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Christmas Dawn 1971

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My first Winter Carnival on the job

Brian and I joined the volunteer fire department at the same time. At 18, he was already focused on his goal to be a physician, attending classes at the local university.

To expand his portfolio, Brian was working as a part-time emergency department technician at the flagship community hospital.

I spend Christmas Eve evening as the ambulance crewmember in charge on the VFD ambulance, Brian was working at the hospital.

It was a dry and warm day, almost hitting 60 degrees. Was above freezing that night, much warmer that the night we ran the sports car crash on the parkway (story here).

Carrying people to the hospital

Advanced First Aid was the certification required to ride as the crewmember-in-charge.  Gasoline and oxygen were the two primary elements of care.

Already experienced the thrill of a 90+ mile-per-hour transport doing chest compressions in a low-top Cadillac ambulance. My shoulders were firm against the ceiling as the backboarded patient was on the stretcher. That 472 cubic inch motor was strong!

Our new Ford/Swab modular ambulance came with an advanced resuscitation tool, a Brunswick HLR 50-90 oxygen powered mechanical resuscitator. Bought a second one for the high-top Cadillac

pontiacambulance provides a video of the operation:

Our experience was that the chest compressor would "walk" even with the chest and shoulder straps tight.

When the fire company responded to assist on a cardiac arrest, they would place the patient in a "Reeves" flexible stretcher.

The plunger would be further secured with triangular bandages tied to the sides of the Reeves stretcher.

The fire company prided itself on the speed and smoothness in applying the HLR machine. It was one of the skill drills frequently performed in the station.

Telephone dispatch

Ambulance runs after 11 pm were dispatched over the "red phone." It was less disturbing than striking the station's tones, turning on the bunkroom lights and activating the volunteer pagers.

Fire companies were rarely dispatched with the ambulance. The ambulance would need to call for assistance once arriving at the scene. A little tricky, since none of the ambulances were provided a portable radio.

"Husband is gurgling in the bed"

That was the information dispatch gave me over the red phone at 4 am Christmas morning.

We were still responding to the incident when our fire company was toned out. The wife called back and used one of the few trigger phrases for an automatic fire company ambulance assist – cardiac arrest.

Many of the lights were on at the house and front door was open. She was doing CPR when we ran up the stairs with oxygen, suction, bag-mask-valve and aide bag. 

Following the HLR protocol, we got him off the bed and into a larger room.  Suctioned his airway, placed an oral airway and started two-rescuer CPR with the bag-valve mask. 

By time we were in a rhythm, I could hear the faint sounds of a wailing Federal 2QB.

I assured the wife that we were doing everything possible for him, and that another crew would be arriving soon to move her husband to the ambulance.

 

 

 

 

 

 

 

 

 

 

 

 

 

If we had not called dispatch, or were not standing at the ambulance, the fire company assumed CPR was in progress. 

Two of the guys pulled out the HLR machine and Reeves. The engine driver would re-position the ambulance for rapid departure, then set up the stretcher.

The performance was great. Smooth packaging and quick movement to the back of the Ford/Swab ambulance.

We were getting pulses with compression throughout the transport.

Once we got him on the hospital gurney, the physician looked into the wide and fixed pupils with an ophthalmoscope. The vessels radiating from the optic nerve showed coagulated blood, appearing as a railroad train.

The appearance of "box cars" in the back wall of the pupil were a grave prognosis. It was used as an indicator of death when ambulances delivered pre-paramedic cardiac arrest patients.

Ran into Brian, who was looking a little shell-shocked. This was the fourth or fifth patient he had to wheel to the morgue since 11 pm Christmas Eve.

<<<<<<<<<<<<<<<<   >>>>>>>>>>>>>>

We had done everything we knew in 1971.

In re-telling the story, I feel like Squad 10 Firefighter Johnny Gage after he "rescued" an electrocuted lineman in the two hour pilot of the Emergency show. 

I wonder if there would have been a different outcome if we had an AED?

Mike "FossilMedic" Ward

If you are working, may your day be boring. I hope that it is full of food, laughter & joy.

Please spend a minute thinking about our brothers and sisters in the armed forces that are deployed in hostile, desolate or dangerous environments.

Detroit EMS: One Year Later

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Charlie LeDuff posts an update

One Year Later: Detroit's EMS System Still in Need of a Cure: MyFoxDETROIT.com

DETROIT (WJBK) – It's a story we've been covering for more than a year — FOX 2 taking a closer look at the way Detroit manages its ambulance service. What we uncovered was a deadly system on the verge of collapse.

Posted December 20, 2011

Mike "FossilMedic" Ward

Earlier posts:

July 02, 2011: “More Ambulances, More Training, Less Fear” New Detroit Fire Commissioner Donald Austin reaches out to medical community, says 22 new transport units will start arriving in January. Not writing up guys for minor uniform infractions

Yesterday's report raises questions if the ambulances have been ordered.

Not dead until the ambulance crew assesses the patient. A Winter Carnival memory.

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"… he a member of (prestigious) Rescue Squad"

This is the fifth Winter Carnival with Firegeezer. Each December 25 I post a Christmas-related story from my time "on the job." 

For 2011 I am going to share a story about two teen-aged volunteer firefighter/EMTs working their first Christmas Eve.  Brian and I started at the same time with the hometown volunteer fire and rescue department.

In thinking about the story, I remember an incident when we were both on the ambulance … and a lasting lesson.

"Respond to the GW Parkway for a Signal 9-I on fire "

The George Washington Memorial Parkway is a limited access highway build in the early 1930s that runs down the Virginia side of the Potomac River, originally designed as a "grand gateway and greenway to the Nation's Capital."

Signage is rare on a scenic greenway. In many fire department responses, the actual location of the car crash would be somewhere else on the parkway.

Our response protocol was for the fire company to head to the reported location of the crash, the ambulance would go the opposite direction.

On this winter night, the engine company arrived first. Reported a sports car overturned and on fire. Brian was driving the ambulance and took the next cut-over so we could turn around and get to the scene.

"Fire is out, police say the driver is deceased"

That was the radio report from the engine lieutenant. In that era, none of the firefighters on the engine were EMT-credentialed. Brian and I took one of the first EMT classes run at the community college earlier that year.

The lieutenant had four years at our station. Ran a lot of calls on the parkway and knew many of the Park Police officers on a first-name basis.

The first arriving police officer was a member of a prestigious rescue squad on the other side of the river. The officer used the cruiser's dry-chem to knock down the fire in the interior of the upside down convertible sports car.  The engine crew delivered a couple of blasts from the pre-connect to knock the rest of the fire down.

As we walked up to the scene, it appeared that the car drifted into a stone barrier wall, flipped over and skidded for a couple of hundred yards. The convertible top was ripped off.

There was just enough space between the car and the wall to partially open the driver's door. The driver remained belted into his seat.

