Money Smart Medics Part 1: How I Got Here

The Excuses

For those of you that have been following my blog, the title probably shocked you a little bit. I have never written about money management, and for a very good reason: I sucked at it. Until about a year ago, my version of budgeting included swiping my debit card until it quit working, which usually indicated that my account had gone so far negative that the bank decided it wasn’t worth the risk to continue trying to profit off my stupidity.

But it wasn’t my fault….

God, no. It couldn’t be. It was the economy, the child support, the ridiculously low EMS salary, the taxes, the gas prices, the “unexpected”, etc. You name it, I had an excuse. (Roll the Blues Brothers scene where Jake is giving his ex fiance all the reasons he didn’t make the wedding….)

I was always behind on my bills, and my checking account became very accustomed to the color red. When I would get paid, looking at my account  balance made me feel like the swimmer in the ocean getting pulled down by the current, struggling to get his head above the water for a breath, only to get pulled right back down moments after getting a sweet taste of that precious oxygen. The cycle continued every 2 weeks.

It didn’t matter how much overtime I worked, I never got ahead.

Ahead…..what was that? To me, “ahead” was something that I would never accomplish. Hell, the word “current” even seemed like a pipe dream. Unless I somehow stumbled into a huge pile of money, my situation was never going to improve. Well, so I thought.

My breakthrough moment was the day I showed up to work with no money, no food and not even enough gas to get home. It was still a week from payday and I had no idea what I was going to do. This wasn’t the first time I had been faced with these circumstances, but over the following 24 hours I would be hit with the biggest reality sledge hammer that I had ever seen.

The Worst Financial Day Of My Life

Having no money or food wasn’t always the end of the world for me. After all, the local hospital fed us lunch and breakfast for free and many of the hospitals in the neighboring city provided all kinds of snacks and meals. You can say I was quite the connoisseur of the free EMS handouts. However, forces much stronger than my resourceful skills made sure that I never came anywhere near any of the hospitals. By 2 pm I was starving. My partner sensed that something was wrong and offered to buy me lunch. I lied and told him that I wasn’t hungry.

At one point in the late afternoon, I arrived at the station just in time to see a tow truck pulling into the employee parking lot. My heart sank. I knew for sure he was there to take my car. After all, I had been ignoring the bank’s calls for weeks. My spirits were lifted a little bit when I realized he was just using the driveway to turn around. Still, I knew it was coming and seeing that truck gave me a level of self-disgust that I had never felt before.

2 hours later, my phone shut off. Fortunately I was able to sweet talk Verizon into giving me 3 more days of service with an empty promise to pay off the entire balance by the weekend. Of course, I did this while hiding in the back of one of the ambulances in fear of one of my coworkers hearing me.

The final straw was getting a call from the local courthouse to inform me that if I didn’t pay my traffic ticket off within 48 hours, a warrant would be issued for my arrest.

I lost it.

I cried, I prayed, I begged, I did everything I could hoping that God would snap his fingers and make this horrible situation go away. What I didn’t realize, is that he was doing just that.

I Never Looked Back

As I left the station in my car (that was running on fumes), I took a long, deep look at my situation and wondered why I was where I was. Then it dawned on me. It’s my fault. While this may seem so simple, it was the epiphany that drove me to change. I suddenly felt empowered. I was going to beat this and I was never going to look back.

A couple weeks prior to this particular incident, I heard a fellow blogger and friend mention Dave Ramsey on a podcast. He talked about how he had struggled to make ends meet and he was making over $100,000 a year! He talked about how he completely turned his life around just by modifying his behavior. I kept playing his story over and over in my head on that drive home. It was my story. I wasn’t alone. I reached out to him and asked for help. As it turns out, he had just started a financial coaching business. I immediately signed up.

As I sat down to meet with him for the first time, I was a nervous wreck. Finances were NOT something I felt comfortable talking about, and you can probably imagine why. I expected to see him fall out of his chair in disgust as he looked over all my finances. I felt like my 10-year-old self, crouched down, bracing for impact the moments before my father ran that leather belt across my backside for something stupid I had done. I was surprised to hear him say “This isn’t so bad. You’re just unorganized”. I pulled my arms off my head, sat up straight, slowly raised my head, opened one eye and quietly uttered the words “really?”

