Syndicated Columnists

Parkland new benchmark for EMS active shooter response

Syndicated Columnists - Thu, 04/19/2018 - 03:10
School shootings are forever benchmarked against Columbine. News reports are sure to compare the death total as “not as deadly” or “more deadly” than Columbine. April 20 marks the 19th anniversary of Columbine. Only Sept. 11 has had a greater impact on EMS in the last 20 years. The mass murders committed in Newtown, Orlando, Las Vegas, Parkland - and too many other locations ...
Categories: Syndicated Columnists

The elephant in the emergency room

Michael Morse - Rescuing Providence - Thu, 04/19/2018 - 03:09

It is difficult for me to expose what most of know, as reluctant as we may be to admit it, as truth. EMS is held together not by highly trained professionals willing, trained and eager to respond to medical emergencies , but rather by billing, revenue and opportunity to increase wealth. Those of us who have chosen EMS as our livelihood are reticent to speak up, knowing that by doing so we are only hurting ourselves and future Paramedics and EMT’s. Providing rides to medical appointments is perfectly legitimate, unfortunately, we are not being honest about the work we do, which makes us part of the problem. Operating under the illusion of necessity is no way to run a business, and make no mistake; EMS is more of a business than it is a public safety agency. Our very name implies something that we are mostly not; Emergency Medical Responders.

It took some time for me to realize that we had lost the war. For the longest time I truly believed that my job as a person responding to 911 emergencies was of utmost importance to the citizens and taxpayers of this great nation. It wasn’t until those very citizens and taxpayers beat me down did I become a taxi driver who charged ridiculous rates for my services.

Of course, my service could charge anything they want; the people who call 911 for stubbed toes during blizzards have zero intention of paying anyway, but I digress. Somehow, the nation’s 911 system has been turned into a socialized transportation program that entitles people savvy enough to utilize the resources at their disposal the right to beckon trained and courteous medical professionals to their homes, places of employment or anywhere they may be.

And we, the providers happily go along with the debacle. It is far easier to give in, and take the people who call us in than to argue, explain, lecture or refuse transport. It’s a game we play now, and I call it “Getting Through the Shift.”

90% of 911 calls are for non-emergencies. Of that 90%, maybe half probably would benefit from some kind of professional medical evaluation and treatment, but could find the means to get them to the treatment they desire on their own. The other half would be just as safe if they opened their medicine cabinets, used peroxide, aspirin, Tylenol and a band-aid. Of course, many believe that the government should provide these things. The local pharmacy charges for band-aids, but 911 does not-unless you are dumb enough to pay the bill.

Here are a few random examples of 911 calls we respond to every day, everywhere:

My Cramps are “extra bad.”

I tasted nail polish remover and it’s eating my tongue

I broke up with my boyfriend and feel sad

I’m tired.

I took some vitamins and now I can’t stop kicking the wall.

The Oxycontin isn’t working!

My tooth hurts.

I need a breast reduction.

I think I’m hurt

I had a nightmare and I’m scared, real bad.

 

These examples are nothing new to those of us in the trenches, and the people we complain to. But there are vast amounts of people who have no idea just how badly they are being taken advantage of. When resources are squandered, and real emergencies happen, people die. It’s all fun and games taking people to the hospital in an advanced life support vehicle for foot pain-until the cardiac arrest happens while you are tied up with a non-emergent person.

While the nation’s EMS crews are running around town like idiots, caring for people who have no business calling 911, other people are dying, and that is a fact. It is absolutely absurd how we allow so much of the populace to squander our vital resources.

One popular answer to the problem is add MORE resources to cater to an abusive public. A common complaint heard among overworked EMT’s and Paramedics is “we need more crews.”

Truth is, we need less crews answering fewer 911 calls.

I answered 911 calls for nearly 25 years. When I left EMS, my truck responded to well over 6000 calls a year. Maybe 500 of those rescue runs made a difference in the person who calleds overall health and well-being.

The rest? We made absolutely no difference at all. And the beat goes on. Until it doesn’t, because the closest ALS unit is busy transporting a perfectly healthy but crying infant to the ER.