Before we got to the patient, the lieutenant told us to get the body bag and lay it out on the stretcher. Fire was building up behind the dashboard. The lieutenant has his crew blast the interior one more time.

Crowing

Crowing is a high pitched sound upon inspiration. More audible than a wheeze. Usually associated with Croup or upper respiratory blockage issues or partial obstruction of the trachea.

It sounded like a baby's cry. Right after the blast from the fire hose.

That startled everyone.

We quickly removed the driver and placed him on the stretcher. In the cold air I could see that he was breathing. His face, arms and chest were black with soot and flecked with yellow dry chemical powder.

We quickly got him into the ambulance, started oxygen and a trauma assessment. He was breathing too slow and Brian started using the bag-valve-mask to breath for the patient.

He had partial thickness burns on his face and full thickness burns to the top of his hands and forearms. It looked like the tops of his hands may have been dragged along the road after the car overturned.  There was some head trauma.

I was finishing the rapid assessment when the lieutenant opened up the ambulance door and said no baby was found. He gave us a driver and we headed to the trauma center.

After this crash, I NEVER accepted as gospel some stranger's assessment of the patient. They were not dead until I assess the patient.

We did something right, here is your subpoena

Almost two years later, everyone on the incident was deposed.

The driver survived and was suing the park police, fire department, federal government (owns the parkway), designer of the brick retaining wall, manufacture of the 15 year old sports car, the shop that maintained the sports car and the Moon to recover damages from his accident.

We never went beyond the deposition phase.

Mike "FossilMedic" Ward

Police CPR Saves Houston Reporter

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Right place, right time

Richard Connelly got my attention with this opening in the November 14 Houston Press:

John P. Zepeda of the Metro PD's canine squad had performed a routine bomb search at the Ensemble light-rail station October 28. Finding nothing, he tried to head back.

But train after train was filled with morning commuters headed downtown, so he and his dog waited things out. Which turned out to be a lucky thing, for as they were waiting for yet another train they heard someone yell for help.

That someone was dragging Houston Press music editor Chris Gray off the tracks, where he had fallen after suffering a heart attack.

Music Editor Chris Gray Had Luck on His Side When He Had His Heart Attack

Security camera documentation of incident:

Chris Gray Rescue Video from Village Voice Media on Vimeo.

Music Editor Chris Gray's Heart Attack: The Video

Nice work!

Update:  FireHat points out that Officer Zepeda is a retired Houston Fire Captain.

Mike "FossilMedic" Ward

Congrats to Captain Happy Medic

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Paramedic/firefighter Justin Shorr takes a headquarters gig

From his website:

On Monday I hang up my turnouts and late nights without sleep in exchange for a promotion and a reassignment downtown. That also means giving up that ever so comfortable and vacation friendly schedule.

I was bummed at first until I realized that now the HMjrs are in school and we can’t just pick up and go somewhere whenever we feel like it anymore. When this job at headquarters opened up it seemed too perfect a fit.

Monday I will take over the vacant CQI position that has been retooled ever so slightly to now officially include research. Talk about a perfect chance to mine the data to see what is really going on out there. I have lofty goals for my service, but it’s going to be a long while of playing catch up and learning the new job before I can start going forward with new ideas.

I also have a new political landscape to consider and will be in direct contact and communication with the regulatory agencies, budget writers and vendors that all have a stake in patient care in my jurisdiction.

It’s an amazing opportunity for me both professionally and personally and I am beyond excited to get started.

A Whole New World

Great job!

Mike "FossilMedic" Ward

The day after… turns out zombies get bored and hungry

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Scenes from the Delaware County Ohio Zombie drill

 

Delaware County Office of Homeland Security and Emergency Management zombie outbreak exercise.

 

Delaware Gazette video by Andrew Tobias.

 

Bored and Hungry

Dave Tobias, a Delaware Gazette reporter, was imbedded with the zombie horde and provided a first person account of the event.

They were also a lit­tle bored. Emer­gency per­son­nel, run­ning the event fea­tur­ing roughly 200 zom­bie vol­un­teers, had been stag­ing for nearly half an hour.

Besides an occa­sional reminder, deliv­ered through a bull­horn, for infected indi­vid­u­als to remain inside the Selby Field fence, the zom­bies received lit­tle com­mu­ni­ca­tion from emer­gency per­son­nel.

Fire­fight­ers and para­medics were them­selves busy strate­giz­ing over what mys­te­ri­ous chem­i­cal agent had afflicted the zom­bies, and how to best address it.

Emer­gency per­son­nel, which included 10 area fire depart­ments, Delaware County EMS, Delaware Police Depart­ment and the Delaware County Sheriff’s Office, began accept­ing large quan­ti­ties of zom­bies for decon­t­a­m­i­na­tion 40 min­utes after they arrived on scene.

click on headline for entire story: Zombie-themed County EMA exercise draws more than 200 volunteers

I remember when the Level A chemical suits came out, the incident went from quick to campaign.

Wonder if there is a way to reduce the waiting-around time for role players.

Mike "FossilMedic" Ward

Zombie HazMat Incident in Ohio

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Delaware County Emergency Management Agency wants you to die this Halloween.

Ok, not really.

But we would like you to come out and play one of the 250 "living dead" that we need for our Zombie Hazardous Materials Exercise.

There will be a contest for Best Make-Up, Best Costume, and even Best Zombie Walk.

This is your opportunity to help our first responders be prepared.

Being a Zombie this halloween may save a life in the future.

Delaware County, Ohio Zombie recruitment page

Creative approach to a mass casualty staffing issue

Kantele Franko files this report for the Associated Press:

Emergency responders will test their capabilities as they use standard decontamination procedures to “treat” the zombies and make them “human” again during the exercise at Ohio Wesleyan University.

“People got zombie fever here in Delaware,” said Jesse Carter, a spokesman for the local health district.

The exercise and dozens more outreach efforts across the country were inspired by an online post from the CDC.

It attempted to spice up the usual emergency preparedness advice — have a plan, make an emergency kit with water and food, and so on — by tapping into the cultural popularity of the zombie theme.

The May blog posting got 30,000 hits in one day, and it continues to draw thousands of visitors daily, said Maggie Smith of the CDC’s public health preparedness office.

Ohio and Kansas hold mock zombie outbreaks

Selby Stadium event as explained by Delaware County EMA

This will be a “Zombie Exercise” happening on Halloween. The victims once exposed to a chemical will be turned into a zombie. Zombies will have to go through decontamination to be turned back to normal.

We will be testing our first responders with approximately 250 Zombie Victims versus the 20-25 volunteers that assist for normal hazardous materials exercises.

To add to the fun (and the reality), if a First Responder comes in contact with the spilled chemical or a zombie while not wearing proper Personal Protective Equipment, they too will be turned into a zombie and will have to go through decontamination.

This exercise will run from 1:00 PM until 3:00 PM and we plan to have everything wrapped up by 4:00 PM.

Click HERE to see the CDC Zombie Preparedness guidelines.