Really.

We sat there well beyond my allotted hour and hashed out a written budget. It all made sense. I was going to do this. The next morning I immediately got on the phone with my bank, my cell phone company, my car insurance agency, and the courthouse. I didn’t make excuses and I didn’t make false promises. I told them the truth. I worked out deals with them to get on plan to get caught up. A plan I could work with. And I did it. My bank actually reversed enough overdraft fees to put me a couple hundred dollars in the black. I carefully budgeted the small amount of money I had on hand to make sure I could get by until payday and I stuck to it.

A month later I had $300 saved up for emergencies and I was caught up on all my bills. Caught up! The next few months were spent building up my emergency fund and then tackling my debt. My budgets weren’t perfect, but they worked. I just wish I could tell you how amazing it felt to lift that weight off my shoulders. I was a new man.

Here I Am

Over the last year I have made amazing strides towards learning how to manage money. Am I perfect? No. Do I still make mistakes? Absolutely! But one thing is for sure, I’m never going back where I came from.

Once I got my financial situation in line, I realized something that I had long forgot. I love being a paramedic. I guess when you’re over your head in personal disaster, it’s hard to see past your own problems, and it’s nearly impossible to help others with theirs. I also realized that I don’t have to leave EMS to be financially secure. I can do the work I love and plan for a healthy lifestyle with a comfortable retirement. And THAT, my friends, is exactly what this series is going to be about.

Learning how to manage money has turned my life around. I have developed a strong passion for personal finance and I have been extremely eager to share what I have learned with everyone. That’s why I started the Money Smart Medics campaign. I know there are plenty of people out there just like me and I want to help. Every Monday I will be posting personal finance articles on this blog. They will be mainly geared towards EMS professionals, but I’m sure anyone will be able to find use in them. I’ll be talking about saving, budgeting, insurance, investments, bargain shopping and a whole lot about preparing for retirement.

I really hope you enjoy this series. I’m really going to be looking for feedback, so please e-mail me or find me on social media to let me know what you think.

Thank you so much and stay tuned!

If Eric Holder Was A Paramedic

Eric HolderOur Celebrity Medic this week has certainly seen his ups and downs throughout his career. From botched gun running operations to investigations of high-ranking political officials, he has certainly experienced his share of stress on the job. With his career surely coming to an end in 2016, it leaves many of us to wonder if he will enjoy retirement or seek employment outside of the justice department? Perhaps a career change to EMS would be in order? That leaves us with no choice but to ask the famous question of the week:

What kind of paramedic would Eric Holder be?

Mr. Holder wouldn’t go though the standard hiring process that many services utilize. Instead, he would be appointed by the sitting director and most likely remain until new management took over. This of course, could mean lighter restrictions and less accountability while at work if he had helped the director promote to his current position.

Standard protocols would prove to be ineffective for Mr. Holder being that he doesn’t work well with stringent rules. Instead, he would adopt a new “patient care constitution” that would be interpreted differently by different groups of people. Of course, only the sections that the director deemed relevant or important would be followed. Any changes made to the treatment guidelines would require a two-thirds majority vote from the paramedics employed at the ambulance service.

While traditional paramedics hand off thorough written and verbal reports at the hospital, Mr. Holder would require a subpoena to appear at the bedside before he provided any information. Of course, only information that he felt was pertinent would be delivered.

Patient privacy would never be an issue for Mr. Holder. In fact, it would be nearly impossible to obtain patient care records. Even in cases where court orders demand the release of such documents, the director would declare executive privilege, preventing their release.

Working the streets as a paramedic would allow him to implement a drug-running operation aimed at tracking pain medications to high-level dealers. This would be very similar to the infamous “Fast and Furious” operation. Only this time, his operation would most likely be called “Quick an Painless”. Given his previous experiences, he would have to take careful steps to ensure his narcotics didn’t turn up at the scenes of any drug overdoses.

