Turn it around

It has been quite a while since I have been able to sit down and do some solid writing. I have been busy between work, training, and still trying to keep up a social life. Naturally a hobby such as blogging takes a back seat when it doesn’t bring checks to the bank. Sigh….

Anyway, the reason I am writing today is to share a quote that came across my Facebook feed. As you may, or may not know I have started doing Crossfit. Its a no non-sense style to exercising and has really caught on with the masses it seems. As a result of that I spend a lot of time online doing research on techniques, nutritional plans, and connecting to other CF’ers out there. The quote came from Crossfit City Line, on Adams St in Newton MA.

““Was it you or I who stumbled first? It does not matter. The one of us who finds the strength to get up first, must help the other.” Author Unkown

The purpose behind this quote is to talk about how it is never too late to work on your own personal shape. It doesn’t matter what has happened in the past, all you can do is work on the present and future. One of the great things about Crossfit, is the sense of community. I am still getting to know people in the box I go to, but they are still there cheering me on as I work to achieve my goals.

Now, you are probably wondering why the hell are we talking about Crossfit again? This is an EMS blog isn’t it?

Well yes, it is. Thank you for noticing! Take the idea of physical fitness out of the equation here. Take that quote, and apply it to EMS.

It doesn’t matter who fell first people, It doesn’t matter who made the first mistake. It is no one else’s responsibility than our own to advance our profession. It is very easy for us to sit here, and talk about how the job could be better. If you don’t want to take the job seriously, or take the time to know your protocols by heart…then don’t complain to me about how nurses don’t respect you. Don’t complain to me when your medical control will not give you permission for certain procedures or medications.

Stand up, be the motivator for your profession. Be the model that everyone should follow behind. Do not become the person that people talk about, the person that has lost touch with the profession. Keep it exciting, one way or another.

It is never too late to turn it around, remember that. Until next time folks, take care…and most importantly stay safe!


Enough is Enough

This blog post is going to start off with a little self-assessment. When you get called out to a call, do you dread carrying someone down from the 3rd floor? Do you constantly break a sweat, to the point some of your partners may be inclined to put you on the cardiac monitor instead of your patient? Does your diet consist of anything that actually grows from the ground, and not some processed food plant in the middle of nowhere USA?

This was me at the end of last summer (2010). We would get called out to calls, that would require extrication assistance (stair chair, long board, scoop stretcher) and I found myself getting so winded after the carry that I would need to sit down in the ambulance before I could continue with my assessment and treatment. In addition to that, I would sweat…the need a towel kind of sweat.

It was embarrassing.

Around September I decided to take matters into my own hands. I will admit that I didn’t start trying to get in shape because of my job. It was because of the job that I wanted. I was looking to join Law Enforcement in some capacity, and as many of you out there know it requires a good amount of physical fitness to really succeed in that profession. Well, I went out and I tried. I did work outs at the gym, and I ran on the treadmill. I thought I was doing great. I was energetic, lost 10 pounds. Then it came time to actually go and test. 3 departments, 3 failed physical agility exams. At first, I was willing to accept that this was not my fate. I was not meant to work in Law Enforcement. It was a lazy way to avoid the harder task here, ACTUALLY getting in shape.

Finally, at the recommendation of many friends and coworkers. I started my initiation into the CrossFit world. I’ve only done one class so far, and it was the baseline workout to gauge how you are doing physically. Let’s just say it was a wake up call for me :).

I’m not on here to promote the CrossFit product, although I will personally recommend it. The reason I am here writing tonight is to talk about the overall picture of fitness. While I was doing some online research, I found an interesting article on the US National Library of Medicine, it was a study from the Carolina’s Medical Center: The Center for Prehospital Medicine, in Charlotte North Carolina. Let me give you some figures from the abstract:

  • Survey’s were sent to 58,435 providers who recertified in 2007. 30,560 (52%) returned questionnaires. Individuals missing data were removed, leaving 19,960 individual records.
  • 23.5% or 4,681 individuals who reported at least one existing health condition.
  • The mean BMI for the study participants was 27.69 kg/m(2). A normal BMI is 18.5-24.9
  • 75.3% or 15,022 individuals did not meet the Centers for Disease Control and Preventions minimum standards for physical fitness.
  • 3,394 classified themselves as current smokers.

