Archive for March, 2010

I don’t know what it is about this week.

Maybe it’s just the karma of things coming together in odd little snipets.

Kind of like this news from Reynolds which really doesn’t bold well for that whole socialized medicine argument.

Then again… it’s not like that same exact thing is happening here in the United States under the disguise of Medicare funding cuts…

Yeah right.

And those weren’t the droids he was looking for either…

I love technology.

Yet as much as I love technology, there are times when it just goes wonky.

Like with Feedburner’s E-Mail Subscription that has failed to send out e-mails for a few days now.

Like FireFTP that just can’t seem to get past the 12.1mb mark of a 13mb file.

Like Callburner that seems to have decided to record one side of a two sided conversation.

Somedays I think I may just need to go old school…

I think there’s a trend there with all the burning and the fire themed technology going wonky on the same day.

Just sayin’.

Photo Credit: I Will Find The Droids I’m Looking For by Stefan on Flickr

	Published Weekly Digest for March 22nd.
	New Post: Weekly Digest for March 22nd http://bit.ly/9atY98 [davidkonig]
	Shared Rainbow Tongue.
	Published EMS Blog Rounds Edition 33.
	Love this – #ebook for #EMS Professionals | MCI Response Tips, Products, and Training | Everyday EMS Tips http://is.gd/aSQBZ [davidkonig]
	Checked in at Levain Bakery
	RT @piosmtraining Consequences to Employees for Using Social Media http://bit.ly/a4vkVW [davidkonig]
	Shared Consequences to Employees for Using Social Media.
	RT @NationalFire: I’m putting together a list of fire & EMS blogs. If you want yours included, send me the link. Please RT. Thanks! =) [davidkonig]
	RT @piosmtraining Consequences to Employees for Using Social Media http://bit.ly/a4vkVW [davidkonig]
	I’m at Dunkin Donuts (81-55 Lefferts Boulevard, Cutthbert Road, Kew Gardens). http://4sq.com/5sfnDp [davidkonig]
	Checked in at Dunkin Donuts
	RT @everydayemstips: Have questions regarding #EMS industry? Join @gfriese @emssafe each Wed. Call in to http://bit.ly/90Np4m #podcast [davidkonig]
	New Post: EMS Blog Rounds Edition 33 http://bit.ly/bWt2gp [davidkonig]
	Checked in at Super Stop & Shop
	I’m at Super Stop & Shop (8989 Union Turnpike, Glendale). http://4sq.com/8NLiao [davidkonig]
	Checked in at Pizza Classica
	I’m at Pizza Classica (89-89 Union Turnpike, Glendale). http://4sq.com/6OBydk [davidkonig]
	Thanks @audible_com for sponsoring @emsgarage ! [davidkonig]
	RT @gfriese: Added new content, created 2nd ed. ebook on #MCI response by EMS. Download, Share, Distribute widely 2ndhttp://bit.ly/atUz2 … [davidkonig]
	Published The Assassination Of Pittsburgh EMS By The Coward Michael Huss.
	RT @geekymedic: Mr Steve Wirth on the next @EMSGarage Watch for it on Friday! [davidkonig]
	Is the entire internet wonky today, or is it just me? [davidkonig]
	RE: I absolutely agree that the current health care reform debate has been swayed in large part by the “special intere… http://disq.us/dkm5b [davidkonig]
	In reply to @AmboDriver I called #EMS2.0 a “special interest group” similar to Big Insure & Big Pharma. Am I wrong? http://disq.us/dkm5b [davidkonig]
	@annagdickson You can have THAT @foursquare mayorship! Please give the bailiff my regards… [davidkonig]
	RT @FireCritic First Due Blog Carnival Episode 1 “I Am A Firefighter Because…” http://tinyurl.com/y959hd5 [davidkonig]
	RT @gfriese: Added new content, created 2nd ed. ebook on #MCI response by EMS. Download, Share, Distribute widely http://bit.ly/atUz2e [davidkonig]
	@AmboDriver Gaining that type of influence is, IMHO, the ultimate goal. Nothing is impossible. Impossible just takes a little longer #EMS2.0 [davidkonig]
	RT @depiction: 1.5 hrs til our @RedCross webinar-we’ll go over how 2 use @geocommons, @ushahidi, @crisismappers, etc. http://bit.ly/boxfUZ [davidkonig]
