Aug 30, 2013

Every EMS system in the country, and most likely the world, has their share of “regular” patients.  It was brought to my attention via Facebook that Springfield lost one of its most well known patients who was a frequent user of the ambulance service there for close to 30 years.  No one, however, has been able to find an obituary, so I decided to write one for him. . . Donald Spittlehouse (1945 – 2013) was called by his own personal higher power sometime in the past two weeks.  While the exact date of his passing is unknown, his loss was felt far and wide throughout the EMS community in the greater Springfield, Massachusetts area. While much of Donald’s background is unknown, his reputation was legendary and the kind of thing that fables are made of.  Some said that he was a simple machine worker who spent most of his life in New England.  Others, however, said that he was an ill fated former MIT professor who fell into a deep state of depression after having his heart broken.  Donald was known by many names, and would occasionally be referred to by the code name “Mr President.”  Some would also say that he could single handedly be credited with keeping the pay phone market alive in Springfield. Donald was most well known for his affinity for trivia, especially when it came to geography.  He could recite without hesitation the capital of each of the United States, and many countries throughout the world.  He was a skilled at crossword puzzles and would often contribute to clues that would commonly stump many amateurs while waiting for the arrival of his “extended family members.”  While some might have been frustrated in their interactions with them, Donald was also the recipient of the kindness and generosity of the medical community in the form of breakfast sandwiches, coffees, and the occasional shower and shave. It is unknown if Donald left any family behind.  He was, however, predeceased by many who had a similar place within the EMS community, namely such legends such as Stephen Donahue and Zoya Shaw.  He is, however, survived by countless paramedics, EMTs, nurses and doctors...

I have been giving some thought to the recent events in Springfield involving an ambulance being struck by bullets, and a rather real looking BB gun being pulled on a tech in the back of an ambulance.  That, along with the law passed this year in Delaware got me thinking, and i figured I would pose a question of the readers. If an EMT or paramedic is assaulted, where should the responsibility of filing charges fall?  Should services have a zero tolerance policy regarding violence against their employees?  Should they be encouraged to strongly advocate for their employees with law enforcement and encourage their people to file charges, assisting them along the way?  Or should they take a hands off approach and leave the decision and procedure of pressing charges to their individual employee? So, what do you...

This past week, Washington DC finally took a step in the right direction by hiring what they call “civilian paramedics.”  While I am not a huge fan of the term they use for their new employees, I cannot help but stand up and applaud their move to hire staff that can be 100% dedicated to addressing the department’s shortages. I have seen a lot of numbers of the past week: 38 paramedics on a shift with only 14 in ambulances.  80% of the department’s 160,000 calls medical in nature.  Trucks out of service.  Running out of gas.  Catching on fire.  Lately, it has been one horror story after another for DCFEMS.  While hiring paramedics seems like a logical move, one city councilman went as far to call it a “step in the backwards” for the department.  City Councilman Phil Mendelson was part of the Rosenbaum Commission which, in response to the assault and death of New York Times reporter David Rosenbaum.  That commission was a driving force in the cross-training of EMS personnel, and the overall integration of the fire and EMS systems in the nation’s capital. The circumstances surrounding Rosenbaum’s death seem more to me to be driven by complacency and burnout than the failure of the EMS system.  The EMTs involved failed to recognize a serious medical emergency and wrote the patient off as being drunk.  Because of this, he did not get the care that he needed.  The only place where the system failed was by not having the EMTs that initially responded to the call properly prepared for what they encountered. Now, almost six years after that committee’s recommendation, it is easy to see that the changes that were aimed at improving the system have failed.  The biggest sign of this is not the response times.  It’s not the number of trucks out of service.  It is the number of overworked and underappreciated paramedics who carried 80% of the department’s volume who have left the department because they have seen the writing on the wall.  The time for change clearly is now. Many have called for the firing of Chief Kenneth Ellerbe.  Some would even argue that due to his...