Mike "FossilMedic" Ward

Naples Community Hospital fires medics, relinquishes ambulance permit

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Stroke patient dies two days after a change in county EMS dispatch policy

A follow-up to this STATter911 post:

Marco Island Fire Rescue ambulance delay report says hospital, FD & other agencies failed to meet community expectations. Chief says citizens deserve answers.

Earlier today, Naples Community Healthcare (NCH) abandons its troubled ambulance service.:

WBBH-TV NBC2 provide the follow-up here: NCH ends ambulance service after patient's death.


NBC2 provides the background for this bad-outcome event:

The NBC2 Investigators first reported a billing battle between Naples Community Health and Collier County Emergency Medical Service in September.

NCH owes Collier County more than $175,000 for EMS ambulance transfers between its facilities.

Collier County Manager Leo Ochs told NCH officials by letter that inter-facility transfers would no longer be performed by Collier County EMS, effective October 1.

On October 3, 80-year-old Marco Island resident Paul Anderson died in the hospital after complications from a stroke. Family members tell NBC2 doctors were unable to operate on Anderson because it took too long for him to get to the hospital.

NBC2 Investigators: Patient dies after ambulance delay.

Please read the first part of the 65 page report provided by Marco Island, Florida, Chief Michael Murphy. You may share my rising tide of anger at a complex system that seemed to conspire to deny a prompt ambulance transfer.

Report HERE via STATter911

No pay = no more transports

The October 1 policy change by Collier County EMS was due to the unwillingness of NCH to pay Collier County for earlier transports. 

Not clear if this means NCH is paying it's overdue ambulance bill.

I predict that all of the players that impeded the dispatch of an ambulance or medivac helicopter will  end up spending ten times the amount of the unpaid transport fees for legal representation and settlement.

Mike "FossilMedic" Ward

Meet me in St. Charles! October 21-23 Gateway Midwest

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My Time and My Dime

I go to a lot of professional meetings, conferences, expositions and trade shows. More than one a month.  It is how much of my work gets done.

Because of other obligations I can only sit through one or two presentations per show.

Not this time …

The inaugural Go>Forward training event is October 21 to 23 at the Ameristar Casino Resort in St. Charles, Missouri. 

Tiger Schmittendorf assembled a great mix of hands-on and face-to-face presentations that will provide skills, concepts and ideas that will help you do your best.

Fire AND EMS

Unique to the Gateway Midwest event is the inclusion of a JEMS seminar during the same weekend.  I was able to add access to that conference for just $50 more.

These are some of the best EMS presenters, who are usually over-booked when they are working at the national EMS conferences.

The social and interactive structure of a Go>Forward event means that I should be able to fully enjoy the presentation AND have an opportunity to chat.

Mike's Schedule

Friday October 21:

The Mental Management of Emergencies: Improving Decision Making Under Stress

This all-day preconference by Dr. Richard Gasaway combines his doctorial research, along with his three decades of street experience, to provide powerful information on how to make better decisions under stress.

Saturday October 22

The morning is EMS-centric:

Keith Wesley, MD, presents Becoming an EMS Professional. Changes in provider and physician roles within EMS require reconsideration of what "professional" means.

A. J. Heightman discusses MCI Management. Besides being the Editor-In-Chief of JEMS magazine, Heightman obsesses about multiple casualty incident management and, through his "day-job," has collected the best examples and stories covering this topic.

David Page presents Cases With A Twist. One of the hardest working EMS educators, co-creator of FISDAP, Page is a driving force within research and advocacy for EMS.

The afternoon has smoke and fire showing

Chris Naum teaches Tactical Ops and the New Rules of Combat Fire Engagement. Naum has been posting some of the best articles on tactical operations, building construction and related history on his blogs Command Safety, BuildingsonFire, and TheCompanyOfficer. I am giddy at the opportunity to sit for one of his meticulously researched presentations.

Chief Steve Przibrowski presents From Silver to Gold – Company Officer to Chief Officer. Covering the issues when going " … from us to them."

Sunday, October 23

A. J. Heightman looks into his crystal ball to see where EMS is going with his presentation Challenging Your Clinical Boundaries.

John Shafer joins Chris Naum in Reading the Building; Predictive Occupancy Profiling

The noon keynote is from Jason Ferris It is not a mission statement … Its a calling.

John Shafer presents a topic he is passionate about, Green Building Construction for the Fire Service. He is one of the newer fireems bloggers, check out Green Maltese.

I wrap up my schedule with Jason Ferris's presentation: Part of the Gang: Indoctrination without Hazing,

Pretty sure I will leave this conference with dozens of ideas, concepts and practicies.

Will I see you there?

Mike "FossilMedic" Ward

go to http://goforwardtraining.com/gateway/ for more information.

Put ffw10 in the promotion code for a discounted registration.

EMS World Expo Thursday afternoon

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What happens in Vegas … shows up on Facebook.

After catching a 6 am flight … to Boston … arrived at Vegas around noon. Near the Hilton Convention Center I passed a burly man.  He still may wonder who was that fossil in a Cadillac shouting "nice kilt!"

Thursday's goal was to work the convention center floor and connect with some folks.

One way to celebrate your 10th year in ems

Jess Phillips, from Iowa, got a tatoo. 

I found the image striking and appreciate her permission to photograph and post her picture.

Blue light specials

Cygnus co-located fire and law enforcement with EMS World Expo with a shared exhibit hall. Heard more than once the exclaimation "this is so cool."

What was cool for me was checking out the next generation of police cruisers, Dodge, Ford and Chevrolet had fully equipped examples of their sedan and SUV packages.

Still regret not buying that red Caprice PC3 that was momentarily on sale at Chriswell Chevrolet this summer. No satellite radio and 13 mpg city … maybe get a pre-owned 2009 Pontiac G8 GXP.

Zoll, CPR and social media

Was impressed with the Zoll E series CPR Dashboard that provides read-time graphical feedback on the chest compressions. 

The impact of technology and research has changed the ems workplace. Steve Berry shared a story about an IO misadventure that is hilarious … but you have to wait for the "cartoon."

Running outta steam … need to tell you about the Cult of Kilts … not sure if it is related to EMS 2.0 … there are guns involved … and giggly girls staring at great legs …

Mike "FossilMedic" Ward

Australian Paramedic Educator recognized

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“Mr Williams is one of the pioneering paramedics to enter academia and is internationally recognised as a prolific writer in paramedicine pedagogy,”

From Monash University:

Faculty of Medicine, Nursing and Health Sciences Senior Lecturer, Brett Williams has won an Australian Award for University Teaching from the Australian Learning and Teaching Council (ALTC).

The award was officially presented at a gala ceremony at the Sydney Opera House on Tuesday 16 August 2011.

Mr Williams was also awarded an ALTC Citation for Outstanding Contribution to Student Learning in 2011, heralding a very successful year for Mr Williams.

