Wednesday, July 30, 2008

Learning from tragedy

In June a volunteer firefighter and a sheriff's deputy were struck by a truck and killed on Rt. 17 in North Carolina near Camp Lejeune. The Marine Corps base was training with smoke which created an extremely low visibility area on the highway.

This article from tells the story.

"Nobody thought how dangerous it was to enter the low visibility area," said Butch Thompson, Onslow County EMS director.

Deputies and firefighters were directing traffic in the area due to decreased visibility on the highway because of fog and smoke from a gun range fire aboard Camp Lejeune when Gene Thomas, a volunteer fireman with the Verona Volunteer Fire Department, and Steve Boehm, a deputy with the Onslow County Sheriff's Department, were struck and killed by a truck traveling northbound on U.S. 17.

Out of a tragedy comes good. Efforts are being made to help fire, EMS and police personnel who are likely to be called into the area again soon.

Does anyone out there remember the days before the scene size-up was added to the assessment process? When I became an EMT in 1980 (yes, I'm old) the mantra was "Airway is always the first priority." The article refers to this:

"We're trained to go into an emergency and we think of the victim's safety many times before our own safety - now we have to think of our own safety," said Steven Conrad, deputy division head of Onslow County Emergency Medical Services. "It's going to cause a delay in getting to patients but it's much needed to protect responders."

From a tragedy comes progress. As we remember those lost, we learn. More EMS providers are killed each year from highway crashes than from violence.

Please take a moment to visit the National EMS Memorial service site for a quick reality check.

Stay safe.

Tuesday, July 22, 2008

Bad news round-up

Sorry, but a lot of the news I have been seeing recently hasn't been cheery. It is important to share the bad as well as the good. Here goes:

A Maplewood, Missouri firefighter/paramedic student who had only been on the job 10 months was killed in an ambush after responding to a vehicle fire. Two cops were also shot. Here is the story from Fox News in St. Louis.

The ambush was a tactic which was originally used against cops in the 60's and 70's. An ambush can also be seen in some domestic violence and violent psych cases. News reports thus far don't give a motivation. It seems the fire was started to draw emergency personnel to the scene. The suspect later burned his house to the ground and didn't negotiate with police.

New Jersey EMTs try to save their jobs. This report from the Star Ledger's

I understand the budget crises that affect municipalities and taxpayers today. I also believe that there is a place for community-based EMS. One of the EMTs that would lose his job is from a family with a long history of public service.

The article makes an interesting point that the financial savings the municipalities see will ultimately be shifted to the taxpayer in the form of co-pays and denied claims when health insurance (if you are lucky enough to have it) won't cover the ambulance bills.

We need a solution that combines community-based EMS and helps the budget woes of municipalities. If I had an immediate answer this blog readership would soar!

Finally, in the category of bad news, Bryan Bledsoe addressed the helicopter issue (again) even before two medical helicopters collided in Arizona. As always, Bryan's columns are good reading.

Now more than ever, stay safe.

Tuesday, July 8, 2008

Lessons learned from Tim Russert

Frank Poliafico, Director of the Initial Life Support Foundation posted this link to a New York Times letter on a listserv I subscribe to. It is a 50-year-old journalist's account of a silent heart attack he recently experienced.

Many on the listserv thought that this would be good to distribute to students. Perhaps you would like to pass it along or place a copy on your squad's bulletin board. The life you save may be someone close to you.

It is also a good reminder that before dismissing a complaint of weakness as dehydration, flu or general whining, always do a thorough exam. A nonchalant or disgruntled EMSer could easily have RMAed this one and found themselves in court--no matter how much the patient said he didn't want to go.

By the way, if you don't know Frank Poliafico, you should. He is an interesting, passionate man who usually has a booth at the major conferences. He is also an accomplished magician.

And if you don't know who Tim Russert is, Google him. He was a talented and highly respected journalist who didn't take shit from anyone. EMSers like people like that.

Monday, July 7, 2008

Fancy Home Defibrillator Used Only Once

The Onion has a funny home defibrillator story in its online radio offerings today.

Enjoy it!

My surgeon called me "dude"

Perhaps it is my age. OK, definitely it is my age. But this story is also an excellent example of how to navigate tricky medical-legal waters: Honesty.

I recently had surgery. An umbilical hernia repair. No biggie. At a check up two weeks post-surgery I told my surgeon about a hard lump under one of the incisions. He palpated and said:

"Oh, Dude. I didn't do right by you on this one. I stitched your abdominal muscle too tight. (pause, shaking his head in disappointment) Well, I'll make it right for you."

I'm not sure what struck me more, being called "dude" or his sincere honesty.

He explained it couldn't be fixed right away...not without giving me a new hernia. I'll get it checked at 12 weeks and see what happens. For those of you who know me, there is no risk that it will affect a swimsuit modeling gig or anything.

Have you ever had a situation like this with a doc? Have you had a situation in the field where you made an error?

I'm not saying this is the way to handle everything but it sure made me think about how I personally handle and teach medical-legal issues.

There is something about sincerity and honesty that go a long way...Dude.