Thursday, November 20, 2008

More on EMS in crisis

Bryan Bledsoe forwarded an article from Men's Health about EMS in crisis. The article takes a look at Philadelphia and New Jersey EMS systems as an example of problems such as system abuse, fatigue among providers and provider shortage.

Melissa Alexander called out a similar EMS piece from the Albuquerque, New Mexico area.

I believe we'll be seeing more and more of these stories. Unfortunately EMS has many crises these days. Perhaps the most important ones are those involving identity and value of the EMS system and the providers that serve in it. Many of the problems we face seem to have roots in these basic issues.

I should note that Bryan Bledsoe was named one of Men's Health magazine's Heroes of Health and Fitness as well as one of ACEP's Heroes of Emergency Medicine. Bryan was an early voice in the air medical transport issue. reports on this story. Congratulations, Bryan.

Stay tuned...

Monday, November 17, 2008

Editorial calls for EMS reform in NJ

I have mentioned the EMS system in NJ several times in my blog. It seems to be at the critical intersection of funding crisis, identity issues, big population numbers and the decline of volunteers seen throughout the country.

This editorial in the Star Ledger provides an overview of the issues in NJ.

What most outsiders don't realize is the impact of transition from older models steeped in tradition to newer models. I believe there is a benefit, both fiscally and for the age old concept of neighbors helping neighbors, in keeping a volunteer presence in communities when it can be maintained with quality and consistency.

Unfortunately the psychology of maintaining that balance can be more elusive than finding 14 million dollars to implement reform.

Sunday, November 16, 2008

Google predicts flu outbreaks faster than CDC

Could it be true? It makes sense. Based on search terms, Google Flu Trends can predict flu outbeaks, and do it well. According to a CNN article:
In the 2007-08 flu season, Google accurately estimated current flu levels one to two weeks faster than published CDC reports in each of the nine U.S. surveillance regions, Google said in a statement.

This shouldn't be a big surprise when in the past, according to the same article, trends were determined by:
...physicians' reports of patients with flu-like symptoms, lab reports of influenza from nasal and throat swabs, and death certificates.

I suspect this will also send up early flags in the event of chemical or biological terrorist attacks as well.

Go Google! And kudos to the CDC for collaborating and seeing the potential in non-traditional epidemiology.

Thursday, November 13, 2008

Coming soon: Tele-EMS

A company called SwiftMD has been contracted by a Montana "Preserve" to deliver "emergency medical services, via the phone, Internet or bi-directional video, to all residents and Ameya Preserve employees and their families."

I found this article (essentially a press release) on as part of my daily searches of EMS news. From the article:

SwiftMD, the revolutionary telemedicine firm, today announced that it has been selected by Ameya Preserve in Bozeman, Montana, to be the sole telemedicine supplier for each of the 300 new homes built in its development. Under the terms of the agreement, the first of its kind in the United States, the company will provide emergency medical services, via the phone, Internet or bi-directional video, to all residents and Ameya Preserve employees and their families. Each home will be equipped with all necessary technological components for the service - an important feature as the nearest healthcare facility is 45 minutes away. The homes are expected to be completed in 2011.

Does anyone else think this is as huge as I do?

From the "Conditions we treat" section of the SwiftMD site:
For most members, SwiftMD is they first call they make at the onset of illness or injury. If it could be treated by a routine office visit or a trip to an urgent care center, SwiftMD is an excellent choice. In fact, the majority of routine and urgent care cases can be safely treated by a SwiftMD physician over the phone.

Our services are appropriate for most people from 3 to 69. To ensure patient safety we do not treat other age groups or people with some conditions, including pregnancy-related problems and psychiatric disorders.

When you call our toll free number you will answer a few questions to determine whether or not a telemedicine consultation is appropriate for your condition. If not, you will be advised to visit a doctor for a physical exam, or call 911 if it’s a life-threatening problem. Otherwise we’ll schedule an appointment and you’ll be talking to a SwiftMD doctor within an hour.

It is rare to find me relatively speechless. Quite frankly I am not sure whether to sign up and see if I can buy stock in this company--or wonder about the quality and direction this takes medicine in...

What do you think?

Wednesday, November 12, 2008

If you like lights and sirens you'll love this

Make way for the Howler.

EMSA, an EMS service in Oklahoma, held a press conference today to announce they were installing Howler sirens in their ambulances.

According to an Associated Press article:

"The most frequent thing motorists say to us is they didn't see the ambulance coming," Wells said at a Tuesday news conference, where the new technology was demonstrated.

During the demonstration, two ambulances were parked near each other. A plastic stepladder with three glasses of liquid on top was placed in between the vehicles.

The ambulance without the Howler sounded its siren and produced its familiar wail. Then, the Howler, which produced booms that sounded like a 1980s video game played at an earsplitting level. The liquids in the three glasses rippled. Wells jokingly said the new sirens sounded like "a vacuum cleaner on steroids."

The Howler is sold by Whelen whose literature on the product recommend hearing protection.

"a vacuum cleaner on steroids..." I'm guessing that hearing protection is more than just a good idea.

Monday, November 10, 2008

It is National Collegiate EMS Week

Congratulations to all those providing EMS on college campuses around the country. The event, sponsored by the National Collegiate EMS Foundation, recognizes the hard work and dedication of campus EMS providers.

The purpose of the foundation (from their Facebook page):

Founded in 1993, NCEMSF is a 501(c)(3) non-profit professional organization committed to scholarship, research and consultancy activities and to creating a safer, healthier environment on college and university campuses. Comprised of approximately 200 college campus based emergency medical service (EMS) agencies trained to respond within minutes and provide care tailored specifically to campus emergencies, NCEMSF's purpose is to support, promote, and advocate EMS on college and university campuses nationwide. In addition to providing for the acquisition of medical knowledge, campus based EMS allows student participants to develop certain life skills including leadership, communication, and decision making. NCEMSF provides a forum for communication and creates an environment where ideas can be exchanged and problems can be solved.

I have a special place in my heart for the college services. When I couldn't take an EMT course because I was too young (many, many years ago) I enrolled in a Red Cross Advanced First Aid course taught by members of the Five Quad Volunteer Ambulance at SUNY Albany. What a dynamic and talented group of college students.

I have no doubt that the passion those students showed toward EMS is one of the reasons I am still here today doing EMS.

Happy National Collegiate EMS Week. Remember all you can do. Know the difference you make. We need a new generation...a future...for EMS. You are that future.

Sunday, November 9, 2008

An unexpected cause of hypoglycemia

The FDA recently announced a recall of syringes:

The U.S. Food and Drug Administration is notifying health care
professionals and patients that Tyco Healthcare Group LP (Covidien) is
recalling one lot of ReliOn sterile, single-use, disposable, hypodermic
syringes with permanently affixed hypodermic needles due to possible
mislabeling. The use of these syringes may lead to patients receiving an
overdose of as much as 2.5 times the intended dose, which may lead to
hypoglycemia, serious health consequences, and even death.

The recall applies to the following lot number and product information:

-- Lot Number 813900
-- ReliOn 1cc, 31-gauge, 100 units for use with U-100 insulin

We think of many reasons for hypoglycemia when working a diabetic call...but this one wouldn't even be on the radar screen.

The full article:

FDA Reports Nationwide Recall of Mislabeled ReliOn Insulin Syringes