In conclusion, Mr. Holder’s ability to maintain privacy, strong political backing, flexibility and willingness to try outside-of-the-box projects all make him a perfect candidate for a job in EMS.

Have an idea for next week’s Celebrity Medic? E-Mail me at sean@medicmadness.com  

 

How Writing May Have Saved My Career

There’s a new post up at Uniform Stories featuring yours truly. I’m really excited to announce that I’ll be writing for them on a bi-weekly basis. This is really a huge blessing for me as I try to take my writing to the next level. None of this would even be remotely possible if it wasn’t for everyone that continues to come back and support this blog every day. Ya’ll (I can say that now that I’m in Texas) are freaking awesome!

In this article I talk about an incident I had a number of years back when I tried to pronounce a patient dead on scene after failed resucitation attempts and was overruled by the ER physician. The ER doc’s decision saved the patient’s life. Go check out the article to see what kind of emotional toll that had on me and how blogging may have been the one thing that kept me in EMS.

Check it out: How Writing May Have Saved My Career

If Al Sharpton Was a Paramedic

Our Celebrity Medic this week is no stranger to tragedy. With all the violent crime in the streets, he has no problem keeping his travel schedule full. Chances are, he will never find himself in a position to need a new line of work. But what if he got tired of his life in the spotlight? What if he decided to seek a more hands-on approach to responding to tragic events? Sure, he might need some training, but a transition to EMS would be right up his alley. So without any further delay, let’s ask ourselves the big question of the week:

What kind of Paramedic would Al Sharpton be?

Training for Al Sharpton would be tricky as most people wouldn’t be sure exactly what his qualifications were. While most paramedics train to thoroughly examine every patient before developing a clinical impression, Rev Sharpton would instead train to find only specific clinical signs to support a pre-determined diagnosis. It should also be noted that his patients would be screened before hand for these specific clinical signs before he would agree to respond.

Traditionally, paramedics responds to all calls for assistance. These might include – but are certainly not limited to – heart attacks, strokes, asthma attacks, pregnancy emergencies, trauma and even minor viral illnesses. Rev Sharpton would be unique as he would most likely specialize in trauma, more specifically, acts of violence. He would also stray from the long-standing belief in EMS that everyone is to be treated regardless of race, sex, religious beliefs or sexual orientation. Instead, his patient qualification criteria would exclude the Hispanic population, Caucasians, and people of Asian descent. African Americans would be his primary focus, however they could be disqualified for service if harmed by a member of the same race. Given the scarcity of patients that meet his criteria, he would have to expand his response area to include the entire United States.

Rev Sharpton would not have a need for the traditional lights and sirens that traditional emergency vehicles have. Members of the communities that he was responding to would be notified ahead of time via press-releases and therefore would have plenty of time to yield the right-of-way for his arrival.

Radio reports and patient-care documentation would be a thing of the past. Rev Sharpton would instead utilize press-conferences, FM radio monologue and speech rallies to deliver patient information to the receiving hospital. The ER staff would certainly know of his arrival as he would tend to make a large entrance. However, they would be surprised to find that he would quickly and quietly leave the facility without saying a word to anyone.

Joining Rev Sharpton at his new ambulance service would be none-other than the famous Jesse Jackson and possibly Michael Bloomberg. Dispatch would be handled by Barack Obama and Eric Holder. Together they would start the first official Racial Tension Task Force (RTTF). While many would speculate that this group would work well together, people might be surprised to find that Rev Sharpton typically works better alone.

In conclusion, we can clearly see that Al Sharpton’s experience dealing with tragedies, background in communication, and ability to quickly assess situations without clear facts or evidence would make him a perfect fit for a job in EMS.

Have an idea for the next Celebrity Medic? Comment below or e-mail me at: sean@medicmadness.com

Why Paramedics are Going to Lose Intubation

I’m sure the headline of this article will have many people lighting up their torches and sharpening their pitchforks, but hear me out before you burn my village down. Most of us have heard and most likely participated in the heated debate about whether or not paramedics should be intubating in the field. If you’ve been reading my blog for any amount of time, you know that I’m no exception. Do I think our industry falls short when it comes to airway management training? You bet. Do I think the solution is to eliminate intubation from the standard scope of practice? No, I don’t. However, we are going to be left with little choice unless we get over ourselves and make the necessary changes to improve our competency in airway management.

