Teamwork

This is a word that is seldom used in EMS, yet it is also an expectation. The AHA, in it's recent changes to CPR, made mention of utilization of teamwork in it's curriculum. This is mentioned as if this never existed in CPR, let alone pre-hospital care and this is not particularly surprising. In EMT school we are taught to work individually, whether it be in class or testing. Each of us must pass without the assistance of a "partner" on exams and in class. Unfortunately, this is not conducive to real-world EMS.

Here are some reasons why I disagree with the individualistic mentality placed on EMS providers:

1. Individualism breeds competition and while competition in theory is not a bad thing, it does not help EMT's function better. Remember, our common goals are to make sure our patients get the proper care they need either during a routine transport or during an emergency.

2. Communications lacks! A large part of our job is communication, whether it be through radios, to our patients, or to our partners, this is an area of our job that is fundamental.

3.  Patient Care is another area affected. Four hands are better than two, just as two heads are better than one. The more information you can get, the more life saving procedures can be performed, and the least amount of time sitting around without a clue...the BETTER!

There are other areas that are affected by our individualized education; however, these three categories are extremely important to our job. So how can we fix this?

1. More education. By changing the way we approach educating new and old EMT's, we can begin creating an environment of community and teamwork within the industry. This means learning as a team, practicing as a team, and testing as a team. This does not eliminate individual testing, but puts less emphasis on that individual mind set.

2. Emphasis on communicating on all levels. I recently had a partner who was near silent in the ambulance and while this is not necessarily a bad thing, it is when he/she could talk without issue with patients in a compassionate tone while responding to me in a harsh and dismissive tone. I do not take kindly to this. You or your partner may be having a tough day, but leave it at the door. You are a team. Without one of you, the team would cease to function.

3. Patient care can be looked at from a variety of angles; however, I like to look at how EMT's handle the patients once they are placed in the back of an ambulance. In my company, what generally happens is the Tech goes in back with the patient while the Driver goes to the front seat immediately to start the truck and get going. I want to propose another strategy. I would like to propose to EMT's, not only in my company, but elsewhere, to hop in the back with your partner and grab a set of vitals or help with some of the treatment before you run to put the pedal to the metal.

All of these basic tactics, while relatively small in the grand scheme of things, contribute to improving the way we function in an ambulance.

Creating an EMS Bachelor Degree

The EMS Bachelor Degree, it is something I have been pondering for a while now. The value of a college education is boundless. I have heard people say why bother, a bachelor degree is just a piece of paper, it doesn't do anything for us. WRONG! I can't say that my entire college career was fun, exciting, or important to me; however, what I can say is this, my college degree gave me the intellectual capacity and experience to think critically, analyze decisions, and understand how to effectively research. What it didn't teach me was how to be a good EMT. There is a lot that goes into being an EMT, far more than we think and it couldn't hurt to fit it all into a four year degree program, or even a two year accelerated program. Here are just a sample of subjects that could be covered by an EMT bachelors program:

Physics, Biology, History, English, Psychology, Chemistry, Mathematics, and Foreign Language.

Physics, while helping to provide EMTs with a better understanding of driving techniques (which should be taught in a specialized driving school) would be helpful for an education in MVA related injuries and other blunt or penetrating trauma related injuries.

Biology would be taught similar to current pre-med programs with studies in programs such as anatomy and basic cell biology.

Chemistry and Mathematics would provide EMTs with the knowledge needed to understand medication dosages and reactions in the human body.

History would give the EMT a background in the field of Emergency Medicine to provide a link to our storied past.

English could be a helpful tool in learning how to effectively write run reports.

Finally, each student would have to choose a foreign language.

All of these programs would provide an EMT with a well rounded education in Emergency medicine including a choice in foreign language which would undoubtedly be of much use in communities across America.

These are just suggestions, but put to good use, these programs of study could be of great benefit to the creation of an Emergency Medicine Bachelors Degree. If anyone has further suggestions or ideas, feel free to comment!

CPR...why do we care?

I have been teaching CPR classes for almost a year now and one thing never ceases to amaze me. I find that a large portion of the people I teach just do not seem to care. Why you ask? Because they do not get how important it is for community and personal health. The challenge I have comes in passing an individual who has taken the course, passed the written and has performed decently on the practical, but I wouldn't trust with my own life. How can I give them a card that says they can treat others when I would rather have someone without any training treat me over them? It is a difficult question and one that I ask myself every class. I think I am a pretty tough CPR instructor. I do not pass you if I think you are not going to perform well in the field and I certainly do not go over the answers with people during the test. If someone has a question or the class is stumped on a few questions, sure, I am more than happy to help and explain the answer if need be, but I am hard pressed to stand in front of the class and have everyone answer. I would rather see on an individual basis how people perform. I think I get the most exacerbated sighs when I say, "ok everyone, take a 10 minute break, then we are going to practice doing all the steps over again", but why is this different than any other class? I want my class to have as much hands-on training as possible and if that means pushing them to perform practicals over and over again, then yes, I am going to push you. I do not let the video do the instructing, it gives a good background to help answer questions on a test, but I do not want my class to just get 100% on the written, I want them getting 100% on the practical.

