Do you even save lives, bro?

Overheard at the tire shop while attempting to get a flat repaired on our ambulance:

Store Clerk (interrupting the mechanic that’s helping us): “How many lives have you guys saved today?”

Sean: “Everyone’s healthy so far today.”

Clerk: “Do you guys see some crazy stuff, or what?”

Sean: “We have our good days and bad days, fortunately today has been peaceful.”

Clerk: “So you haven’t seen any crazy, mangled, bloody people today? That’s no fun! What’s the worst thing you’ve ever seen, bro?”

I don’t know why this scenario continues to get under my skin. I got over being called an “ambulance driver” years ago and I have accepted the fact that everyone assumes that I’m either a firefighter or that I want to be. However, I simply can’t seem to shake the irritated feeling I get when I hear that ignorant statement.

I can’t help but wonder if we are to blame for this. Most people wouldn’t dream of asking that question to a Child Protective Services agent or a counselor that works with battered women. Is it the “adrenaline junkie” label that many of us so proudly wear? Perhaps we are over-glorifying our profession. I have yet to see a C.P.S. agent or counselor hype their jobs up or refer to themselves as “emotional junkies”. I can’t figure this one out.

When this conversation comes up, it takes every ounce of self control not to honestly answer their question. I have to remember that they are expecting some answer that involves someone getting decapitated or shot. Maybe even a funny story. They aren’t wanting to hear about the child we had to leave lifeless on the icy bridge because there were too many other critical patients that had a chance of survival. They probably also aren’t interested in hearing about the 6-month-old sitting in a car seat in the back of the ambulance while we do CPR on his mom.

So what is the worst thing I’ve ever seen? I don’t have an answer for that because I choose not to make comparisons on the things I’ve witnessed during my career. That would require me to dig up some of those memories, and I really have no desire to do that.

Does anyone else feel this way?

The Dual Medic Dilemma

I have spent the overwhelming majority of my career as a paramedic working in single-medic systems. I had EMT-Basic partners and for the most part, all of the Fire Department first-responders functioned at the EMT-Basic level. That meant that I was ultimately in charge of every call. Assessments, documentation, and advanced-level procedures were all my responsibility. It was a great experience and it made me the medic I am today.

Now I work for a service that only employs paramedics, and I absolutely love it. I have a very experienced and well educated partner and we work seamlessly together. I only have to attend every other call and I have a second set of hands to perform ALS-level procedures during critical calls. For me, it’s a dream come true.

Here’s my dilemma……

While I love working in a dual-medic system, I can see that one of the reasons it works so well is because the majority of us came from a single-medic environment. Most of us spent our careers having to be responsible for all aspects of patient care. Yes, we made mistakes and we all had to learn hard lessons along the way, but we aren’t afraid to act. None of us have seen it all, but I can say with confidence that most of us wouldn’t hesitate to take on any scenario that comes our way. Would I be able to say the same if had we all come up working in a dual-medic system? I really don’t know.

I have always been of the opinion that having too many paramedics on scene (on a regular basis) can actually be detrimental to the quality of care provided. While many argue that 2 heads are better than one, I see it another way. Yes, it is nice to be able to bounce ideas off one another, but at what point does a resource become a crutch? Throughout my career, I have worked with plenty of paramedics that started out in systems that made it a practice to deploy multiple paramedics to every call. Some of them turned out fine, but in my experience, the majority of them struggled when it came time to make decisions and act independently. When everyone functions at the same level, it’s easy to hide weaknesses. For example, if I’m not very competent in a certain skill or area of care, it would be easy to “delegate” those tasks to another provider while I do something I’m more comfortable with. While I don’t encourage people to perform procedures that they are confident in, avoiding it all together doesn’t fix the problem.

Let me bring you back to a couple experiences I had as a brand new paramedic:

I had been working on my own for 1 week. We were dispatched to a call for a cardiac arrest. When we arrived on scene, I was absolutely shocked to see a sheriff’s deputy holding a 6-week-old baby in his arms, doing CPR. I was told this patient was an adult prior to our arrival. This was my first time not only intubating a child, but also running a critical pediatric call all together. I was scared out of my mind, but I had to act. I knew what to do. I had trained long and hard for that call, I was just scared. I had no choice but to overcome my fear and treat that child, and I did just that. Would I handle that call better today than I did 10 year ago? Absolutely, but at that time, I did the best I could and I’m confident that the outcome would have been same had I responded today.