Categories: Syndicated Columnists

Obscure funding sources for EMS departments

Syndicated Columnists - Wed, 04/18/2018 - 15:52
Operating foundations and family foundations are a significant source of grant money, but they can leave out a significant number of funding opportunities. It’s all about the relationships. A lot of money is held in places you will not find in public records. Following is a brief description of two hard to find pools of money: community foundations and donor-advised funds; as well as family foundations ...
Categories: Syndicated Columnists

Medic Mindset Podcast: Pediatric care with Dr. Peter Antevy

Syndicated Columnists - Wed, 04/18/2018 - 09:25
Dr. Peter Antevy is asking paramedics to completely rethink how they take care of kids. His bio is full of innovation awards and accolades for his paradigm-shifting approach to pediatrics in emergency medicine, but he’d never tell you that. Instead, he’d want to sit down and listen to you talk about your pediatric calls and he’d seek to understand how you think on those calls. He ...
Categories: Syndicated Columnists

EMS in the warm zone: Tactical medicine inter-agency training

Syndicated Columnists - Wed, 04/18/2018 - 08:00
It is reassuring to see the gradual acceptance of a national standard being developed to encourage EMS personnel to train and integrate with law enforcement to enter secured, but still chaotic scenes to offer life-saving interventions to casualties. We are slowly seeing response trend away from role-defined emergency responder training with disciplines working in silos, training in isolation from one ...
Categories: Syndicated Columnists

Engine Co. EMS; Giving Birth

Michael Morse - Rescuing Providence - Mon, 04/16/2018 - 09:59
 

By Michael Morse

They are the best of calls, they are the worst of calls…

Just about every firefighter I know would rather enter a fully involved, occupied fertilizer factory without a charged line than deliver a baby. Until, that is, they deliver one. Field deliveries are a bit unnerving, but they can be one of the most gratifying moments in a firefighter’s career. Sure, your patient load doubles, and it can be a bit messy, but I have found little more satisfying that pressing the mic button with my sweaty fingers, asking dispatch for a time check, and then announcing over the air, “It’s a girl; time of birth 2330 hours.” Even the people listening get a moment of pride and satisfaction and feel a part of something bigger than the job.

 

Making that announcement is more involved than just saying the words; training and experience certainly help. Having a member of the crew who was present during delivery of a child of his own or who has actually done a field delivery is a luxury and will definitely ease the tension. Understanding our role as health care providers and being proficient is essential.

 Chaos is never welcome at any emergency scene, and considering the birth of a child anywhere but in a controlled environment is foolish. Calming the scene and creating a serene atmosphere once you realize that delivery is imminent can be accomplished while attending to the task at hand. The expectant mother and others in attendance need to know that things are as under control as they can be, and it is up to us to be the bringers of calm. By being confident and capable, we do just that.  

Some Things to Consider. . .

The rest is here, thanks for following the link, you will be glad you did!

http://www.fireengineering.com/articles/2018/04/engine-company-ems-childbirth.html

Categories: Syndicated Columnists

Inside EMS Podcast: Is 'Alexa' the future of patient care?

Syndicated Columnists - Thu, 04/12/2018 - 19:14
Download this podcast on iTunes, SoundCloud or via RSS feed In this Inside EMS Podcast episode, co-hosts Chris Cebollero and Kelly Grayson discuss the recording of their 200th episode and reflect on the past four years of co-hosting the show. They also talk about a recent article about Brewster Ambulance Services in Quincy, Ma., installing Amazon Echos in its ambulances to assist their workforce. Learn ...
Categories: Syndicated Columnists

8 tips for talking about sexual harassment with caregivers

Syndicated Columnists - Thu, 04/12/2018 - 09:29
By David Nelson, DMin Like families, organizations are challenging in the best of times. They can become even more difficult during divisive movements. The recent “Me Too” movement, bitter political divides and other trends have challenged most of us to pay even more attention to the importance of creating a workplace of excellence. Here are eight tips for talking about sexual harassment ...
Categories: Syndicated Columnists

I don’t do drugs

EMScapades Cartoon - Tue, 04/10/2018 - 11:23
Categories: EMS, Syndicated Columnists

Why would you allow your children to be put in danger?

Michael Morse - Rescuing Providence - Tue, 04/10/2018 - 07:12

My new article at Fire Engineering talks about our kids joining us as firefighters. Thanks for reading.

“…Firefighting is the life we have lived. We are fully aware of the danger and the hardship. We know that there will be dark days ahead for most, if not all, firefighters…”

http://www.fireengineering.com/articles/fire_life/articles/2018/april/the-next-generation.html

Image by Eric Norberg

Categories: Syndicated Columnists

More will be said and done!