Those are some alarming numbers! These are the best statistics published, that I could find in recent history. Let me put it to you this way, you know those frequent fliers that we all complain about. Yeah, you know…the ones with the HTN or the Hyperlipidemia, diabetes, 2 pack a day smokers, and the ones that also happen to be having the inferior wall myocardial infarction on your stretcher?

Based on these statistics, You are not any better than they are at taking care of yourself!!!

I am not here today to point fingers at anyone. Lord knows, I am not perfect (despite being a Paramedic). All I am asking you to do, as a responsible healthcare provider…is to take care of yourself first. It is a concept that we tend to forget about, usually it is overridden by our need to help people. Simply putting a few changes in our daily routine can make a huge difference. We are a tightly knit group in Public Safety, we get bent out of shape when one of our own dies. My question to you is, why are we not getting bent out of shape for something that will put you in the grave much sooner than a line of duty death?

Take this as food for thought, like I said I am not here to point fingers. Merely inspire a little motivation for a better you. I hope it helps, feel free to leave comments with your changes that you may have made to improve your overall health below. I look forward to reading them!

Stay safe my friends!


Social Media – Damned if you do, damned if you don’t.

We all have them, Facebook, Twitter, Flickr, etc. These accounts keep us in touch with each other. I myself have Facebook, Twitter, and Google Plus. Each of these accounts stand on their own merits, each offer different angles to the basic principle of social networking – a means to stay connected electronically across the globe. However, it also can create quite the headache for not only EMS, but Public Safety as a whole. Personally, I do not have much of an opinion about the restrictions that should be placed on an employee and their right, or privilege to access social media during work hours. That being said, social media can be used for a lot of good during an emergency, or massive public event. The majority of this post will be spent looking over the good, bad, and ugly sides of the social media world.

Since I try and keep a slight optimistic side to my life, lets talk about the good sides of social media first. Social media allows for almost instantaneous connections across the globe. It is probably the most rapid form of information deployment out there to date. I would even say it is more reliable than its predecessor “The Emergency Alert System,” that we see overtake our airwaves and televisions every once and a while. An example I like to use is a Tweet from Twitter after the Super Bowl this past weekend. Twitter announced that in the last three minutes of the game, they were seeing an average of 10,000 tweets per second. That is an insane number of tweets if you actually do the math out (1.8 Million in total to be exact). If you look at those numbers in an emergency situation, you could have collected 1.8 million different potential leads in a case. Conversely, you can very easily get as much information out there to the public through your followers and re-tweets. Twitter allows for rapid deployment in 140 characters, this requires you to keep your information relevant and brief. I think that is an absolutely amazing tool, that we would be foolish not to capitalize on.

Let’s talk about the bad portion of Social Media. I have a personal Facebook account, the account is locked down tighter than Fort Knox. However, I still operate under the idea of “Don’t post anything that you wouldn’t want to explain later.” Overall, that is a good way to look at social media. Facebook tends to draw the idea of “look at what I am doing.” This attracts people to post pictures for people to like, allows you to check into locations, and post statuses about what it is you are doing. Now, that is all well and good if used properly. We all know the type of person out there, commonly described as a ‘whacker’ or a ‘buff.’ They are out there looking for that great picture of the incident. I have no problem with outside photographers taking pictures of incidents. I actually encourage it because it allows the public to get a real view of what it is we do. I do have a problem when those pictures come from the providers/responders themselves. The motives behind the pictures may be for glory purposes, the ability to gloat about the great call that they just did. Most of us keep the patients identity out of the picture for fear of reprimand for violation of patient’s privacy. There is sort of an ethical debate about whether or not responders on the scene should be posting pictures. To be honest, I am leaning towards shouldn’t. We should be focused on maintaining the safety of what we are doing, not posting updates to various social media websites about what we are doing. If you wanna post, or write about it later then that is different.