I recently read an article by Dr. Minh Le Cong on the Prehospital and Retrieval Medicine blog asking what the “gold standard” of airway management is for paramedics 1. Had I read this article 10 years ago, I would have been painting my face, soaking my torch in kerosene and rallying the villagers to start the witch-hunt.  Now after a decade of involvement in management, Q.A. and EMS education, I simply nod my head in agreement. Let’s face it guys, we have some serious work to do. Our educational systems, clinical sites, monitoring procedures, and most importantly, attitudes are all killing us when it comes to airway management.

Allow me to elaborate….

Initial advanced airway management training for paramedic students is highly inadequate. Studies have shown that it takes ER physicians anywhere from 18-35 successful monitored intubations to be considered “competent” and somewhere around 47 to be “good” 2. Anesthesia residents obviously require much more. Paramedic students? Well, the National Standard Paramedic Curriculum recommends 5. Mind you, paramedics traditionally perform the skill with much less frequency and in much less desirable environments, yet we are expected to be “competent” in the skill. Do you see a problem with that? This is unacceptable and we have to find a way to change this. Having said that, I have to point out some serious obstacles that we face in gaining more monitored experience. 

Hospitals and anesthesiologists aren’t exactly making this easy for us. We already have to compete against medical students for intubations during O.R. rotations and fewer and fewer anesthesiologists are allowing paramedics to perform the skill under their supervision. That’s a huge problem and I could write several blog posts on that topic alone. We are also missing out on opportunities as alternative airway devices are taking the place of ET tubes in many procedures. Clearly, getting over this hurdle isn’t going to be easy but something will have to change if we are going to increase our educational standards.

Another issue we have is continuing education and monitoring. Once our paramedics clear their initial training, many of our systems just cut them loose and hope for the best. A few years back, I worked for an EMS service that has a very unique coverage area. Depending on your assignment, you could find yourself working in a busy metropolitan area, or an extremely rural area with a very small call-volume. I knew a few paramedics in the rural stations that went nearly 2 years without attempting intubation. Nothing personal against those paramedics, but do you honestly think they possess the competence and / or confidence to handle a difficult intubation? More importantly, do you think anyone was watching over them to make sure they were practicing the skill enough to maintain competency? The system I mentioned only deploys one paramedic to every call. Imagine a fire-based system that deploys several paramedics to every call. We’ve already established that our paramedics aren’t intubating enough when they are the only advanced provider on scene, imagine having to split that skill between 4 paramedics.

We need to be monitoring our paramedics to make sure they are performing the skill enough to maintain competency. If they aren’t, we need to bring them in for monitored practice and refreshing. We also need to be doing quarterly airway training. The Law Enforcement community figured out a long time ago that most of their officers will go their entire career without firing a shot. They also recognized that if that time came, they had better be able to react appropriately and hit their target. That’s why they have to qualify with their firearms quarterly. We need to be doing the same.

One of the biggest things we need to change is our attitudes towards airway management. Back in 2010, there was a panel discussion on JEMS.com about the issue. I think William Gandy hit the nail on the head when he said: “Paramedics should be thoroughly schooled in airway evaluation and should have a variety of airway adjuncts, such as bougies, video laryngoscopy and supraglottic airways, available and be willing to use them3. The 4 words to take away from that sentence are “WILLING TO USE THEM”. I’m going to come right out and plead guilty to previously possessing the mindset that airway management revolved around direct laryngoscopy and that the use of any additional tools somehow made me less of a paramedic. Many of us in EMS still possess that mindset and it is killing patients.

