Buddy the Beagle Hitches a Ride

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Owner aboard ambulance, dog stows away

The hospital was an hour’s drive from the patient’s home. Mason County (Texas) EMT Tanner Brown and and his partner were 20 miles into the trip when a motorist flagged them down and told them there was a dog on the side of the ambulance.

As reported by Michelle Gaitan of the San Angelo Standard-Times, Buddy, a beagle mix, appears to have hopped onto the small side step of the ambulance in order to stay with its owner, 85-year-old rancher JR Nicholson, who was being taken to Fredericksburg hospital for reported dizziness. Once they were alerted to the presence of the canine stowaway, Brown says, “we didn’t have anything else to do but to load the dog up and put him in the ambulance and take him to the ER with us.”

Buddy made the most of his opportunity.

“It was kind of funny. We were inside [the emergency room] and he had jumped onto the control switch and turned on the sirens and the lights,” Brown recalls. “We didn’t know what was going on.”

Nicholson had picked up Buddy just four months earlier from an animal shelter — long enough, apparently, for the dog to become powerfully attached.

“I was impressed,” Nicholson told the Standard-Times. “He didn’t have to go to the hospital with me, but he did.”

Read the full article at: ems1.com

New Facility Puts First Responders First

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Md. county builds $50M EMS center

At the dedication of the county’s new 110,000 square-foot EMS center, local officials in Harford County, Maryland observed how “public safety often gets put on the back burner,” and how local emergency response systems tend to go unnoticed — until they are needed. And so it was with justifiable pride that the officials dedicated the county’s new $50 million Emergency Operations Center on Nov. 10.

Writing in The Aegis, Allan Vought reports, “Council President Billy Boniface, a volunteer fireman in his pre-council days, said the council had reservations about trying to undertake such an expensive project during a downturn in the economy, but likewise noted ‘a core responsibility of local government is providing public safety service.’”

According to Vought, the facility includes a large main situation room twice the size of the one it is replacing; a rumor control center to receive calls from concerned citizens during an emergency and to monitor social media; a large training room; a police, fire and EMS radio room, which takes up much of the second floor; and offices for both the Fire and EMS Association and the Harford EMS Foundation, which operates the county’s paid ambulance service. Officials note that it is the first time both county emergency operations and the volunteer service leadership will be under the same roof.

“In 20 years [the life of the bonds sold to build the project] I hope this pays dividends and I believe it will,” Boniface added.

Vought writes, “Everyone who toured the two-story, 110,000 square foot building following the ceremony seemed to agree that it will place Harford in the forefront of emergency operations as it is occupied over the next few weeks and months.”

The EMS community at large — as well as the public it serves — can only hope that Harford County might serve as a model for other local governments as they assess their present and future emergency response needs.

Read the full article at: ems1.com

A Battle Plan for the ‘Forgotten Army’

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House bill would boost EMS funding

We expect our EMS agencies to be as ready and well-equipped as our military services, writes A.J. Heightman in the Nov. 2014 issue of the Journal of Emergency Medical Services. Yet the reality is that EMS receives little to no financial assistance from the federal government to fulfill its mission.

But a bill known as the “Field EMS Bill” making its way through Congress provides a glimmer of hope, Heightman says. The bill would provide federal leadership and increased federal funding for EMS — and not a moment too soon.

Heightman compares current funding for EMS to federal spending on the wars in Iraq and Afghanistan to highlight how the U.S. is neglecting its “standing army” of first responders — with potentially grave consequences.

According to Heightman, the U. S. has spent over a dollar per capita to wage war on foreign soil over the past 13 years, yet spends less than a quarter of a penny per capita to equip EMS agencies.

Making matters worse, while the workload of the fire services is 80% EMS and 20% fire response, most of the federal funding has gone to bolster firefighting efforts, not EMS equipment and training, Heightman notes.

He adds that EMS is also hobbled by a “broken” ambulance reimbursement system in which the reimbursement offered by Medicare is often less than what it costs to respond to each call. And then there are those among the 36 million annual callers who aren’t insured or who abuse the transport system for a free ride to the hospital.

“Bake sales and donations” won’t cover the cost of essential equipment like full-face respirators and ballistic vests that responding crews will need during a mass-casualty event, Heightman writes.

The Field EMS Bill has 32 cosponsors and is supported by a majority of the big EMS-focused national organizations. Although the bill is not likely to pass by year-end, Heightman urges his readers to contact their elected officials and ask that they support the bill.

Read the full article at: jems.com

Paramedic Denied PTSD Benefits

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Claims responders are treated like ‘disposable heroes’

Practically by definition, emergency responders are regularly exposed to gut-wrenching scenes in the line of duty. The lingering effects of such exposure is well-documented in military personnel, many of whom struggle with Post-Traumatic Stress Disorder (PTSD) when they return from active duty. But paramedic Joanne Trofanenko discovered that, by contrast, emergency responders in British Columbia who suffer from PTSD are treated like ‘disposable heroes.’

