After reading about the budget shortfalls and response time issues with Detroit EMS, I am left to wonder why they haven’t considered contracting the service to a private ambulance provider? This is just another example of what happens when government is in charge of providing healthcare. Obviously Detroit’s issues go much deeper than EMS. As a matter of fact, their EMS service probably isn’t the problem at all. It’s the lack of funding and support that has put them and their citizens in this unfortunate position. Keep in mind, this is a service that not only bills the patients but receives tax dollars as well.
Had this problem come up with a private provider, they could put the contract up for bid and get someone else in who is capable of fulfilling the needs of the community. For those of you that argue that private EMS is bad because they can go out of business, then just read these articles. This sounds like a service that NEEDS to go out of service so someone can come in who isn’t subjected to cuts and do the job.
Our response time is atrocious. At any given point, day or night, consecutively for the last few months, there were no units available. That means if you call 911, it may be an hour, it may be two.
Emergency workers told Local 4 that they’re already understaffed, but come July 1, 33 more EMS positions will be eliminated.
The cause of the layoffs comes from a planned $1.8 million cut to the city budget.
Rationing care? That nonsense could never happen here!
I feel for the EMT’s, Paramedics and patients that have unfortunately been subjected to this. I really hope this gets better for them.
Ladies and Gentleman, It’s my pleasure to introduce you to the kings of “Heart Stopping Rock and Roll”…..The Defibrillators!
On bass guitar is “Pace”. Pounding away on the drums is the infamous “A-rrhythmia”. Hammering out those insane guitar solos is “Tach”. And last but not least, the voice behind the music….on rhythm guitar and lead vocals, the one and only “Ectopy”!
Ok so now for the real story…..
My boss came to me with a special project the other day. Being that there are a decent number of EMTs and Paramedics that play instruments at our company, I was asked to organize a band. This group will consist of nothing but EMS professionals. So far I have me on guitar and vocals, and 2 other paramedics that play drums and bass. I’m hoping to get at least another guitar player and maybe a keyboard player in the group.
So my question to you is, what would be a catchy band name for a group of paramedics? We will playing mainly classic rock, blues and whatever else we feel like doing.
Below is a picture of a group I put together at the last minute (mainly of EMS personnel) for a public safety earlier this month. (I’m on the far right)
As you all know I periodically publish new articles in my “Celebrity Medic” series. Each time I feature a celebrity or fictional character and tell a story about what kind of paramedic they would be. There is no doubt that all of the celebrities featured the series make outstanding paramedics. What I want to know is what celebrity medic would you want as your partner?
I have opened up a poll on Facebook for everyone to exercise their rights and vote for their favorite celebrity medic. The polls close on September 1st so cast your ballet now before it’s too late!
Try to image yourself having a true medical emergency. Whether it be chest pain, shortness of breath or a stroke. You are scared as you don’t really know what’s wrong. Perhaps it could be nothing. Maybe it’s worse. Perhaps you wont make it through the night. You aren’t trained in emergency medicine so you don’t know what’s serious and whats not. Naturally, you call for help. 2 people show up to care for you and take you to the most appropriate hospital. One of the men that comes to your aid appears to be uninterested in your problem. He rolls his eyes and asks you if you considered going in to see your primary care physician in the morning.
Does he not understand that I’m having an emergency? Did I do something wrong?
Now you don’t know whether to feel scared or stupid. You have never done this before. You want to make sure you are OK, but now you are worried that you are wasting this man’s time. You decide to go to the hospital, obviously against this guys wishes. Reluctantly he loads you into the ambulance, sits behind you and doesn’t say another word for the rest of the trip. You were seen by the ER physician and as it turns out, there isn’t anything seriously wrong. You go home with some relief, but at the same time you think to yourself that this was definitely a bad experience.
Now next time you start to experience chest pain, wouldn’t you think that you would be more likely to stay home or wait until the last minute to ask for emergency medical services again?
As EMS professionals we tend to forget the impact that we can have on every call that we run. Sure, in this scenario nobody physically suffered from this paramedic’s actions (or lack of action). However this experience could affect someone’s willingness to seek much needed help days, months or even years down the road.
