Monday, November 12, 2012

Online Bachelor's Degree for Paramedics

For anyone interested, Anna Maria College has just started a fully-online degree completion program for working Paramedics.
The program leads to a Bachelor of Science in EMS Administration degree and is 100 % online. The program also has no clinical requirements.
For more information, follow the link to Anna Maria's BSEMSA Web page.

Wednesday, February 1, 2012

Just in case anyone missed it, I've pasted below an excellent article that appeared in a recent edition of the Worcester Telegram & Gazette, written by reporter Brad Miner. In an era dominated by a healthcare reform debate that couldn't care less about prehospital medicine, it's nice to see someone write thoughtfully -- and accurately, in my opinion -- about the state of affairs:

Central Mass. EMS Struggles to Make Ends Meet

Friday, September 2, 2011

Stop The Presses (Yet Again)

Ok, remember how in cardiac arrests we used to do CPR until you had the pads on, and then we would stop to analyze the rhythm?

And then remember a few years ago we were told that we needed to do uninterrupted CPR for two minutes before we did ANYTHING?

Well, now it turns out that, at the least, the latter is no more beneficial than the former, and at worst, may be hurting our patients.

Evidence-based medicine is only as good as the evidence that begets it.

Now someone bring me MAST trousers and an amp of Bretylium....

Monday, July 11, 2011

EMS's Own Silent Epidemic

A simple question from the "Why Do We Do This?" File:
Why do 911 ambulances transport stable, uninjured psych patients who have no medical or toxicological complaints?
It's never made any sense, and recent injuries to good friends of mine in the field have only highlighted my disdain for the practice.
A friend of mine just learned today that he's out of work for another week, making four total, due to a back injury incurred lifting a stretcher on which was loaded an angry psych patient -- who had no medical complaint, other than being angry. This patient decided to lunge, without warning and at the exact perfect moment during my friend's lift, and now he's been off the job for a month. He has a mortgage and several small children to feed on a Paramedic's salary, so you can imagine what this is doing to his financial security.
And for what?
There was no compelling reason for this patient to go anywhere in an ambulance. Indeed, given the patient's state of mind, she would have been far safer in the back of a police cruiser, in handcuffs if need be, applied by a law enforcement officer with the authority and training to restrain this person.
For EMS personnel, psychs represent nothing but risk.
We aren't allowed by law to restrain them, but they turn violent so often that we are often left with no alternative.
There is no medical problem for us to attend to, and the minimal training we get in EMS for responding to psychiatric emergencies is laughably inadequate.
In my opinion, the number of EMS providers significantly injured on the job by psych patients is a silent epidemic that for some reason is talked about only on ambulance docks, or in crew quarters, or on the bus.
I have yet to work for an EMS agency that really addressed the issue, or even mentioned it in passing.
In the 17 years I've been in EMS, I've been injured exactly once -- by a psych patient who, for no reason and completely out of the blue, scissor kicked me in the chest as I was getting her settled on our ambulance stretcher.
I suffered an agonizing month with costochondritis, a painful injury that made attempts at sleep excrutiating and deep breaths impossible.
And because I couldn't afford to take the time off from work (due to my own mortgage and legion of mouths to feed), I kept the pain to myself and suffered in silence until the injury healed itself.
How many millions of dollars a year are wasted in EMS on time lost to injury due to violent psychiatric patients?
These patients rightly belong to the police.
They have the authority and the means to safely restrain these patients, and the backseat of a police cruiser is a far more secure environment -- with its cages, Lexan glass and doors without handles -- than the patient care compartment of an ambulance, with its myriad of options for escape and self-injury.
I understand completely that most police officers are going to be resistant to the idea.
And while I respect those folks and have many friends in law enforcement, I say it's time for that particular branch of public safety to step up and assume this role that so clearly belongs to them.