Then there is the ugly side of social media. The side that gets people in trouble. There have been several cases of discipline handed down, or at least attempted to be handed down, about people complaining about superiors on social media website. Like I said earlier, if you don’t wanna explain what you posted to an employer later on…then don’t post it. Facebook can often be construed as some place where your actions have no consequences. Just think before you post, if you couldn’t walk up to that supervisor and tell them face to face what your problem is, then you better not be posting it on a website. I would like to dive into the legal side of this argument but unfortunately I do not have the expertise on the laws to really display a proper argument. I am going to refer you to an article, written by David Konig, that talks about how to properly handle social media faux pas. You can find the link below, along with several other links to articles that are a good read on the subject.

Speaking of the side of social media that will get people in trouble, I bring you to YouTube. YouTube has increased in popularity exponentially in recent years. This is a story of a Fire Department in Macon, GA. It is a YouTube clip of an apparent attempted robbery. A masked gunman burst into the firehouse, forces everyone onto the ground, drags a “probie” off camera and then a gun-shot is heard. I am all for a little chop busting when it comes to the new guy, but this is down-right unacceptable. The problem with social media is that we are forced to deal with how things appear, and not how they are. The appearance of this video is that there is a possible shooting incident inside the firehouse. In actuality it is only a prank. According to the article (cited below) on EMS1.com, five out of the seven firefighters on the video were in on the prank, and the two rookies were not. Frankly, if any of the firefighters that were in this video walk away from this incident with still having a job it will be a miracle. There are so many what-if’s that can be raised in this situation it is scary. I’ll spare you the time of going through them.

With the exception of the last couple of examples, problems with social media are rarely ever bad intent issues. Usually people mean well, and don’t see the fall out from their actions. Hopefully, you will choose your posts wisely. Remember that just because it is online does not mean that it is protected. Also, some organizations do have social media policies. This governs use of social media while at work, as well as information that may be “corporately protected.” As long as you always use sound mind and judgement when posting information online, you should have no problems.

Feel free to browse some of the articles that I have linked here, it’s where I got my information, you may find some of it helpful too!

STUDY: Twitter helps boost EMS Response

Social Media and EMS

Discipline over Ga. Firehouse ‘prank’ video

EMS and social media: Don’t be a Weiner

If you’re reading this and have some legal expertise on the subject, feel free to comment or email me at anderson.ryanm@gmail.com. I would love to hear some examples on the subjects.

National EMS Assessment: A series of posts, and soapbox moments. (Part 1)

First and foremost, many thanks to The Social Medic. I was reading his post on “Why Basics are More Important Than You Think.” Thru this blog post, my attention was brought to the Federal Inter-agency Committee for Emergency Medical Service’s Report on the “2011 National EMS Assessment Report” [CAUTION: It is a large PDF]. I got 7 pages into the 550 page report before I felt the need to hop on the good ol’ soap box. Be advised, statistically speaking…If I only made it 7 pages before I found something to talk about, I can assure you that it is safe to expect at least 78 more posts regarding this report. Maybe I’ll condense some of ‘em for ya.