Another scenario was 3 weeks after being released to work on my own. We responded to a lady in active labor. Being that this was her 10th pregnancy, with one time being twins, I made the decision that we were going to load her up and drive that ambulance like we stole it. The problem was, the baby started coming out as soon as I loaded her into the back. I gowned up, elevated her hips, put on my gloves and mask and probably repeated the words “Okay, Ma’am, Okay….” about 100 times. I was sweating profusely and could hardly get a word out. I don’t know why, but the thought of delivering a baby on my own scared the hell out of me. At one point, the lady actually placed her had on my shoulder and said “relax kid, It’s going to be fine. I’ve done this plenty of times. I’ll get you through it.” And that she did.

Both of those scenarios scared the living crap out of me, but only once. When I ran the 6 month old in cardiac arrest with a complete airway obstruction 7 months later, I was ready. Sure, it was scary, but I didn’t lock up. I was confident in my ability to treat that child and I can honestly say that I wouldn’t have changed a thing about that call had I ran it today. Likewise, when I responded to the woman delivering triplets over an hour away from the nearest hospital, I was ready. Could I say the same had I been able to take the path of least resistance and allow a more experienced paramedic to take control of those 2 calls? My guess would be no.

I’m simply torn. I absolutely love the system I work in, and when done right, I believe it’s one of the best ways to deliver quality patient care. I’m just not sure how to overcome the issues that a dual-medic system brings.

I would love to hear your thoughts and experiences. Do you, or have you worked in a dual-medic system? If so, how do you ensure that new paramedics are ready to function independently and with confidence?

If Lois Lerner Was A Paramedic

If the only things in life that are certain are death and taxes, then our Celebrity Medic this week is going to be a perfect fit in the EMS field. With scandals on the rise, data being lost, and public scrutiny at an all-time high, I think the time to consider a new career is better than ever. So why not consider taking the plunge and starting a new job in EMS? I guess that leaves us to ask the big question of the week:

What kind of paramedic would Lois Lerner be?

Leaving a big job like the IRS and coming to work in the EMS field would be no easy task. Working 9-5, paid holidays, pension plans and the ability to turn someone’s financial world upside-down would all be things of the past. Or would they?

At Mrs. Lerner’s ambulance service, shifts would not be selected based on seniority. Scheduling would be determined based on political beliefs, and party affiliation. As you could imagine, those employees who associated themselves with conservative or “Tea Party” groups would be working the less-than-desirable shifts and would most likely be denied vacation requests. Others that sided with Mrs. Lerner’s beliefs would enjoy holidays off and short-hour shifts.

While Mrs. Lerner would most likely treat her patients according to the standard of care, she would likely take a much different approach when doing assessments. Letters would be sent to the patient’s houses several months before her arrival to inform them of their medical discrepancies. They would be given a brief period of time to resolve their emergency prior to her direct involvement. If the issue was not resolved, a team of EMT’s would be sent to question the patient and obtain all of their medical records by way of court subpoenas. If the patient chose not to cooperate and ignore the problem, Mrs. Lerner would assume that the highest level of emergency care was needed and the patient would be treated accordingly. This would also place the patient at the highest billing level.

While most ambulance services bill the patients and their insurance companies shortly after the date of service, Mrs. Lerner’s service would actually payroll deduct the co-pays monthly and expect full payment on the 15th of April every year. Of course, special discounts and rates could be issues on a case-by-case basis depending on the patient’s political party affiliation.

Mrs. Lerner’s electronic patient care records would need to backed up on a daily basis, due to the high risk of data loss. These records would be stored on secure servers and copied and placed on external hard drives to ensure a fail-safe means to store the data. Of course, in the event that the Q.A. department needed to review any of her charts, the heightened security measures would likely make them nearly impossible to retrieve.  The Q.A. process would be rather difficult as not only could they not retrieve her charts, but she would also refuse to show up for meetings.

