EMS Today – Saturday March 6, Sunday March 7, 2010

This is the final episode of my continuing coverage of the EMS Today conference in Baltimore!

I was on the verge of continuing the festivities from the Fire/EMS Blogger Meet-up on Friday night when I became separated from a group of bloggers as we were walking out of the Pratt Street Pavilion.

I seem to recall walking next to Justin Schorr (@TheHappyMedic) who was wearing a pea coat and a navy blue knit hat looking very much like David Keith (Major Matthew Coonan) from the movie U-571.

I walked down the stairs and out the door before I realized I had left everyone else behind. I also realized it was getting late, I was in downtown Baltimore, and I had hit my therapeutic range of ETOH.

Common sense prevailed and I double-timed it back to the hotel. I ran into a good friend from Physio-Control in the lobby, had a couple of gin and tonics, and headed up to the room for some well-deserved sleep.

Saturday, March 6

Once again I woke up at 7:00 a.m. and briefly considered attending the closing ceremonies. The closing keynote address was to be delivered by Gordon Graham, JD who is one of my favorites! If you’ve never heard him talk, you owe it to yourself. But even Gordon Graham couldn’t get me out of bed before 9:00 a.m.

After a very slow start and several cups of coffee, I finally made down to breakfast by 10:00 a.m. I’m not sure what was better: the fried eggs, bacon, and toast or the Bloody Mary. Either way, I felt much better when I headed to the exhibit hall.

In the Philips section I ran into an old friend named Dan Carlascio who was the first person to hire me to teach a 12-lead ECG class! That was at Loyola University back in 2001. Now Dan works for Philips as the Clinical Implementation Manager. We caught up for a little bit and then I made the rounds.

At 11:30 a.m. I showed up for my 12:00 a.m. appointment with Jamie Davis of the ProMed Network and the MedicCast.

I ran into Mike Ward (@FossilMedic) who went out of his way to introduce me to Bill Schumm (@FireGeezer), which I really appreciated. I wish I would have had a mug for him to sign!

Next I found out that another special guest would be joining us on the MedicCast! None other than Tim Phalen of ECG Solutions. I’ve always thought that Tim Phalen was a class act and a really good guy, but I think Jamie Davis was even more excited than I was!

We would also be joined by Cees Verkerk of Physio-Control, Angel Burba from Howard Community College, and Rory Putnam of Northern Essex Community College.

I’m sure he was just being polite, but Jamie Davis referred to our discussion about 12 leads and ECG education as “one of the best segments he’s ever recorded.”

Listen for yourself and see if you agree!

Note: Please ignore the facial tic. That’s what happens when you cure a hangover with 6-cups of coffee! I’m not normally Parkinsonian.

12:00 p.m. MedicCast live from the floor of EMS Today!

Unfortunately, the connection reset at 26:42 which means that the video stream for the second half of the MedicCast was lost, but Jamie Davis tells me the audio was preserved, so I’ll update you with a link to the full podcast as soon as it’s available.

*** UPDATE ***

Here is a link to the full audio stream.

Angel Burba, Tom Bouthillet, Tim Phalen, and Jamie Davis

Angel Burba and Rory Putnam

Tim Phalen and Jamie Davis

I had just enough time to make it to the next educational session!

1:30 p.m. – 3:00 p.m. Fire-Based EMS: The Issues, the Challenges

IAFC EMS Section
Gary Ludwig (Chair), John Sinclair (Immediate Past-Chair, International Director), David Becker (Vice Chair), J. Robert Brown, Jr. (Treasurer), and Norris W. Croom III (Director-at-Large)

I had been looking forward to meeting Gary Ludwig (Deputy Chief of Memphis Fire Department) for some time. I didn’t realize I was going to have the opportunity to meet the entire executive staff of the IAFC’s EMS Section! That was an unexpected pleasure.

It’s usually not all that difficult to get one person to pose for a quick picture after an educational session, but there were five of these guys! They were all extremely nice and didn’t seem put out at all. Gary Ludwig even suggested that I let someone else hold the camera so I could get in one of the pictures; an offer I gladly accepted. I used this picture because as a photographer, it’s just a much better shot.

I wasn’t sure what to expect with this session, but it ended up being a very informal discussion about a wide range of issues including the economy, transport and billing, ambulance wars, social media in the fire service, tattoos, body modification, the right to free expression, and customer service.

