Emergency Response

  Recently, WGGB News Channel 40 in my old stomping grounds up in Springfield, MA posted a news article about “Emergency Response” in the city of Springfield.  The source of this story is said to be anonymous, however many of us have our speculations as to where it came from, none of which will be shared here, because they are after all speculation. WGGB raises concern over 350 responses that were considered “lengthy” by the city.  A concern created by one of those “lengthy” responses on a snowy morning January where a shooting victim waited 17 minutes for a response due to system overload.  There are, however, a few facts in the story that WGGB does not do a good job at pointing out that I feel need to be brought to light. The city contract, as documented in pages seen in the report, calls for a response of under 10 minutes 95% of the time to “Priority 1” calls.  According to the report, AMR in Springfield meets that standard 97% of the time.  They exceed expectations set for them. Annually in the city of Springfield, there are approximately 35,000 calls for 9-1-1 service.  WGGB is taking issue over 350 of these.  I do not have to break out my calculator to be able to tell you that this is 1% of their responses. Take a trip to Detroit, Philadelphia, or Washington DC and ask them how they would feel if they got an under-10 response 97% of the time.  Ask them how they would feel if they got that response 80% of the time.  Chances are, they would be thrilled with that improvement. In my opinion, WGGB and Brendan Monahan are trying to make a story out of a non-story. Medicine is a constantly evolving creature.  That is why we say we “practice” medicine.  Recently, I watched Killing Lincoln on the History Channel about the days leading up to and following the assassination of President Abraham Lincoln.  After he was shot, a doctor is shown telling two men to “move his arms up and down to expand and contract the thorax.”  Do you know why we don’t do that anymore?  Because we know...

The Sticky Test

One of the first assessment skills I learned when learning about trauma assessment was the “sticky test.”  Done early in the assessment, it was designed to a be a quick once over on a patient to check for any bleeding.  The EMT runs their hands over the patient occasionally looking at their gloves to check for any bleeding that might be severe enough to need immediate treatment.  It is a very effective technique.  I know of people who have found missed stab wounds or injuries simply by looking with their hands. At a fire department where I used to work in Massachusetts and in a few departments in my new system I have noticed EMTs and first responders using black non-latex gloves.  Black.  How are you supposed to see anything or know where your hands have been with black gloves on? On a typical call, I usually go through two sets of gloves, sometimes more.  If I am not taking my gloves off, I am always looking at them before I touch a bag, or my radio, or before I go into my pockets or a cabinet to get any equipment.  How can one do that if they are wearing black gloves? Furthermore, what about black straps or bags?  Doesn’t that pose the same problem?  Maintaining clean equipment is dependent on being able to tell what equipment is contaminated.  It’s time to move away from the red and the black. Green, especially ANSI compliant light green, is the way to go for bags.  Sure, it’s a little tough on the eyes but it makes the provider more visible and it makes it much easier to identify those little pieces of a call that we occasionally take with us. The same goes for straps.  Anything that we can do to make ourselves more visible is vital.  Its time to move away from black. And finally, the black gloves?  Let’s toss those boxes out.  The companies that make them need to stop.  You can’t properly treat a patient if you cannot properly assess them, and you can’t properly assess a patient with black treatment gloves...

Product Review: Coast Portland HP 14 Flashlight

Early in January I was contacted by Coast Portland and given the opportunity to review their HP 14 LED flashlight.  Their timing was perfect, as I was in the market for a new light since my old one had seen better days.  This was my first opportunity to use an LED flashlight as all of the ones I have owned prior to this have been halogen.  I have heard from a lot of people that these days, LED was the way to go, so I decided to give this one a try. For the last month, I have been using the light on the job.  Here is what I thought about it: At $65, the HP 14 is affordable and not overpriced.  It advertises a run time on the high setting of just shy of 5 hours, with a considerably longer life of 20 hours on the low setting which when compared to LED flashlight reviews of similarly priced lights is excellent.  In the month that I used the light, I had no issues with the quality of its performance.  The battery life seems pretty true to me and the quality of the stream stayed consistant. The first thing that stood out to me about this light was its overall appearance.  The HP 14 is a sharp looking light.  It is light weight, comfortable in your hand, and easy to use and adjust.  Not only is it powered by 4 AA Batteries, but they are included with the light. Switching from high to low is as easy as double clicking the power button on the back end of the light.  The lower 56 lumen setting offers a much softer but still bright and usable option.  The telescoping focus while quick to adjust but takes two hands to do.  At its narrow setting, you get a nice tight, bright stream, with the wider one giving you a nice area and it softens the light enough that on the low power setting you can easily check a patient’s pupils.  The light needs to be usable not only to illuminate a scene but for patient care as well when being used by a paramedic.  The HP 14...