The story, reported by Natalie Clancy on CBC News, describes how Trofanenko’s life changed on Oct. 19, 2010. She was the first paramedic on the scene where an ambulance had plunged off a cliff and sank to the bottom of a lake. Two paramedics were found dead inside the vehicle; the driver was a close friend of Trofanenko’s.

For the next couple years, Trofanenko struggled to perform. “My brain would freeze and I wasn’t processing as quickly as I used to,” she said.

She realized that something was seriously wrong when she responded to another drowning call at a lake that resembled the lak where her friend had died, and she suffered a panic attack. She went on sick leave and was diagnosed with PTSD.

Even though it is well known that PTSD may take years to emerge, WorkSafeBC, the benefits administrator in British Columbia, denied Trofanenko’s claim because it was not filed within one year of the injury.

“I didn’t know I was sick,” Trofanenko said.”I didn’t know I had PTSD. I knew I was struggling, but I didn’t know I had this.”

She appealed and lost WorkSafe’s denial of her PTSD claim as a result of the 2010 incident, but won a second appeal related to the flashback she experienced in 2013. She received wage-loss benefits for six months then was cut off after an attempt to return to work as a paramedic failed. A third appeal has been denied. WorkSafe is denying the claim outright, Trofanenko says, “saying it wasn’t bad enough to cause distress and PTSD.”

British Columbia does not consider stress caused “by acute reaction to a traumatic event” as an occupational disease, where a claim can be made at any time, CBS News reports. By contrast, Alberta passed legislation introduced in 2012 that does not require emergency workers to prove that their PTSD is work related.

CBC News

Santa Cruz Responders Can Take Heat

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‘A medical team with an armed escort’

Firefighter-paramedics in Santa Cruz recently received training in law enforcement tactics that will allow them to enter “warm zones” where a threat remains but the situation is considered safe enough to render aid.

According to the story, which first appeared in the Santa Cruz Sentinel, leading emergency responders believe that having fire officials with medical training working together with police will result in less loss of life among first responders and crime victims.

“We will be closer to our police officers and providing emergency care where we haven’t in the past,” said Fire Battalion Chief Mike DiTano.

The story notes how the 2013 shooting deaths of Santa Cruz detective Sgt.Butch Baker and detective Elizabeth Butler galvanized efforts to provide tactical training to firefighter-paramedics.

“You can certainly see the need for [tactical training] following the loss of Baker and Butler, especially when you have an armed suspect who circles back to ambush the emergency responders,” Deputy Police Chief Rick Martinez said. “Having a team protected and capable of responding will hopefully increase response times.”

Federal funding covered the cost of 80 hours of tactical training for four firefighter-paramedics, who receive no extra pay for the voluntary assignment. The training, Martinez said, “includes a lot of movement and repetition and practicing those movements with an armed team. Those are things those responders need — security and positioning.”

emsworld.com

EMS Team Takes Ebola Patients in Stride

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12 years of training prepared team for duty

There are risky patient transports. And then there are transports where the patient has an infectious disease that kills roughly half the people who contract it.

Wade Miles, interim director of Grady Hospital Emergency Medical Services in Atlanta, GA, has led a team that specializes in the transport of patients with dangerous communicable illnesses for over 12 years. And despite the fear that has swept the country since Ebola touched our shores, Miles tells Meagan Hurley of the Marietta Daily Journal that his team was not apprehensive about working with Ebola patients.

“We started the team 12 years ago, and the team wasn’t specifically for Ebola, it was for any seriously communicable disease, but we did have Ebola on the radar, and other diseases like smallpox,” Miles says. “So we’ve been preparing for it for 12 years. In our minds, we had already transported 12 Ebola patients because we do a practice one every year in training.”

Miles and his team have successfully transported three Ebola patients to facilities in Atlanta, and that they are honored and prepared to help out further as needed.

“It’s kind of like preparing for the Super Bowl and finally making it, you know?” Miles said. “You train, you do all your studying, you do everything you can to prepare yourself and your team and every time it’s just training, but then you finally get the real patient. It was pretty flattering for all of us.”

To prepare for an infectious disease like Ebola, Miles says the first step is education — knowing everything about the disease and how it is contracted and treated. Then tools and procedures are designed to protect personnel and the ambulance using CDC guidelines.

“We have a team medical director who oversees everything along with us,” Miles says.

Although Miles handles the risk without evident stress, he admits that his wife and daugher were a little worried by the assignment, and that some of his friends were dumbfounded: “I got a few text messages from friends, you know, asking, ‘Why would you ever agree to do something like that?’ And my response was, ‘I could’ve said no. We didn’t have to do the transport, but somebody would have.’ It might as well be the team that was trained for it.”

mdjonline.com

Looking Back on a Career in EMS

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Paramedic reflects on the good and the bad

When his back started to require more attention on some calls than his patients, Mike Rubin decided to walk away from active EMS duty while he still could. In an article on emsworld.com, Rubin talks about the aspects of being a paramedic that he will miss — and those that he won’t.

Most of his EMS memories are pleasant, Rubin notes. Among his favorites:

Good calls with good outcomes: Rubin writes that “seeing patients wake up made me wonder why I’d waited so long to get into EMS.”

