One last serving of photos from the Sovereign King Love Feast.

SK, EMS, GPD, & Friends

D.O.T.M Presents Stilltown Vol. 1

Brand new music from the best hip-hop artists in Pittsburgh, PA.

http://www.mediafire.com/?gkhm0z15mty

01. Jack Wilson – Clap Your Hands Say Yeah (Prod. by SPAED)
02. Reverrb – Here You Go, Kiddo (Prod. by 2 Deep Productions)
03. Shindiggaz – GI Joe (Prod. by DJ Thermos)
04. Divine Seven – Str8 From the Heart
05. Jon Quest – Emcee University (Prod. by Shade Cobain)
06. B-FreeDaMisfit – In the Sunshine
07. Ayatollah Jaxx – Nothing Like You Ever Heard (Prod. by Chim Beats)
08. Apex – Get Ready (Prod. by Ulliversal)
09. Living Proofe – Be (Prod. by Nice Rec)
10. Idasa Tariq – Blacksmith Application (Prod. by Idasa Tariq)
11. Billy Pilgrim & Reverrb – Regardless
12. Lone Catalysts feat. Mood – Beware
13. Jev the Ghost – Open the Door (Prod. by Vills)
14. Internal Korruption – Get Out (Prod. by Internal Korruption)
15. Davu – Get Loose (Prod. by Shade Cobain)
16. Gene Stovall & Armstead Brown – Remote Control (Prod. by Armstead Brown)
17. Good Company – Might Not Make It (Prod. by Fundamental)
18. Divine Seven – Reachin’ (Prod. by Shade Cobain)
19. Shindiggaz – Ninja Turtles (Prod. by DJ Thermos)
20. Jack Wilson feat. Billy Pilgrim & Deric Norgren – Meets His Speaker
21. Jasiri X – Silent Night

Big ups to Rory @ stilltown.blogspot.com

Therm&Soul&Friends – Adventures on Gunstar9 - Coming real soon. Like in the next two days. Keep checking back here.

Why did she die? Because 2 off duty EMS operators walked into her shop for coffee and watched her fall down and did nothing to help her but told her co-workers to call 911 before walking out of the store.  Mayor Mike Bloomberg is railing that their actions are heartless and unconscionable, which they are however it also has something to do with race.

I am not usually a race monger and abhor that type of thing when others do it but in this case it is an obvious case of discrimination but if the two EMS people turn out to be minority based then chalk it up to laziness.

What do you think? Anyone have more info?

==–Bonju Patten

I work in a large town somewhere in Suffolk. Let’s call it Utopia.

“Early weather reports are suggesting the public, particularly if you live in the East of England should prepare for snow.” – BBC Reporter, two days before.

“We have never been more prepared. We have stock piled ten times the amount of salt and grit we had this time last year. We are ready.” – Spokesman for Suffolk County Council and mirrored by another in Essex.

“The people of the east of England are today waking up to hear weather reports saying there is going to be winds blowing over from Siberia and that this will bring a lot of snow with it. I kind of doubt that, this is England. I mean… We don’t really get snow this time of year do we?!” – A member of the publics reaction to the BBC weathers ‘extremist’ reporting.

“The snow is expected to fall over night. Experts predict a fall of at least six inches.” – Local weather report on the day.

“Yes, we’ve watched the weather reports, yes as I said before we are prepared. As a matter of fact we have seventy drivers extra and they will all be reporting in at 6pm. They will be on standby from then on.” – Spokesman for Suffolk County Council. Three hours prior to the fall.

At roughly 5 pm on Thursday 17th the snow began to fall. It was earlier than expected and it caught us all by surprise. The sheer amount that fell in the first hour was more than any of us thought possible in England. Now before I go any further I don’t want you to think I am trying to make this into some tragic hollywood style story. No, I just want to get down on paper the events how I saw them as a paramedic on duty that day. I’m sure the rest of the world ground on as usual oblivious to awful cock up going on around them but hey, that’s just life isn’t it?

If you had been out had about on that day, christmas shopping or whatever, you too would have thought, ‘Gosh! That’s a fair bit of snow. I thought that wasn’t supposed to come to tonight?’ You wouldn’t be wrong for thinking that either. Hell, thats what we all thought. I mean that’s what we were told wasn’t it? Then as time dragged on and the traffic in front of you started to back up you’d likely start getting a bit concerned. You’re an hour away from home and you’ve moved maybe half a mile in the last hour. Worse still is that the snow has not stopped. If anything its coming down thicker and quicker if that seems possible. You look outside your window and see people trudging through snow thats laying on the pavement. Its at least three inches already. You notice your fuel light is going to come on if you don’t fill up soon so you make a point of pulling into the next garage you slowly approach. Oh dear, the garage has closed its doors and switched its pumps off. You sit in your car paralyzed with dread. Its getting bitterly cold out. The snow is heavier than ever, you’ve got no fuel, little Johnny and Mable are starting to get hungry and cry, your heating is not adequate and… wait, over there! Why, there’s an ambulance sitting next to one of the pumps. One of the paramedics is walking over right now in his hi-vis jacket. You wind the window down.

