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Dan Limmer

Dave Page strikes again

Dave Page is one of the brightest stars in EMS today. He is smart, talented, focused, visionary and an amazing educator. My EMS news feeds picked up this story today:

Students get paid to learn to be lifesavers

It is win/win/win when we train people for careers, offer a hand to those who might not be able to afford it and expand diversity in EMS. I applaud Dave and his colleagues for his efforts in the Emergency Medical Services Academy.

I post this coinciding with the confirmation hearings of Sonia Sotomayor for a reason. There is no place for discrimination of any kind--reverse, forward or otherwise in EMS. I would hate to see the issues surrounding the New Haven firefighters having a negative impact on any qualified individual in choosing to follow their passion into the emergency services.

Memories of Love and War

You'll see in my profile that I also wear the hat of a journalist. No one in EMS has only one job, right?

I had an idea which began percolating years ago as I was in the back of an ambulance with an 80-year-old woman during a 30 minute ride to the hospital. I had a precautionary line started and 12-lead done with 25 minutes to go.

This is where many of the excitement-driven medics would languish, longing for the next glimpse of major trauma or cool invasive procedures. Me, I figured we had time to chat.

It turns out this woman was a nurse in World War II. She didn't say specifically, but alluded to coming from a wealthy family in Manhattan. In the 1940s women had certain programmed career choices. She became a nurse. A poster in the hospital said the Army needed nurses stateside for 1 year. What the poster didn't say was after a year and one day she would be headed overseas.

She enlisted and ended up in North Africa seeing battlefield casualties. She spoke little of that; her generation guards their military experience with an iron clad stoicism that has spanned 60 years. I could see between her words, in the pauses where memories remain cloistered, that there was more. I regret never going back to see her. To talk more about that time, listening to more of the memories, even if for my own selfish desire.

While I may have saved a patient or two in my days in EMS, I look back at my time with her as one of the best and most profound experiences in 30 years riding in the back of an ambulance. I think about it often.

I recently returned to the assisted living facility where I met the World War II nurse several years ago. My chance to talk again with her had passed. Knowing this, my goal was to gather more of these memories before they were lost forever. It wasn't an original idea. Many have written and photographed projects before me. It was a personal quest.

I pitched the series to our local weekly newspaper and they went for it. Today's installment brings this blog post full circle. The link below is to an article I did for the Valentine's day edition of the paper. I interviewed three fascinating people about their half-century relationships and how they were affected by war. It is called:

The Generations Project: Memories of love and war

More for the educators...

I'm in awe. After looking at the video in the previous post I wanted to know more about this classroom and professor. I found a video which gives a better idea about the man and his methods.

It is something to aspire to. Imagine your EMS students considering their education a journey rather than a hurdle to get "the card." Imagine probing questions, discovery and insight being part of that journey...and your classroom.

Imagine your students feeling like this:

One for the educators...

I taught an instructor CE class on online learning last Friday (to a great group in Bangor, Maine). One of the statements I made was that our educational system in EMS uses the worst possible methods for the students--and the best for us--or at least the one that makes us feel best and most secure. If you haven't guessed, I am talking about lecture.

Everyone is angry at the AHA for going to the video-driven classes but the AHA is right. We talk too much. Students don't practice and apply enough. Listening to the instructor is one of the worst ways to learn. I'm sorry but war stories have a limited value and only when short and in context. Students need to think, apply and problem solve.

In Maine there are many who oppose online classes (better termed asynchronous learning). When I suggested a hybrid online/classroom-based EMT-I class two years ago you'd think I kicked Johnny and Roy right in the nuts.

My opinion: asynchronous learning can provide better learning than we offer in the traditional classroom when done right...and make it easier for us to reach more people. Doing it right involves well constructed classes, choosing appropriate topics and providing active student/instructor participation.

I believe students text and Facebook in class because they are bored. Students are tech savvy and have outgrown our fascination with PowerPoint long ago (which seems to drain interactivity right out of the classroom unless it is done properly).

My sister-in-law (a teacher and school board member) recently posted a youtube video on her facebook page. It gives an interesting glimpse into the lives of students and some shocking realities for the classroom. Please take a look.

Emergency Care in Japan

I picked up this article from The Japan Times on my daily EMS news feeds.

It seems like Japan is having hospital diversion issues similar to the US--and the rest of the world. From the article:

The deterioration of emergency medical services has become a nationwide worry. In October, a pregnant woman transported by ambulance was refused admission to eight hospitals in Tokyo and died after giving birth. In December, an elderly woman seriously injured in a traffic accident died after she was refused admission to six hospitals in Fukushima and Ibaraki prefectures.

The Fire and Disaster Management Agency's 2008 white paper says that, in 2007, an ambulance took an average of seven minutes to pick up a patient — 0.4 minute more than in 2006 — and 26.4 minutes to take the patient to a medical institution that accepted him or her — one minute more than in 2006. Both times were the worst ever. The 26.4 minutes to transport a patient was 6.5 minutes longer than 10 years ago.

Medics, muscle cars and Margolis

Scott Snyder out at the San Francisco Paramedic Association sent me a link thinking it would be good "blog fodder." He was right:

Paramedics get muscle cars

There are two things I find interesting. First is the "muscle car" reference. It doesn't seem to fit with my thinking on EMS. And lets be real, we could all drive 4 or 6 cylinder vehicles but we'd beat the crap out them and they wouldn't last 18 months. Couldn't take the beating.

I just hope nobody crashes one. The lawsuit will certainly bring out that headline in a negative light.

OK, stereotypes dealt with, I then noticed the reference to advanced practice paramedics. You may recall how that was initially one of the levels proposed in the early EMS Scope of Practice drafts. It was considered impractical, before it's time and taken out relatively quickly.

I remember presentations given by Gregg Margolis about the process and the advanced practice paramedic. We also had personal conversations. I had the good fortune to work for Gregg at The George Washington University. Gregg was an advocate for the APP. I think that it is important to note that the advanced practice paramedic concept has resurfaced.

I think most changes in EMS will be evolutionary, not revolutionary. Gregg was looking for a revolutionary change. One that would have given EMS increasing professionalism, more training and responsibility and perhaps most importantly, a career path.

Gregg worked on a revolution and didn't get it the first try. But when someone tries for something lofty but worthy, people notice. It is like planting a seed. The APP concept in Raleigh likely isn't the full scope of the original concept, but it is a sprout from the seed Margolis (and others) planted.

I just thought it was important to mention this evolutionary step toward a revolutionary vision. Good happens slowly. Sometimes imperceptibly. But it seems to be happening here.

Thanks, Gregg. You are good for EMS. Revolution or not.