMS and share why I feel so privileged to have spent time in this most amazing of careers.

It seems a fitting place to say my goodbyes. Justin and Ted Setla have been a constant part of my life for the past few years and the opportunity that presents itself to me, that allows me to take my future in a different direction can be traced back to Justins and my ‘Project’ which later became the Chronicles of EMS after Ted found us and brought his vision to the screen.

One person who was watching along was Mathias Duschl, a paramedic from Switzerland who also shared our vision of trying to make EMS better for all of those that we care for. Just over a year ago, Matt and I met in Newcastle, where he showed me this rather cool medical device called the RhinoChill. I was hooked, and our relationship developed until he invited me to become part of the Benechill family. That has led to now, and my new career in research across Europe.

Im not quite done for with EMS yet though, I have this last shift left.

One shift left to enjoy the feeling of being an operational paramedic…
One shift left to maybe make a difference….
One shift left to try not to show my frustration with some of the people who will be calling 999…..
One shift left to avoid the one job on my ‘tick list’ that I still haven’t had to deal with and one that I don’t ever want to see.

But most importantly, one shift left to work with my wife!

We haven’t worked together for about 6 years. It didn’t seem to work once we were well into our relationship and on the way to getting married. I am her boss at work….She is my boss 24hrs a day! I think you can see the conflict.

Tonight will be different, because this is the last chance we will get to work together for a very long time, maybe forever. Tonight is going to be great.

I think that my leaving the ambulance service is harder for her than me at the moment. EMS has been ‘our thing’. We met over a decapitated head (only a medic would find that amusing!), and most of our conversations revolve around the job and the patients that we meet.

She needn’t worry though, she is now my insight into paramedicine on the front line. I will live through her and the stories that she tells me when she gets home.
Whatever control, or the world wants to throw at us, we will enjoy working together and seeing out my last shift at North East Ambulance Service.

But, what about me?

Sandra (my wife) keeps asking me if I am upset to be leaving and I keep saying, no not really. I am excited about the prospects ahead and the work that I can do and contribute to, that may well go on to save thousands of lives around the world. But then I am here, sitting alone in my response car and I realize that I am upset to be leaving. This is who I am.

That’s a simple sentence to write. Five words.

This is who I am.

I am a paramedic.

I am incredibly proud of that title. It is who I am.

The situations that I have experienced, the patients I have cared for, the good times and the bad.

The memories that I have, both happy and sad.
The pieces of my soul that have taken on indelible imprints of people I will never ever forget and who still touch my heart to this day…..

I see them all now, I hear the cries and screams; the blood and the devastation.

The lifeless baby and the hanging body. The man whose hand I held while he looked me in the eye to tell me that he was going to die, and he didn’t want to, he wasn’t ready yet. The grief and the despair.

Its all there….and it wont go.

But…

There is also the joy, satisfaction and happy times.

Laughing so hard with Dominic, that I had to sneak out of patient’s houses so that they wouldn’t see my hysterical laughter.

The caressed hand that brought so much comfort.

The sound of a baby’s first cry and the thank you from the grateful parents.

The visits to the intensive care units to see those that we have saved on their way back to their families.

The times when you come home so tired that its difficult to keep your eyes open, but you know you have made a difference.

The first time I worked with Sandra, when I knew…..she was the one.

There is so much that I could write, but I guess that’s what the 450,000 words were about from my blog.

EMS is not just a job. It cant possibly be. It changes who you are and how you view the world. It can make you hard, but it can also reduce you to tears when you least expect it.

I have been in the ambulance service 12 years. That may not be long to some of you, but it has seemed like a lifetime to me. I can’t imagine that I was ever happy doing anything else.

In my very first year,  a paramedic came up to me and said

“ if they were to cut you in half, you would have green and white checks through the middle of you “ (they were our service colours at the time)

I feel the same now.

I may be leaving the ambulance service tomorrow, but it will never, ever leave me.

-Mark Glencorse, Paramedic

The first recorded EMS Bromance was in the late 17th century when two stretcher carriers began to hang out together off the battlefield.

Centuries later a Geordie Paramedic and a Yankee Fireman who spent most of his time providing EMS began reading each others blogs on the interwebs.

Reading led to commenting, commenting led to cross posting, cross posting led to extensive discussions, discussions led to podcasts and podcasts led to a TV pilot.

There was a little more to it, but that’s the gist of mine and Mark Glencorse’s friendship.  It started with curiosity about each other’s systems and led to what will surely be a lifelong friendship.  Mark made a huge impact in my life and my career.  While this therapy experiment called the Happy Medic was helping me heal, learning from Mark and the community that I discovered has helped me grow, both personally and professionally.  I think we can all agree that when I first noticed a visitor to the blog was from outside the US, telling me that years later I would be watching videos of us goofing off around San Francisco and England would have brought a chuckle.

But watching the videos reminds me of how passionate about EMS Mark and I were and how we wanted to share our unique experience with as many people as possible.  That passion remains.  A passion not just for running calls and treating patients, but also looking outside the ambulance for solutions.

I chose a staff job at HQ.

Mark is heading into the private sector.

Although his blog 999Medic was shuttered awhile ago, Mark is still active in the online EMS Communities on Facebook and Twitter.  This week Mark will be working his last shift in EMS.

I have accepted the honor of hosting a message from Mark about the experience very soon.

I hope that when it is up you will read it and share it with your friends, readers and co-workers.

Stay safe,

HM