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!


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.

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.

The Most Dangerous Job in Public Safety?

Part of the EMS 2.0 mission is to improve the standard of our profession in clinical practice, knowlege base, technology, and safety. These combined makes what I am about to share with you pretty scary. Studies are finally starting to show the REAL danger that is out there from working in EMS. I was cruising the EMS Information sites today and looking at some of the articles that were published in JEMS during the November 2011 issue, by David Page, MS, EMT-P  Titled: “Studies Show Dangers of Working in EMS.”

Studies are showing EMS to be one of the most dangerous professions. Data was examined from 2003 to 2007 found that there were 65 EMS Fatalities, or 13 per year.

“Forty-five percent (29) of EMS worker deaths resulted from highway incidents, mostly due to vehicle collisions, and an additional 12% (8) involved personnel being struck by vehicles. Thirty-one percent (20) of EMS fatalities involved air transportation incidents. It’s important to note that these statistics don’t take into account any civilian or patient deaths that may have occurred as a result of EMS crashes or other incidents.” David Page MS, EMT-P

That is insane!!

We are in a field that is based soley in transportation. We answer a 911 call, we respond to said 911 call, and we transport the patient to the hospital. We haven’t gotten our profession to a treat and release basis yet (frankly I don’t think I want it to get there). So a majority of our mission is transporting a patient, and that is what is killing us the most? WHATS WRONG WITH THIS PICTURE?

Let me give you some examples:

Fire – they figured out that fire will burn you, and smoke will destroy your lungs. Solution? Better bunker gear, and better SCBA to improve respiratory function during interior operations .

Police – They realized…oh hey…bullets? Yeah they’re dangerous…lets put something protect us from that!

EMS – 45% of worker fatalities between 2003 and 2007 were related to 99% of our job function? Oh, but the R&D is too much to come up with a solution?

Give me a break.

I’d love to see our vehicles get to a point where we have a 5 star crash rating for both crew and patient compartments. I realize that isn’t going to happen overnight. This is a two way street where we need to be vigilant as much as management needs to be willing to provide proper equipment and training to make our job safer.

I hope the numbers have decreased since the last data set was collected (2003-2007), because these numbers are just too outrageous to ignore. The official study can be found in Prehospital Emergency Care Fatal and nonfatal injuries among emergency medical technicians & paramedics. Prehosp Emerg Care. 2011;15(4):511–517. A simple Google version will bring you to it.

Until then please remember to come to a complete stop at a red light, and don’t just “roll through it,” Look four times instead of two, and wear a safety vest or some sort of  high visibility uniform attire.

Stay Safe out there everyone, I don’t want to have to stop to give YOU a moment of silence.

Here’s a little collection of Ambulance crashes I have found through Google searches, just in case you were feeling safe and secure in your rig….

Keeping it Together, a Discussion About Unity.

So I have taken a couple weeks off from blogging. It’s been a busy end of August.

As usual, I was browsing the typical social media outlets and I saw a post from a fellow paramedic. He was mentioning how there was a showing of different agencies from around New England for (what I believe) was an EMS LODD Funeral. He was in shock that there was less than 300 people there for a LODD Funeral. To be honest, I can’t say that I blame him.

I look at the displays of unity from across the area, PD and Fire always have a strong showing at a funeral for one of their own. Thankfully, I have yet to experience a first hand EMS LODD Funeral. I have had colleauges sadly pass away due to accidents or illnesses. They are just as sad, just as tragic, but there isn’t that sense of sacrafice because it obviously was a tragic passing.

When will EMS providers get the picture about unity?

I sit around work and listen to people who do nothing, but complain, about doing work. If something goes wrong, there’s 10 people in line to throw some one under the bus, and 2 standing next to him. It is sad really. These attitudes are our biggest downfall. I would love nothing more than to see the EMS Profession grow into something that people want to make careers out of…but day after day we are sabotaging our own advancement.

My suggestion? Get involved. Get involved with National Associations, such as NAEMT (Please forgive my shameless plug). They are really making a substantial effort thru political channels to give EMS Providers the legislation necessary to bring our profession to the next level. I applaud them for doing that.

Next, share you’re ideas. We are not going to get anywhere if we don’t even try. Maybe using blogging websites, or other forms of social media opens doors I, personally, never thought of walking through.