Professor Marnie Hughes-Warrington, Pro Vice-Chancellor (Learning and Teaching) said the awards reflected Mr Williams' commitment to enhancing the the quality of learning and teaching to the students at Monash.

“Mr Williams is one of the pioneering paramedics to enter academia and is internationally recognised as a prolific writer in paramedicine pedagogy,” Professor Marnie Hughes-Warrington said.

“He has introduced undergraduate paramedic students to the challenges of out-of-hospital clinical practice by developing a suite of authentic teaching and learning objects in both face-to-face and e-learning environments.

“These developments have provided the students with active learning opportunities and realistic exposure to the uncertainties of out-of-hospital care, bridging the gap between theory and practice,” Professor Hughes-Warrington said.

Go HERE for full article.

Department of Community Emergency Health and Paramedic Practice

Mr Brett Williams BAVEd, Grad Cert ICP, Grad Dip EmergHlth, MHlthSc, PhD (Candidate) 

Mike "FossilMedic" Ward

Updated: 5 dead, 45 hurt at Indiana Fair Ground stage collapse

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Storm-related wind gust collapses grandstand stage

 

Update, Sunday 2pm Eastern:
The death toll has risen to 5 and authorities are reporting 45 injured so far.
Additional videos and photos added.  Scroll down.

IndyStar.com has the story:

Three people were killed and 24 injured tonight when the grandstand stage collapsed at the Indiana State Fairgrounds, according to Indiana State Police Capt. Brad Weaver.

The gust of the wind brought down the production equipment shortly before 9 p.m. tonight, according to Indianapolis Star reporter David Lindquist, who was at the fairgrounds for the Sugarland concert.

It took less than 20 minutes to free those who were trapped, Lindquist said, crediting fast action by everyone despite the inclement weather.

3 dead, 24 hurt in Indiana State Fair stage collapse

Rescue Efforts:

UPDATE: Information still dynamic

State police reporting three deaths, a tweet from the fairground Twitter account says four.

Stage collapsed into a V.I.P. area called the "Sugar Pit."

From MSNBC live blog of  WTHR coverage:

11:02

Tony Francis was in the second row with his wife. Francis said he is a first responder and his wife is a nurse.

Regarding fatalities, he said, "I saw at least five myself. When I left they had just lifted the master speakers and they found two more underneath that."

Francis said his wife "triaged about ten or twelve people with compound fractures, lacerations, a lot of head injuries and neck injuries."

Indiana State Fair stage collapse: Live blog

UPDATE 2:

Indiana State Police 12:25 AM news conference reports 4 dead and 40 injured.   WTHR report

Mike "FossilMedic" Ward

 

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Indiana State Police press conference at 1:45 am

 

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View of stage about 1 hour before the collapse  (Getty / Foley)

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Getty / Foley

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Indy Star / Kryger

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Indy Star / Kryger

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Associated Press / Cummings

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The Internet is my Religion

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Something worth 12 minutes of your time

In darkened rooms, staring into bright screens, we may fantasize about making a difference as we blog away.

Jim Gilliam's presentation at the Personal Democracy Forum 2011 puts that fantasy into a real-life example.

The Internet is My Religion

TechPresident provides a summation:

Religion at a conference about technology in politics?

A personal life story on the same stage that saw heady talk about statecraft and Internet infrastructure?

A guy staring out at rows of faces tilted downwards at laptops, not up at him — at least at first — and explaining that he can feel Christ in the wi-fi?

Unexpected. Transgressive. Radical, because it was painfully sincere.

More HERE

Jim Gilliam website

NationBuilder (Internet tools to shake up a broken political system

.

Mike "FossilMedic" Ward

Culturally Hip Hands-Only CPR PSA

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Hands Only!

Hangover II and Community actor Ken Jeong lends his talent to this public safety announcement

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Drew Grant, writing in Salon.com, provides a "tisk-tisk" to the approach: Ken Jeong's CPR infomercial: The "Hangover Part II" star lends a helping hand to a funny, weird PSA that has a little bit of heart

The YouTube video is part of an American Heart Association fundraiser:

Donate $25 by 5pm EST on June 18th and be entered to win the CD "Glee: Journey to Regionals" signed by Chris Colfer!

Donate $28 by 5pm EST June 21st and be entered to win an iPad2 and "Push Hard & Fast" t-shirt signed by Ken Jeong!

Sudden cardiac arrest can happen to anyone, young or old, at any time. It is a leading cause of death in the U.S., and it happens when the heart abruptly stops.

When an adult collapses, odds are that it’s from sudden cardiac arrest. Odds are also high that if bystanders respond at all, the only thing they will do is call 9-1-1.

Medical attention is critical, but bystanders must act first — and fast — because every minute counts.

Even scarier? About 80 percent of victims collapse at home – many times while the victim’s loved ones stand by helplessly because they don’t know what to do.

The good news is that chance of survival more than doubles with immediate and effective CPR.

And the American Heart Association is making it easier for people to remember the steps to take in a sudden cardiac emergency with Hands-Only CPR.

Hands-Only CPR – or CPR without using breaths – involves two simple steps to help an adult cardiac arrest victim:

1) Call 9-1-1

2) Push hard and fast in the center of the chest until an AED arrives and is ready for use or healthcare providers take over

Remember the classic Bee Gees disco hit "Stayin' Alive?" It’s the perfect beat for remembering the right rate of chest compressions during Hands-Only CPR.

Disco may be dead, but it’s helping keep people alive.

We’ve enlisted the help of actor and real-life doctor Ken Jeong to help spread this lifesaving message.

Check out his hilarious take on “Stayin’ Alive” clad in a white suit like the one worn by John Travolta in the classic film “Saturday Night Fever.”

Go HERE for more details.

Mike "FossilMedic" Ward

da’ Shore has a great Memorial Day flush

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Biggest Demoflush Since 1992!

When dinosaurs staffed Dodge Type II, Suburban and Cadillac ambulances, the Town of Ocean City's implemented a unique measurement of weekend crowds: 

Demoflush.

Estimating resort weekend population based on the amount of sewage generated is a unique Ocean City tradition.

It started in 1971 as the city struggled to develop a health services plan for a narrow penninsula resort that went from 1,493 permanent residents to summer weekends with 50,000 to 250,000 visitors.

A 1973 seminar in Operations Research in Health Planning included reports on the Ocean City project:

The statistics yielded by the surveys were detailed by Peter G. Goldschmidt, also a graduate student at Johns Hopkins. (he went on to become a physician and PhD)

A clinic operated by a local physician with summer assistants provided most of the care for the visitors; the clinic saw about 160 patients on an average August day but was forced to turn away another 20.

Of every 1000 accidents or episodes of illness reported in the survey, only about 200 cases were actually treated and carried to the point of discharge; the rest either did not seek care, were unable to obtain it, or did not follow up on the initial visit.

Visits from permanent residents were found to make up 20 percent of all visits in 1971; this was projected to increase to 35 percent in 1980, with planned development of the area, and the summer population by that date was projected to increase to 300,000. Apart from accidental injuries, the major complaints reported were "nervous anxiety" and high blood pressure.