This specific bullet point talks about data collection, as it relates to EMS Workplace Health and Safety. Anyone who has read more than one of my posts knows I am a hard ass for scene safety. Not in the sense of over bearing cowardliness, but more a self-awareness while on emergency scenes. According to this report that was published, the following points were made:

  • 12 (24%) of states have a formal recommended Wellness and Prevention Program for EMS Professionals.
    • How often are you complaining about the 350lbs patient in the 3rd floor walk up that you now have to carry down to the truck? Me…every time. The idea that we don’t actually recommend a fitness program for our employees is absolutely crazy. Does our hiring standards actually indicate any picture of physical health, or is it just a screening to see if we can do the tasks of the job? Most agencies it is the latter. Why are we not requiring our employees to maintain some sort of physical fitness standard?
  • Only one state currently monitors EMS on the job injury data.
    • THIS IS CRAZY! The idea that no one pays attention to job related injury is a little hard to believe. First and foremost I know it is done on a national level, because the Bureau of Labor statistics has information about, on average, how many providers go out on back injuries alone per year. My feeling is this report is designated to EMS specifically, and EMS Injuries usually get lumped into the same reporting system as all other work related injuries. It works but there really should be a separate reporting system. Having a separate reporting system will allow for easier monitoring of work environment’s and allow for faster developments of products and tools to protect us on a daily basis.
  • 18 (36%) states monitor EMS on the job fatalities.
    • Again, this blows my mind that there isn’t an entity responsible for monitoring such events. In all fairness, I can’t find information if this is the same case for all First Response agencies, or if it is just limited to EMS. Why wouldn’t we want someone monitoring this? After all we are all about QA/QI right? Then why are we letting this slip by?
  • 11 (22%) states monitor EMS Vehicle crash data.
  • 7 (14%( states monitor EMS blood-borne pathogen exposure data.

Again, this is the 7th point in the beginning of a VERY long document. My initial feelings after reading the first few pages of this expansive document are varied. I am very concerned that so little agencies monitor the statistics of the job. I am concerned that so much potential data for improvement is just going by the wayside and isn’t being analyzed. However, I am extremely optimistic that the document is released. It’s a grouping of ideas that show where we need to improve, and where we are excelling in the every day function of our jobs.

If you have a division of your states Office of EMS that is responsible for data collection and professional standards, that person can collect all this data that is being reported. That data is made public, available for all to scrutinize it. People realize that the number one cause of work related injury in EMS providers is back injuries. According to a study done by the American Journal of Industrial Medicine showed that about 10% of EMS providers are out because of back injury with lost time at work at any time in the country. The national average for the same statistic overall is only one percent.

This problem does not get solved on a national level. This needs to start from the ground up. First, we need to be sure we are using proper lifting techniques. Next, we need to make sure that we are physically fit enough to use said proper lifting techniques. In the event of an unfortunate work place injury, it needs to be documented. It needs to be sent to the states Dept of Labor, but also OEMS should start collecting such data. Then on a local level, we look at ways that we can prevent this from happening. We look at statistics and compare them to response patterns. What I would look for in response patterns are:

1) How many responders were on scene? Fire, PD, EMS etc.

2) How many of the responders aided with lifting the patient?

3) How many of the responders were not active in patient care?

  1. Why? Were they carrying equipment? Were they monitoring scene safety?

4) What is your opinion on how this can be corrected?

The most important part of that questionnaire, in my mind, is the fifth question. It is easy as supervisors, managers, and directors to “Monday Morning QB” a call, and judges the provider. It is a good way to provide some sort of self-evaluation to see if the employee truly sees the error of their ways. It could provide a great opportunity for them to voice their opinions and let them feel like they are needed. This information can also be passed up the chain of command and brought to EMS meetings to ensure proper safety is met with all the different entities responding to a scene.

I am looking forward to working through the National EMS assessment over the next few months (its 550 pages people, I don’t have THAT much free time). I hope it provides the powers that be on Capital Hill as much insight as it has for me thus far.

Tactical Emergency Medical Services – a preview

As you may, or may not know…there is a little hidden underground of EMS professionals known as Tactical Medics (The term “medics” in this case is not strictly for Paramedics. It is a generalized term for all EMS providers trained at the tactical level.)