I was shocked to hear how many participants thought a paramedic should be allowed to have tattoos on their face and rings in their nose if that’s what they wanted
to do, as long as the patient care was adequate! News flash: when you’re on duty and wearing your department’s uniform, you’re not in a “free speech and free expression” zone! I thought that was well understood but apparently not.

There was also some Generation Y bashing which seemed to be a common theme this week. One participant went so far as to say that texting is bad because it breeds separatism which is the enemy of teamwork! I think that was a little extreme. The rationale was that “EMS is a team sport” so anything that takes you away from the team is bad. I don’t know if EMS is a team sport or not (I’m sure you could argue it) but firefighting definitely is!

Before someone sends me hate mail about the previous comment, is flying a jet plane a team sport because the captain has a co-pilot? Just asking.

Regardless, I’m not sure it’s fair to say that someone who is introverted, prefers to be by himself during his down time, or texts his girlfriend isn’t a team player. I also don’t think it’s fair to say that an extrovert is automatically a team player simply on the basis that he hangs out in the dayroom watching football with the guys.

I’ve read enough military non-fiction to know that many special forces types have insular personalities, but they are highly driven, technically proficient, and they perform very well as part of a very high functioning team. Isn’t that what matters?

Overall an interesting discussion, but I don’t think any of it rose to the level of the biggest issue or challenge faced by fire-based EMS. In my mind, the biggest issue by far is how to do both things well, but that was a discussion for another day!

3:15 p.m. – 4:15 p.m. EMS and Public Health Collaboration: A Model for the Future

Norma Battaglia, RN, MS

I got out a little bit early from previous session so I made a beeline over to Norma Battaglia’s session!

For those of you who don’t know who Norma Battaglia is, she was one of JEMS magazine’s top 10 innovators in EMS for 2008. She’s also the Prehospital Manager for Tuscon Fire Department.

Norma gave an overview of Tuscon’s practical, collaborative solution for the problems of high-volume, low acuity 9-1-1 calls, which included a unique collaboration of EMS with various public health resources.

I took away some awesome ideas and I found Norma to be very congenial. It’s not easy teaching a Saturday afternoon session on the last day of a conference. Attendance is low and everyone is ready to go home. But we got through it and Norma patiently answered questions after the class was over.

With this session and the overview of Wake County EMS’s Advanced Practice Paramedic program I have a lot to think about!

Sunday, March 7

It was finally time to head home after having thoroughly enjoyed myself and forged many new friendships that I hope will last for a lifetime.

I had a chance encounter with Gary Ludwig at BWI and we talked for a while about paramedic recruitment and retention, and how Memphis Fire Department has a liaison officer who helps new paramedics get settled. He gave some examples and I thought it was a very thoughtful solution to a common problem for fire departments like mine that often recruit paramedics from out-of-state.

After some problems with my seat assignment I made it home comfortably with the assistance of a competent gate agent in CVG and an awesome flight attendant on the home stretch to SAV (not to mention some highly skilled pilots).

Maybe you should go undercover, Mr. Anderson.

See also:

EMS Today – Thursday March 4, 2010

EMS Today – Friday March 5, 2010

14 Comments

  • EMS is most definitely a team sport—much like piloting is, I imagine, based on comments my pilot friends make. Every critical call I run, I'm reminded of how much teamwork it takes. My partner and I have to be able to work together, communicate, keep an eye on the big picture, and take up slack for each other.However—both my partner and I are introverts, and in our downtime, we prefer to do our own thing. Does this make us less of a team? I doubt it. I personally think team work is based more on respect, shared experience, and open communication then on constantly hanging out together.Also—I'd love to hear you expand on the thoughts on paramedic retention.

  • Tom B says:

    Samuel Kordik -Thanks for jumping in! How about golfing? Is that a team sport? Let's assume you have a caddie.I'll definitely consider a future post on paramedic retention (although I'm certainly no expert).In fact, in my opinion, it's at least 50% paying a living wage with good benefits and treating people with respect!Tom

  • RobertB says:

    Amen to that. Paying a living wage is a start. When I don't have to work two (or three) jobs to pay the bills, then I'll feel like Paramedicine is a respected profession and we've graduated from the role of 'ambulance drivers' in the minds of the public, policy makers and other healthcare professionals.

