Syndicated Columnists

EMS Butt Hurt And Owning Your Engagement

EMS Office Hours Podcast - Wed, 08/16/2017 - 16:59

This episode focuses on some butt hurt I got online and the glaring differences in engagement when it comes to EMS content online. Take a listen

 

 

 

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Chesterfield Fire and EMS medical services unit pulls double duty

FireRehab.com - Tue, 08/15/2017 - 15:05
The 41-foot medical ambulance bus provides on-scene rehab and mass casualty incident response

Let them have their fun

EMScapades Cartoon - Tue, 08/15/2017 - 12:04

New comics every Tuesday and Friday!

Categories: EMS, Syndicated Columnists

Carbon monoxide in home sickens 4 officers, 8 others

FireRehab.com - Tue, 08/15/2017 - 08:02
Firefighters responded to the scene and found people on the lawn outside the house

Caregiver, or taker?

Michael Morse - Rescuing Providence - Tue, 08/15/2017 - 06:48

He said she didn’t give him his medications’ she said she did. After 27 years of marriage, it had come to this.

For the last seven years she was his caretaker. He was confined to his bed for the most part after three heart attacks and a stroke rendering him disabled. It looked like she was running out of steam, the burden thrust upon her taking its toll.

Their house was a mess – laundry, dirty dishes, paperwork and pill bottles were strewn about haphazardly; clutter filled the room where he spent the majority of his life. A small TV sat at the end of his bed, his portal to the world. I wonder what he watched as the days dragged on, his room a cell rather than a place to rest from leading a fulfilling life.

People forget the caregiver far too often. Their lives and ability to embrace it are as diminished as the person they are caring for. Often they fall into depression, and become sick themselves. Sometimes, they even steal the medications from the person they are caring for.

There is only so much we can do

He was hysterical, sitting up in his bed, struggling to breathe through the hole in his throat. The stoma remained clear, but I was concerned his movements would somehow clog his airway. She had a glazed look about her. At first I thought she had been drinking; her speech was clear but slow, her pupils dilated.

“He needs to go to the hospital,” she explained in a dreamy voice. “He says I didn’t give him his nighttime medication, but I gave them an hour ago.”

I looked on top of one of the dressers that crowded the room and saw a dozen pill bottles, some empty, others tipped on their side, duplicate prescriptions, half-eaten candy bars and trash filling every inch of the space.

“Do you have a list of his medications?” I asked.

She handed me a crumbled piece of paper she picked up from the floor. Lasix, Cardizem, Lisinipril, Lipitor, the list was lengthy. Two names jumped off the page, Oxycontin and Vicodin. There were no bottles on the dresser that matched.

“What about these?” I asked her.

“I had to hide them. He takes 30 if I let him.”

“Where are they?”

“I have them.” She opened a bedroom door. A giant Rottweiler was on the bed looking at me. She entered the room; I stayed outside as she read the names from the bottles from behind the door. She pronounced the names like she had never heard of them.

There is only so much we can do. I wish we could do more. This would be a perfect opportunity for a community paramedic to do a follow-up visit.

Unfortunately, a community paramedic program is a very long way off in Providence, R.I. We have a leadership void in the EMS division of the Providence Fire Department. Without vision and support from the administration and the firefighters’ union, we will continue to respond to 911 calls, offer little or no follow-up and chase the radio every shift.

I had seen enough. We got the man ready, put him in the stair chair and brought him out of his prison. He was crying quietly, saying he loved her and didn’t want to leave his home. I left his wife alone with her husband’s prescriptions.