As a follow up to last week’s article about violence against EMS professionals, I wanted to share with everyone the state law that was passed in Delaware at the end of June. On June 30, the state of Delaware added “emergency medical technicians and paramedics” to a state law that makes “offensive touching” a class A misdemeanor.  To summarize the law, offensive touching is defined as “touching another person either with a member of his or her body or with any instrument, knowing that the person is thereby likely to cause offense or alarm to (the) other person. . . “  Interestingly enough, the law also includes “intentionally striking the other person with saliva, urine, feces, or any other bodily fluid” and mandates that a defendant be tested for “diseases transmittable through bodily fluids.”  In the state of Delaware, punishment for a class A misdemeanor could land someone in prison for up to a year, and could result in a fine up to $2,300. EMS advocates, services, and unions that represent EMS professionals should take note of this, and start laying the groundwork with their local law makers if laws similar to this do not already exist within their state.  This is a major victory for EMS professionals everywhere.  While laws such as this one do not make my job any safer persay, they do at least create greater consequences for those who choose to assault EMS professionals. Like I said, take note, share and advocate.  Our safety is no one’s responsibility but our...

The other day, I had a chance to read an article about Toronto EMS, and their relationship with the fire department, or more specifically, the fire department’s union.  In a recent study done by a third party, it was recommended that paramedic unit hours be increased, and that a fire station on the city’s west side be closed down.  Ever since then, it seems like in Toronto, the fight has been on, and boy is it an ugly one.  With headlines like the one on a 2010 article reading “We’re in a War with the Fire Department” do nothing but draw unnecessary lines in the sand. Dispatch protocols were reviewed, and fire first response was removed from 50 of those protocols, but added to 22 others.  In the year since the revamping, they have been added back onto less than ten of those they were removed from.  It is the position of the Toronto Paramedic Association that what the citizens of Toronto need is exactly what last year’s study calls for: more paramedics.  Ed Kennedy, president of the Toronto Professional Fire Fighters’ Association disagrees.  He feels that care being provided to the citizens of Toronto suffers without the fire department’s first response, and even says that Toronto should scrap their third service paramedic system in favor of a fire-based EMS service. My question to Mr. Kennedy is a simple one: where is the evidence?  What does he have to hang his hat on that says not only that fire fighters should be added back as first responders but should, in fact, take over the ambulance service?    The study, which provides evidence to the contrary, recommends against consolidation and advocates for the addition of 25 ambulances per day, a jaw dropping number regardless of the current size of the service.  It is time to cut through the B.S. and let the evidence speak for itself. Toronto EMS, however, is not without their problems.  Their response goal of under 9 minutes 90% of the time is not even close to being achieved, and currently sits at an abysmal 65%.  Does that mean that the system needs first response, or does that say that the need for...

Imagine if you will. . . It’s a typical day for you.   You came into work, just like any other shift, you got assigned your truck, and you hit the streets.  You did a few calls, here and there, mostly routine, you transported them, finished your paperwork for each, and got yourself back on the road.  Then, you are dispatched to a male in crisis. You arrive on scene, just like any other call to find the depressed, suicidal, and slightly intoxicated patient.  You put him on the stretcher, and place his bag on his lap and load him into the ambulance.  Initially, your patient is calm and cooperative, so you hop in back, sit on the bench seat, and get on your way to the city hospital, just like any other call. Without warning, the patient goes into his bag and pulls from it a black handgun.  A scuffle ensues, and you are able to disarm the patient, restrain him and finish the transport.  After removing your heart from your stomach, you inspect the gun and find it to be a BB gun.  Regardless though, you feared for your life, and you are assured that after being medically cleared, the patient will be dealt with by the proper authorities. This really happened to a good friend of mine.  Lucky for him and his family, he was fine.  The outcome of the patient, or rather the assailant, however, is unknown to me. Safety is a growing issue.  Recently, a Jersey City EMT had a knife pulled on them in the back of an ambulance.  They were able to dodge the first swipe, sustaining only a minor laceration, but the party they were transporting then impaled the knife in the EMT’s shoulder.  Fortunately, the injuries sustained by the EMT were not serious, and according to an article I read, they will be fine. An official in Jersey City made some eye opening comments in the article.  Robert Luckritz, the Director of Jersey City Medical Center Emergency Medical Services said that “some EMTs accept it as part of the job.”  He went on to add that “it is relatively common that EMTs are assaulted and it...