  • Tom B says:

    RobertB -I think it would also help if we stopped allowing "ambulance drivers" to be a part of our profession! :)I've also come around to Skip Kirkwood's line of reasoning that we all need to be referred to as paramedics. That way, on the news, it's not, "Police, Fire, and emergency workers are at the scene of a…" That's not helping us forge an identity.Tom

  • Paying a decent wage would be a great start in my view. I have a friend who has been a cop for a year and is making 15% more than I am as a medic of two years. Were I to stay with my company for ten years, I'd top out at less than I would consider to be a decent living wage. That alone will force me into other lines of work.But respect as a clinician is also an important part of the picture, and that is really in our hands. If we really focus on providing superb care, and encourage other EMS colleagues to do the same, we can win the respect of other healthcare professionals.At a government level, perhaps increased focus on licensure and more stringent standards would also increase the recognition and respect of paramedics.

  • Tom B says:

    Samuel Kordik -Very well said!Tom

  • RobertB says:

    Not sure I agree with us all being called paramedics. There are Paramedics out there that don't deserve to be called medics after they graduated some 'zero to hero' program in 6 months, and EMTs who are barely able to remember the ABCs. Then again there are EMTs who I'd proudly stand alongside and both be seen as 'medics'. I think what's needed is better academic control (ie ONLY accredited programs) and a better continuing education program (including skills) requirement.In my mind we Paramedics need to be able to differentiate what we do as skilled clinicians from that of 140 hour technicians. Only then will we be aligned with other medical professionals in public perception and pay grade.PLEASE don't get me wrong. I know MANY EMTs who are gifted and skilled providers that ALSO deserve to get paid more than a half a buck over minimum wage.(Thinking I've cracked the seal on a can of worms here…:-)

  • Tom B says:

    RobertB -I think the solution is to do what Canada does.Everyone is a paramedic, but there are three levels of paramedic.For example, you might be an advanced practice paramedic with an enhanced skill set, but everyone would be a "paramedic" from an EMS profession standpoint.These strange distinctions between EMT-B, EMT-I, EMT-P, MICP, CCEMT-P are too much for the public and media to understand.A cop is a cop. A firefighter is a firefighter. Why can't a paramedic be a paramedic?Tom

  • Excellent point, Robert. There is a difference between a technician who follows an algorithm and a clinician who does a thorough assessment and provides excellent care based on his/her own analysis and differential diagnosis. I think the Dreyfus model discussed in AMLS Instructor course applies well here—every medic is somewhere on a scale between novice and expert.We as an industry to be more proactive about pushing people towards that expert side. I have a friend who works for an EMS agency that differentiates, internally, between entry-level paramedics and "Advanced Paramedics." Becoming an Advanced Paramedic requires time spent on a double-medic truck, extra CE training with the medical director, extra testing, and more stringent CE requirements. Once they reach that level, more treatment options are available to them.Tom, your idea of different "Paramedic" levels is a good one—as long as we are all "EMTs" (how often have you heard people call us that?), then we will be viewed as basic technicians, not professional healthcare providers.I think more education might be in order to. Certainly we do more than an RN does, but a paramedic fresh out of school knows a lot less.

  • Tom B says:

    Samuel Kordik -In my opinion, the current DOT paramedic curriculum should be the minimum entry requirement for the EMS profession.You will note that I don't refer to EMS as an industry. For some reason that really bothers me.I completely agree that enhanced education is the only way to move from "technician" to "clinician".Tom

  • RobertB says:

    Maybe now the EMS community is gaining more of a voice through social networking and blogging, the time is right for a new 'white paper' ? A manifesto for change !! Don't leave things in the hands of the NREMT and DOT !

  • Tom B says:

    RobertB – The DOT and NREMT are convenient targets, but I think there's plenty of blame to go around! Too many special interest groups and no unity.Tom

  • Tom,Thanks again for being on the show. I will definitely let you know when you can listen to the show we recorded.Right now, that episode is scheduled to be posted the evening of Sunday, March 21, 2010 the MedicCast blog.I hope you will join the show again soon! Until then, stay safe!

  • Tom B says:

    Jamie – Thanks for the update! We'll look for the podcast on the 21st of March! I'd be happy to be on the show anytime! Tom

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