Categories: Syndicated Columnists

Near-miss reporting prevents future medication mistakes

Syndicated Columnists - Mon, 08/14/2017 - 09:31
"Continuing quality improvement (CQI) reviews reflect that medication administration errors occur in the pre-hospital setting. These include errors involving dose, medication, route, concentration and treatment." — Prehosp Emerg Care. 2007 Jan-Mar;11(1):80-4.Paramedic self-reported medication errors. Vilke GM1, Tornabene SV, Stepanski B, Shipp HE, Ray LU, Metz MA, Vroman D, Anderson ...
Categories: Syndicated Columnists

Top Innovations of Modern EMS: #10 Safety sharps to reduce needle sticks

Syndicated Columnists - Mon, 08/14/2017 - 08:00
When AIDS, hepatitis and other bloodborne pathogens emerged in the ‘80s as invisible killers, dirty needles were widely considered EMS providers’ greatest risk. Through the mid-‘90s, disease prevention consisted mainly of personal protective equipment and annual classes on how not to get infected. The curriculum justifiably portrayed uncapped needles as accidents waiting to happen; ...
Categories: Syndicated Columnists

Timeless Deeds

Michael Morse - Rescuing Providence - Sat, 08/12/2017 - 09:03

By Michael Morse

If I told this story once, I have told it a million times. When I had no hope, nowhere to turn and no answers, I called 911. My father was in the final stages of brain cancer, my mother was at the end of her rope caring for him, and I was a young man. When he started to hallucinate and became uncontrollably irrational, she broke down. I arrived at their home after work for a visit and confronted absolute chaos. When it became clear to me that I could not handle the situation, I made the call. I had no idea what to tell the 911 operator and simply said I needed help with a cancer patient. Within minutes, an engine company from the Warwick (RI) Fire Department arrived with a crew of three. I tried to explain the situation but could not find the words.

The firefighters entered my parent’s home and got to work. They recognized my father’s extreme frailty and my mother’s agitated state. I have no idea how they did it, what they said, or how they knew exactly what to do, but within minutes, the worst moments of my life were over. By the time the first ambulance and paramedics arrived on scene, my dad was entertaining the firefighters while my mom relaxed in a different room.

Twenty minutes after I made the 911 call, my parents were in separate ambulances, both stable and well cared for. The firefighters stayed and secured the home, instructed me to take my time on the way to the hospital, and reassured me that what was happening was not unusual. Their calm demeanor and professionalism put my life back in order. I was able to do my part in continuing to take care of my family–not just that night but in the difficult days and weeks that followed.

To say that I was profoundly affected by the firefighters would be an understatement. Three years later, I found myself in the 42nd Training Academy of the Providence (RI) Fire Department, where I began a 25-year career responding to emergencies every bit as traumatic as my own.

It is understandable that firefighters are not as excited by EMS calls as they are for fire and rescue jobs. EMS is often considered an interruption to our “real” mission: fighting fire. What to us is an ordinary call is to the people experiencing it a truly memorable event. We see a lot during our tours. What appears mundane to us can be quite extraordinary to the people who are living through it for the first time. Losing control of a situation is not something people think about, but more often than not it is the reason why they call 911.

Every firefighter who has sworn the oath of office carries with him or her an immense responsibility. What we do, who we are, and how the public we protect perceives our actions has the potential to live long after our time is through. When a loved one is injured, sick, or dying and entrusts their care to another, a bond of humanity between strangers is formed, and this bond is everlasting. It matters not that the emergency might be insignificant to us; to those who need us, it is enormous. The lasting effect we have on victims, patients, and everybody involved with whatever it is we were called to can span generations.

I learned firsthand what caring, competence, tradition, and excellence existed inside the fire stations that I once drove past without a second look. Learning that the people in uniform who respond were not only good, but also exceptional, changed the way I perceived society as a whole. When I became one of those people, I never forgot how good it felt knowing that people really do care about others. It made me take the time and put forth the effort needed to learn how to best act during an emergency.

The firefighters who responded to my home are retired now, but my memory of them, though faded, is alive and well. When it was my turn, I hope I served the community well. I like to think that even though I am no longer in the fight, my deeds will not be forgotten. If you are fortunate enough to be on the responding side of the 911 call, always remember that what you do is vitally important, and can be timeless no matter how routine the call.

 

http://www.fireengineering.com/articles/2017/08/engine-company-ems-timeless-deeds.html?utm_content=bufferee033&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

Categories: Syndicated Columnists

Flashback: Yes, 911? I’m having a feeling of impending doom.

EMScapades Cartoon - Fri, 08/11/2017 - 09:44

New comics every Tuesday and Friday!