On completion of the study, the team recommended immediate establishment of first-aid stations on the beach and the development of a disaster plan for the area, with all health activities to be coordinated by a health care corporation in order to provide continuity of service the year round. The city council endorsed the plan and charged the medical commission to carry it out.

Two first-aid stations, staffed by nurses and aides, were opened the following summer and handled 1600 calls for service, most of which did not require physician care.

The health care corporation was established but is still without a staff; political realities intervened with the discovery that the health care of the summer visitors had low priority on community funds raised from the permanent residents, and efforts to raise funds from other sources have so far been unsuccessful.

More here: Operations Research in Health Planning (1973)

During that time a "rogue" physician established a clinic near the convention center, complete with a private ambulance that never moved from it's perch on the corner of his lot.

In 1974 the town had one Maryland Cardiac Rescue Technician on the job. Frank Muller took one of the first CRT classes in Baltimore. The nearest hospital was 30 miles away in Salisbury. We transported to a clinic in order to stabilize patients before the 45 minute transport.

Our operating medical director (OMD) taught us to set up ekgs, start IVs and do minor suturing when we brought patients into his clinic. It was just-in-time training as the need arose. We worked under his direct supervision, supplementing a thin clinic staff.

The OMD taught me how to set up an EKG after transporting a large, panic-strickened, 40-something guy with chest pain who was profusely sweating and slick with suntan lotion.  The patient arrested in the clinic and did not get to Penninsula General Hospital. My first time using a defibrillator.

Peter G. Goldschmidt and Andrew W. Dahl published the results of their work.  "Estimating Population in Seasonal Resort Communities" published in the April 1976 issue of growth and change: A Journal of Urban and Regional Policy

Tex Jobe, US Army Corps of Engineers photo, June 1998 via Wikipedia

Joan Shriner, writing in Friday's Maryland Coast Dispatch provided the details:

According to (Town of Ocean City) Communications Manager Donna Abbott, this year’s demoflush population calculations for the holiday weekend saw an estimated 281,895 people, which is well over last year’s estimate for Memorial Day weekend, which was set at 254,717.

“I have demoflush figures back to 1992 and I could not find a higher demoflush estimate for Memorial weekend then what we just had this past weekend,” Abbott said.

read more here: Holiday Weekend Gets Season Off To Booming Start

Memorial Day Crowds

  • 2011: 281,895
  • 2010: 254,717
  • 2009: 270,421
  • 2008: 226,748
  • 2007: 259,823
  • 2006: 239,789
  • 2005: 216,371
  • 2004: 242,286
  • 2003: 197,725
  • 2002: 237,791
  • 2001: 216,038
  • 2000: 242,730
  • 1999: 248,446
  • 1998: 234,961
  • 1997: 204,972

Demoflush figures courtesy of Ocean City Tourism.

Ocean City is the second largest city in Maryland on summer weekends.

Mike "FossilMedic" Ward

Related post: August 21, 2007 Beach Patrol First Responders

The 9th “New Normal” Memorial Day

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What should we do for Memorial Day?

I cannot match the power or eloquence of Kelly Grayson's Memorial Day post.

I want to reflect on how Decoration Day is reflected in our new normal.

Be aware that there are more deployments

Active duty, reserve and National Guard troops are experiencing more combat exposure than earlier generations. Some reservists have completed three deployments.

James Hosek, Jennifer Kavanagh, Laura Miller (2006) How Deployments Affect Service Members

The one-third cut in active-duty manpower at the end of the Cold War, from 2.1 million to 1.4 million in uniform, combined with a shift in the national security environment, has today resulted in the need for longer and repeated deployments, especially for the Army and the Marine Corps, and these deployments have posed challenges for active-duty service members and for their families.

Terri Tanielian (March 2009) Assessing Combat Exposure and Post Traumatic Stress Disorder in Troops and Estimating the Costs to Society: Implications from the RAND Invisible Wounds of War Study

 

Learn from the Millennium Cohort Study

A prospective study of veteran health started in 2001 and ending in 2022, may identify trends we will encounter when helping our brothers and sisters who have served.

US Medicine: What We Can Learn in 21 Years. Looking at physiological (respiratory, cardiovascular and muscolo-skeletal), environment (sleep) and psychological (Depression, Post Traumatic Stress Disorder). Click HERE to see the presentations list.

Initial results include identification of increased alcohol risks for reservists and national guard members after deployment.

Of 50,000 responders, 4.8 percent of active-duty members and 7.1 percent of reserve-component members reported the onset of alcohol-related problems after deployment. Six percent of active-duty members and 8.8 percent of reservists and Guardsmen reported that they had begun heavy weekly drinking. In addition, 26.6 percent of active-duty members and 25.6 percent in the reserve components reported post-deployment binge drinking. (HERE)

Also identifying an increased rate of respiratory symptoms of no known etiology

Troops fighting in Iraq and Afghanistan have a higher rate of developing persistent or recurring cough or shortness of breath than nondeployers (14 percent vs. 10 percent), according to a survey of more than 46,000 military personal. Yet, the cause of this spike remains a mystery. The survey – based on self-reported symptoms – did not find an increased rate of chronic obstructive pulmonary disease or asthma. (HERE)

As well as hypertension after multiple combat exposures

"Deployment with multiple combat exposures appeared to be a unique risk factor for newly reported hypertension," Nisara S. Granado, an epidemiologist at the Naval Health Research Center in San Diego and lead author of a report in the Sept. 14, 2009, online issue of Hypertension, said in a statement.

Hypertension, or high blood pressure, thus joins the list of problems resulting from constant exposure to the life-threatening experience of combat. They include post-traumatic stress disorder, depression, substance abuse and attention deficits.

Nisara and her colleagues drew on the records of 36,061 service members, including 8,829 deployed to Iraq and Afghanistan between 2001 and 2003. After a three-year follow-up, the researchers found that those who reported multiple combat exposures were 33 percent more likely to report they had high blood pressure than those spared combat.

Troops sent to combat areas but not exposed to combat were 23 percent less likely to report high blood pressure than those who saw action, the researchers said. (HERE)

Act individually to make a difference

Bill Carey, in Backstep Firefighter, shares a recognition from the Boston Medal Day:

The Massachusetts Iraq and Afghanistan Fallen Heroes Memorial Fund was founded in 2010, to build a permanent memorial to the sons and daughters of Massachusetts who have given their lives in service to our nation in Iraq and Afghanistan.

Firefighter Daniel J. Magoon Engine Company 21 and Firefighter Edward A. Kelly Tower Ladder17, dedicated hundreds of hours of personal time helping to build the organization and coordinate its first major event. The memorial team would not have become what it has without the leadership and guidance of Firefighter Edward A. Kelly and Firefighter Daniel J. Magoon during its critical initial forming stages.