If police officers approached every aggressive subject thinking “should I shoot him?” as opposed to “how can I stop the threat?” we would have a lot more officer-involved shootings. The same goes for airway management. We think we are doing our patients good by intubating everyone that presents with anything above a moderate level of distress. The truth is, we aren’t. In the cases where intubation is actually indicated, we have a huge potential to save a life. However, using the tool prematurely or inappropriately can be extremely detrimental and often fatal. For example; the bad CHF or COPD cases. These people often can’t come off the ventilators and therefore wind up dying in the ICU. In those specific cases, we need to be trying everything from medications to CPAP before even considering intubation. Just like the law enforcement analogy, we can’t approach every patient thinking: “Should I tube them?” Or even worse: “Can I tube them?” We need to be thinking about how we can improve ventilation and oxygenation. 

When it comes to intubating, we have this terrible habit of making it as difficult as we possibly can. Every time I hear the “we intubate in ditches while it’s raining” BS, I wan’t to choke someone. Why on Earth would anyone elect to intubate anyone in anything but the most convenient and practical location possible? I’ll tell you why: Because we don’t take it seriously. While there are those select few times that we will find ourselves forced to intubate in difficult environments, they are extremely rare and should be avoided at all costs. With every time that we place a blade we are causing damage, pain and potentially negative neurological effects such as increased ICP. We need to be approaching every case with the intention to intubate on the first try. That means having suction ready, having different size blades nearby, properly positioning the patient and using apneic oxygenation. It also means getting off our high-horse and using every available tool to make the intubation as easy and safe as possible. Got a bougie? Use it! Got a video laryngoscope? Then why in God’s name are you using a regular laryngoscope? The “I don’t need it” attitude is dangerous and it kills patients.

If you’re a paramedic working in the field, don’t wait for your employer to hold your hand and force you to practice. You can be the change we need. Stay up to date on your skills. Take 30 minutes each month and go practice on the airway manikins. Talk to your medical director and ER docs and see what you can learn. Whatever you do, don’t just sit around and complain that “The Man” is trying to take away your ability save lives and stamp out disease. If you read the previously mentioned JEMS panel, you will see that nobody is out to abolish prehospital intubation…..yet. That can and will change if we continue down this path.

Notes:

  1. Prehospital Airway Management – What is the Gold Standard? | Prehospital and Retrieval Medicine
    -http://prehospitalmed.com/2014/07/18/prehospital-airway-management-what-is-the-gold-standard/
  2. Laryngoscopic Intubation: Learning and Performance | PubMed
    -http://www.ncbi.nlm.nih.gov/pubmed/12502974
  3. Experts Debate Paramedic Intubation | JEMS
    -http://www.jems.com/article/patient-care/experts-debate-paramedic-intub

If Willie Nelson Was A Paramedic

This week’s Celebrity Medic has certainly seen his share of rough times, but will most likely never have to seek employment again. That is, unless he gives the finger to the IRS forgets to pay his taxes again. With Willie’s extensive knowledge in herbal remedies, experience working on a bus and ability to work with old, broken equipment, a job in EMS should be right up his alley. So without further delay, it’s time that we ask ourselves the almighty question of the week:

What kind of Paramedic would Willie Nelson be?

Even though his heroes have always been cowboys, his mamma certainly didn’t want him to grow up to be one. The truth is, a career of helping people has always been on his mind. All this highwayman really needs is an old bus and a good hearted woman to work with.

While most paramedics often seek an easy day shift, this midnight rider would most likely prefer the night life. Many people would call him crazy for working those kinds of hours, he’ll gladly pound the pavement until the the party’s over and the blue skies bring him sunshine. At that point he’ll be clocking out and headed home for a Bloody Mary morning in the city of New Orleans.

Willie’s coverage area certainly wouldn’t be limited to a single city or county. From the Mendocino County Line, to Luckenbach, Texas and even the seashores of old Mexico, this desperado would be on the road again at the first sign of trouble. Of course, with Georgia on his mind, expansion into new territories would always be a possibility. There would be no need to build stations when he could just stay at the Heartbreak Hotel.