On the positive side, her political connections would likely make it easy to receive grants and significant tax breaks for her ambulance service. That is, of course, assuming that she isn’t targeted for severe audits by the next administration…..

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

Product Review: Leatherman Raptor Trauma Shears

[Video review at the bottom of the post]

This Father’s day, I was surprised to open a really neat pair of trauma shears. Given that I’m a really big fan of multi-tools and other gadgets, this gift was right up my alley. I had looked into buying a pair of these recently, but hadn’t convinced myself to spend the money. Needless to say, it was an awesome gift. So awesome, that I figured I would write up a little review to share with everyone.

Unwrapping

The Raptor comes packaged with a user guide and a plastic belt holster. The tool requires no assembly and it’s ready to use right out of the box. The first thing I noticed was the weight of the shears. They are heavier than most of the trauma shears I have used. This isn’t a bad thing though. They feel very durable and well built.

Features

The shears come with some really handy features that I have already had the opportunity to use. From breaking windows, to cutting rings, these shears have almost everything that I could need. Actually, I stopped carrying my multi-tool and switched to the Raptor along with a nice folding knife.

Here’s a list of the extra features:

  • Ruler
  • Ring Cutter
  • Seat Belt Cutter
  • Oxygen Tank Wrench
  • Window Punch

In addition to the tools included on the shears, they also fold up so you can carry them in your pocket.

Field Test

As of the writing of this article, I have been carrying them for 3 shifts. I have used the oxygen wrench several times and I have cut clothes in both trauma and burn scenarios. I have yet to use the seat belt cutter, ring cutter or window punch. Once I do, I will post a follow-up review.

So far the oxygen wrench is my favorite part. It is such a valuable tool and an often overlooked necessity for EMS providers. While it’s always important to make sure you have an oxygen wrench in your ambulance, it’s also very common to find yourself in situations where you are away from your ambulance or gurney and have to switch tanks or operate someone else’s tank. Being that I don’t like to carry multiple pieces of equipment on me, the Raptor fits my needs perfectly.

Carrying

While the shears are really handy and very well built, they are definitely bulkier and heavier than most others out there. They don’t fit in the shear pouches on my trauma pants and I don’t particularly like to carry knives or multi-tools in pockets where I keep my phone, keys, or where my hands frequently go. Because of this, I opted to use the plastic holster that they come with. The holster has a retention feature so you don’t lose the shears by snagging them, and so nobody can easily grab them. Once I got through the inevitable jokes about gun holsters and practicing my draw, I found that this is a very comfortable and convenient way to carry my shears. Not to mention the fact that they are much more convenient to grab from my belt, as opposed to my thigh.

Purchasing

The Raptor sells on Amazon for around $55.00 to $60.00. You can buy it on Amazon by clicking here. You can also buy it directly on the Leatherman website, however they sell for $74.85, so you’ll most likely save money by going through Amazon or similar stores.

If the Food Industry Was Treated Like Health Care

Running a grocery store is no easy task. You have employees to pay, inventory to maintain, perishables to sell before they expire, and tons of health and safety regulations to keep up on. Not to mention the fact that you have to try to keep your prices low enough to stay competitive, yet high enough to turn a profit. That doesn’t even take into account the cost of operating florescent lights, massive A/C units, and refrigeration units – all of which run 24 hours a day. When I try to piece all of this together, it’s a wonder that any grocery chain can manage to stay in business.

So we’ve established that in order to run a grocery store, you have to play a constant game of tug-of-war in order to maintain a balance between meeting your overhead costs and keeping your prices reasonable so that you’re not shut down by the competition. Can we all agree that it’s no easy task?

Now let’s throw a little government interference intervention in the mix and see what happens….

So there we are, minding our business, trying to stay afloat in a roller coaster economy, when our friendly neighborhood Department of Agriculture representative walks in the door and says “I’m from the government and I’m here to help”. He tells us about this horrible problem we have with starving people in the United States and promises that he’s going to do everything he can to make sure that nobody goes to bed hungry. Everyone is going to pitch in a little bit to a make sure our brothers and sisters are fed. Sounds like a noble idea right? Sure.