‘You need to turn around miss. The fuel station is closed,’ I say.

You look at me gob smacked. Your eyes are brimming with tears and you wince as your children scream.

‘Why?’ you ask as I move to walk away. I shout over my shoulder to busy and caught up in what the hell I and my colleagues are going to do to notice how cold and uninterested the words that come out are.

‘There’s no bloody grit. Chief in there can’t keep the forecourt open if its covered in ice,’ I say gesturing to a man in the forecourt shop sitting behind his till all nice and warm. And with that I’m gone.

I walked away from that car without a seconds thought. The sounds of the screaming children abruptly muffled by the stressed out mum closing her window.

My colleague was actually filling up at the time I had that brief conversation. We’re allowed you see. The petrol stations have to keep a reserve for us and allow us to fill up when we need. Incidentally had I turned up in my own car and flashed my ID I would have been able to fill up too. It’s not just the vehicles. Vehicles are useless without staff to drive them.

We finished filling and left. Anarchy had started early. We did not want to be around to watch the public shouting abuse and gesticulating mob fashion at the poor clerk indoors. It just goes to show how close to a complete break down our society is, when the most minor of things occurs. I say minor because, not 300 miles further north is Scotland. Now I’m pretty sure they won’t be acting the same way these crazed-its-the-end-of-world-nutters are acting. What about the Swiss? I’ll bet they’d be laughing their arses off. England! One little snow storm and they fall to pieces. Its true, we do fall to pieces. Then again, it doesn’t matter how minor the weather is if you’re not prepared for it.

We were most definitely not prepared.

By 8pm, Utopia was at a standstill. Literally. The major junctions and roads were gridlocked and nothing was going anywhere.

Those that tried had pretty good odds on not getting to their destination either by getting stuck which was the most likely option or by coming off the road altogether and crashing.

I lost track of the number of road traffic accidents I heard over the radio. But why? Why was this happening?

We got a red call to a woman with a broken hand up in a nearby town. Ordinarily it would take us maybe fifteen to twenty minutes to get there on blue lights from Utopia. On this occasion it took us an hour and a half. The A14 was down to somewhere in the region of 10 – 20mph for the majority of the journey. To make matters worse… it was just a bloody hand injury for crying out loud! Why the hell someone up in the control centre couldn’t have seen sense and told them to sod off I don’t know. No sooner had I got the patient aboard the husband announced matter of factly that he’d be following in his car. I gave my best sneer and evil eye and slammed the door. I think he could tell we were not impressed.

I heard a cardiac arrest (someones heart has stopped beating – this person is dead without help) go out in the immediate area and a roll over RTA (a car has rolled over, likely trapping the occupants inside) somewhere in Utopia as I rejoined the A14. My fists clenched till my knuckles cracked as I listened to the woman in the back making demands of my colleague and asking why we weren’t going faster. My colleague to his credit, kept his cool and simply grinned back. A bit of drool swung pendulum like from his gritted teeth (this is how to tell if this particular colleague is stressed out – you watch for the drool bungie) as his glared at her. It must have worked as she apparently wouldn’t dare make eye contact again for the rest of the hour long journey back in.

So, between us getting that call and finally dropping the bitch off and hospital our ambulance had been tied up for nearly three and a half hours. On any other day we should have knocked that one out in around one hour. This was happening all over the county. It didn’t take long before we had no ambulances left to send. The police were in a similar pickle, and the fire brigade I am happy to say didn’t know what had hit them. No sleep for them tonight. Gits.

A Thursday night this close to christmas is going to a busy one for everyone involved in any area of public services. The snow really couldn’t have come at a worse time. Most of the major drinking and eating establishments had some form of christmas do on and it was late night shopping.

A little before midnight, the buses decided that they were not going to play anymore. It was just too dangerous on the roads, and they couldn’t move for traffic anyway. Not half an hour after they had pulled out the taxies also decided that they had had enough. Now I am no mathematician but to my reckoning that left a few thousand people stuck with no way home either because all public transport was suspended or because they simply could not get out of Utopia with the roads in the state they were in.

So, what happens now? Well, if your not stuck freezing in your car somewhere, in a ditch upside down, getting hypothermic outside waiting for a taxi that will never arrive then your probably tucked all nice and snug indoors and completely oblivious to nightmare that hasn’t really even started yet.

Its just gone midnight and the snow is still falling. A call comes in for a man collapsed in the street. Initial reports are sparse but we know he’s young and we know he’s not half a mile from the hospital. There are no ambulances available.

A car has span out of control and gone sideways into a tree in the middle of nowhere. He can forget it. There are no ambulances available and even if there was it will be diverted way before it even makes out of Utopia. Gotta hit those times!