Medical billing is no easy task, and Willie’s ambulance service is no exception. However, with Medicaid and insurance reimbursement at an all time low it would be safe to say that his bucket’s got a hole in it. To address this cash-flow problem, Willie would stop accepting forms of insurance and government aid. Instead, he would operate on a simple cash-pay system where if they had the money, he’d have the time.

At the end of the day, he’d clock out, travel down the lost highway and roll right into his sweet baby’s arms to help him make it through the night once again.

Have an idea for next week’s Celebrity Medic? Comment below or e-mail me!

Could you do me a small favor?

Over the last few months, I have really tried to evaluate what I’m doing on this blog and where I want to take it. I have some exciting goals and plans including a possible podcast, e-book, and a new article series.

I would really like to gather input from everyone who follows my blog as I move forward with growing and improving. I have put together a quick 7-question survey and I would REALLY appreciate any feedback that you have to offer. You can complete it here on this page or by click the following link:

http://seaneddy.polldaddy.com/s/reader-survey

Thanks a bunch, guys!

Take Our Survey

Ebola and What It Means For EMS

Yes, I have an opinion on whether or not we should bring American citizens with Ebola home for treatment, and trust me, I’ll get to that. However, I’m going to discuss a few things about the virus and what it means for us in EMS.

As most of you know, there is tons of hysteria over the decision to bring our citizens home for treatment and plenty of fear that doing so is going to open us up to risk for an outbreak on U.S. soil. Well, that threat has existed ever since the discovery of the virus and it continues today. As it currently stands, we aren’t at a very high risk for infection. However, these outbreaks show us that these diseases are out there and that we need to educate ourselves on them and take the necessary precautions.

Ebola Hemorrhagic Fever (Ebola HF) is a viral hemorrhagic fever that is severe and often fatal to humans and animals. The exact natural reservoir host isn’t known but it is believed to be bats. What the CDC does know, is that it originates from animals. 1

The virus is NOT airborne. It is transmitted through direct contact with blood or other bodily fluids. Typically, those at risk of infection are people that are close to the infected patients, like close family members and healthcare providers. 2 It has an incubation period of approximately 21 days with symptoms showing up anywhere from 2-8 days after the infection. So far, the virus has been found to be non-contagious prior to the onset of symptoms. 3

Some of the symptoms include:

Early Symptoms:

  • Arthritis
  • Backache
  • Chills
  • Diarrhea
  • Fatigue
  • Fever
  • Headache
  • Malaise
  • Nausea
  • Sore Throat
  • Vomiting

Late Symptoms:

  • Bleeding from eyes, ears and nose
  • Bleeding from mouth and rectum
  • Eye swelling
  • Genital swelling
  • Increased feeling of pain in the skin
  • Rash over the entire body that often contains blood
  • Roof of mouth looks red

Source: Medline Plus 4

So what does this mean for EMS? Well, not much. As it currently stands, our risk of exposure is pretty low. However, when we run into patients with unexplained symptoms as described above, it would be good practice to ascertain whether they have left the country recently or been exposed to anyone that has. Of course, proper isolation precautions should be utilized. For situations where the Ebola Virus or other similar infectious diseases are suspected, gloves, gowns, masks and eye protection should always be worn.

Now that I’ve given you the facts, let’s talk about my opinion a little bit…..

I have to admit, I can’t help but shake my head when I read all the fear and massive hysteria over the decision to bring infected patients back to U.S. soil. I can understand the concern, being that we have never had an infected person in our country, but the disrespectful meme comics and doomsday predictions are nothing more than ignorant and absurd. Like I mentioned earlier, the risk hasn’t changed. If we are going to worry about infected patients entering our country, we need to focus on the ones entering through our borders, not the ones flying in on state-of-the-art medical aircraft wearing air-tight space suits.

There is always the possibility of an infected person arriving on an airline, however given the several layovers, long periods of travel, short symptom-onset, and heightened screening measures, it’s unlikely that someone will reach our country before diagnosis. Even if they do, let’s remember that this disease isn’t airborne, so they aren’t going to be infecting everyone that passes by.