Michael Morse - Rescuing Providence - Mon, 04/09/2018 - 10:12

Tradition…

Bagpipes, the dress blues, stories of friendship, of sacrifice, of bravery, camaraderie and accomplishment; these are the things that drew me to the fire service. The bucket brigade, Jakes and Pikemen, then Laddermen and Hose Jockeys, horses in the barn pulling the steamers, dalmatians, bells and whistles, airhorns, sirens, flashing lights and everything that ties us to the past and brings us into the future have a solid place in my heart, and always will.

I am a fireman. My kids know it, and their children will know it, and with any luck, their kids will too. My helmet will probably hang on a hook in a garage not yet built, gathering dust until a child finds it, and puts it on his head, and begins the journey that I have taken. I wish him well.

Tradition.

For my last twelve plus years I worked in the Providence Fire Department’s EMS division. It isn’t often now that I have the opportunity to don the turnout gear, and put the helmet on my head. I miss it. But I have no regrets.

EMS traditions are not as glamorous, or colorful, or respected by most. They never will be. Funny thing is, I’m more proud of the 12 years spent on a rescue than I am the dozen I spent on engine and ladder companies. There is something about the personal nature of this job that attracted me to it. And, a few traditions that mean more to me than anything else.

Professionalism. Compassion. Competence. Excellence.

Providence firefighters wheel to the rescue truck the man who was rescued by Providence firefighters when he became trapped by a cave in of a wall while doing sewer work for Armando Ricci and Sons, Inc. on Parade Street. The Providence Journal/Mary Murphy

Every time, without fail, that a family member or friend needed an EMS response, those responders were excellent. Not good, not adequate, but exceptional. My father, who in the final stages of cancer would hallucinate and become unmanageable at home was treated by EMT’s from the Warwick Fire Department, not like a nuisance, or a silly old man, but like a Korean War Veteran, and engineer, and son and father who needed help in his last hours. My mother, the victim of a massive stroke while visiting family in North Carolina; by all accounts the EMT’s who responded acted the same way, and managed the scene with grace and dignity. The Paramedics from the air ambulance that flew her home, with me on board exuded such expertise I never worried about a thing. They helped my parents, and in doing so helped everybody whose lives they had touched.

I often hear about people who were involved in a car accident, or had an allergic reaction, or whose grandmother was choking at the restaurant, or the million different reasons we are called. One thing remains the same, by all accounts. EMS was simply awesome.

Tradition.

Big boots to fill. I’m proud to fill them.

My wish is that some day, when the kids find my dusty helmet hanging in the garage, one of them sees the worn jacket, the one with the Providence Fire Department patch on one sleeve, and the EMT patch on the other, and I hope he puts it on.

And I hope he never looks back.

Categories: Syndicated Columnists

When all is said and done…

Michael Morse - Rescuing Providence - Sun, 04/08/2018 - 13:19

Is it the day he puts in his papers?

Image by Eric Norberg

 

 

 

 

 

 

 

 

 

The last night in the station?

Driving away from the station after the final shift?

When he says, “I’m home,” and stays there?

 

 

Or is it when the fire in his heart diminishes and the thrill of responding to emergencies in the dead of winter is no longer there, but he does his job and leads by example and never lets “the kids” know that he knows the end is near?

Image by Eric Norberg

Is it when the thought of working a holiday is no longer acceptable, and unused sick or vacation time begins getting used?

Or when “the tones” at 3:00 a.m. sound like the bells of hell rather than a subtle way to say get up, get dressed, and get on the truck?

Image by Eric Norberg

Is a firefighter through when he makes rank?

Or if he chooses a different career path, like EMS or Fire Prevention?

Image by Eric Norberg

Or arson investigator?

Is a firefighter no longer a firefighter when the years of injury finally make it impossible for him to do his job without putting himself, his crew, and the people he is sworn to protect in danger?

Does he become less of a firefighter if he retires on a disability?

Image by Eric Norberg

It’s none of those things. A firefighter is no longer a firefighter when he stops breathing. Then he is a dead firefighter. Three days later, he will be a dead and buried firefighter. Then, he will live forever with the rest of the firefighters who came before him and lived the life and loved the job even when it became more and more difficult to feel it the way they once did.

     A firefighter is no longer a firefighter only when he chooses to no longer be a firefighter. Nobody can make that choice but the firefighter. What makes a firefighter a firefighter resides deep inside, and nobody can change that unless the firefighter chooses it. Simply hanging up the turnout gear for the last time does not strip a firefighter of his status.  

Nobody can take away the things that make us firefighters. Nobody can strip us of our memories, our heart and soul, or our willingness to put it all on the line when needed. Nobody can take the friends we make during our journey away. Nobody can make us forget those friends we have lost.