	RT @setla: I want to talk with a #Ning #Developer, We want to change the rules of engagement for #CoEMS, contact me ASAP [davidkonig]
	@setla My pleasure. Love the #Ning . Just wish I had more time to learn it from a #Developer perspective myself. [davidkonig]
	RT @depiction: Our #RedCross Month #webinar is less than 15 minutes away! http://bit.ly/boxfUZ [davidkonig]
	Love it!!! RT @AmboDriver: That’s my official motto: “Difficult problems solved immediately, impossible problems solved in a few days.” [davidkonig]
	Great #MCI resource from @gfriese: Download, Share, Distribute widely http://bit.ly/atUz2e [davidkonig]
	Shared Video From Pittsburgh City Council.
	RE: @AmboDriver This is awesome on a whole lot of levels. I think it should become Chapter One in all future EMS curr… http://disq.us/dkmt9 [davidkonig]
	RE: Thanks for digging through the much and shining the light on the truth, as well as the comment. I agree wholehear… http://disq.us/dkmtn [davidkonig]
	Checked in at Green Field Churrascaria
	Here for the farewell Ken Kriska party (@ Green Field Churrascaria) http://4sq.com/cGhbkr [davidkonig]
	Checked in at Dunkin Donuts
	I’m at Dunkin Donuts (81-55 Lefferts Boulevard, Cutthbert Road, Kew Gardens). http://4sq.com/5sfnDp [davidkonig]
	Published EMS Version .1 Versus Today.
	RE: Once again I completely agree that this is what they ultimately intend along with shifting blame off themselves. http://disq.us/dknwp [davidkonig]
	RE: The movie is a bit long but had a very interesting message of the power a legend can have I think can apply to thi… http://disq.us/dknxt [davidkonig]
	Checked in at Forest Park
	I’m at Forest Park (Forest Park Drive, Queens). http://4sq.com/53hrtV [davidkonig]
	Shared Fight for your Right: EMS Garage Episode 79.
	Fight for your Right: EMS Garage Episode 79 – http://b2l.me/k72×5 (via @EMSGarage) [davidkonig]
	New Post: EMS Version .1 Versus Today http://bit.ly/cArq75 [davidkonig]
	New Post: The Assassination Of Pittsburgh EMS By The Coward Michael Huss http://bit.ly/bp4IVK [davidkonig]
	RT @gfriese: submit entries for EMS Expo innovation awards http://bit.ly/9ghjK5 [davidkonig]
	RT @foursquare: Officially declaring 4/16 as 4SQ Day! 4 squared = 16 = 4/16 (thx @redheadjessica) http://www.facebook.com/FoursquareDay [davidkonig]
	The Assassination Of Pittsburgh EMS By The Coward Michael Huss http://bit.ly/bp4IVK [davidkonig]
	Checked in at Georgia Diner
	Brunch with Stef (@ Georgia Diner) http://4sq.com/4wreZ4 [davidkonig]
	Shared Fight for your Right: EMS Garage Episode 79.
	Gotta get some coffee (@ E-Sparks Coffee) http://4sq.com/8l219V [davidkonig]
	Checked in at E-Sparks Coffee
	Shared Give me that Filet-O-Fish via CVS.
	RT @NotifyNYC: Due to emergency activity at 80 Maiden Lane in Manhattan; 80, 90 and 100 Maiden Lane are being evacuated. [davidkonig]
	RE: I completely agree with that Steve. Truth is that I think most of us miss that balance when we first start, becaus… http://disq.us/dkr9f [davidkonig]
	Spending the day with the family and the night watching the Undertaker go 18-0 at Wrestlemania! [davidkonig]
	Checked in at Borders
	I’m at Borders (8000 Cooper Ave, 80th Street, Glendale). http://4sq.com/50ivuO [davidkonig]
	Checked in at Iavarone Bros.
	Getting the Wrestlemania 3 foot American hero (@ Iavarone Bros.) http://4sq.com/9xeFuw [davidkonig]

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Facebook is really an interesting platform. The barriers to participate are limited to an internet connection and the basic understandings of e-mail and web browsing. Because of this low barrier it can provide a bridge where the generational gap is narrowed. Not so much on thinking, but rather on communicating. While there is evidence of this on many levels, the recent comments on the JEMS links regarding the situation in Pittsburgh has really highlighted it for me personally.

