The Permisson Paradox

Tweet Rogue Medic has a great  post about medical oversight for EMS, and I am looking forward to reading part 2.  It reminded me of a JEMS column Bryan Bledsoe wrote a few years ago titled Adios Rampart. Both debunk the myth that patients can be kept safe if paramedics must request permission before doing […]

What Should the Basic EMS Package Include?

Tweet When you pick a cell phone, cable, or internet plan, packages range from basic to premium, extreme, or turbo. When you call 911, that choice is made by local system design and a dispatch triage program. On EMS Office Hours, Jim, Josh, and I discussed whether certain medications should be included in the BLS […]

Did Breaking the Rules Save the Girl?

Tweet MD Responders Broke Rules to Save Girl. A five year old girl reportedly went into cardiac arrest after an asthma attack, and was transported on board a fire engine to the nearest hospital while CPR was being done.  According to a Prince George’s County Fire/EMS Press Release, she began breathing on her own before […]

Punishing Your Best People and Longevity

Tweet Last week I listened to a great discussion on the EMS Educast about how a service’s best providers can be punished by its continuing education and protocols.  Mic Gunderson, an EMS system consultant, described how both are often geared towards maintaining minimum competence levels of the lowest performers.  A few days later I had […]

A Cardiac Arrest Is Not the Time to Learn CPR

Tweet I’ve been following Rogue Medic’s excellent discussion about how Cardiac Arrest Management is a BLS Skill.  If the role of ALS is defined by advanced procedures, the only benefit of ALS would be from manual defibrillation instead of an AED.  This is only because shocks from a manual defibrillator can be delivered with less […]

Load and Go Just Needs to Go

Tweet Starting the first day of EMT class, we are taught to “load and go” with priority patients, and to not delay transport while waiting for ALS.  With the recent NFPA ambulance crash data report, maybe we should rethink this.  According to Art Hsieh (who is one of my heroes) on EMS 1, we crash […]

Response Grid Ridiculousness

Tweet About 400 miles away from where A Tale of Four Street Corners takes place is another example of a ridiculous response pattern. In an area where I once worked, a city was protected by a Paid City Fire Department and a private ambulance company.  Fire and ambulance service outside the city are delivered by […]

Shootings and Seizures

Tweet I still get excited about shootings.  I don’t know why, and am frankly a little embarrassed about it.  I’ve been on about 80 or so in the past twelve years.  The novelty has certainly worn off, but for some reason I walk a little faster to the truck and must resist the urge to […]

EMS Hospital Alerts

Tweet This is a follow up to Handling the Under-Triaged Patient. Because some patients require time-dependent interventions more than others, certain ones are assigned an “alert” designation.  This creates a streamlined process to minimize delays in triage and registration.  Specialists from other areas of the hospital, or possibly at home, come to the emergency department […]

We Can’t Control Who Calls Us, But…

Tweet We can control how we respond to those calls. About a year and a half ago I attended a screening of the film Firestorm, a documentary about the low-acuity calls that paramedics in the city of Los Angeles respond to.  Ambulances and fire trucks went screaming lights-and-sirens to each call and transported most of […]