People are freezing on the A14 and A12. They abandon their cars and walk.

The calls to people outside and freezing go through the roof.

We have nothing to send.

An ambulance fast response vehicle (erm… it’s snowing?), okay response vehicle is dispatched to the collapsed male in town. It doesn’t make it. It spins off the road instead and gets stuck in the snow.

And on and on.

The male collapsed in the street did eventually get a response. He was twenty eight and he died because his heart had stopped while he walking home from a night out on the town.

A lot of the people who abandoned their cars on the roads were able to find their way to a late night Tesco. It had remained open and was sheltering anyone who needed it. A couple of hotels had also done the same.

Yet what had happened?

The gritters did eventually make it out on to the road but it was too late. The snow was too thick and deep and all the shit they sprayed just sat on top. Apparently they had been taken completely by surprise. Nearly six hours had passed before they were able to mount a response in force, around about the time they had expected the snow in the first place.

So there you have it. A bit sensationalist you may think, but hey I see this shit first hand. I am sure if you yourself work in any of the emergency services you may be able to testify to the utter chaos an unprepared town can find itself subject too. Maybe you have seen worse or maybe you think I am talking out of my arse. Well whatever you may think, if you ever find yourself in a blizzard in England, think carefully before you try and call for help. Do you really need help? Because I guarantee there will be plenty who do.

So for around five years now I have found myself a soldier of the retail culture. I don’t feel a distinct need to get into the details of this exciting life – because anyone who does  graduated high school in six years or has a large themed sweater collection – but, I would like to pass on some knowledge to you, the reader. Which by the way mom, is what I will be henceforward calling you.

There are certain things that you should never, ever, say when shopping. Unless of course you want the salesperson to hate you. Which is exactly what transpired when you walked in the store, by the way.

1) Do you have/ I need (Insert horribly non-descript noun).

Let’s make this simple. If you don’t know what you want, don’t go shopping. Go home. Go to the public library and get on the interweb. Go to a train station and play hopscotch on the 3rd rail. Just don’t go shopping. That’s like going to church when it’s not Christmas Eve or Easter. It doesn’t make sense. Asking a salesperson for help should not be like a game of charades. I don’t want to throw out random words while you point furiously at objects and fondle the air like you’re performing a mammogram. We are not Italians at dinner. We do not operate on waves and thrusts for communication. Use words. Descriptive or specialized words. Please don’t ask “where the stuff for men is,” or “what should I get someone who is outside a lot?” Please don’t tell me what you want “looks kind of like this thing” your neighbor has. Don’t tell me it had points, or edges, or was smooth on one side but rough on the other. And please,  I promise you, I have no idea what “stuff for cold weather” is, or ever was. I could say water heater, mittens, or cocoa mix and I would be 100 percent correct. The only way to be less descriptive would be if you were mute, and didn’t actually ask the question.

2) Can you go ahead and wrap this up real nice -maybe some tissue paper and a box? I’m about to give it as a gift.

Can I do YOUR job? Unfortunately sir, I can’t. But I went ahead and threw six extra sensor tags on there, and cut the sleeves with this boxcutter here. Hope that helps!

3) What would you wear/choose?

Oh dear Lord I cannot handle this one. Now, I can understand asking a salesperson a question like this if it seems like they might have some intimate knowledge of the product or the person you are buying the product for. If it’s a choice between two pairs of snowshoes, go ahead, ask away. If your son is about my age, we share the same build, and its a question of taste or size: be my guest. But when the question is “do you think my daughter would like a blue or white t-shirt” – kill yourself. I don’t know your daughter, I don’t care about your daughter, and I care even less what color t-shirt she gets from her mother. The real question you should be asking is “sir, when did I become such a horrible parent that I have no clue what my own daughter’s taste and interests are?” Interestingly enough, I have an answer for that. “Judging by the fact you just asked a complete stranger for help, I’m going to say you failed on about day 3.’” That, or “you look really fat today, miss.”

4) Can I pay by check?

Nope, but you can sure as shit eat a grenade.

5) It’s not on sale? What if I pay in cash?

If you’ve never worked in retail, or more specifically a retail store that sells high ticket merchandise, you may never have heard of this one. But I swear, we get this a lot. People will look at a kayak, go through the motions of buying it, and then at the end be infuriated it’s not on sale. I can understand the frustration: it’s a costly purchase, you really want a boat, the economy is dying, the Mets haven’t won in years, Sarah Palin is still alive, etc… I really do feel for you. But people – and WAY too many of them – seem to think that a sale is dependent on the medium in which they pay for the item. No. No it is not. In fact, if you pay for an item with cash it is more work for me. I have to count your money – most likely first having to wipe off some type of bacon grease or indistinguishable fur  – and then organize it in the drawer and prepare your change. I also will have to do the same that night at closing, wasting even more of my time. There is no special deal for doing this. No douchebag discount. For God’s sake, act like anyone past their thirteenth birthday, and pay with a credit card.