To illustrate my point here is a screenshot of a comment left by Larry Grayam. Now there are dozens of comments like Larry’s, but his stands out to me for a specific reason that I will get to.

First, I find it impressive that his first EMT class was in 1968. I was always under the impression that the designation of EMT didn’t start until the 1970’s after the disastrous 1960’s jigsaw puzzle of Red Cross certifications, but that’s really a minor point. Back then I know that latex gloves were not in fashion, portable oxygen was a luxury, and no one had yet invented the plastic disposable cervical collar. Today latex gloves, high concentration oxygen, and disposable c-collars are all commonplace and have become the “standard” of treatment. There are other such comparisons that can be made, but I think you understand my point.

What is also different today, as Larry points out, is back then “THE PATIENTS NEEDS ARE ALWAYS YOUR FIRST PRIORITY. It seems that our new modern EMS has not learned this simple lesson.”

Today we are about Body Substance Isolation (BSI) and Scene Safety. You as the provider come first, everyone else is second.

Why has this changed from Larry’s days as an EMS provider?

So let’s be honest, we have learned this simple lesson. We learned that when patients transmit diseases to us through blood or urine, we are the ones who have to live with their past indiscretions. We have learned that when we emotionally invest ourselves in the well being of our patients, we become emotionally divested from our families and we are the ones living in broken relationships. We have learned that when we physically place ourselves in harms way, we will be forced to fight for the financial ability to get the help that we once provided access to for others. We have learned that when we make the ultimate sacrifice, our sacrifice will not be acknowledged or will be overshadowed by the same exact sacrifice as other professions in the eyes of the public.

The fact is we learned that it is not in either the patient’s best interest or our own to continue with such a blind mentality because at some point… we’re just not going to be there anymore whether it be from illness, injury, mental instability, or death. So tell me Larry, then what happens to the patient?

Now this is not to say that EMS providers should not be compassionate and as you may or may not know I am an advocate for caring rather than treating. This is not saying that we should not put in a solid 666% effort to do everything we possibly can to reach, care for, and transport a patient. Yet, I’ve learned my lesson about exactly what happens when you place the patient first above all else. I learned it when I got divorced, I learned it when one of my partners got stuck by a dirty needle in a patient’s pocket, and I learned it when 220 stories of concrete and steel came down taking my friends and partners (who were busy putting the patient first) away… forever.

See, I’ve learned it Larry (and everyone else from that era with this antiquated thinking) and in an odd way I’m really glad that you and your partners never had to.

The Associated Press reported yesterday that 4 EMS Workers were being punished for the death of Curtis Mitchell.

Mr. Huss said they should have walked to Mr. Mitchell’s home to retrieve him. “It’s that simple,” he said.
- Pittsburgh Post-Gazette

At the center of this mess has been Public Safety Director Michael Huss, who’s sole purpose of employment by the city of Pittsburgh is to direct the efforts to keep the public safe. While his quote above indicates that he was there on the scene, he has to my knowledge failed to disclose where he was during this time frame. However his lack of transparency did not prevent him from this prediction:

The six paramedics on the three ambulances could be disciplined, Huss said. He declined to say what that might be.
- Time 2/28/10

So the three different medic units, six medics in total, are possibly facing disciplinary action that may or may not have already been decided. This ominous tone is an attempt at bravado but ultimately is a cowardly act of deflection. Which then brings us to yesterday’s news that:

City officials decided to fire one acting crew chief, Josie Dimon, an 11-year veteran with medic unit No. 8. She will first serve a five-day suspension and can defend herself against the charges during that time. Another crew chief and two district chiefs each received three-day, unpaid suspensions.
-Pittsburgh Tribune-Review 3/23/10

This comes after the Pennsylvania Department of Health Investigation cleared the paramedics of any wrong doing. Now I am all for agencies not using their state minimums as their personal maximums, however Mayor Ravenstahl seems to indicate that it is a feeling as opposed to being an actual policy:

“When you look at the state’s requirements that nothing was done wrong, we feel differently,” said Ravenstahl. “But one thing that’s important to understand is that we have higher standards — in terms of what we expect from our paramedics here in Pittsburgh — than what the state requires.”

Ravenstahl, along with other city officials involved in the case, has not revealed what those standards are.
-WTAE 4 3/19/10

So if these standards are higher, why are they secret? I would think that is something the Mayor would be proud of… unless he thinks that he can just conjure up higher standards after the event and make them retroactive.