To us, this may be one call out of 10 that we run in one shift. We go on to the next call and the next call and probably forget about this patient by the time we clock out. But to the patient, this ONE CALL can make a big impact on their life. If we performed life-saving interventions, they may get to live another day to spend with their family. If we fail to perform our jobs, we can negatively impact someone to the point where it actually costs them their life! Remember this is ONE CALL that we are talking about here.
I’ll be the first to admit that I have been guilty of taking what we do for granted and getting by with the minimum. For the longest time I would clock in, check out my drugs and then just do what I had to do to stay out of my supervisors office. I wasn’t rude to my patients, but I certainly lacked the TLC factor. My patients never called in complaints, but they also never called in compliments, which meant that I wasn’t doing a good enough job.
Customer service is something that is more important that anything else that we do. Sure, we may be able to start and IV while driving 70mph or intubate in the rain on the side of a busy freeway, but what good is that going to do anyone if they are too afraid to ask for our help? Simple things like talking to the elderly lady about her grandkids, or giving your pediatric patients a sticker and a toy really go a long way.
When I talk about good customer service in EMS, I am constantly reminded of the movie “Patch Adams”. The lead character in that movie did absolutely nothing medically to help his patients but what he did do significantly improved their quality of life. He made them laugh, smile and feel good about themselves. Isn’t that what we all really want?
As with any job, you occasionally run into difficult people. Some people aren’t going to be happy no matter what you do. But you still have a job to do. Sometimes you just have to bite your tongue and kill them with kindness. When all else fails, you can at least say that you tried your best.
Taking this approach not only improves your relationships with your patients, but it improves your outlook on your job. Once I realized that I am here for the patients, my stress level significantly decreased. I stopped hitting the dashboard when I was dispatched on transfers and nursing homes. I didn’t mind so much when I got back-to-back late calls. Overall, it improved my job performance to the point where I was promoted to a very nice position in the company over much more senior employees.
Just remember, you work for the patient, they don’t work for you. It is YOUR job to make sure that they have the most pleasant experience possible. If treating people with dignity and respect is too much to handle, then go work at an impound yard or a prison. It really is as simple as treating everyone as you would want your family to be treated.
For those of you out there that already do this, keep up the good work.
As always, I welcome all comments and hate mail. Have a great week!
The last “celebrity medic” featured a popular scientist that had the ability to travel through time. Well this week I want to step it up a notch and feature 2 totally awesome time traveling dudes that I feel would be a perfect fit for a job in EMS. Whether they are running excellent adventures to calls for critical trauma, or bogus journeys to the local nursing homes, Bill and Ted would most definitely lead the EMS industry.
So as always, we must ask the ever important question. What kind of paramedics would Bill and Ted be?
Shifts
As mentioned before, time travel makes shifts a thing of the past.
Vehicle
I’m going to have to stick with the original time-traveling phone booth. This is for the simple reason that it is just to awesome to modify. Multiple patients can be transported in this vehicle, however they would be have to be placed in a standing position.
Scene Safety
Being cleared to scenes would not be necessary for Bill and Ted’s ambulance service. Their safety would be ensured by bringing along “Billy the Kid” and “Genghis Khan”. I can assure you that the team would be left unharmed.
Supervision
Bill and Ted may make good medics, but would require some oversight. And what better person to fill the roll of “Totally Excellent Paramedic Supervisor” than the one and only Rufus? He’s smart, experienced and comes complete with his own phone booth.
Medical Direction
Finding a medical director would not be a problem for team. Dr. Sigmund Freud may be old-school, but he would be a great fit. The “Freud Dude” could also be utilized for critical incident stress debriefing.
Fitness Programs
As we all know, physical health is something that is commonly overlooked in EMS. Bill and Ted would have the benefit of utilizing “Joan of Arch” to start their first aerobics class.
Service Name
Wild Stallions Ambulance Service dude!
Equipment
What would Bill and Ted’s ambulance service be without some totally awesome equipment? Below is a list of some essential tools:
Fender American Stratocaster / traction splint.
Guitar Tuner – Could double as an Sp02 monitor.
Marshall 150watt guitar amp with external port for attaching defibrillator paddles.
Hollowed out drum – To be used as a c-collar.
Yamaha Keyboard – Can be used to make siren noises or as a backboard.
Guitar Cables – Can be used as restraints.
As always, I welcome any comments or suggestions. I hope you all have a great week!