6) In arguing the semantics of sales/discounts: “Now listen, I shop here a lot.”

Congratulations, I now like you less than when we began the conversation. Now when you talk I will be trying to remember the names of characters from 90’s TV shows.

7) Do you work here?

Okay, now let me be clear here. If you ever have a doubt someone works in a store, you need to ask this question, I get it. I encourage it. But there are certain situations where it is beyond redundant or illogical. If I’m decked out in EMS gear, wearing a name tag, carrying around a radio, holding a cardboard box of merchandise, restocking a shelf, saying hello to you as you walk in the store, and assisting other customers while behind the register, ALL at the same time…you don’t really need to ask. I’m either going to say yes, or “Actually no. Remember the really retarded kid in highschool who had a keychain with like 5,000 things around his neck, jingled like a marching band as he walked, and said hello to everyone? Yep, I’m here now. Just kind of living the dream, you know?” Either way, looks like I’ll be helping you.

#8 Excuse me: son, young man, chief, *snap of fingers*, *wave of jacket*.

Oh, sorry grandma. I forgot we were putting on a production of ROOTs today. Let me run in the back and grab my ripped cotton shirt and the words to “Wade in the Water.” Then I’ll be right out to help you.

People suck.

BT-Dubs – Really WordPress? I couldn’t write eight followed by a parenthesis, or it came out as Kind of killing my “god this loser has snapped” vibe…. *Palms forehead*

A pregnant 25 year old woman died while heartless Emergency Medical Services technicians refused to stop and help.  See NY Daily News  story here.

    Eutisha Revee Rennix

The young lady was working at an Au Bon Pain cafe when she her breath became short, and she experienced intense stomach pain.  There happened to be two EMS technicians in the store who had made take-out purchases.  Co-workers requested that the EMT’s help.  The off-duty EMT’s refused and left.  One of them said ”call 911.”  EMS later reported to the scene, but the young lady died.

Mayor Bloomberg was furious.  He said that even if the EMT’s were ”just normal human beings, drop your coffee and go help somebody if they’re dying.  Come on!” 

Would the family have a case against New York City for the EMT’s refusal to help?  Probably not.

This situation illustrates an ancient legal concept, i.e., the law imposes no duty upon a bystander to come to the aid of someone in danger.  The common law imposes no obligation upon a person to rescue another.  This is so even where the so-called good Samaritan would not be placing himself in danger, such as providing CPR to a person in distress in a coffee shop. 

Although the EMT’s are in the business of providing first aid, the two EMT’s were not on duty.  It is unlikely that the City would be held responsible for the EMT’s failure to act.  The only possibility of a case against the City is if the Fire Department’s rules and regulations for EMS place a duty on EMT’s to act when they are off-duty.

In any event, this episode of extreme heartlessness reminds us to help thy neighbor. 

If you have been involved in an accident, please feel free to contact me for a free consultation at 800-581-1434, or write to letters@seitelman.com.

Mark E. Seitelman, 12/21/09, www.seitelman.com.

8:15am or 0815hrs? I no longer know which form applies to me anymore. I know to most people that probably seems trivial, however to me this is huge. The two formats say the same thing essesntially so why the confusion?

8:15am is the time as we all know it. 0815hrs of course is military time. Military time is the universal time language for emergency services. It has been 5 now since I worked my last EMS shift. At first I did not care because I was so pissed off about how badly I got screwed in my situation and I am still majorly pissed off. The problem now is I miss it. I miss the action the sense of purpose I had when I wore that uniform

Currently I work for a major retail company in a local mall. Not bad, amazing company to work, love my job love my co-workers and Allison (my girlfriend who I live with) loves the hours because I am home at night when she goes to sleep. So all in all not a bad gig I got going on. But I feel a void in my life. A certain emptiness that gets filled for a moment everytime I see an ambulance go by or here sirens out in the distance

I am sure at this point your saying to your self “this guy I a damn fool and should go back to EMS” I fear though that I won’t be able to. I fear that because of what happen and the EMS community being so small I will not get a second chance within the county. More importantly I am afraid of failing again. I am afraid that I will become so scared of making the same mistake that I will make another mistake, an even bigger mistake one that could be life threatening

I do not know what to do and yes I am turning to the Internet, turning to people I have never met to help me andaybe provide some guidence for me

I thank you all for taking the time to read this and I thank you for any words of advice you might share.

Horse Drawn Ambulance circa 1888

Far to many people entering the profession today see EMS as a stepping stone to careers in the Fire Service, Law Enforcement or Nursing Career fields.

We need to turn EMS into a profession of it’s own. We can longer afford to be viewed as a stepping stone. For EMS to take that next big step as a profession we have to be able to attract and retain high quality personell that look at EMS as a long term career not merely a stopping point on there way to meet there true career goals. How do we do this?

