Archive for February, 2013

Improving EMS 1.5

Recently I began writing small blogs about methods to improve EMS. I have posted one and already some of the responses have led me to new insights.

First I must tell you all that having readers that provide feedback is very educational for me. Thank you.

Second, I think something that could help, in the same topic of education and how it can help improving EMS, is our graduation ceremonies. Currently in many of the programs little to no emphasis is given to graduation of EMS personnel. I think this has to change. We have to give the graduation of new EMTs the importance it deserves. As instructors we have to encourage students to go to the graduation ceremony. We need to invite the leaders of the field in your area to come and speak to the new graduates. State representatives in charge of EMS regulation should be encouraged to come and speak, to introduce themselves and what their role (no matter how small that role may be depending on what state they’re in) in EMS is. As senior medics we need to take a few moments to encourage and lead.

Oh how I think that word is misrepresented. “Leader”, all too often senior medics think it gives them a free pass to just torture new people. Don’t get me wrong, a little ribbing is expected. Funny times for all. But some take it too far. This, however, is a topic for another post.

I am mentoring a student for a local college and I take it very seriously. I want to encourage them to be the best they can be. I am not of the theory that you have to learn a lot about EMS once you are out there working on your own. Sure you will learn a lot and sure we have to be ready to learn for the entire time we spend in our career. That is true of life in general I believe. There is a lot that can be learned before you go out on your own as a medic. As senior medics we can help with that. We can also help by celebrating along with them the next generation of medics.

While we are on this topic, what do you all consider a good gift for a new paramedic graduate? A Littman is always good, any other good ideas?

“Prioritize. You can’t expect to remember everything you need to know in EMS if you spend all shift on Facebook or watching TV. Refresh on some info during your down time.”


Improving EMS Part 1

I’ve said it before, and I’m probably going to say it again many times before my career with EMS is done, we are a young field in the grand scheme of things. I believe some mistakes were made at the inception of EMS and now we are having growing pains.

The first thing I’m going to talk about is education.

We do more on a full arrest than nurses with 4 year diplomas. I’m serious, depending on the service, you can do intraosseous establishment, intubation, ventilator use (something that requires a respiratory tech in most ERs), rhythm interpretation and appropriate treatment. Some systems have the ability to do rapid sequence intubation, tracheostomy, needle decompressions, and very potent narcotic use. Yet we are still not considered a profession.

I have been studying some online classes for my RN degree and have learned something. At the very inception of nurses there were groups of people that were thinking of the future. They were planning and they understood what was going to be needed for future growth as a profession.

Where EMS grew out of direct profit and has for a long time been considered a step child to the fire department, nurses were developing guidelines to establish bare minimums. Some of their guidelines included:

  1. The minimum education required for a technical nurse was a 2 year degree. Associates. This was developed for registered nurses and could be considered the foot soldiers of nursing. They can do the technical aspects of patient care and even supervise others in patient care.
  2. The minimum education required for professional nurse a 4 year degree. Baccalaureate. They can climb the ladder in different facilities and can take more managerial positions.

Now I’m not saying this would instantly benefit all involved in EMS, I’m not even saying that it wouldn’t hurt some systems that have horrible paramedic retention. I am saying that we cannot be a 2 day a week class for 9 months field anymore. We can’t be certificate paramedics. We need to provide routes for currently certified individuals to become nationally certified. We need to guide new students in learning that this field should entail a lifetime of education. We are not fire fighters, we are not police officers. We are EMS and we have the potential to do things medically to people that have far reaching and long standing consequences.

I believe that this is a first step in vastly improving our career. I will be posting other steps I believe will help EMS continue to grow and develop into the profession I believe it can be. Now before you completely disagree with me please take a moment and think, could more requirements in education really hurt?

Any thoughts? Send them to me below or visit my twitter account @ouremssite. I am eager to hear what some of you think.


Mark Twain quote

The front line

The following story, while completely true, must for the protection of all involved, mask identities, times and locations. Any relationship to actual people is coincidental and should not be interpreted to reveal identities since I have actively attempted to hide them.

There are always people in the world, everyday people, that go out of their way to keep all of us safe. I have a story for you. A story that may never make it into known history books or media.

A man on his travels through the world from eastern Europe to America contracted a disease. He didn’t know he was particularly more sick than anyone else who has a common cold was, except his cold didn’t seem to be getting any better. When he was detained by immigration officials he explained to them where he had been and a quick exam revealed he was positive for an airborn respiratory infection. What he and the medical staff were not expecting was finding out that whatever medications they would use on the disease seemed to do nothing to cure it. Some very strong antibiotics were attempted, the strongest available actually, and the disease was not fazed.

Can you imagine the dangers? An airborn disease, easily transmitted via a cough or a sneeze, being carried by a world traveler who entered the United States illegally and now has the potential to spread?

A team had to be assembled, the patient had to be moved from one location to another and utmost care had to be taken to not expose others. A specially trained nurse was flown in with a sealed enclosure that would be used to house the patient until he arrived at a different medical facility. EMS personel had to be brought in, vetted for security purposes and prepared for the transport. Security was high, not due to the patient being a flight risk or dangerous, but due to the risk of exposure to an inocent public. Specialist doctors and military experts have to be brought in and the caravan can begin.

A vehicle has to be escorting the ambulance in the front and one in the back with a third vehicle for the doctor.

What I want to put in your minds is this, imagine the nurse in the back of the unit with the paramedic. Imagine you knowing the disease this patient has is airborn and if you do contract it there are no antibiotics or medications that can even slow it down. But our work must be done. Imagine if you will knowing that if you make a mistake it may not be just your life, but that of your family, your wife, your children that can be contaminated. It’s true that it’s a job and we are not really hero’s but it’s also true that these things that medics do, that nurses do, that all first responders do can carry a huge risk. But our work must be done.

I know this is but a small example of a story that may never be widely known. This is a story about all of us. All of us in the field. I just had to share it with you guys and say thanks to all of those involved. You risk much, I hope we don’t squander our reward.