This kind representative informs us of this nifty little thing called an EBT card. He explains that less fortunate and struggling people are going to be issued these cards to buy their groceries with. Now what does that mean for us? Well, not much…..yet. We simply run it like a credit card and the money is transferred to our account. The only stipulation is that the people using it will be limited to what they can buy, since it’s supposed to only cover necessities. It doesn’t really matter to us, because we are getting paid and we gained a bunch of new customers. Right?

This “EBT” thing really starts to catch on. More and more people are signing up for the program and our customer base keeps growing. As a matter of fact, nearly half of our customers are using EBT cards. There’s only one problem: The people using it don’t feel like they are being treated fairly. They can’t help but feel discriminated against when they see everyone else buying what they want. Enough of them get upset to the point where our friend from the Department of Agriculture comes back and informs us that his agency is going to “tweak” the program just a little bit. They decided that the people using EBT cards will no longer have limits on what items or how much they can buy. However, since they really can’t afford to just extend everyone an open tab, they are going to have to cut back what they reimburse just just a little bit. They tell us not to worry about it. Since the customers will get to buy whatever they want, we’ll make that money up in the larger quantities of items that we are selling.

This new program really starts to take off. People are loading up their carts to the point where we have had to hire more employees and start placing much larger orders to keep up with the demand. The downside is, the government is having problems making good on the bills so they decide to decrease our reimbursement even more. Now we are starting to see a more noticeable decrease in profit. However, we are still bringing in a decent profit, so we don’t do anything about it. After all, these people now make up the majority of our customer base, so we really can’t afford to turn them away.

As more time goes by, the bills get larger and the government keeps running out of money. Another problem that rises up, is the masses of people that aren’t covered by the EBT program are now getting upset because they can’t afford the groceries and they think it’s unfair that they don’t have access to the food that everyone else is getting. To fix this, the government now mandates that you must provide groceries to everybody, regardless of their ability to pay. Your profit margin disappears and it is no longer possible to sustain business with your current prices. To fix this, you increase your prices to make up for the huge losses you are taking on the non-payers.  To top this off, the government has continued to decrease your reimbursement on EBT payments to the point where you are getting paid less than what it actually costs to purchase the products. You are losing money every time someone swipes their EBT card. However, you continue to accept the form of payment, because it’s the only payment you are going to get from these people.

Even with the massive decrease in reimbursement, the program continues to run out of money. To fix this, the Department of Agriculture starts imposing confusing guidelines that make it difficult to get any reimbursement at all. So now you have to hire a team of billing experts to learn the guidelines and keep up with all the changing policies to make sure that you can receive what little reimbursement you can get from the EBT purchases. In the mean time, the amount of EBT and non-paying customers continues to increase, causing you to continually raise your prices. Unfortunately, as your prices continue to rise, fewer and fewer people are able to afford to shop at your store, so they either have to join the EBT program, or they just stop paying. Sure, you can go after them and try to collect what they owe you, but you are absolutely swamped with people refusing to pay, so you wind up settling for pennies on the dollar. As all of this snowballs, you fight to stay in business. You plead with officials to bring reimbursement back up to where it needs to be. You even try to promote programs that encourage customers to consume less food in a feeble attempt to decrease your losses.

While all of this is going on, reporters are appearing on national TV, magazines and newspapers criticizing you because you charge $36.00 for a gallon of milk that only costs you $2.00. They accuse you of being greedy and robbing the middle class. Now the government – the same ones that sold you on the program to begin with – have jumped on the band wagon and are trying to pass bills to reform the food industry. Now they want to set caps on how high you can set your prices and penalize you for people that overuse your services. Some are even proposing that they just take over the food industry all together.

Eventually the entire system becomes unsustainable and we can only imagine what comes next……

THIS, my friends, is exactly what we are doing to our healthcare system right now.

While this may have been a hypothetical situation, is it that crazy to think that we could do this to our food industry? After all, it is essential to our survival. Doesn’t everyone deserve to eat?