Firefighter Magoon’s (Treasurer of Organization) and Kelly’s (Board of Directors) selfless service, leadership, and organizational abilities are in keeping with the finest traditions of the Fire service, and reflect great credit upon himself, Boston Firefighters, and the Boston Fire Department.

Kelly Grayson (Ambulance Driver) makes two great recommendations in his MEMORIAL DAY post:

Remind yourself also that your sacrifice is infinitely easier. All you need do is sacrifice a moment of your time every few years to pull a lever.

The way to honor a dead soldier is not simply to fly a flag on Memorial Day.

Vote to preserve the freedoms they died defending. Elect leaders worthy of those rough young men and women who stand ready to do violence on your behalf.

And stop by your local Veteran’s Cemetery and put out some flowers on the grave of your choice. It need not even be the grave of someone you know.

Bring your children along, and explain to them why it’s important

Mike "FossilMedic" Ward

“Information in your file indicates that your injury is not affecting your earning ability at this time,”

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An unusual memento

It was delivered nine years and 364 days after Police Officer Jason Schechterle was pulled from his crushed and burning cruiser.

An out-of-control cab slammed into Officer Schechterle's Ford Crown Victoria cruiser.

Right in front of Phoenix Engine 5.

It was 11:21 p.m.

Suddenly, there was a fireball.

Capt. Michael Ore’s crew jumped out of the engine and began unraveling the hose.

Then Ore saw the flashing lights. “We’re on the scene of a 962 …!” he shouted into the radio, giving the code for an accident with injuries. “Give me a first-alarm medical. Police car involved.”

And then: “Trapped victim!”

Flames licked at the broken frame of the patrol car, its back seat crushed by the impact.

“Hurry up!” he yelled to his crew. “There’s a man burning to death in there!”

Darren Boyce aimed the hose inside the car, while rookie Henry Narvaez fought to open the driver’s door. “I can’t get it open!”

Ore tossed an ax to Narvaez, who broke through the window. Boyce kept the flames at bay, but the front seat was smoldering beneath the smoke and steam. The stench of melted plastic filled Ore’s nostrils as he and Narvaez tugged at the officer, fighting to free him.

But he was still strapped into his seat belt, and they couldn’t get to the latch.

“Get a knife!” Ore screamed.

A policeman who’d just arrived sliced through the seat belt, while a second officer loosened the legs. Together the men pulled the officer through the window just as an ambulance drove up.

As they shoved him onto the gurney, a piece of skin peeled off the officer’s arm — revealing a small patch of white on an otherwise blackened man. Ore, a 26-year veteran, was stricken.

“I’m not sure we did this guy a favor,” he thought as the ambulance pulled away.

Associated Press (June 09, 2002) An officer lives, but is the cost too grave? After suffering fourth-degree burns, doctors couldn’t believe Jason Schechterle was alive (Part I of a three part article)

Poor outcomes when Police Interceptors are rear-ended at high speed

Jason Schechterle is one of 10 police officers seriously burned after a rear end collision in the Ford "Panther" series.

In the same period, 17 police officers died of burn injuries in cruiser collisions (1981 – 2006). Crown Victoria Police Interceptor Victims

In addition to fuel tank rupture, a high speed rear end collision jams the front doors of the cruiser. The burning officer is trapped.

It took Engine 5 and fellow Phoenix police officers about eight minutes to get Schechterle out of his cruiser.

You are Fit For Duty (really?)

The unusual memento was a letter from the Industrial Commission of Arizona, signed by Antonio Escobar, Awards Specialist II.

Escobar informed Schechterle, who was burned beyond recognition in the crash and has undergone more than 50 surgeries in the past decade, that he is fit for duty as a cop.

"Information in your file indicates that your injury is not affecting your earning ability at this time," the state employee wrote. "If you have any questions about your award, we will be glad to explain anything that seems unclear."

"No permanent work restrictions noted."

Then came the bureaucratic kicker: "There are no medical contraindications which would preclude [Schechterle] from returning to the same or similar work, thereby sustaining no loss of earning capacity."

Read the rest of Paul Rubin's article from the May 5, 2011, issue of Phoenix New Times: "Disfigured Former Phoenix Cop Was Incredulous When the State Recently Declared Him Fit for Duty"

Laura McGrory, director of the Industrial Commission, told New Times "Jason doesn't have to do anything. We will re-evaluate his case, period, and go from there. Let's just call this a teaching moment."

Since the crash, Schechterle has made many teaching moments to support others.

A member of the 100 Club of Arizona, he also established a non-profit foundation Beyond The Flames and is a motivational speaker.

“The one true blessing we have, the one thing we have control of, is our attitude. It’s the only thing you have control of, every single day, every situation. You get to decide what your attitude is going to be” – Jason Schechterle

3TV catches up with Jason Schechterle 10 years after fiery crash

Like yesterday's story, "Corporal David Brown follow-up," the worker compensation system is not an advocate for the injured.

Mike "FossilMedic" Ward

SLS AMG Emergency Medical response concept

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Want!

 

Mercedes has announced plans to introduce the SLS AMG Emergency Medical concept at RETTmobil 2011.

Designed to draw attention to the company's lineup of safety vehicles, the one-off concept has traditional livery, a prominent light bar and the latest communications technology.

In the standard car, power is provided by a 6.3-liter V8 engine that develops 571 PS (420 kW / 563 hp) and 650 Nm (479 lb-ft) of torque.

This enables the SLS to rocket from 0-100 km/h in 3.8 seconds and hit a top speed of 317 km/h (197 mph).

Read more HERE

 

Mike "FossilMedic" Ward

 

Corporal David Brown follow-up

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Motor officer critically injured, returns home after five months of recovery and rehabilitation:  February 25, 2011

NBC News 11 Atlanta

From the Montgomery Advertiser:

“We are just excited and elated that he is coming back," Tommy Brown, police Cpl. David Brown's father, told the Advertiser. "By the grace of God, he's here with us."

Brown lost an arm, a leg, and suffered traumatic brain injury Sept. 11 when escorting a funeral procession on his police motorcycle.

He collided with a car that pulled into his pathway and the motorcycle caught fire. On the way to the hospital, his ambulance overturned on an interstate ramp.

Montgomery mayor says twice-injured Cpl. David Brown can't get worker's comp

MONTGOMERY, Alabama (October 28, 2010) — Mayor Todd Strange said the city can't grant workers' compensation benefits to the family of police officer who was critically injured while escorting a funeral procession last month because he was off-duty.

Strange said Cpl. David Brown was not working for the Montgomery Police Department that day and had a private contract with the funeral home.

The city received no compensation. Strange said he would like to provide Brown and his family with workers' compensation, but the city must follow the law.

The family sues the city for worker compensation, pointing out that he was using Montgomery Police equipment and was in uniform.

Michael A. DeMayo, in his Workers' Compensation Lawyer Blog, provided a slightly different picture of the mayor after a March 22, 2011 ruling in favor of the family.