Finally…When push comes to shove, be there. Don’t back down, don’t run away, and fight for yourself (collectively, not individually) EMS is a profession that I love very much. However the majority of EMS Systems are built on the never ending “revolving door.” Meaning there is always a constant turn over of employees and experience levels. If we ever solve these fairly substantial issues, then we will see EMS rocket into version 2.0

MCI Triage – When $h*t Hits the Fan

Let’s talk about going from “0 to 60mph.”  We often hold these MCI drills (usually at the expense of Uncle Sam and his glorious grants). Does this training prove fruitful? I think so. While during the event it may seem like a cluster, afterwards it can be very easy to critique the event and usually you will find very little that needs to be fixed in this post 9-11 era.

For a case study I am going to use an example from Western Massachusetts. A few months ago, something happened in Massachusetts that hasn’t happened for almost a hundred years. Two tornadoes touched down in the Greater Springfield Area. This then launched the Greater Springfield into a disaster response mode , the likes of which hasn’t been seen since I started my career almost 7 years ago.

I spent some time talking with a former supervisor of mine, and fellow EMS 2.0 blogger, Scott Kier about the events that unfolded that day. He talked about the staging plans on the north and south sides of the tornadoes path. He praised staff for their dual command centers, and the communications staff for keeping everything in check. Luckily there were little casualties as a result of the storm. Most of the transports they did were all secondary injuries or normal medical jobs. Triaging casualties can be very difficult, especially if people aren’t on the same page. Thankfully two things happened that day to make it flow pretty easily. First, excellent crews that rose to the occasion of helping people at their time of need. They put their personal wants and needs behind and answered the call. I feel like this is a reflex reaction and no matter how burnt our or “crispy” you may be, its often hard to deny it. Second, there was a low casualty rate as a result of the storm, which didn’t bog down resources.

Scott spoke of “crews going door to door checking on the residents, making sure that everyone was okay.” I was proud to hear that such a large service still had the caring of a small town service. Scott also talked about how even at one point “crews had to take shelter in a resident’s basement because the second tornado was touching down.” The “Big-City” that everyone always talks about suddenly appeared as if to be a tiny “one horse town.”

It is very hard to keep your cool when mother natures is reigning down her wrath. I have to say from the stories that Scott told me, I am very proud to call you guys colleagues. I brought attention to this story because I feel it truly emulates the EMS 2.0 Mission. These providers were methodically searching the city looking for sick and injured. They were on the same page, and gained a lot of attention from local, state, and even some federal agencies.

Thank you to the Greater Springfield EMS providers for helping bring EMS 2.0 to your city. Keep up the great work, and most of all stay safe!

Safety and the EMS Professional


It’s a phrase we all get used to saying, but how often do we actually put this into practice? Along with the “Health and Well-Being of the EMS Professional” This is another favorite lecture of mine to teach. I will take this lecture and drag it out forever to literally beat a dead horse. What happens when violence finds you? It is easy to protect yourself when you know what kind of situation you are walking into, or potentially walking into. How do we protect ourselves when it inadvertently begins to surround us?

My station is based out of an area in Boston known as the Southwest Corridor. I am not a City employee. I work for a private service in the area that primary provides secondary and transfer coverage. There has been the usual summer spike in violence in the Dorchester, Mattapan, and Roslindale neighborhoods. The most recent shooting happened to be a triple shooting and practically right across the street from our base. See the story here: Roslindale Shooting.

More than ever we need to be cognizant of that going on around us. Some may say that I can be a bit paranoid about scene safety, but I can assure you that there are things on scene that I will notice 10 mintues before any one else. I worked with a friend of mine one day, and we were in this flop house in the “Big City” somewhere. I had asked her on the way out: “Hey, did you notice….” and continued to list of several rather obvious details to the call at hand. She had no idea what I was talking about.

Gone are the happy go-lucky days of only worrying about scene safety when we are actively assigned a call. “Scene Safety” now applies from the time we punch in, to the time we punch out. We are in mobile bill boards, uniforms that can very easily be mistaken for law enforcement, and are housed in neighborhoods that I wouldn’t send my worst enemy into.

Next time you head out from your station, don’t just look both ways to avoid those masshole drivers. Look to notice that male standing on the corner. Think: What is he doing? Is he holding something? Am I trapped in traffic if something happens? Pay special attention to that guy that is riding your bumper. Is he trying to cause some sort of road rage incident? Like I tell all my students in lecture, make sure you always have a way OUT. This applies to traffic, scenes, and when you are out in the bars. You never know when your going to find yourself in pinch and rushing for safety!