Categories: EMS, Syndicated Columnists

How to rehab firefighters in extreme heat, cold

FireRehab.com - Fri, 08/11/2017 - 09:30
Rehab is difficult and doubly so when the temperatures soar or plunge; here’s a look at how to handle those challenging days

Piss is my favorite

Michael Morse - Rescuing Providence - Thu, 08/10/2017 - 10:10

Overheard in the back of Rescue 1, during a clean-up.

“Piss isn’t too bad.”

“Puke is the worst.”

“Nah, shit’s worse than puke, any day.”

“Blood is easy, it doesn’t stink.”

“That’s why piss isn’t bad, easy clean-up.”

“Old piss is pretty bad.”

“New shit is worse than old shit.”

“It’s still runny.”

“Speaking of runny, snot’s pretty bad.”

“Yeah but you hardly ever wear it. ”

“Yeah, puke wins that one.”

“But shit’s still the worst.”

“Yup. Piss is my favorite. Definitely.”

“I guess.”

Categories: Syndicated Columnists

12 firefighters overcome by carbon monoxide at blaze

FireRehab.com - Thu, 08/10/2017 - 08:01
The firefighters were somehow overcome by carbon monoxide, sending one into cardiac arrest

Quality improvement in action: Cutting opioid overdose deaths in half

Syndicated Columnists - Tue, 08/08/2017 - 16:06
By Mike Taigman and Jon Kelly When was the last time you saw a cop hug a homeless junkie and tell him, “I love you and hope that you get into rehab soon"” If you live in Lowell, Massachusetts, it’s a pretty common sight. In Lowell, opiate-related overdose deaths have been cut in half through a compassionate collaboration between the Lowell Fire Department; Lowell Police Department; ...
Categories: Syndicated Columnists

Is EMS innovation taking us backward?

Syndicated Columnists - Tue, 08/08/2017 - 15:44
By John Chamberlin, NEMSMA One of the most basic paramedicine assessment tools, the stethoscope, was invented in 1816. That basic assessment tool has evolved through various processes of innovation but still remains a primary assessment tool. Like the stethoscope, the industry of paramedicine continues to evolve through innovation. New equipment, new material for uniforms, electronic charting and assessment ...
Categories: Syndicated Columnists

3 steps to properly documenting patient care in EMS

Syndicated Columnists - Tue, 08/08/2017 - 15:36
By Steve Johnson When asked by clients to review crew documentation to assist in their compliance efforts, we consistently find opportunities for improvement. It seems that too many crew members either don’t properly understand the requirements for compliant documentation, or worse yet – may not care. Clearly, the latter is a huge compliance risk that should not be tolerated, and fostering ...
Categories: Syndicated Columnists

9 steps to fostering EMS community support

Syndicated Columnists - Tue, 08/08/2017 - 15:26
By Thomas L. Little Every EMS service has many opportunities to build and maintain community support. Providing top-notch patient care is a priority, but public education and outreach pay big dividends, too. The demand for up-to-date, timely health and safety information is greater than ever before. Establishing your organization as a health and safety authority in the community is an effective method ...
Categories: Syndicated Columnists

It's time to weigh in on EMS Scope of Practice revisions

Syndicated Columnists - Tue, 08/08/2017 - 14:19
If you ever wanted the opportunity to weigh in on the future of your profession, the time is now. The National Association of State EMS Officials is seeking input from across the nation during its revision process of the National EMS Scope of Practice. Your input will be valuable in helping to move our practice forward, from EMR to Paramedic level. A quick history of the EMS Scope of Practice If you ...
Categories: Syndicated Columnists

What a weird day

EMScapades Cartoon - Tue, 08/08/2017 - 11:01

New comics every Tuesday and Friday!

Categories: EMS, Syndicated Columnists

Nobody told me

Michael Morse - Rescuing Providence - Tue, 08/08/2017 - 09:48

By Michael Morse

EMS was something that I had to learn if I wanted to be a firefighter.

I didn’t embrace it. I went through the motions, memorized rather than learned, and barely passed the exams that were needed to obtain my certification. I took the EMT Basic class with about seventy like-minded individuals, all of us recently hired as firefighters in Providence, Rhode Island.

