An “Each Question May Be Your Last” Respiratory Assessment

Tweet I remember the first really bad respiratory patient I went on as an EMT about 12 years ago.  A 40-year-old employee at a Target store had has an asthma attack around midnight. She was in a tripod position, an inhaler was next to her, and her shoulders lifted up each time she took a shallow […]

Learning from Dumb Intubation

Tweet In September’s EMS World, your truly wrote an article called 10 Steps to Smarter Intubation. It describes the approach I’ve come to use when thinking about intubating someone.  I’d like to think I was always a smart intubator, but that would be a lie.  I have done some dumb intubating in my career. Dumb […]

Knowing When To Hold ‘Em

Tweet On last week’s episode of EMS Office Hours, Jim Hoffman, Josh Knapp, and Tim Noonan discussed “Zebra Hunting.” Among other topics, when a patient with a suspected pnumothorax should have their chest decompressed. If I understand Josh correctly, he stated that chest decompression is a relatively benign procedure.  He believes that the harm from […]

Pain Management and Tiered Response Are Not Compatible

Tweet Pain Management was the topic of the latest episode of the First Few Moments podcast.  Kyle David Bates, Brad Buck, Wilma Vinton, Roland Rolfsen, Dr. Laurie Romig, and Tim Noonan discussed the why, what, when, and who of it.  Playing devil’s advocate, Kyle asked why it is important for us to manage pain.  After all, life […]

Comments on Corner Posting

Tweet My attack on the July cover story of JEMS generated some pretty passionate comments about corner posting, and got even more after Rogue Medic’s post.  Here is my response to some of them: In response to my request for evidence that corner posting improves clinical outcomes, High Performance EMS author Dale Loberger writes: Jersey […]

If You Haven’t Opened a Book Since School, You Probably Won’t Read This Anyway

Tweet It was the year 2000.  The Twin Towers stood tall, everyone was drunk with money they made from Al Gore’s internet, and race cars were driven by men.  I had just hit the streets of Buffalo as a cocky, know-it-all EMT, and was in college as a communications major. In my classes, a major point […]

If Her Syringe Didn’t Killer Her, Mine May Have

Tweet Protocols were the topic of last week’s EMS Office Hours.  Jim Hoffman, Josh Knapp, Dave Aber, Tim Noonan & I discussed how the definition of “consider” and “up to” is different for different people.  I recall a former US president having similar issues.  Like many podcasts, I was reminded of a call I was on. The text said “21 YOF overdose” on the […]

Corner Posting: Better, Faster, & Cheaper than Stations? Prove It.

Tweet In the cover story of this month’s JEMS, Jonathan Washko adds more fuel to the fixed/static/hybrid deployment debate.  I’ve done all three, and found a home in a station-based hybrid system.  Washko concludes that street corner posting is better, faster, and cheaper than static or hybrid systems.  Unfortunately he presents his opinions as facts.  I happen to agree with some of […]

Defending the Pit Crew

Tweet Over at Rogue Medic, during a criticism of the latest AutoPulse ASPIRE EXPIRE CIRC trial, he also criticized the Pit Crew approach to resuscitation. Or ADHDCPR, as he likes to call it.  I presented a half-day workshop about the pit crew last month.  Here is why I believe the concept works: While Rogue Medic […]

One Step Forward, Two Steps Back – Focus People

Tweet Another great episode of EMS Office Hours accompanied my workout today, and of course it stimulated some thoughts.  Here are some of them: First, more isn’t always better.  I know some people who love the AutoPulse, but they have no idea how many patients walk out of the hospital after having it put on. […]