If Hillary Clinton was a Paramedic

There’s no doubt that this week’s Celebrity Medic has had plenty of experience working in the public eye. While many would argue that she will never have to worry about finding a new line of work, I beg to differ. Being “dead broke” after leaving the White House, a botched presidential race and a problem-filled term as Secretary of State are all reasons that the former First Lady should consider having a backup plan. I think this would be a perfect opportunity to consider a career in EMS. With her desire to change healthcare, a change like this would be right up her alley. So without further delay, let’s ask ourselves the big question of the week:

What kind of paramedic would Hillary Clinton be?

Historically speaking, Mrs. Clinton has always been a big proponent of expanding Medicaid and Medicare coverage and she has even been quoted advocating for a socialized system. This would be a good thing as she would see the over-consumption of unnecessary medical services as a success and therefore would avoid the burnout that many EMS providers face.  Things like medical necessity and appropriate utilization of EMS would be a thing of the past.

Hillary would have strange relationships with her partners as she is known for having a short temper but is willing to tolerate pretty much anything without seeking someone else to work with. Chances are, she would spend her entire career working the same partner she started with, no matter what personal issues she might encounter.

Documentation wouldn’t be much different than traditional EMS patient care reports. However, instead of submitting her PCR’s electronically, she would most likely try to get them published in hard-back book format and hold signing events around the nation. Unfortunately, she might be surprised as her following wouldn’t be quite as large as she expected.

Q.A. at Mrs. Clinton’s ambulance service would be difficult as she might not find it necessary to attend debriefings or meetings concerning her performance. When questioned about her reasons for performing or not performing certain procedures, she would most likely respond by asking her Q.A. director what difference it makes.

Training and experience wouldn’t be necessary for Mrs. Clinton to make her way up the ranks. Instead, being married to someone in upper management would be sufficient to seek higher-level positions. Middle-management positions would be ideal for her as she would be extremely loyal to the officials running the organization. Even in the event of wrongdoing or mismanagement by upper management officials, Hillary would gladly take the blame and even attempt to cover up in order to maintain a good public image.

When it comes to managing resources, Hillary would likely be more conservative than expected. In fact, she would likely deny EMS crews on scene of mass-casualty assignments any additional requested resources. Of course, these decisions would likely be relayed through a third-party, such as a dispatcher or field supervisor. This would prevent her from having to directly take the blame.

In conclusion, I feel that Hillary’s experience getting by with no money, her desire to provide medical care to everyone, and her dedication to management officials all make her an excellent candidate for a career in EMS.

Have an idea for the next Celebrity Medic? Feel free to e-mail me at sean@medicmadness.com

 

Perception

I recently decided to take a trip back in time on my Facebook timeline. I stumbled across lots of good and bad memories, but what stuck out today was some comments I had made a few years back when the local county fire department was seeking funding to provide paramedic-level service to a remote community in southern California. At the time I was working for the ambulance service in the area and I had been called some pretty derogatory names both on social media and even in the opinion sections of the local papers over my stance on the subject. I had made it clear that I didn’t feel the entire county should have to shoulder the cost of the service for one very small remote community. Mind you, this community was provided 24/7 fire protection and EMT-Basic level first-responder service from a large and very well run fire department.

I had never been against the idea of a community coming together to pay for a higher level of service. That’s the beauty of this country. We can do that. The issue I had was the entitlement mentality when these people wrote all the nasty letters to the editor saying that this service should have already been there. They mostly blamed my employer, accusing us of somehow being responsible for the county not funding the service. I was personally called names when I voiced my opinion in the defense of my employer and a few of my coworkers who never said a word were actually told that they weren’t welcome to eat or shop at a few of the local establishments in that community while they were on duty.

At the time, I knew they had it pretty good given the size of their community. What I didn’t know is how good they had it. Fast forward a few years later to when I’m working for a rural EMS service in North Texas, and I had a crystal clear picture of how good they had it.