Nobody told me that 10 years later my career would transform from firefighter most of the time – EMS when I had to TO EMS all of the time – firefighting when I had to.

Nobody told me that EMS was anything but a thorn in the side of the fire department’s day-to-day operations.

Nobody told me that 99 percent of the lives I would save as a firefighter were on EMS calls.

Nobody told me about the connections with people who called the fire department for medical help would stay with me for the rest of my life.

Nobody told me that I would find purpose, direction and satisfaction right there in ALS Providence Fire Department, in vehicle Rescue Co. 1.

The Providence Fire Department operates with 14 engine companies, 8 ladder companies, a special hazards unit and two battalion chiefs. Oh, I almost forgot; 7 ALS vehicles. For the majority of the time I spent on the streets there were five ALS vehicles. After much delay, hand wringing, budget manipulation and outrage from surrounding cities and towns who found themselves responding disproportionately to Providence on mutual aid calls, the other two were added.

The department responds to over 40,000 calls a year, which increases every year by thousands, and 32,000 of those calls are for EMS.

Nobody told me that I wouldn‘t feel as though I earned that badge until I transferred to Rescue Co. 1. Our truck responded to well over 5,000 of those calls annually.

Nobody told me that I would be challenged like never before on every single shift.

Nobody told me that the people who died in my care would take their last breaths in the company of somebody who used every bit of his mind, body and spirit to keep them alive.

Nobody told me that by doing so I would be able to move on to the next call with clarity.

Nobody told me that I would find my own concept of spirituality right there in the back of Rescue Co. 1, and it would keep me focused for the rest of my life.

The rest of the department lovingly refers to the people who choose EMS as “Rescue Blows.” It has been said that people who choose to respond to the bulk of business that comes our way are afraid of fire, can’t run with the pack, or are simply weird.

I used to refer to people in the EMS division as Rescue Blows, and thought they were different as well.

Nobody told me that I was right, that Rescue Blows ARE different.

Nobody told me that it takes a lot of courage to step away from the pack, face scorn and ridicule and do the job you know in your heart is the right job for you.

Nobody told me that by doing the job few firefighters wanted to do I would distinguish myself as a stand-up guy, and a valuable part of the fire service.

Nobody told me that people would notice that by treating the homeless, downtrodden and diseased the same way I treated the wealthy, privileged and powerful I could make each and every firefighter proud of who are, what we do and how we operate.

If somebody had told me these things, I wouldn’t have believed them. Some things you just have to find out for yourself.

Categories: Syndicated Columnists

Lasting Impression

Michael Morse - Rescuing Providence - Tue, 08/08/2017 - 05:15

He was dead. His friends paced the room, smoking cigarettes, sneaking glances at their fallen comrade. He died sitting in his favorite chair, or at least his most recent favorite. One of the smoking guys had let him stay with him these last few months, he had nowhere else to go. The doctors at the VA had given him six months to live a year ago, he was just holding on. One of the guys cooked a meal for him last night, a steak and macaroni and cheese. There was nothing left on the plate that sat empty in front of him.

We chatted for a while, the two guys, me and Brian. The dead guy may have been listening, some day we’ll find out for ourselves. He was a combat veteran of the Vietnam War, and so were his friends. Hepititis C is what eventually did him in. He was a good guy I was told.

The police handle these things once we declare a person dead. We waited for them to show up. I asked if the rosary that was wrapped around the dead guys hands was of his own doing. One of the guys said that he put it there when he found him. We stood by, silently until the police showed up.

“I can’t breathe in here,” was the first thing he said. “Put out those cigarettes.”

The tranquil, respectful environment was instantly transformed. Now, I stood in a section eight apartment with three nearly homeless vets, run down, kind of grungy and oppressive. And one of them was dead. I wish I smoked, I would have sparked one up right then and there. I was in their house. If they wish to smoke, smoke away, especially at a time like this.

“I’m sorry for your loss,” I said and told the cop the official time of death. The two living combat vets stepped outside to finish their butts. I couldn’t help but think of this line as we drove away.

“The evil that men do lives after them; the good is oft interred with their bones.” William Shakespeare

Their friend was dead, and the government officials were assholes.

Categories: Syndicated Columnists

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