Assembly Bill AB2456 recently passed through the state Assembly and is now making its way to the Senate floor for a vote. What does this mean to us as California EMTs and Paramedics? Well….lots of things. Some known and some unknown. The proposed bill aims to virtually eliminate local EMS agencies and give ultimate governing authority to our wonderful State EMSA. That’s right, the same agency that takes 90 days to process your license renewal, doesn’t return phone calls and takes years to complete investigations. Yep, those guys.
Mark my words, THIS WILL AFFECT YOU NEGATIVELY.
The sponsors of this bill want to see statewide protocols as opposed to the county system that we currently have in place. Sure I get the reasoning behind this, but do you really think that they are going to adopt aggressive and cutting edge protocols? No, because that would require them to fund mandatory training for the majority of the counties around the state that still play “mother may I” instead of para-medicine. Instead you would see everyone “dumbed down” to the level of the county with the tightest standards. I hope you don’t mind taking a few steps backwards because thats where we are headed.
Such a wonderful plan must come with a price right? Nobody eats for free in this world. The proposed legislation will add at least $800,000.00 to the state budget. That’s right, the budget that our legislators haven’t passed on time AGAIN. But don’t worry folks because it wont add to the current deficit. No, instead we the EMS professionals will pay for it in the form of fees tacked on to our license renewals.
The authority may develop and, after approval by the
commission pursuant to Section 1799.50, adopt a schedule of fees
to be collected from each certifying entity, and an increase in fees
pursuant to subdivision (d) of Section 1797.172, in amounts
sufficient to support the authority’s actual additional costs to
promulgate regulations pursuant to paragraph (1). The fees shall
be imposed proportionally between the certifying entities, and
through EMT-P licensure fees, based on the number of EMT-Is
and EMT-IIs Advanced EMTs certified by certifying entities and
the number of EMT-Ps licensed by the authority.
Translation: We are going to take as much of your money as we see fit.
Our current EMSA is under-staffed and under-funded. Do you really think that they are equipped to handle the task of managing EVERY agency in California? Imagine how much money it would take to hire the staff, buy the equipment, establish committees and do studies to formulate a statewide set of protocols. All of that money will come from you and me.
If you are interested, you can download and read the legislation by clicking on the link AB2456. See it for yourself.
It’s time to act
If we do nothing, this bill will pass with flying colors. Maybe we don’t have a perfect system, but lets not let the legislators in Sacramento decide what IS best for us. You can help kill this bill by calling not only your local senator, but every senator out there and voicing your opposition. It doesn’t take much time and it’s really easy. Just call them, tell them your name, zip code and the fact that you are an EMS professional and explain that you OPPOSE this bill. We have to get people from all over the state lighting up their phones to get the message through.
Follow this link for a list of all the Senators and their phone numbers. California State Senate
Please don’t let this pass. Make the calls, talk to your friends, and write letters. Lets work together to bring EMS forward, not backwards.
If you have any questions regarding this bill, you can e-mail me at sean@medicamdness.com. I will answer any questions I can in a timely manner.
Welcome to part 1 of my new series on “turning your Android phone into an EMS tool”. The goal of these tutorials are to help place the power of technology in the hands of EMS professionals. I have always been of the belief that being intelligent isn’t necessarily knowing everything, but knowing where to find information. Technology and the internet have empowered us as healthcare providers to be more productive and efficient all while providing exceptional patient care.
If there is one thing that I make sure I have before every shift, it is my Android phone. I use it to look up drugs, research medical conditions, review protocols, translate foreign languages, identify pills, do math, take notes and make base contact. Ever since I bought my “Droid” a year ago, I have constantly been working to customize it to the point that it has truly become my personal EMS assistant. This guide will take you through easy steps towards customizing your own phone to help you in your everyday roll as an EMS professional.
So lets move on to the good stuff shall we?
Introduction
This tutorial will no require NO additional applications. I am going to show you how you can modify your phone to help make your job easier. Nothing that I show you will void your warranty or cost you any money. As a matter of fact, this entire series will show you how to transform your phone into your EMS assistant without spending a dime.
Step 1 – Setup your “EMS Screen”
Having multiple screens is just one of the cool features that comes with Android phones. In this section we are going to clear out one of those screens to be your “EMS Screen”. I typically make mine the one on the very right. This of course can be changed to your liking. If you really want to get fancy, you can install the “Helix Launcher” from the app market. This app allows you to add up to 7 screens on your Android phone. This is optional and something that can always be done at a later time.