Very shortly after I started my new job at the rural service, I got my reality check at 3am. We were toned out to respond to a report of a “sick person” in the far corner of the county. Throughout my entire career up until this point, I could pretty much guarantee that first-responders would already be on scene given the lengthy response time. Not this time. Not only were they not on scene, but they hadn’t even checked en-route. Prior to making contact with the patient, I didn’t think it was a big deal. In my mind, it was probably the usual I’ve-been-sick-for-days-and-waited-until-3am-today-to-call kind of situation. Wrong again.

My partner and I walked down this very narrow walkway to a restroom in the very back of the house. There sat a middle-aged man on the floor leaning against the wall, holding a small trash can that he had been vomiting in. I immediately noticed the ashen skin tone that I had seen on several patients who’s hearts were on the verge of stopping. I leaned down to speak to him and to assess his circulation. I couldn’t feel a radial pulse, which came as no surprise given his presentation. He was very slow to respond but did mention that he had felt weak and very sick to his stomach for the last hour. My first thought was that we needed to get moving. It was going to be at least a 30 minute drive to the nearest rural hospital and an hour drive to the closest PCI-capable hospital.  As fast as I wanted to get him out of there, a few problems stood in my way: He was too big to safely carry, too weak to stand, and the hallway was too small to get our gurney through. This left us with only one option: Call for additional help and start treating him where he was.

We immediately placed him on oxygen, attempted to obtain vital signs and was in the process of placing the ECG electrodes when he went limp and fell to his side. I had turned the monitor on just long enough to see the 3rd-degree AV block before he collapsed. He had no pulse. I started CPR while my partner grabbed some additional gear from the ambulance. I attempted to ask dispatch if the volunteer fire department had checked en route yet, however my radio couldn’t get a signal in the house so I had to use my cell phone. I was informed that they had been toned 3 times with no response and that the only other ambulance in our area was on another assignment. This meant that a different volunteer fire department would have to be toned out to see if they could respond as mutual-aid. My partner and I were able to get an IV, intubate the patient and push the necessary medications in attempt to regain spontaneous circulation. Fortunately, we had a LUCAS (auto CPR) device on our ambulance, which helped prevent fatigue. After over 30 minutes, we had run out of options. What little electrical activity we had in the beginning had diminished to a solid flat line on the ECG monitor. I consulted with the ER doctor who agreed that it was time to stop resuscitation efforts.

The volunteers never came. Now I’m not saying that in a negative way. That’s just the nature of volunteer departments. They show up if they can. Most of them have jobs and lives and can’t always jump at the sound of their pager. What got me about this call, is that the patient lived in a community that was the same size as the one in California. Same tax base, same EMS response time.

Fast forward another year and I’m on scene of a call where an elderly man has fallen and broken his hip. Once again, this man is too large for 2 people to safely carry. I called dispatch to see if the first-responders had checked en route only to be told that they don’t exist in this area. There was a nearby volunteer fire service, but they don’t respond to medical assignments unless the crew on scene specifically asks for them. Once again, roughly the same size community.

To me, this is the level of service that I would expect in a remote community. The pizzas don’t deliver out here, the grocery store is at least 30 minutes away and the medical services aren’t down the street. It’s a price you pay when you live away from the population centers.

Back when the big debate over paramedic service was still hot and heavy, there was actually a woman quoted saying that she has serious medial problems and has chosen to live in a rural community, therefore she has a RIGHT to a timely EMS response. I have never understood how somebody could move to a rural community and then expect the save level of emergency service that the people in larger, metropolitan areas receive. I sometimes wonder if these people would think so negatively about the services they currently receive if they suddenly had to live with the services that I now receive.

If LeBron James was a paramedic

This week’s “Celebrity Medic” features a man that has made a good living in the game of basketball. While some would argue that he would never have to work a regular job again, unexpected injuries and the rise of athletes going bankrupt shows that there is always risk that comes with success. In such an event, a career change to EMS would be a perfect fit for the basketball superstar. So let’s ask ourselves the big question of the week:

What kind of paramedic would LeBron James be?

While LeBron would probably start his EMS career around the Cleveland area, he would most likely change jobs frequently and would potentially take his talent to the South Beach area. Such a decision would most likely be contingent on where his friends wound up going to work.