The second theory, and scariest in my opinion, is the possibility of a terrorist attack. When our enemies are willing to strap bombs to their chest, we certainly can’t overlook the possibility of intentional infection with the intent to spread. Having said that, conventional air travel isn’t typically possible for this group of people, therefore greatly extending their travel time to the United States. Once again, with the short symptom onset and no treatment rendered, it would be highly unlikely that they could reach the western hemisphere before becoming incapacitated. Is it a threat? Sure. Is it likely? No.

Now, back to the Americans with the Ebola Virus……seriously guys, let’s kill the panic. The disease isn’t airborne and these patients aren’t walking the streets. In fact, they are in the ONE place where spreading the disease is virtually impossible. They aren’t freaking zombies, they’re U.S. Citizens. It’s going to be in our best interest to get real hands-on experience treating infected humans. We can only go so far treating monkeys in a lab. If everyone is so worried about a future outbreak in the United States, then wouldn’t be in our best interest to learn as much as we can about this disease?

The bottom line is, we will be fine. Just like every other time these outbreaks have occurred, we will see it die down. Only this time, we’ll have physician and another medical professional survive because of the treatment we made available to them. It’s a win for everybody.

Notes:

  1. About Ebola Hemorrhagic Fever | Center for Disease Control and Prevention
    -http://www.cdc.gov/vhf/ebola/about.html
  2. Ebola Hemorrhagic Fever – Transmission | Center for Disease Control and Prevention
    -http://www.cdc.gov/vhf/ebola/transmission/index.html
  3. Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire | NCBI
    -http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766904/
  4. Ebola Hemorrhagic Fever | Medline Plus
    -http://www.nlm.nih.gov/medlineplus/ency/article/001339.htm

Arming Medics: The Podcast Debate

Image Credit: EMSWorld.com

Last week I had the opportunity to once again join Scott Kier on the EMS In The New Decade Podcast. Our topic was EMS personnel carrying firearms. Yep, THAT topic again. Nothing gets my blood pressure up like a good gun debate and this podcast episode was no exception. Joining us was Chris Montera, host of the EMS Garage podcast. As most of you know, I hold the opinion that we should be allowed to carry. Chris, feels very strongly to the contrary. Mix us together on a podcast and you get 55 minutes of intense debate.

My opinion on this subject has changed a few times over the years. For the most part, I have been in favor of EMS personnel carrying firearms, however I had held this opinion with a healthy dose of skepticism. Like many people, I feared that the less-than-mature of us might abuse the responsibility and end up killing someone unnecessarily. As more states and services started allowing their providers to carry, I realized that the scare might have been over nothing. After all, we hear the same thing from opponents of open / concealed carry every time a state lifts a carry ban. Everyone predicts massive bloodshed, and it keeps not happening.

Another thing I realized is that we keep making decisions based on the abilities and expectations of “that guy”. You know who I’m talking about. We all work with “that guy”. The one that pushes every rule, questions every policy and always finds himself in the hot seat for something that “wasn’t his fault”. Don’t get me wrong, this is a legitimate concern. However, it should open our eyes to a larger problem: Us. Lets face it, we have low standards and we need to do something about it. When we are left with no choice but to default to the lowest common denominator every time we write protocols or policies, we have a big problem on our hands. I worked in the State of California for over 8 years and the EMS industry was essentially frozen out of fear that “that guy” wouldn’t be able to handle new or advanced procedures. Only, instead of “that guy”, it was more like “that department” or “that county”. Instead of shaping up or shipping out, we all got dumbed down to lowest level in a ridiculous effort to play it safe.

So where exactly do I stand on this? I believe that my right to defend myself shouldn’t stop at the time clock. HOWEVER, being that my employer is ultimately responsible for my actions while on duty, I do believe that they should have the ultimate say on whether or not we are allowed to carry. Until we find a way to relieve the legal liability from the employer, I simply don’t believe that it would be fair to tie their hands and force them to roll the dice and hope that we don’t screw up. I’m not opposed to additional training and I’m certainly not opposed to monthly or quarterly qualifications. Hell, I think we should be doing that with half of the skill sets that we utilize as EMS professionals. Open carry creates a problem for us as our attention would have to shift towards weapon retention. In my opinion, concealed carry would be a better and safer option. I’m not asking to issue guns to every EMT and paramedic, I’m just asking that my employer be given the option to allow me to carry a concealed weapon that I’m already licensed and legally able to carry.