Being a firefighter is for life. There is no such thing as a retired firefighter. We can’t even die without being remembered as a firefighter. And after living the life, and feeling the heat, and knowing exactly how good it feels to do the job, who would want to?

Categories: Syndicated Columnists

How politics and partisanship impact emergency services

Syndicated Columnists - Fri, 04/06/2018 - 13:10
By Dr. Randall Hanifen, faculty member, Emergency & Disaster Management at American Military University Ever since the creation of political parties, we have encountered political battles. Until recent history, government functions were more about give and take. This give and take – the spirit of compromise – was at its best for organizations that served the people, such as emergency ...
Categories: Syndicated Columnists

Dear EMS: It's not you, it's me

Syndicated Columnists - Thu, 04/05/2018 - 11:23
It seems like every day there is another story discussing first responder fatigue, poor resiliency or stress. Has the job gotten that bad that no one can survive it anymore" Or does the problem lie within; is it us" There is no arguing that in the past, call volumes were not nearly what they are today. EMTs had to do a lot more with a lot less, yet it was, for the most part, a career that people retired ...
Categories: Syndicated Columnists

The Dangers of Firefighting

Michael Morse - Rescuing Providence - Thu, 04/05/2018 - 10:30

Uniform Stories used words

from one of my articles and created this short film.

https://www.firerescue1.com/health/articles/134918018-The-ugly-truth-about-firefighting-the-public-doesnt-understand/

 

Seeing what somebody else envisioned when reading my words is surreal.

Here’s what I wrote that got the project underway:

Much thanks to Rebecca at Uniform Stories.

 

We know what we see is real. We know how it feels. We live with the memories, and know that more will come.

We are tuned in to every aspect of the firefighting life. We know when a brother or sister is lost, and we mourn in our own way, no matter how far away the incident was that took them from us. We don’t have to know the name of the deceased, or their story, because we are the people who make the ultimate sacrifice. Inside every one of us lives a small part of the rest, and we feel the loss more profoundly than people could imagine.

The truth is, this is not the easy life that the general public wants to think it is. This is far more than shopping for lunch, parades, Dalmatians, and Fire Prevention Week. This is life, and loss, and tragedy. This is insomnia, and injury, and depression. None of us gets through it unscathed. None of us expect to. Some of us will not get out alive, and we know all too well that the someone could be us.

So we protect the public from whatever misfortune comes their way, and put out their fires, and tend their wounded, and keep them as safe as we can. We pull the dead from the car wrecks, and cover the bodies at fire scenes so the news cameras won’t bring the horror into the nation’s living rooms. We protect our people from more than just the physical; we keep them from knowing the truth.

The truth is ugly, and devastating. People will tell us that they can imagine how horrific it was for us, but they will never, in a million years, really imagine the depth of that horror.

They will never have to deal with the guilt, the constant mental playback, wondering if only I were a little bit faster, a little bit better, a little more poised, a little more heroic. They will never feel the profound sadness that we do as a result of seeing too much. They will never breathe in the smell of death as it lingers on the recently deceased, before the undertaker does his work. They will never wonder how they will even make it home, and get on with things after what they’ve witnessed.

They don’t have to know about any of it. We let them imagine how bad it can be, and allow them the luxury of thinking that they have imagined it right. They don’t have to bear the burden of life at its most raw and powerful. They have the luxury of watching the world go by through their screens that don’t scream, screens that don’t burn, or bleed.

We let them think that life is fair, with an occasional aberration. We allow them the luxury of the illusion of safety and fairness as life barrels along. They do not need to know how often things veer out of control. They don’t have to know what we know. We remember how it felt to be innocent. We know exactly how good it feels to not see the brutal realities that linger just out of sight. We don’t want them to know about any of it.

All we want is to keep the people who depend on us far away from the things we dread, and we want to survive this career with our hope, health, and sanity intact.

 

Categories: Syndicated Columnists

Anticipation Can Be Everything In EMS

EMS Office Hours Podcast - Wed, 04/04/2018 - 10:17

Being able to anticipate things in EMS can be helpful. When you think about it, you can actually try and anticipate many things in your EMS day. By doing this you will find yourself better prepared what you find even if you didn’t actually anticipate it.

Take a listen to this weeks episode to see what I mean below.

Be sure to share, tweet and like this on your favorite social media platform.

 

 

Go visit the main site for more EMS study resources and content. Start being an EMS professional now here. 

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