Now that you have a clear desktop to be used as your “EMS Screen”, we need to start unpacking and decorating. To begin, lets place a really simple app on your screen that comes pre-installed. The calculator. I am a firm believer that no paramedic should be without one. To do this, you need to scroll to your EMS screen, press and hold your finger on the desktop until you see a menu box pop up labeled ”Add to Home Screen”. From here you will need to select “shortcuts”, then “applications” and finally select the app you want to add to your screen. In this case we will select “calculator”. Remember this method can be used to add any application you want to your EMS screen (or any screen for that matter). You can move the calculator icon around by pressing and holding it until unlocks, then you can move it about as you wish. I prefer to keep my calculator on the top right of the screen, you can find a place that works for you. Now repeat this process and add “Maps” as well. This will come in extremely handy when locating calls.
Now we need to make a couple folders that will be used to place contact numbers in. To add a folder, simply press and hold on the screen (just like the previous step) and select “folders”. From here you need to select “new folder”. Now that the folder is on your desktop, we need to change the name to better organize our contacts. Do this by opening the folder, then pressing and holding the title bar until a screen pops up that allows you to rename your folder. Input the desired name and hit OK. I typically have 2 folders on my EMS screen, “base” and “dispatch”. I use these folders to store dispatch and base hospital phone numbers. You can add as many as you like, but be careful not to take up too much room. There is a lot more to come and we will need all the space we can get. (Side Note – These folders can also be used to store shortcuts to applications)
Now the final thing to add in this step is our Google Search Bar. Having quick and easy access to Google’s powerful search engine may be the most useful feature that we add to our EMS screen. You should already have a google search bar on your home screen. You can either move that one to your EMS Screen or just make a new one. For the purpose of this article, we will just make a new one. To do this, press and hold your EMS Screen and select “Widgets”. From here we need to select “Search”. Once the search widget is in place, then you can move it to wherever you like. I prefer to keep mine on the bottom of the screen. Do what works for you.
Below is a picture of what our EMS Screen should look like so far.
Step 2 – Set up your contacts
This may seem like an obvious task to you, but you would be surprised how many paramedics don’t take advantage of even the most basic cell phones out there. As EMTs and Paramedics we have tons of phone numbers that should be accessible at all times. The simple steps that we cover here will also come into play as we cover some more advanced Android features later in this lesson.
There are various types of phone numbers that we need to keep. These of course may differ based on the area that you work, but here is a good starting point.
Dispatch (EMS, Fire, Police, etc)
Base Contact (Both core numbers and ER numbers)
Poison Control
I personally like to keep these numbers grouped together as it makes finding them much quicker. We will do this by creating new contacts and placing their respective category in front of the contact name. For example, when entering a phone number for your EMS dispatch, your contact name should look something like “Dispatch – EMS”. Likewise, your fire dispatch should be “Dispatch – Fire”. This way they will show up next to each other on the contact list. Below is an example of an organized contact list.
After creating the name of your contact, you will now want to add custom phone number fields. This will prove to be handy when adding phone numbers for the local hospitals. I typically like to add a number for making base contact and the general ER number. You can properly label these numbers by changing the default label from “home” to “custom”. This will bring up a window asking you to input the name that you wish to use for the label. You can then add as many more numbers as your wish using the “+” button. Below is an example of creating a custom label.
Continue these steps until you have all your desired contacts added.
Step 3 – Place Your Contacts in Folders
Now that we have added all of our contacts, it is time to put them all in their respective homes. We are going to do this by pressing and holding the EMS Screen , selecting “Shortcuts”, then selecting “Contact”. Now simply select the desired contact and it will be placed on your EMS Screen. Next we need to move it into the desired folder by pressing and holding the contact shortcut, then dragging it into the folder. Repeat this step until you move all of your contacts into their respective folders. Now when you need to dial one of your saved numbers, simply select the folder and select the desired number.
Below is an example of how you utilize the contacts saved in your folders.
Coming in Part 2
This tutorial was designed to get you started and lay the foundation for your new EMS tool. Part 2 of the series will feature some of the following:
A list of free useful apps that can be used in the pre-hospital setting.