The fact is that Pittsburgh’s standards were not higher during the event as suggested by this quote:

Paramedics or firefighters will now be required to go to a caller’s door.
- Time 2/28/10

There comes a time when you need to stop laying blame and start accepting responsibility for both the actions and the delinquency. The disciplinary action against 4 workers (which calls into question as to what exactly happened to the other 2 since it was previously predicted that 6 would face disciplinary action) for a standard retroactively applied is an attempt to assassinate Pittsburgh EMS as an independent EMS provider.

How is it an assassination attempt you ask? How else would you characterize it when Josie Dimon, a paramedic on Medic 8 who was out there working in the snow, be the only one to be terminated while Kim Long, who was not on an actual ambulance but working in the EOC in a leadership role, is simply suspended for this incident? Oh… and as it turns out… for one other:

Long, a 19-year veteran, was in Allegheny County’s Emergency Operations Center that weekend and called Mitchell’s home several times to get details. She did not tell ambulance crews that Mitchell was in too much pain to walk to them, and once told Mitchell’s wife he needed to take a bus. Long received a second three-day suspension for a separate incident, in which she told a mother with a sick 2-year-old to walk through the snow to an ambulance, Huss said.
- Pittsburgh Tribune-Review 3/24/10

It seems Mr. Huss is going after those who obeyed direction as opposed to those that gave it. If you ever need a justification for going rogue in a poorly led system, that decision would be it.

While I have made no secret about my displeasure in the handling regarding this case by the so called city leadership, I’ve really left the heavy lifting on this to Rogue Medic (who shares his thoughts on this news with The Scapegoats Will Be Punished) and TOTWTYTR (who shares his thoughts on this news with Human Sacrifice). I just want to publicly thank them for adding their voices and sharing their additional knowledge so that we do not have to rely on just the mainstream media’s obviously poor version of events.

Sources: Associated Press, Time, Rogue Medic, Pittsburgh Tribune-Review, WTAE 4

Inspiration for the title of this post: The Assassination Of Jesse James By The Coward Robert Ford

One of the biggest draws (whether we like to admit it or not) to joining up in the Emergency Medical Services is the adrenaline rush it can provide. The EMS Blogosphere is no different in the excitement factor and is usually a whole lot more convenient. Here are some of the things I read that got the adrenaline pumping:

• Steve Whitehead explains that trust is a currency. I find that to be profoundly true, since it’s value can be traded up or down, exchanged, and also lost
• Chris Kaiser put a different spin on the trust theme because ultimately it’s everything. There should however not be any confusion in thinking that because money is currency like trust that therefore money is everything. Because it’s not. Of this, I assure you…
• Greg Friese offers up some important EMS Week 2010 Tips. I know it may still seem like a long way off… but in reality EMS Week is coming up faster than you think and if you don’t start planning now you may end up with a marginal program as opposed to a superior event week

And finally…

• The EMSEducast had a fantastic episode on Presenting at EMS Conferences. The discussion was fantastic and provided some real insight into not only conferences, but just general good career advice. You can listen to the episode bly clicking the link above or you can subscribe in iTunes and never risk missing an episode again!

Have a safe week… and if you are like myself and suffering with a cold, be sure to read the side effects label on any medication you may be taking. Drowsiness while caring for a patient or while driving isn’t something we want to expose others to…

Ever since coming back from EMS Today the core of this post has been rattling around in my head. Last week I read EMS 2.0: The Logistics of Change by Kelly Grayson and I felt both a greater need and urgency to write this post. Unfortunately, as it is a common occurrence, unforseen circumstances have delayed me until now (which was actually 3 days ago).

The Real Influencers of Change

The process of change is not going to be an easy one to endure. I agree with Kelly Grayson when he says, “We don’t hold the reins of EMS. None of us do.” This is something I’ve understood from early on.

Where I respectfully disagree with Kelly is when he says, “No, the people who will shape the future of health care in America, and by extension EMS, are politicians and policy wonks who know little of our concerns.”

The real people who will shape our future are our potential patients. Ironically this is playing out in our political system right now with the current healthcare reform proposals. The politicians and policy makers have been forced to revise and revamp those proposals constantly due to pressure from the people they are there to serve, the actual everyday public.

