Category Archives: News

The most important chart she’ll ever write

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.

The Ultimate Lifesaver – EMS in the Wall Street Journal

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

 

Goodbye EMS

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 Original EMS Bromance

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

Man Up NFL – Ditch the helmets

FOOTBALL!

I’m talking American Football.  The game where almost 50 men complete against one another 11 at a time with plenty of breaks in the action to catch their breath.  They are strong, large men, many of them obese and wear enormous pads and helmets to protect them not from the other men, but from the other men’s pads and helmets.  Why do I care? Well, I always have, but watching a college game yesterday made me want to comment on it.

Chris Owusu, a wide receiver for the Stanford college team was removed from the field Saturday after being struck in the helmet by…another helmet.  This was his fourth concussion and reports have him being taken off the field unconscious.

This phenomenon is nothing new in the world of American Football and has been studied for decades.  A simple google search returns studies that talk about ensuring the players hit each other less, or not head to head.  Good luck.

 

The entire motivating factor in American Football is to hit the other guy hard, yet there is no stat for hits.  So if the culture of the sport is encouraging dangerous play, shouldn’t we protect the players?  Surely stronger pads and helmets will protect them right?  Sadly no, it just adds a harder hit from the other guy.  It’s a lot like arguing that car accidents will be safer if we all had bigger heavier cars.  Foolish, yet that is what the NFL, NCAA and youth programs are doing.  They add more pads and stronger helmets, all the while seeing more injuries and more serious injuries to boot.

 

I’m not a huge fan of American Football and have a number of ways to make it more interesting to watch, but none of them is “HIT HIM HARDER!”

My first order of business is to remove the helmets in use now and replace them with nothing.  Yes, nothing.  It’ll take a little while for the game to adapt but far less people will be getting concussions if they have to go skull to skull against the other guy.  It might actually require them to learn how to tackle, not just hit.  Look at rugby and Australian Rules Football, both requiring more strategy, fitness and contact to tackle a person as opposed to simply hitting him so hard he passes out.  Imagine an NFL lineman who can run farther than 40 yards…all.game.long.

But American Football fans don’t want to watch men who can play an entire game.  They live for the hard hit across the middle, knocking the player who caught the ball on his face in some form of ancient battle.

Removing the helmets, the radio transmitters and making the players actually play the whole game with limited substitutions (imagine that!) will greatly increase the pace of the game as well as the entertainment factor for those of us interested in a competition, not a battle.  Not to mention, less career ending injuries.

 

Lose the helmets NFL, what do you think you are? Hockey?  As far as I can see the only hazard on the field is the other team and the only reason is because they’re heavily fortified as well.

Surprise You Make the Call – Prank

I read this story over at Curt Varone’s Fire law blog a few days ago but it’s really had me thinking.  Where does your prank end and vandalism against my property begin?

We’ve all done something funny at someone’s expense which they didn’t think was too funny at the time, but what about the situation in Curt’s story?  Comment here, there or both.

 

Was that example a prank or something else?

 

You make the call.

Thank You OCFA Engine 26

10 hours cramped into a fire engine.

450 miles.

14 minutes and 40 seconds that made me cry.

Thank You.

I never would have guessed

Reports of shootings and stabbings just blocks from where Washington DC “Public Safety Officials” chose to deploy firefighters in an effort to deter crime?

You mean it’s not working? Who would have guessed?  I’ll need a minute to compose myself.  Discuss amongst yourselves, I’ll give you a topic:

“Police and Fire are never expected to cover expenses, why is EMS?”

Ah, I’m better now, thanks.

 

The cartoon Statter911 links to says it all.

 

It’s not working DC, pull those fire and EMS crews off the street corners and let the police deal with law enforcement.

You’ve been watching too many movies. Before trying anything else sit down for a minute and really think it through.  It seems cardboard cutouts of police cars and fake cameras would have a bigger impact, and be safer.  Don’t forget that your firefighters and paramedics are “public” too and fall into your “Public Safety” arena.

 

Good grief.

the Crossover Episode 15 – DC Needs their heads examined

The Happy Medic and Motorcop are back with a look into the Washington DC idea of preventing crime using unarmed firefighters, then some tips on how to answer the dreaded oral boards question “Why do you want this job” and we finish with an exciting announcement about cancer and the month of September.

EPISODE 15

Job Opening – Paramedics needed

Michael Morse is hiring for The EMS.

 

I don’t swear often, but when I do, I say:

“Michael, Hells yeah I’m in!”