The mayor is appealing that ruling. Click below for the details:

Ray of Hope for Montgomery Police Officer in New Ruling; North Carolina Workers’ Compensation Experts React

The detailed description of his situation includes this: (Brown) now owes $3,000 in co-payments and $1.5 million in medical/surgical bills.

Why talk about this on Firegeezer?

1)  The video shows the outpouring of assistance by Montgomery Police DepartmentMontgomery Fire Department, Prattville Fire Department and others to modify David Brown's home and maintain the yard while he was in rehabilitation.

2)  Career firefighters and paramedics could be placed in the same situation when donating time to their community emergency services.

What happens if you get critically hurt or killed as a responder or instructor while donating you time?

Your employer will seek ways to deny coverage. A large Texas city did it when two off-duty firefighters perished at a building collapse.

The city initially denied city-funded LODD benefits and the rural hometown VFD could not afford the half-a-million annuity needed to provide the same benefit payout.

As the two young mothers started their appeal to the state supreme court, the third effort in an on-going legal fight. The Texas city mayor agreed to provide the LODD benefit.

Mike "FossilMedic" Ward

Earlier:

October 21, 2010: Injured Motor Officer off ventilator

September 13, 2010: We only hurt the ones we love

 

K. C. Amb. Crew Clueless When Patient Dies

19 comments

Department Stonewalls for Three Months

 "unknown at what time change in patient occurred." READS THE AMBULANCE REPORT, thus confirming that Frank Nigro, 52, may have been dead for as long as 40 minutes in the back of a Kansas City FD ambulance on January 19 while he was being transferred from one hospital to another during a snowstorm.  Because of the weather, the transfer took 41 minutes to complete.

KCTV Ch. 5 reports:

When Frank Nigro first came home complaining of neck pain, his tight-knit family in the Northland didn't think much of it. He went to the emergency room for treatment and they sent him home with pain pills for a strained neck. But two days later, after what seemed like a simple neck injury, Nigro could no longer get up so his family called 911.

The family said by the time Nigro reached St. Luke's Northland, he could no longer feel the right side of his body. An MRI revealed a lesion on his spinal cord, his family said. It was something so serious that he was loaded into an ambulance for a transfer to St. Luke's on the Plaza, where a neurosurgeon was standing by.  Frank Nigro never made it out of the ambulance alive.

The family said Nigro had no color when he arrived at the hospital because he had been dead long before he got to the hospital. It was only when the crew went to unload Nigro at the emergency room that they noticed the, "patient appeared pulseless … apneic with no heart tones …."  Hospital records indicate that when the crew arrived with Nigro, his body was "cyanotic" and "cool to the touch."  St. Luke's on the Plaza listed him as D.O.A., or dead on arrival.

Acting as agents for Nigro's family, KCTV filed a string of public record requests with the fire department, but they were all denied.  However, with the news just now coming out on the incident, the City Council is taking an interest and opening an investigation.  So far, it is still a secret as to whether the paramedic was in the back tending his patient, or riding in the front cab with the driver.

Read the full story from KCTV HERE.

KSHB-TV Ch. 41 filed this video report that includes an interview with a city councilman:

 

*  *  *  *  *  *  *

A Mother’s Day Memory

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My first ambulance field rotation was on Mother's Day, 1971.

I was a high school senior taking the "Emergency Medical Technician/Ambulance" course offered through the adult and vocational training division of the community college.

Mike DeWalt was in the class and let me ride with him at Northern Virginia Doctor's Ambulance. This was a private ambulance service that provided occasional back-up for the Alexandria Fire Department.

A Busy Sunday

The EMT-in-charge was a tall, skinny musician who worked part-time at the ambulance service. A very friendly and helpful guy, he was reading Dale Dubin's Rapid Interpretation of EKG's

While Virginia had not authorized a paramedic training program, Glenn Luedtke wanted to be prepared. 

Some of you know Glenn from his recent work on the NAEMT EMS Safety Course.

Or his tenure as the EMS Director for Sussex County (Delaware) or Cape and Islands (Massachusetts).

There were six nursing home-to-house transports scheduled that morning. Followed by six return trips that evening.

Idealistic high schooler meets complex relationships

With nearly no life experiences, and that teenaged sense of "how things SHOULD be," it seemed to me that many of these patients were going to homes hostile to the visit.

I could not understand why Glenn talked so loud to the patients, or why he insisted on talking with the family before we moved the stretcher into the house. 

Now I get it

During the past three years I have been on a geriatric journey with my parents. Including a recent acceleration that requires more action than discussion.

I whined about an interfacility transport experience five months ago (On Airline Travel and Ambulance Transfers ) and finding my "Adult Command Voice" (“The Greatest Generation” white-knuckles through another Winter Carnival ).

The novelty of being the designated adult/primary caregiver has worn off.

We are in the day-to-day grind of assuring a safe and comfortable environment for a couple who are struggling to maintain as much independence and autonomy as they can while medical conditions continue to change.

The excitement two weeks ago was an intense effort get Mom out of a hospital and into an assisted living facility that evening. Worked with Dad to visit a couple of places and make a decision by early afternoon. Not a lot of choices within our timeframe.

Followed by an evening stand-off with my Dad who wanted to take her home (where there was no assistance in place and physically inappropriate).

We told you …

The language of federally-regulated health care ranks right up with airline travel. Accurate statements made in a neutral tone using industry terms. 

They were told on admission that she was on "observational" status and would be discharged in three days. They did not realize it until her last night.

Even with this issue, the federally-regulated part of health care provides much better information than the unregulated parts of health care. 

"What I want is …"

… not what we can get you.  It sometimes feels like I am explaining to a 9 year old why he cannot drive the car.

This morning I am at work, the final day of EMS testing, looking at the list of things to do this week. Wondering if it is safe to make a business trip and resenting the probable answer.

On this Mother's Day I understand the complex emotions felt by the children when we delivered their Mom's for a visit in 1971. Relationship defined by decades of experience, conflict and compromise.

Mother!

Mike "FossilMedic" Ward

 

 

Kansas City fails to meet ambulance response times

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After Fire Department takeover of MAST, a year of poor ambulance response times

An April 23 editorial in the Kansas City Star:

The Fire Department has failed in every three-month period since the takeover to meet the council’s response requirement citywide.

In fact, the department hasn’t yet reached the mandated response time citywide in any single month. The times have been slowest north of the river, and often not much better in the city’s southern parts.

(ambulance picture from Mike Ransdell @ Kansas City Star )

Read more here: The Star’s editorial | KC’s ambulance response times are unacceptably slow

Issues with the work hours and compensation of the former MAST paramedics. 

Accusations that the fire department is forcing single-role ems providers to work a 52 hour work week for the pay they were getting while working a 40 hour work week.

A proposal to place single role providers on a 24 hour shift was reversed last month after consulting with the city attorney. 