Saturday, April 30, 2011

Suffer A Child

We decided she was about 8-months-old, and that seemed in line with the Broselow Tape, which put her weight at around 10 kg.
Her injuries weren't horrific, although the skull-deep laceration that ran from the top of her head to just between her eyes looked pretty dramatic.
But her loud wailing and vigorous movement led us to believe that our inability to find any other injuries was probably the right assessment.
Even if we could have found a broken bone or more cuts, it's most likely that the worst injuries are ones she won't know for a few years at least.
Because while my partner and I tended to this pretty little girl in the back of some random roadside ambulance, a couple hundred yards away her mother had died in an accident that left the first-arriving EMS crews so unnerved that their hands still shook.
I don't know what other family will be there for our patient -- hopefully a large and loving clan that will give her a chance at some semblance of a normal life.
When we got to our destination -- one which I'd love to name, but can't due to privacy laws -- I was impressed at the compassion of the trauma team.
They moved with the usual sense of purpose, but it seemed like each member who came into contact with the little girl took a moment to coo at her, or tell her how pretty she was, or cover her with a warm blanket, even if for just a moment.
And it gave me hope.
This job can make you cynical and hardened. It can take away your humanity, if you let it.
But at other times, you can see how it brings the best out in people, and give you hope even for the smallest and weakest among us.
I witnessed a tragedy today, and I witnessed sublime compassion.
I am going to go home after this shift, and I am going to thank God for what I am privileged to do for a living.

Tuesday, April 19, 2011

A Challenge Bigger Than A Marathon

Marathon Monday was yesterday.
That's the Monday each May where more than 30,000 aspirants gather on Hopkinton's town common hoping to join the hundreds of thousands of runners through history who have earned the title of "Finisher" of the Boston Marathon, the world's greatest road race.
Yesterday my buddy Pat Purcell, of Westborough Fire Department and Worcester EMS, once again successfully navigated the 26.2 miles from Hopkinton to Boston.
I've run Boston with Pat five times, although I took this year off.
Before that, the last year I didn't run was 2005.
Pat finished that year, though.
After trekking from Hopkinton to Boston in a sun that beat down with an ungodly heat that turned the final 1/4-mile slog to the finish line into a concrete oven, Pat received his medal and continued running to Children's Hospital, where he visited me and my son Brendan in Brendan's room on the hospital's 9th floor.
Pat had run the marathon that day in honor of Brendan, and presented him with a Dana-Farber Marathon Challenge medal in his hospital bed.
Brendan was suffering from a malignant brain tumor known as medulloblastoma, and at the time was in the middle of a grueling run of chemotherapy treatments. In the preceding days he had done little more than lay in bed and struggle to breathe.
But when Pat arrived to visit, Brendan stirred and accepted the gift with the closest thing to excitement his broken and battered body could muster. If you didn't know Brendan, you wouldn't realize how much Pat's gift meant to him, but my wife and I did, and we've never forgotten.
I don't know how many years now in a row Pat Purcell has labored to complete the 26.2 mile Boston Marathon on behalf of the Dana-Farber Cancer Institute, or how much money he has raised ($50,000? $100,000?)
I DO know that because of the money raised each year by Pat and hundreds of people like him, the scientists and clinicians at Dana-Farber are making incredible gains in the fight against cancer.
And I know that those gains are the reason I was able to play catch with Brendan and his brother Kevan today, and why Brendan is a happy, healthy 8-year-old 3rd-grader.
I also know that there are still far too many kids who won't have success against cancer, and that the battle goes on.
So while I didn't raise money this year, I figured I'd take an opportunity to appeal to readers of this blog to perhaps consider a donation to Pat Purcell's Dana-Farber fundraising page.
Simply follow the link, and click on "Support A Runner" on the right hand side of the page. Enter "Pat Purcell" for the name, and it will bring you to his page.
I thank from the bottom of my heart anyone who is able to donate. The battle is a long way from over, but every dollar brings us a little closer to victory.

Saturday, April 2, 2011

Is CPR As Effective As We Thought?

Dr. Bryan Bledsoe has made a career of challenging assumptions with the pesky tag team of facts and the scientific method. I found this article about another Sacred Cow -- in this case, the foundational belief that it is CPR alone that saves lives in cardiac arrest -- very interesting reading.