• First off EMS needs to define itself as a separate vocational entity. There is a lot amongst EMS providers today about where we fit in. Are we part of Public Safety or are we part of Health care? The honest answer it neither. EMS is EMS. We need to stop trying to fit our square peg into the round holes. We need to recognize and EMS as a profession of it’s own rather than trying to fit it into a predefined category that really does not represent what we are about. Until we do this we will never be able to develop a culture with a history and rituals to call or own.

• We need to develop a true National Standard for training at all levels. Along the same lines we need to standardize the levels of EMS (Basic, Intermediate, Paramedic).

• We need to promote EMS to the general public as a profession. This needs to be done by WORD, ACTION and DEED. We are still consider Ambulance Drivers by many people simply because they have no clue what we do. Instead of getting mad we need to recognize every public contact as a teachable moment.

• We need to raise the bar for education. In the State of Ohio in order to sit for the licensing exam as a Barber the applicant must have a minimum of 1800 hours of instruction. For a Paramedic 800 hours. EMS has grown and the scope of responsibility over the last 15 years. There is to much information presented during the Paramedic training program to fit it all into 9-12 months. We need to require all paramedics to compalte a two year Associates degree program before being eligible for Certification/Licensing.

• We need to revise the EMT code ethics and hold all providers accountable to them.

• EMS needs to develop a system to allow us to police ourselves.

• We need to stop giving it away. Local Governments have a responsibility to provide pre-hospital care and transportation. In order to achieve  professional  status we need to stop doing it for free. We need to demand pay for the work we perform.  As EMS practitioners we have invested alot of time and energy into procuring our certifications/licenses. Not to mention the time and effort required to maintain them.

• We need to make it harder to get into the field. A lot or agencies  follow the ‘meat in the seat’ philosophy to hiring. In other words if you have a pulse a certification care and a drivers license you are eligible for hire.  Pre hire written, skill and physical agility testing need to become the rule in EMS not the exception.

• We need to develope new providers entering the business. For the most part EMS has developed a sink or swim philosophy for new providers. We need field training program using experienced and qualified providers acting as field training officers. We also need to develop a mentoring program for those that are considering entering EMS or those that are brand new to the field.

• We need to take an active lead in research pertaining to pre-hospital care. Almost all new developments in EMS are a result of research conducted by non EMS personnel. We know what works and what we need. We have to become forerunners in research and development as it applies to EMS.

• In order to keep quality providers in the field we need to bulid in opportunities for career advancement.

Once we we become recognized as a profession we can stand up and demand compensation and benifits commensirate with our training and job requirements.

I’m really sorry that I haven’t been updating the blog, school kept getting in the way.
But now school’s up for Christmas, I can start updating again! I’m going to patch KMS today and create an Evan! Also, I’ll be making an Evan Skill video if I get a chance with good information on their skills! (I’ll probably have to make ten of them since there’s 10 masteries, haha!)

Merry Christmas everyone!

P.S. Check out my webs site for some MapleStory fanfics I’ve written: http://darkraiyoshi.webs.com/

I stepped outside into the cool, crisp, Louisiana winter evening and looked back at that huge, white building that I call my second home. I smiled to myself and knew that I had made it. I made it past the hard times, the rough calls, the constant questioning, and my own self doubt. I thought back at the conversation that I had just had with my boss and laughed at my calm exterior. I laugh because I was still shaking on the inside. In fact, my palms were still moist and my voice was slowly returning to the sweet southern drawl that everyone knew. The woman that I was in his office was slowly returning to her normal little-girl self. The cold wind whipped into my face, making my eyes water and sparkle under the lights of the parking lot filled with old ambulances and an abandoned basketball goal. I looked down at my worn boots and stooped down to tie my laces, as usual. I heard the door open behind me and quick footsteps hurried to the rig.

“MsP, you ready?” I heard my partner say in his booming, night-time Jazz DJ voice.

“I was born ready.”

As I jumped into the rig, he looked across at me with a curiosity on his face, expecting me to start rattling off the details as I normally do. Instead, I sat in silence, basking in my triumph. Finally, he raised an eyebrow, slowly edged forward, and sighed.

I broke in the silence and finally asked, “So, D. How much of that did you hear?”

“Enough to know that I want to hear the whole story from you.”

I smiled and started at the beginning.

I may be the youngest medic at our company, but I am also the highest trained. I spent a lot of time and my own money to be a critical care, advanced cardiac, pre-hospital trauma, pediatric advanced care specialist. I care about my patients to a fault, almost. I rarely get a refusal- my dad says it’s my “BS” gene… he says I can bullshit my way into the White House tree decorating party. (Though in recent news, that doesn’t seem so hard…)I work with a smile, I hate it when RN’s seem disappointed in my hard work, I still get excited over trauma and crazy medical calls.