While the discussion remains a "private lawyer-client" matter, pretty confident it may relate to the experience from other fire-based ems services that struggled with application of the Fair Labor Standards Act to "uniformed civilians."  (article HERE)

Firefighters receiving cross-over training and taking ems overtime shifts instead of the single role civilians.

Single-role former MAST employees not confortable with fire union representation.

Another hostile takeover of an ems service with a messy and unfinished merger one year later.

Mike "FossilMedic" Ward

related articles:

November 22, 2009 (KCFD takeover of MAST):  The Neon Red Elephant of EMS   

November 05, 2010 (why firefighters would want ems):  The F-word in EMS .  

 

Ms. Bus Driver helps evacuate a nursing home

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The Emergency Evacuation

It was a typical Thursday evening. I had just gotten home from my after-school program run and was just putting my feet up and getting ready to eat dinner (thank you microwave dinners deluxe)when a phone call interrupted my, one time a week, quiet evening at home.

"Ms. Bus Driver, its an emergency, can you help?"

Amazing how one phone call can cause so much havoc in one evening. Not really knowing what I was about to get myself into, I immediately said, "Yes, what do you need me to do?"

"Go to Transit, get a bus with a lift, and go out to Nearby Town, and help evacuate the nursing home. There is a fire. Make sure you call Mr. Bossman when you get to Transit."

By the word "fire", the adrenaline was pumping, and I had already put my shoes on and was on the way down the stairs. The call came in at 6:51 pm. I was at Transit and on a bus by 6:54 pm. I was entering Nearby Town following the ambulances with lights and sirens by 7:07 pm. By 7:09, I was at the nursing home.

The smoke was thick. It felt like a hot August night and the road was blocked off. The fire reached within 30 feet of the nursing home. We were against a wall of smoke racing against time to get the residents to safety. It was chaos. Organized chaos, but chaos.

Police were redirecting traffic, roads were closed, trains were stopped. The fire had jumped the 4 lane highway in several places. The county had come to a standstill. Reports flew in, 1000 acres burned, then 2000, then 5000, then 7000+. Damage is unknown.

Speculation begins: Was it a careless brush fire, Was it someone burning trash, Was it a controlled burn out of control?

WHOP WHOP WHOP WHOP WHOP The helicopter soars overhead dropping water on hot spots where the trucks can't reach. Homes are in danger, some already burning.

People are being evacuated to nearby churches, schools, towns. Fire departments from all over are battling the blaze. Emotions are running high and the intensity is heart pounding.

School buses, Transit buses, and Ambulances are piled into the parking lot at the nursing home. I load up two people in wheelchairs, secure them and go to make my way over to the safety shelter.

I return again in the hopes of helping to transport supplies, or other needed items or other people who needed transport.

I think it takes about 40-50 minutes to evacuate everyone. Ambulances are making several return trips for bed bound residents. Over at the evacuation shelter, people are swarming, nurses are working to make sure everyone is safe and the smell of smoke hangs in the air. The nursing home becomes a ghost town.

Did I just help evacuate a nursing home?

Wow.

The Bus Driver

<<<<<<<<<<<<<<<<<<<<    >>>>>>>>>>>

Thanks to Ms. Bus Driver for allowing us to repost her experience. 

With her permission came this observation:

It was quite intense.  My adrenaline was definitely pumping and it was fantastic to work alongside medical and firefighting personnel and assisting them in whatever they needed! 

Check out her blog site: 

Tales from the School Bus

Mike "FossilMedic" Ward

UPDATED Six shot 2 am Sunday. All 17 staffed Detroit ambulances on other calls. Five ambulances unstaffed. Police transport.

9 comments

WDIV Channel 4 got the "no ambulance available" aspect of this story.

6 Shot In Detroit, No Ambulances Available Victims Drove To Police Precinct

Six teenagers in a sedan were fired upon. WDIV states that when the victims called 911, were told no ambulances were available.

Clip 1

Shooting victims get to 12th Precinct Station (formerly Western District).

Police call for EMS, still no units available. Transports made by police cruiser.  One of the six has died.

Wisam R. Zeineh, President of the Detroit Emergency Medical Services Association, is interviewed by Channel 4.

Clip 2

Zeineh points out that all 17 staffed ambulances were on other incidents Sunday morning.

States that the city is authorized to staff 22 ALS units, but five units were unstaffed.

Not sure how many of the 17 staffed ambulances were downgraded to EMT ambulances.

Also note the repositioning of the single-role ems providers group from labor to advocacy group.

UPDATED: Fox 5 video

No Ambulance Available for Shooting Victims 1 dead, 5 injured; no arrests

Wonder why there was no fire company first responder assistance sent to the police station? The fire department staffs six squad companies that have made critical transports in earlier incidents. (see John's response)

Mike "FossilMedic" Ward

98 days after last skill use … oops

1 comment

Bicycles, business travel and out-of-hospital intubation

During a discussion of out-of-hospital intubation practice, Scott Bourn shared his agency's experience with paramedic skill proficiency. Bourn, PhD, RN, EMT-P, is the Vice President of Clinical Affairs for American Medical Response. 17,000 ALS providers working for 88 local medical directors. He noted that proficiency drops off when a skill is not used for more than 90 days.

Interrupted Flyer

It was 98 days since my last airline trip. The longest business travel interruption in a decade.

Scheduling my flight at the last minute meant I had a middle seat in the back of the plane. Planned to ugrade when I checked in at the self-serve kiosk.

Where is my?

The first stumble was looking for the carry-on toiletries. The collection of TSA appropriate liquids in the correctly sized zip-loc bag was missing.

Oh yeah, left that in the office after the January blizzard DHS Threat Level White  

Aisle Seat upgrade

Some airlines have a menu-syle system for various upgrades and services.  For $30 bucks I can get out of the middle seat and get an aisle seat with incrementally better legroom.

Not completely thinking this through, selected a bulkhead seat. Maximum legroom but no way to place a carry-on under the seat in front of you.

When Group 1 means middle of the pack

The upgrade also placed me in Group 1 for boarding. For this carrier, "Group 1" on the ticket means you are in the fourth or fifth group (of eight) boarding the plane.

The stratification of various frequent flyer/bonus programs is amazing. By time Group 1 was boarding, most of the overhead bins were taken around Seat 7D.

But wait, there is one more thing …

The McDonnell Douglas MD-80 has a 2 seat/3 seat configuration in coach. 

Seat 7D functions as a jersey barrier to the balance of the passengers boarding the flight.

Not a comfortable place to sit.

Should of stayed in the middle seat in the rear of the plane.

It is not like riding a bicycle.

Part of the intubation discussion was that, once you learned the skill you would retain the capability to perform the skill months or years later.

Not sure that you can be competent in using a critical but infrequently used skill. Surprised at the fumbling and stumbing with business travel tasks that are "easy."

In many systems, paramedics may have an opportunity to intubate once or twice a year.

How many critical skills are you responsible for that are infrequently used?

Mike "FossilMedic" Ward