Higher education in EMS would be nice, but I don’t think it is a necessity to effect the majority of the change we appear to be seeking because the people who really matter don’t care about the letters after our name… they care about how the change will affect them and we need to be able to speak to them in ways they will understand. It’s vitally important to recognize that fact. For the change we are looking for specifically in regards to being considered a profession as opposed to an occupation, that is something that we need higher education in EMS for.

The Role of Social Media

So where does Social Media fit into all of this?

Social Media is simply providing a platform and is what we make of it. It is a tool that we can use to speak to those that can actually effect change about the issues and ideas that matter most to us and get feedback from them on their thoughts and what matters most to them so we can look and see how it can be made better by meeting everyone’s needs.

Social Media isn’t the star of this show as some people would believe… but it is the idea of communicating from the people behind the creation of the media that is the real star.

The Potential Process of Change

Understanding all of the above, here is what I think a potential process of change could be for EMS 2.0:

1. Start the conversation from within – This has already started with blogs, The Chronicles of EMS, podcasts and the seemingly never ending 140 characters of Twitter. The conversation, even 9 months or so in, has really just started and will likely continue for another 2 years or so
2. Identify the priorities – From the conversations we’ll be able to identify the priorities. It’s important when doing so that we don’t alienate a sector of EMS. Traditionally we are an industry divided along the lines of municipal paid agencies, commercial paid agencies, and volunteer agencies as well as other service “based” EMS agencies as opposed to stand alone EMS agencies. Excluding one sector or another will in all likelihood be the downfall of any proposed change.
3. Take the top 3 priorities/goals and develop a message – Once we can identify the top 3 priorities/goals we need to create a message. It’s important to understand that the message needs to be framed to those that matter most… so saying, “We will be able to refuse to transport a patient to a hospital when it is a non-emergency” won’t go over as well as perhaps “We will be able to save the patient, and the tax payer, money by being able to refer them to a facility better equipped for their needs”. We need to remember that the message needs to be about them, and not about us.
4. Communicate those messages effectively to those that matter most – We need to be able to effectively communicate those messages. Social Media provides another great resource to do this, but it will require us to break out of our comfort zones. We need to be able to build relationships with those in our communities who are not directly involved in EMS but have the power to effect the change we want to see. Facebook, MySpace, and local blogs are three examples where we can do this easily.
5. Address the concerns of those that matter most effectively – Someone is going to raise the opposition to change. We need to take a page from Web 2.0 on this and be transparent and address that opposition head on.
6. Collectively support the efforts to effect the change – When that politician does take the first step after being cajoled by their constituents and that legislation does get drafted, we need to support it as a collective even though individually it may not affect us. It’s like the smoking ban, all it took was one state to do it and the rest followed like virtual dominoes

Does the process above look easy? If it does, then I’ve obviously not communicated it effectively… because it will indeed be a very hard and difficult road. The toughest part will be the time frame, which I would give a 7-10 year estimate on, simply because we have become such an impatient society and want what we want now.

Yes. I said 7-10 years before we can effect any real change. Now this isn’t necessarily the process that’s going to happen, and I’m not even really advocating this as the process to use… but I think that realistically it is something similar to this that will need to happen for real change to occur.

What You Can Do Now

So while change is still further away than most of us would like, let’s talk about things that you can do today to help make that change actually happen:

• Participate in the conversation on blogs, in forums, and wherever the conversation is happening
• Support the communities where the conversation is occurring
• Go find 10 non-EMS blogs that you can identify with, add them to a feedreader, and build a relationship with that blogger. It doesn’t matter the type of blog (although political blogs, local blogs, personal blogs, and mommy blogs are probably the most likely genres to help spread the message when that’s ready) just as long as you are building an authentic relationship through commenting, linking, and having a conversation even if it has nothing to do with EMS
• Identify what YOUR priorities for EMS 2.0 would be and communicate that
• Be patient but remain passionate. Rome wasn’t built in a day and change will not magically happen overnight but it definitely will not happen if you lose your passion for it

As always, feel free to share your thoughts in the comments…

The Olympics highlighted one thing for me… everyone needs an anthem.

I think it’s about time we get one for Social Media, although I’m not entirely sure that this should be it simply because it’s more of a spoof than an original piece of work. I’d really like to see an original piece with this sort of hook

Found via Mashable