My enthusiasm is infectious to coworkers, but misunderstood by one. My boss always sees my enthusiasm for new protocols and methods as “childish” or “silly.” Our company is filled with old medics, who have been there since the company was founded less than a decade ago. Before that, they had all worked for the same company in another region. They were established, they knew each other, and they knew what to expect. I can see where my boss was terrified when I made the leap from Basic to Medic. I came to them in my patch shining, guns blazing, boots untied, pony tail high on my head, eager smiled manner and started questioning everything. Why did we use this drug when it was no longer used in our new protocols? Why weren’t any of these seasoned veterans willing to train new hires when they had so much knowledge? Why didn’t any of the staff take the lead and organize our supply closet and inventory sheets? All that he could say was that “it’s just how things are around here.” Finally he grew tired of my questions and let me somewhat take the reigns. He moved me up to an inventory supervisor when my obsessive compulsive side would not let up, then to a new hire preceptor when I showed my knack for teaching, finally moving me up to the preceptor supervisor when I proved my ability to delegate and solve problems among staff. I was moved up through all of these positions without a pay raise. But I never asked for one. I was making good money, had a lot of overtime opportunities, and was able to make important decisions on my own- at 22! I was on top of the world.

Then, out of nowhere, he started questioning all that I did for the company. He heard that I was unhappy- which was true. He started putting limits to my work weeks- which wouldn’t bother my any if I was still given the same amount of hours that the rest of the staff were guaranteed. But to their 120/hr pay period checks, I was roping in 72-96/hrs over 2 weeks, still making considerably less, and still taking on a lot more responsibility. Needless to say, I was frustrated!

So on this particular winter day, he called me into his office. I knew what this was going to be about, and I knew that even though I was a kid- I had to act like a woman. I walked in with my shoulders back and chin up. I smiled my friendliest smile and said, “You rang, boss?”

“MsP, we have a problem with you.”

I tried not to blanch at that statement. My fingers tightened around the chair’s arm, my knuckles turning white in protest. “What seems to be the problem?”

“Well, you just seem to have lost your enthusiasm. I don’t see the same medic that we all once loved. Where’s that energy?”

I looked at him with a fire burning in my eyes- the fire that only burns when you make a Cajun girl mad. I smirked, knowing that it was now or never. “Would you honestly like to know why I seem so down?” He looked at me, apprehensive once he met my gaze, but nodded slowly. “It’s because I’m the station’s puppy. I’m fun and I’m cute and everyone wants me around… until I start getting noticed. The moment that students pass their national registry and thank their preceptor and not the company, you get upset. When their class was interviewed about their experiences in clinicals and they thank me, but not the company, everyone gets upset. Which I don’t understand why, because none of you go out of your way to help them! You can’t just say, ‘follow me kids, do what I do.’ You have to let them make the mistake, correct it, and move forward. You have to give them resources to move forward!’ He looked at me shocked. I’ve never really confronted him about his lack of enthusiasm for the newer generation of medic. “I’m sorry that the medical director loves me and listens to when I ask questions about new protocols in other states. Do you not want me researching better way to treat our patients?”

“Some of those methods are seemingly more expensive…”

“That’s your problem, no offense!” I wasn’t yelling, but my usual soft voice was strong and assertive. “It’s not about the money. It’s about helping people. I’ll be DAMNED if I work somewhere where the green is priority and the patient and medic are last. I didn’t get into EMS to get rich…I wanted to make a difference. And it’s about time that someone around here does.”

He looked at me and slowly smiled. “Welcome back, kid. We’ve missed that honesty here lately.”

I looked at him, fire still burning in my eyes and said, “I can do great things. Just don’t hold me back. Make me that promise now and I promise I will never let this program become mediocre. I need space, boss, if you keep my bound I can’t shine. Don’t hold me back.”

With that, he nodded and I walked out the same way I entered, calm and confident on the outside… and a nervous wreck on the inside. As I exited the office, I realized that the office staff and dispatcher were smirking slightly, one secretly gave me a quick thumbs up. I had felt so alone lately that I didn’t realize that I had a large support group behind me, waiting for me to stand up for myself.

As I finished the story, my partner looked at me and said, “I’m proud of you kid. One day when you own this company and become medical director, don’t forget us little people.” I smiled at him, my future unlimited and heart soaring, grabbed my gloves, radioed us 10-97, and ran onto that scene feeling 10 feet tall. This is what I was born to do… just don’t hold me back.

The Erie County Division of Emergency Medical Services is pleased to announce EMT-Basic original and refresher courses starting in January-2010.

This line-up of courses will be hosted by the Bowmansville, Doyle 1, Holland, Lake View and Reserve Fire Companies; and at the Erie County Emergency Services Training & Operations Center (Fire Academy) in Cheektowaga.

Download, print, post and distribute the attached announcements.

Contact the EMS Office at 681-6070 with any questions.