Working in the south would come with it’s share of problems as the heat and humidity becomes unbearable in the summer months. It would be extremely important that he work in an ambulance with a reliable air conditioning unit.

Instead of working traditional 12 or 24 hour shifts, LeBron would mostly likely work shifts that lasted only a few hours. Of course, his shifts would be unique in that they would typically end at a quarter past three. This scheduling model would be ideal as he tends to function better in the earlier hours of the shift. This would also allow one of his part-time paramedics, Tim Tebow, to cover the later portions of shift as he tends to function better during those hours.

Education for LeBron wouldn’t be much different than anyone else except the fact that he would charge all of his paramedic training expenses on his Discover card. The reason for this is because it is rumored that if he gets enough points that he believes he can travel for free.

His EMS uniform would be a standard issue Class-A with an extra large hat. His undergarments would have to be made from a material that allows adequate air-flow and helps to prevent heat exhaustion.

Just like any other paramedic, LeBron would have his strengths and weaknesses. For example, while he may not be proficient in management and prevention of heat exhaustion, he would have expertise in ring removals and choking.

In conclusion, I feel that LeBron would be a perfect fit for a job in EMS. While many people might criticize his attitude and intentions, it would be undeniable that he would perform exceptionally well when he’s hydrated and surrounded with the right team.

So now let’s hear it from you. What kind of paramedic do YOU think LeBron James would be?

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

6 Signs You’ve Been Working System Status Management Too Long

When I think of my time working system status management in a busy metropolitan EMS service, I am reminded of a quote my step-father often uses to describe his time in the Army: A million-dollar experience I wouldn’t pay a dime to repeat.

For nearly 8 years of my life, I spent at least 12 hours of my days and nights sitting on street corners, running transfers, hating dispatch and getting off late. I gained more experience as a paramedic during that time than most will in their entire careers. I ran nearly every imaginable call and transported everybody from A-list celebrities to a convicted serial killer. I stepped foot in military bases, jails, mansions, trailers, and even a space ship once (yes, you read that right). The experience truly made me the paramedic I am today, which is good because that means I don’t have to do it anymore. Now I’m enjoying the life of a slow-to-medium paced rural EMS service where I can relax and talk about all the cool things I did in my younger EMS years.

It’s been roughly 3 years since I worked my last shift at a SSM service. However, there are many habits that will most likely stay with me for the rest of my life. If you work – or have worked – at a service that utilizes SSM, then you will most likely appreciate the following 6 signs that you have been doing it too long.

  1. You have the ability to hear your call sign in your sleep.
    This is especially true for those of us on night shifts. I was always amazed at how I could fall asleep after hours of idle time and still manage to differentiate my call sign from the rest and wake up to respond like nothing happened.
  2. You catch yourself identifying areas of town by their post location.
    I can’t tell you number of times I have told a friend or relative that my house was in 61-B’s area, only to be answered with the typical “huh?”
  3. You have ever pulled into a post location while in your personal vehicle and parked.
    I actually did this while on a date one time. After years of pulling into the drug-store parking lot at Post 8, I went into auto-pilot and pulled into my usual spot and parked. It wasn’t until my date for the evening looked at me and asked if I needed to run into the store that I realized what I had just done.
  4. You have a list of at least 5 restaurants that owe you food that you paid for.
    I used to keep the receipts of the meals I paid for and had to leave behind after getting a call. This came in handy for later shifts, but I mostly used them for bragging rights.
  5. You have mastered the art of hiding ambulances from the public’s view.
    Sometimes I wondered if seeing an ambulance made people want to go to hospital just as an advertisement for a juicy cheeseburger made people hungry. It didn’t take long before I started looking for places to park where I could eat meals and get caught up on charts in peace.
  6. Your partner has ever had to wake you up to inform you that you’re on scene of a call.
    I somehow managed to master the art of sleeping in the most uncomfortable location known to man: The passenger seat of an ambulance. Working late nights and long hours for several years had taken a toll on me. There were several times that I didn’t even know that we were en route to an assignment. Anyone that has worked SSM long enough knows exactly what I’m talking about.

Now it’s your turn. Comment below to share your stories of working in a busy 911 system.