When I bring this topic up, I am often advised that if I want to carry a gun, I need to go be a cop. I’ve heard it a thousand times and this podcast was no different. Here’s the thing: If anyone becomes a cop for the sole purpose of being able to carry a gun, then they are dangerous and have no business anywhere near law enforcement. The games for the crowd that becomes EMT’s so they can drive fast. I’m not looking to expand my role as a paramedic. I’m not looking to track down bad guys and turn my profession into a modern day group of vigilantes. I just want the means to protect myself. For the most part, I don’t think EMS is THAT dangerous of a job. Having said that, neither is going to the bank or the grocery store. Am I walking around every day in fear that I’m going to need to protect myself? No, but I do know that bad things do happen to good people. Just like the fire extinguisher in my ambulance, the seat belt and airbag in my car, and the accidental death policy taken from my paycheck every month, I hope to never use it. But if a situation should arise, I would like to have the option to be prepared.

The interesting thing about this debate, is that party lines don’t exist. Chris Montera is an avid supporter of the 2nd Ammendment and concealed carry. He makes that clear at the beginning of the podcast. Like many of us, he feels that allowing concealed carry would have a negative effect on our image and of course, he worries about “that guy” killing someone and bringing a negative public opinion of our professional. Those are very legitimate concerns and I certainly respect his experience and opinion. Overall, it was a great debate. I walked out with a black eye and delivered a few good blows as well. If this is a subject that you are passionate about, then you won’t be disappointed by this podcast.

Check out the podcast by clicking the link below:

Episode 14: Should We Arm Them? [EMS In The New Decade]

Product Review: CPR RsQ Assist

CPRRsQAssist[Video review at the bottom of the post]

A few weeks ago, I received this handy device in the mail to test out. The CPR RsQ Assist is essentially what the name says: A CPR assist device. The idea behind it is to guide lay-rescuers through CPR and to reduce fatigue. From what I found, it does both very well. More on that in a minute….

Opening the Package

The CPR RsQ Assist comes ready to use. No need to assemble or install batteries. It comes packaged in a round, plastic carrying case that’s easy to open. The case is handy for storing the device and keeping it free from dust or other objects that might damage it. So far, I have kept mine stored in the back of my SUV and it has held up against me tossing in work gear, music equipment and even firewood.

Using the Device

For EMS providers and rescuers trained in CPR, using this device should be a no brainer………just put the device on the chest and start pumping.

For the lay-rescuer or bystander with no CPR training, it has a button in the center of the device that activates voice prompts to guide the rescuer through chest compressions. The device even gives voice prompts to help rescuers keep compressions going at a rate of 100 per minute. Pretty cool if you ask me.

Being that the manufacture promises a significant reduction in fatigue, I decided to put it to the test. I pulled out the CPR manikin at work and did a couple rounds of 200 compressions using the CPR RsQ Assist and then did the same using the traditional method with my hands (after plenty of rest between sessions). I can honestly say that it felt like I exerted myself far less when I used the CPR RsQ Assist. Of course, I don’t have any scientific data to back this up, just my personal experience.

Field Application

The CPR RsQ Assist is certainly a good investment for lay rescuers and businesses that see a large amount of people passing through their property on a regular business. While the device isn’t specifically marketed to first-responders, I think it could actually be of great benefit to rural providers who might be waiting a long time for an ambulance or extra help to arrive. The reduction in fatigue should equate to longer periods of quality CPR, which ultimately leads to increased chances of survival. At less than $100 per device, it should fit most budgets.

Information and Purchasing

For more information on the CPR RsQ Assist and for purchasing, you can visit their website: www.cprrsqassist.com

The CPR RsQ Assist can also be purchased from Amazon.com for $79.50: CPR RsQ Assist Hands-Only CPR Device