More tips and tricks for adding different kinds of shortcuts to your EMS Screen.
A tutorial on how to place your protocols directly on your EMS Screen.
A guide and demonstration on how to put it all together.
If you have any questions or comments, please feel free to e-mail me or comment below.
I recently had the opportunity to review Informed’s “EMS Field Guide – ALS Version”. I took the guide with me on every shift for a month and used it at every opportunity that I could. Overall I found the book to be an asset. It’s a good size for carrying in my back pocket or in my backpack, plus it contains a bunch of useful information. Below is a breakdown of my experience with the product.
In Field Use
For the first couple shifts, I had trouble remembering that I had the field guide with me. I was used to using my nurses drug reference, a medical dictionary and my Android phone. Once I started to get the hang of it, I actually found myself turning to the field guide before using any of my other resources. While the guide simply can’t compete with the volume of the nurses drug reference, I had no trouble finding any of my patient’s home medications in the field guide. Not to mention the fact the drug guide in the back is simple and to the point. I don’t have to read through 2 pages of information to get what I’m looking for. Definitely EMS friendly.
I tried out the Radio Report sheet found on the first page of the guide a couple times. I found it to be pretty handy but I ended up using my custom one that I have printed out on a 3×5 card. This wasn’t at the fault of the field guide, I’m just used to using my own format. One thing that was really neat was the ability to reuse the page by wiping it down with an alcohol prep. I wrote on it with a standard ball-point pen and had no trouble wiping off what I had wrote. The content never completely wiped away, but it didn’t bother me as the writing was so faded that it didn’t get in the way. Here are some before and after pictures.
The 2nd picture demonstrates how it looks after wiping it down with a single alcohol prep.
One section that I found to be the most useful was the poisons. While this certainly couldn’t replace calling poison control, I did find it to be really handy. I basically lists several different types of poisons and then explains recommended treatments (given that your protocols permit) and tells you what symptoms to expect. I can honestly say that this is my favorite section in the whole guide. I found more use out of this than I did anything else.
Other features not tested in the field
There is tons of great information in this book, however I did not test all of it in the field. In some cases this was because I simply didn’t run any calls that could apply to those sections. In other cases, it was because I don’t believe in relying on guides for doing things like ACLS.
The emergency medications listed in the book are pretty handy, but I think it should be used more as a study guide / refresher and not necessarily something that you turn to before administering a medication. I firmly believe that this information should be drilled into our heads so that we don’t lock up when we leave our field guide at home. Having said that, we are humans (well most of us) and we do forget things from time to time. Especially when we don’t use the knowledge on a regular basis. So having the information in your back pocket could save you from doing harm.
The pediatric medication chart looks extremely promising. It’s like a Broselow tape but only a fraction of the size. This is something that I actually would use in the field if given the opportunity. While I still believe in knowing your doses, I think having the ability to check your work is extremely important when it comes to weight-based doses. I typically do the math, draw up the med then, quickly check my guide / Broselow Tape to make sure that my dose is correct. This way I’m confident that I’m giving the right amount of medication, and yet not screwed when I forget my field guide.
I found absolutely no in-field use for the ACLS section. However I did find myself refreshing my memory while sitting on street corners or while sitting in quarters (given the Dodgers weren’t playing).
The MCI / Multiple patient section is pretty cool as well. When responding to an MCI (especially if you are the first unit in) it would be great to review the algorithms and refresh on the unit leader rolls before getting on scene. The information is brief and to the point. My only suggestion for this section would be to add a spreadsheet of some sort to keep track of multiple patients. I realize that in an ideal situation, I would be “that guy” standing around with a clipboard and radio while everyone else works. However I typically have to assist with packaging and loading patients being that our resources are limited, so something that I can keep in my pocket would be worth it’s weight in gold.
Conclusion
I can honestly say that this guide will be permanently added to my arsenal of resources that I use in my daily responsibilities as a Paramedic. It’s small size is ideal for EMS responders and the information packed into the guide is priceless. I realize that there are smart-phone versions of this guide (which I plan on buying) but I would still recommend having this guide. Phones lose reception, batteries die and they are fragile. While I do consider myself to be a proponent of high-tech gadgets, I still enjoy the old-school reliable method of having a paper copy when it comes to this kind of valuable information.