Ed Searfoss

SearfossI first met Eddie shortly after I got hired at Hall Ambulance. If my memory serves me correctly, he was hired with the group just before me. At that time, I only knew him by name. It wasn’t until right after paramedic school that I got to know him. I had just finished my paramedic internship and was scheduled to take my national registry exam. I was placed on night shift temporarily with George Baker, who happened to be precepting Eddie for his internship.

I remember thinking that Eddie was really on top of his game, and at times, it made me a little jealous because I struggled through my internship. Nonetheless, I gained a lot of respect for his knowledge, work ethic, and personality. I remember sitting in the back of 333 night after night going over textbook material and scenarios with him as we both studied to go take our registry exams. He used to always tell me “you got this” and joke about how he was never going to pass. We both knew better.

Another thing we had in common during that time, was that we were both soon-to-be fathers. We were scared out of our minds as we were about to take on a huge amount of responsibility, both personally and professionally.

Fast forward about a year later and we were both working night shift as paramedics. We both showed up to work with the same bags under our eyes from working nights and trying to get sleep during the day with toddlers running around. We weren’t on the same ambulance, but we ran plenty of calls together. Most of my early mornings were spent chatting with Eddie and the other new paramedics (we all got stuck on nights) in the crews quarters while trying to finish up our patient care reports. I didn’t see the significance of those experiences at the time, but now I look back and realize that those conversations we had every morning is what made me grow into the paramedic that I am today. We weren’t afraid to talk to each other, admit our mistakes and share our experiences.

It wasn’t long until me and Eddie were being considered for promotion to the relief supervisor position. I didn’t know how many positions they planned on hiring, but I had already figured that Eddie would get the spot before I did. That wasn’t a bad thing. It just showed the level of respect I had for him. To my surprise, we both got the job. I remember us trying to guess who would be Paul-Sam 19 and who would be 20. Once again, I didn’t see the significance of those experiences at the time.

About six months later, we were both promoted to full-time supervisors. Eddie stayed on night shift, and I was shipped out to the desert. At the time, our staffing was so low that I ended up spending most of my nights and days working on an ambulance in metro Bakersfield. While day shift certainly had it’s share of shortages, night shift had it worse. Most supervisors that worked nights would stress out, but Eddie never lost his cool. He never asked for help from any of us. In fact, there were plenty of nights when he was down 3-4 ambulances and yet he still insisted that the East and West Kern supervisors headed back to our areas so we could get some rest. All of us in the supervisor group used to joke that he was a well oiled machine. His supervisor reports were extremely detailed and well written, he never cracked under pressure and he could always find time to crack a joke and make you smile.

When my marriage took a turn for the worst, I was in a dark place. I thought I was leaving my personal issues at home, but anyone on the outside could clearly see that I carried a big load around with me. Eddie was the first person to step up and tell me what I needed to hear. I was at Post-1 late one evening swapping out an ambulance that was out-of-service. I wasn’t sleeping much and the constant driving between East Kern and Bakersfield certainly wasn’t helping. I sat down in the supervisors office and stared at the computer screen for a solid 15 minutes without moving a muscle. I remember Eddie closing and locking the door to the office, sitting down next to me and asking if I needed anything. He told me that he was my friend and that he understood what I was going through. He also told me some hard truths about my decrease in work performance and my recent change in attitude. I didn’t want to hear it, but I needed to. He never made me feel like he was coming down on me or criticizing me. He was just being a friend.

In the summer of 2011, I left my job at Hall Ambulance and moved to North Texas. Eddie left shortly after and moved to Hawaii. He eventually returned to Bakersfield to do what’s best for his daughter and resumed work at Hall. I deeply regret not staying in touch as much as I should have. Needless to say, when I got the news of his passing yesterday, I was overwhelmed with emotion and regret. His family, Hall Ambulance and the entire EMS community took a huge loss. I know he’s in a better place now and I can only pray that God continues to look over his daughter. She was his pride and joy and his #1. I hope that someday I can grow to be even a fraction of the kind of father he was.

Please keep him and his family in your prayers.

Rest in Peace, Eddie Searfoss and thank you for everything you did.