I have given my perspective on my classes, but I have not truly answered my question, why don't people care about CPR? Well, they do, it is just that they need to be motivated. There will always be a student who is taking the class because they feel they have to or are "forced" to and will take it out on you; However, there is also a large portion of people who want nothing more than to be a driving force for community health in society and if you make the course interesting, hands-on, and fast paced, they are going to enjoy every ounce of that class. My new resolution for the year is to not just teach CPR, but to TEACH CPR, that means pushing my students to bring 150% to each class in exchange for my putting in 200%. I will stay after for remediation, I will go over questions as long as you need to pass, but I will not pass you if you are not comfortable performing CPR. This is not just any skill, this is a life saving skill and we should treat it as such not only as instructors, but as students. My best to all those who work hard at this job, and to those who are feeing run down or unmotivated to teach, here is my advice...you bring 200% to each class and I assure you, the majority of your students are going to give the same or at least 150% back. Believe in your students and they will trust you as an instructor.

Finally Back...

It's been quite some time since I have written on this blog for good reason...my life has been crazy! Between keeping up with school and a new internship, moving to a different city, and trying to get my life in order so when I graduate in 3 months I am not running around like a chicken with its head cut off.

Needless to say, my last winter break, besides being by far one of the best I have had, was busy, but exciting. I have also finished my very short historiography/research paper on EMS. I have opted not to post it on the blog because of its length (18-19 pages). However, I believe I achieved an A of some sort on the paper, so I am happy with it. I also think it covered a great deal of topics in such a short document. It still needs to be worked on if it will ever be considered for publishing, but hopefully it will, at least for now, provide people with a brief idea as to what EMS is all about.

Life and Death

Its been quite some time since the last time I posted on here, and this is mostly due to a recent death in my family that was very close. I have seen many people die this year, more than usual. In fact, this year has been the worst year for deaths since 2007 when I lost my grandfather, and two close friends who were much too young. This year, while the deaths have not all been close to home, I have seen many of my friends suffering with the loss of family members, friends, and relatives, mainly from cancer. It just goes to show that life is short and unpredictable and that you need to live life to the fullest. I know that after this year's experience, my goal will be to talk to my patients even more than I do now. Especially the ones that know that the trip with me will probably be their last. Holding a hand or two, offering comforting words, maybe a laugh or two. It was hard seeing my family member towards the end, but one thing that comforted me was that he felt "ok" with things. He had sold his stocks, made sure that his life insurance was in order, and closed any deals that were left unattended. He said to me that towards the end, things don't seem as crazy, you kind of look forward to death just so it can be all over. Of course, he hoped for a cure or some miracle, but sometimes there are just things we can't do. It took only three weeks for my uncle to pass away, he wasn't old, he wasn't young, but I certainly never expected to be at his funeral at this point in his or my life. It took three weeks from the time of his diagnosis to his untimely death, a period of time that has been very hard for my family, but, as I said earlier in the post, this is why we all need to take the time away from work, away from the stresses of life, and spend time with our families, friends, loved ones, and/or pets and live our lives to the fullest.

I think Dr. Sidney Friedman from M*A*S*H put it best when he said:

"You know, I told you people something a long time ago, and it's just as pertinent today as it was then. Ladies and gentlemen, take my advice - pull down your pants and slide on the ice."

Peer Advising

When I was a freshman in college, I was given a peer adviser, whose job it was to check in one me throughout the year and help with class selection/advice. So, why not apply this to my campus EMS squad? The way this would work is by having probationary members paired up with senior members who run the calls. Each week the advisee and adviser meet to discuss the probationary member's progress on calls, address questions the new member may have, and to assess how best to help the new member continue to improve. This would enhance our quality of care exponentially. Just imagine, new members and old members exchanging knowledge on issues and learning from each other. The probationary members would feel more confident and our senior members could increase teamwork on scenes, feeling confident in the probationary member's skills and knowledge base.

My goals for my EMS squad are to create a higher quality of care for our patients, make better EMTs/FRs, increase teamwork on scenes, and instill a sense of accomplishment and pride in what we do. This is just one way.

Get out there and VOTE!

This past weekend, I went with a group of 57 students from my school to Washington, DC for the Rally to Restore Sanity. We left at 11pm on Friday and got to DC at 7am Saturday, by 8am the Mall was filled. The final numbers on attendance was somewhere in the ballpark of 215,000. With that said, the rally was incredible with Stephen Colbert and Jon Stewart using humor to present an very serious issue in this country. In the spirit of what was said at the rally and its overall message of "we may disagree, but lets at least try to work together", GET OUT THERE AND VOTE! Its a right and we should use it to steer this country in the right direction, Republican or Democrat. Enjoy the polls people!