Tactical EMS came about after a series of tragedies in our nation such as Waco, TX,  the North Hollywood incident, and most recently the Burbank CA shooting. It has changed the way Law Enforcement has responded to such incidents but yet EMS still responds relatively the same way…Stand on the side lines, until L.E.O.’s secure the scene, and then we begin triage. It is a safe way to do business and we usually just clean up the mess that’s left afterwards.  Tactical EMS works on both sides of this fence of scene safety. If you picture the Police Officers in harm’s way, and then EMS is back behind cover in a “safe location” waiting for the action to end. It allows Officers to have the knowledge to provide front line emergency care, and it allows EMS to assist in retreat to cover in the event that there is an officer down.

Why have we not evolved with Law Enforcement on this purpose? There are several big city agencies, usually urban environments who have members that are designated as tactical members who will assist in SWAT callouts. This is a concept that is very much in its infancy, much like the profession in a whole. I think it is imperative that each and every organization have some sort of “Special Ops” division that has a few specially trained members for these purposes. Yes, the cost can be a hindrance up front. There are several grants and such available from the Department of Homeland Security that you can use to train members regionally.

I did my training back in 2009 with STS Consultants, (click on the link for more information about the company, and the TEMS program) at a Western Massachusetts training facility. I learned a lot about scene safety, mostly scene survey. I learned how to asses a situation before I had even walked into the house. I learned how to asses for rapid routes of egress under stressful situations with low visibility. Overall, I couldn’t recommend this program more to anyone who wants to take it. I can think a dozen times where I noticed something on scene because I have had this training that could have potentially harmed myself, my coworker, or the other first responders on the scene.

In closing, the TEMS program is an innovative solution to help save an injured member of public safety. The primary purposes of TEMS is (according to STS Consulting):

  • Recognize a life threatening injury.
  • Provide treatment under hostile conditions
  • Conduct remote assessments and treatments
  • Plan and execute a rapid rescue to hard cover or safety.
  • Concepts of “Self-Aid” and improvised bandaging will be applied.

T.E.M.S. programs are offered all throughout the country. I only highlighted STS Consultants in this blog, because it was where I was personally trained. A simple Google search can guide you to various T.E.M.S. programs throughout the country, with various intensities in training, and various student dynamics. I hope this got you thinking about your agency, and the need for implementing or improving your T.E.M.S. program.

Take care everyone, until next time.

2012: What Will It Do For You

This post is going to be straying from the usual gun-ho EMS topics, and take it to a little bit more personal level. After all, if we don’t take care of ourselves first…how can we take care of others?

Well, its here. Its 2012. Another year, another chance, another fresh start. That being said, I’m here to offer a few personal & professional points to carry with you through 2012. They say a lot of New Years resolutions fail because they tend to be too broad, and nonspecific. In order for you to truly succeed with your resolution, make it smaller and quantifiable. Take the “I’m going to loose weight,” and make it “I’m going to be able to run five miles in 30 minutes.” Instead of saying your going to be nicer to people, actually open up your smartphone calender and block off time to go to a soup kitchen, or volunteer at a shelter. It will surprise you how quickly you will see your resolutions succeed.

Now that you have an idea on how to write your resolutions, lets think about where to direct your time and energy. This is when I tell you to analyze your professional, and personal lives.

Are they in unison?

……..Are you content?

……………….Are you HAPPY?

We work in a profession of selflessness. Day in and day out, we are asked to give up time. Time spent with our Husbands and Wives. Time spent with our children, and time spent with our friends. We miss meals, holidays, long weekends, vacations, and most importantly sleep.

I want you to think about a couple of questions:

1) Do you still see the joy out of being able to help someone in their time of need?

2) Do you feel like you are trapped, and are generally uninterested in your career any more?