• EMT COURSE APPLICATION-SPRING 2010
• EMT RECERT COURSE APPLICATION-SPRING 2010

DEADLINE FOR APPLICATIONS IS JANUARY 7, 2010
(FOR COURSE #226)

JANUARY 18, 2010 (FOR ALL OTHER COURSES)

Is anybody using anything other than the GCS for field assessment of head injuries?

Way, way back in 2003 DTs pointed out in a paper that there were only two GCS scores that were reliable:  GCS 3 and GCS 15.  And a 3 can be obtained by the CPR dummy, a chair, a rock…

The main problem is the number of ways a patient can score a GCS.  Different values for Eye, Verbal, and Motor can change and still give an overall GCS that remains the same.

A pre-hospital provider reports to medical control that his patient has a GCS  score of 9.  There are eighteen combinations of the three sub-scores which will result in a GCS of 9:

E4V4M1, E4V3M2, E4V2M3,  E4V1M4,  E3V5M1, E3V4M2, E3V3M3, E3V2M4, E3V1M5, E2V5M2, E2V4M3, E2V3M4, E2V2M5, E2V1M6, E1V5M3, E1V4M4, E1V3M5, and E1V2M6.  Each of these combinations is attainable; that is, it is not impossible for a patient to be E4V4M1.

Glasgow Coma Score Distributions

As the apex of the Bell curve is approached, the individual sub-scores comprising the GCS total score become less predictable.  There are, for example, seventeen (17) possible combinations each to account for a GCS total of eight (8) or ten (10); if one were to guess the individual sub-scores, one would have a 3 in 50 chance of pinning down the appropriate values.

The inherent problem with this scoring method is easily illustrated.  A patient who at the scene scores an E3V4M3 on initial examination receives a GCS of 10.  En route to the hospital, after interventions have been applied (e.g. O2, bleeding control, etc.) another GCS of 10 is derived – this time, however, from sub-scores E2V3M5.  The patient’s overall condition, according to the GCS scale, has neither degraded nor improved, as both are GCS 10.  However, the individual scores have changed significantly either because of or in spite of prehospital interventions. In this case, the Best Eye response has degraded from “Opens on command” to “Opens on pain”; the Best Verbal response has degraded from “Disoriented speech” to “Inappropriate words”, while the Best Motor response has changed from “Flexion withdrawal” to “Localizes pain.”

To the receiving ER physician or Medical Control the changes in these individual performance criteria may provide significant insights to the patient’s condition or underlying problem, but reporting only the GCS total, which remains constant (10 in the example) will impart none of this information.

A workaround might be to report “Eye, Verbal, and Motor” scores separately rather than their sum.  Care would be needed in reporting over the radio, as “E” can sound the same as “V” if one is reporting “E 2 V 3 M 5″ for instance.  Or I suppose we could just say “Eye”, “Verbal”, and “Motor”, but this seems unwieldy.

But somehow I think we can come up with something just as quick but more useful.  We in EMS are used to scrapping stuff all the time when something better comes along – MAST, paper bags for hyperventilation, tourniquets, then bring back the tourniquets – we’re flexible.  The GCS itself is a replacement for a previous system.

Of course, we’d need to overhaul the Trauma Score (which uses GCS as one of its inputs), but, hey.

Anyone?

I started a new job a couple of weeks ago.  All I can say is the new service I am working for is AMAZING.

With a few exceptions my time t the Big Green was a positive experience. The Big Green affored my opportunities I would otherwise not had. I was honored to be part of the Special Operations Group and proud of our service in Galveston and at the Presidential Innaguration. That being said, I think just due to the size of the company, the whole time there I felt like I was just “meat in the seat”

I don’t feel that way working for Big Potential EMS. For the first time in a long time I have found a job where the employees matter. My opinion matters.  The people I work with are there because they love wat they do, not just for a paycheck. Patient care is a priority. If you make a mistake it is treated as a learning experience.

I am moving in a couple of weeks.  My buddy “M” from the Big Green is looking for a roommate and I was looking for an apartment so it all pretty much worked out.

I am on my second partner in two weeks allready.  My first partner was as green as could be.  Young kid, EMT-B straight out of college. Our first shift together was his first shift ever in EMS.  He worked a couple of shifts with me before being accepted into the PA program at the University of Findlay. My new partner is a well seasoned EMT-I who has been around EMS for awhile.

I have made alot of changes in my life in the last 6 months. I got rid of alot of the dead weight and users in my life. I found out who my real friends are. Being back on 24/48’s is taking a little bit of getting used to. Working 6-7 days a week at the Big Green I did not have much time left over for me. To be honest I am going stir crazy on my days off. I don’t know what to do with myself half of the time.

Call me sadistic but I am thinking very hard about going bakc to school again. I have been looking at RN and PT programs in the area. I am going to take a little time off for myself. Hoping to get hired at Cedar Point part-time this summer. I will be suprised if I am not back in school this coming fall.