If you don’t have this guide, I would highly recommend buying it. It’s inexpensive and you will be glad you did.
This weeks “Celebrity Medic” features someone who used science to develop a time machine and then spent 3 “Back to the Future” movies trying to undo damage to the space-time-continuum that was caused by time travel. While he may have created a monster, he showed the world that he was a true genius. But now that the damage has been repaired, what is this scientist supposed to do? Such a master mind could be put to good use in the science of pre-hospital medicine.
So as usual, we must ask the big question. What kind of Paramedic would Doc Brown be?
Shifts
Being that Dr. Brown has the ability to travel through time, shift work be a thing of the past (time travel joke).
Response
Doc Brown wouldn’t respond to calls in the present time. Instead, he would find sick people and travel back in time before they became ill and warn them to either take care of themselves or seek treatment to prevent whatever caused their health issues. He certainly wouldn’t have any issues finding patients and he would have the luxury of taking all the time he needs.
Vehicle
The Delorean wouldn’t exactly be good for transporting patients, but perhaps it wouldn’t matter if he’s confronting them before they become sick…..
Uniform
I think it’s obvious that he would continue to wear his white hazmat jumpsuit. The only difference would be a star of life instead of the radiation symbol on the back. Also included would be a patch that read “GSEMS” which stands for “Great Scotts Emergency Medical Services”.
Protocols
Protocols? Where he’s going they don’t need protocols……
Radio Reports
Doc Brown wouldn’t need to give radio reports as he could travel forward in time to give the ER staff a decent heads-up that he’s bringing in a patient before returning back in time to the scene of incident.
Partner
This one is no-brainer. The only people qualified to work for Dr. Brown’s time-travel GCEMS service would be 2 individuals that are already experienced in the field. Bill and Ted! (More on that to come)
Equipment
Doc Brown is no stranger to handy gadgets. This is one of the many reasons that I feel he would be a perfect fit for the pre-hospital emergency medical field.
Delorean – Modified for use as time machine / first-responder vehicle.
Heart Monitor / Defibrillator – Powered by used soda cans and other household trash.
Plutonium powered Pulse Oximeter – What else would he power it with?
Brain Wave Monitor – Could be used to detect strokes and bleeds.
As always, I welcome any comments or suggestions. Have a great week!
We all know them. We run calls there, mostly at the end of our shifts or in the middle of the night. They all have a unique smell that we love so much. When we pickup patients there, it always seems to be shift change. Nobody seems to have a clue as to what’s wrong with the patient yet everyone including the janitor can tell what room you are looking for the second you walk in. Having a nurse that speaks fluent English is considered a priveledge that only few have experienced.
Sound familiar?
Every community has its nursing home that we all love to run. Unfortunately many of them are just as described. They are about as consistent nationwide as McDonalds. So what makes paramedics think that bitching and treating the staff like crap is going to change anything?
As you can tell, I’m the first one to recognize that nursing homes have their share of problems. But let’s not forget that EMS has its share of problems as well, like arrogance. At some point in time, we as paramedics and emts decided that we are better than anyone not trained to our level in emergency medicine.
Many of us talk down and outright belittle the staff at these facilities. And for no good reason! It is not our job as EMS professionals to judge other healthcare workers. These people are faced with a task that most of us couldn’t handle. Paramedics bitch and complain about washing their rigs. Imagine giving all of those elderly people a bath every day. The nursing home staff is taking care of those elderly people simply because nobody else is willing to do it.
We manage to run medical calls at peoples homes with NO report given and we do our assesment and go on with the call. Yet we consider that to be a huge inconvenience when the patient is at a nursing home?
“Shut up and play your guitar” is a saying I frequently use when musicians and singers start bitching about politics. Well I ask all of you to shut up and run your calls. Pick up your patient, get your paperwork, smile and wish the staff a good day. You can bitch and complain as soon as you leave the hospital. Let’s be professional and keep the venting away from the patients and staff.
August 25th, 2010 
Sean 
Posted in 
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This weeks “Celebrity Medic” features someone who used science to develop a time machine and then spent 3 “Back to the Future” movies trying to undo damage to the space-time-continuum that was caused by time travel. While he may have created a monster, he showed the world that he was a true genius. But now that the damage has been repaired, what is this scientist supposed to do? Such a master mind could be put to good use in the science of pre-hospital medicine.