The value of paying attention in class: Rubin was always gratified when something he learned in class actually worked on a real patient.

Partners with good advice: “Nothing against wives,” he writes, “but sometimes you need a friend who doesn’t know you that well.”

Partners with good ideas: “I can’t count how many times my coworkers knew a better way and made it so.”

Among the things about EMS he won’t miss:

Unstable respiratory patients: “Watching someone struggle to breathe is especially hard, I think, because we’ve all been short of breath. Ninth-inning Red Sox rallies still do that to me.”

Parents who don’t advocate for their kids: Rubin was stunned when parents placed their own interests above the need to deliver care to their children. “The worst part was knowing even clueless parents have the final say,” he says.

Harsh tones from telephones, pagers and radios: “I still flinch when the phone rings,” Rubin writes. “I’ve read it has something to do with a heightened startle reflex. Good thing I don’t do IVs anymore. Or serve the soup course.”

All in all, Rubin is satisfied with the career he chose, and looks forward to new pursuits: “I’ve learned more about the human condition than any engineer I know. I’ve been to the brink and back; it’s time to move on,” he writes.

emsworld.com

Using EMS to Avoid Going to Jail

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How to recognize feigned illness or injury

Abuse of EMS comes in all forms. Earlier this month, a Lake Placid, NY man called for an ambulance because he was “too drunk to walk home.” Similar stories abound of those who, for one reason or another, view the EMS system as a free taxi service.

Writing in jems.com, paramedic Steve Berry discusses a related phenomenon that he terms “Incarceritis.” He defines the condition as “when a patient intentionally falsifies or grossly exaggerates symptoms of illness or trauma in order to avoid incarceration.” Some of the more common forms of Incarceritis that Berry has encountered include contrived chest or abdominal pain, hallucinations, and “sham shaking.”

Berry outlines a professional protocol to help correctly respond to potentially fraudulent complaints, which he finds especially prevalent among inmates whose only real illness is that they are sick of being behind bars and would like even a short vacation from the custody of the justice system. His tips include:

  • Repeatedly ask questions and document inconsistencies, but don’t point out discrepancies, which could allow the patient to redefine their symptoms
  • Observe patient’s behavior when healthcare providers are not present
  • Document subjective data from before and after the onset of the patient’s purported condition
  • Keep in mind that the situation might be the real thing, so always perform a full objective medical assessment at the outset

jems.com

EMTs Stop Cops from Beating Patient

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Mentally disturbed patient was handcuffed to stretcher

Two EMTs have filed a report claiming that four New York City police officers beat a patient handcuffed to a stretcher as the EMTs attempted to transport the patient to a nearby hospital. The police stopped only when the EMTs intervened.

According to documents obtained by the New York Daily News, the violence broke out on July 20 when the patient spit and swore at Emergency Service Unit officers at a stationhouse in Brooklyn. The patient was restrained for transport and was combative and banging his head against the wall.

“Pt. came out of the cell in cuffs. Pt. became combative with PD and (was) put on our stretcher,” wrote one EMT in the Unusual Occurrence Report filed with FDNY officials.

“Pt. was struck in the face by an officer … pt. spit in the face of an officer, whereupon the officer punched the pt. in the face multiple times.”

After the mentally disturbed patient spit at the officer again, more officers joined the fray, the report said.

“Three cops began to punch the patient in the face, EMS (had) to get in the middle of it to intervene. Pt’s wounds and injuries cleaned in the (ambulance),” the report said.

A New York Police Dept. spokesman told Reuters NYPD’s Internal Affairs unit was looking into the report.

firerescue1.com

Paramedic: Careful What You Wish For

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The human cost of testing one’s mettle

Steve Whitehead, a Colorado firefighter/paramedic, posted an article on ems1.com recently that urged those new to the job to never forget the lasting, human costs that underlie their daily professional activities.

Whitehead remembers his own eagerness to test his mettle when he was just starting out.

“At the outset of our careers, we typically refer to them as ‘good calls,’ the calls where our skills and training are brought to bear,” he writes. “We want to know what it’s like to be in the middle of the chaos. We want to feel the thrill of life and death hanging in the balance.”

But with the wisdom of experience, Whitehead reflected on how blind to human suffering such ambitions turned out to be. For example, he recalls his desire for a challenging cardiac arrest presentation, “until the day a family called for their two-month-old infant who had stopped breathing in his crib. I don’t wish for challenging cardiac arrest scenarios anymore.”

Three other challenges he wished for included a dramatic car accident with complicated extrications; a prehospital delivery; and a large MCI. You can guess how the fulfillment of those wishes impacted Whitehead.

“It’s worth remembering that when we wish for ‘good calls’ and the opportunity to test ourselves, we are also wishing for fear and tragedy and pain and misery and grief and sorrow,” Whitehead writes.

The lesson, he says, is preparation: Tragedy is inevitable, but preparation is not. With proper preparation, emergency medical personnel can make a bad situation better.

“If you remain in this industry for long enough, life will bring you more than enough tragedy. That is simply the nature of human existence,” Whitehead says.

“Be patient, be willing and be prepared.”

ems1.com