If you answered no to question number one, or yes to question number 2 then it is time for you to move on. You don’t have to leave EMS, just get some sort of change to happen that will renew your love for your job. See about opportunities in training, (speaking from experience) it can be a great renewal to work with people who are excited about the career. You’d be surprised how quickly you will “get the wind back in your sails.” If Education isn’t your thing, then try a change of scenery. Bid on another station, see about cross-training so you can work in dispatch. These are just a few things that you can see about changing at work before you loose all faith in your specific Public Safety profession.

Most importantly, remember those family members, friends, and other various loved ones I talked about earlier? See them. I recently had a 2 week stretch where I didn’t work ANY overtime above my 48 hour schedule. I felt like I had weeks off. I was used to having “hours” off here and there to make it seem like days, but after resting and stuff it really was just hours. I spent time with my girlfriend, friends from college, family members, and people that really do make life seem enjoyable. That happiness is something that your patients, and your coworkers will notice, because no matter how hard you try it is not something that you can hide.

A sense of contentment is what will bring this profession into the next level. If you are contsantly talking about how being a Paramedic isn’t good enough, or is “just a stepping stone,” then that is all it will ever be. If you can’t find the enthusiasm in your job, then why even do it at all?

What ever holiday it is that you celebrate, I hope it was one filled with happiness.

Stay safe in 2012, we lost enough brothers and sisters last year.

Stop, and Remember…..

A Time to Remember

Today, I am writing this post as my girlfriend and I are currently 34,000 feet in the air somewhere over the “fly-over states” of the Midwest. We are heading to Vegas for a quick weekend vacation with another couple. It has me thinking of all that I am lucky enough to be able to do in this country. We owe that to a very certain group of people. The service men and women of this country fight day in and day out to maintain our freedoms and protect the life we lead, and all to often, take for granted.

I am writing today to memorialize an EMS ally that many of you may not know. Major John Pryor, was a combat surgeon with a forward surgical unit in the United States Army. December 25th 2008 Major Pryor was killed when his surgical unit went under attack while providing life saving care for our troops in Baghdad.

While attending college in Massachusetts I had the pleasure of leading a campus based EMS organization. That organization, every year, would travel to a national conference held by the Nation Collegiate EMS Foundation. This foundation provided professional networking and training for the colleges around the country that ran their own Emergency Medical Service. Services varied from First Response to full blown ALS transporting services at some of the bigger universities. If there was ever an underground EMS 2.0 Movement, it was here. People here are enthusiastic, creative, and motivated. They are motivated to go out and change the world.

Dr. Pryor was a practicing Trauma Surgeon at the University of Pennsylvania. He would always bring a wealth of knowledge to the NCEMSF Conference. He would show how battlefield trauma care is actively shaping the way that Civilian EMS provides trauma care. He would bring pictures to show the work that was being done overseas, but most importantly he would motivate you to go out there and change the world. Dr. George Koenig (President of NCEMSF Board of Directors at the time of his death) described it perfectly in a letter to the membership:

“He is best remembered by his favorite quote by Albert Schweitzer. “Seek always to do some good, somewhere. Every man has to seek in his own way to realize his true worth. You must give some time to your fellow man. Even if it’s a little thing, do something for those who need help, something for which you get no pay but the privilege of doing it. For remember, you don’t lie in a world all your own. Your brothers are here, too.”

The EMS community lost an amazing ally and advocate that Christmas. He was a humble man, that truly had the power to motivate many.

I had the pleasure of attending a few different lectures of his while at the conference. Once was a Key Note, and the other was a optional lecture. Both times I walked out of there with a wealth of knowledge pertaining to a world I have never seen. Battlefield medicine is a very interesting topic, and something that I have never personally had the pleasure of experiencing.

To all the men, and women who are serving overseas, and their families forced to spend the holidays without them…My prayers are with you that you can find a peace in knowing that you are doing this country a great service. One that I will never be able to pay you back, except with overwhelming amounts of gratitude and support.

Thank You. If you would like to read a little more about Major John Pryor, MD please click here.

Merry Christmas everyone.