How many fire stations do we need in Hampton? Where should they be? How should they be staffed? Should we have a combined public safety facility at the beach? There are many more EMS calls that require an ambulance versus real fires that need fire trucks and pumpers, but how many, where do they occur and when? People with answers are encouraged to respond.

1:15pm – Waterview Rd – Unattended Death

11am – 23xx Ct Rt 7 – 80’s male difficulty breathing

Medic 26 responds to a local Extended Care Facility (Nursing Home) for a female in her 60s complaining of chest pain.

This is fairly standard run for my service, we have many contracts with the nursing homes in the area. I probably make two chest pain complaints a shift. They can be everything from the hypochondriac to an actual heart attack.

Today is no different. The patient is complaining of chest pain, the facility have administered nitro three times with no relief. I ask the standard littany of questions, in no particular order:
Where does it hurt?
How long have you had this pain?
Does it go (radiate) anywhere?
Have you done anything that makes it hurt more?
Have you done anything that makes it hurt less?
Does it hurt more when you breathe in or out?
On a scale of 0-10, 0 being no pain, 10 being the worst pain you’ve ever felt how would you rate your pain?

I have the benefit of written medical history, MARs and the patient to gain all of the requeset information that would be pertinent to my assessment. The patient replies with standerdized answers, it has been hurting all day, pain is an 8, the pain is here (pointing to her sternum), nothing makes it better or worse and it doesn’t hurt more when I breathe. The patient was recently released from the hospital for hip replacement.

I start my physical assesment, take vitals and hook up the lifepak 12. Everything looks fairly normal. Establish IV, no nitro since it hasn’t worked yet (and I’m not convinced this is cardiac related). On the way to the elevators the nurse says that the patient has a few broken ribs. My biggest mistake was not inquiring further, but I suspect this could be part of our problem.

The hospital is less than 2 miles, the patient is in no distress, easy non emergent transport. I put the patient on oxygen 2 liters via nasal canula just for protocol sake.

I give the triage nurse my report, all vital signs normal. The patient’s husband meets us at the hospital. Enter the great epiphany. Mr. Husband informs the triage nurse that the patient “coded” in the hospital last week and the broke some ribs performing CPR. You would think that someone would have mentioned to me this MINOR detail. With all the pieces of the puzzle now on the table, this is a no brainer. Yes, your chest hurts because you have broken ribs. Why the heck did the nursing home administer nitro for this chest pain?

The triage nurse and I agreed that the chest pain (which I did notice hurt more when we moved her to the stretcher) was most likely from the fractured ribs.

Please engage your brain before blindly following protocol.

- Posted using BlogPress from my iPhone

A couple of months ago, I was sitting down at EMS Expo in Atlanta with some of the greatest people I’ve ever met, most who were podcasters. At some point in their careers as medics, they decided to reach out to the professionals around them and started these shows to enlighten, to inspire, to bring the community to their attention. As a young medic and preceptor, I constantly turned to these shows as my own source of inspiration and as an aid to inspire my own students. I thought that one day, once I had lots of experience under my belt, I would join their ranks and be a podcaster. I want nothing more in life than to be the inspiration just ONE young person needs to join our ranks as a medic, EMT, or doctor… I want to make a difference in one person’s life.

Then, I met an outstanding group of young healthcare professionals with the same goals as me: to inspire, to inform, to be active parts of our fast paced careers. One night, as we all discussed a few issues each of us had in our respective fields, I jokingly said that we should have our own show. Instead of laughter, there was a pause… and then agreement. Jared, Scott, and Meris all brainstormed that night with me and we all decided together that this is what our industry needed. A group of young, motivated healthcare professionals to tackle issues in our various fields and to share our experience as the new generation of provider.

So, over the last few weeks our project has started forming. Ideas have been thrown, show topics have been discussed and debated, social media domains have been secured, and excitement has run rampant through our group.

The first show date has not been set, due to school schedules between the group, but know that it will be in the next month. We are hoping to launch our website in the next few weeks as well and links will be provided via various social media.

So, I am pleased to announce our project: the GenMed show.

Why GenMed? Because we are proud to be the young blood in the industry. We’re the new generation. We consider ourselves Generation Medicine.

Who are we?

There are 4 hosts. I am a full time critical care paramedic, preceptor, and Pre-Med student from Louisiana. Jared is a CNA and respiratory therapist student in Texas. Scott is an emergency responder and Paramedic student in Canada. Finally, Meris is an EMT/FF and nursing student from Virginia.

Now: for your part in this. We want you to share your ideas, we want to hear your feedback, we want you to be involved in this with us! We also ask you to follow us on our journey via Twitter (@GenMedShow) There will be more updates up on that site soon. So, readers, now is your time. Let us know what you think about our project… either by commenting here, on Jared’s blog, or our twitter accounts. We hope to hear from all of you soon!

Signing off,

MsParamedic and the GenMed team!