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

I like Twitter.

I stress the word like because I find it useful for some things, but not so useful for many others. This doesn’t mean that I don’t believe in it’s power or it’s influence, just that I recognize the limitations the tool has and my expectations don’t exceed it. It’s important to remember that as you read on.

So in the same vain of answering Greg’s question, I am now going to answer a question most recently asked by Steve Whitehead on Twitter that deserves more than 140 characters will allow:

Can The Real Protocol Please Step Forward?

There is a reason why medicine is still considered an art.

You can have two patients with the same complaint, but because of having vastly different histories the same treatment applied to both may help one but harm the other.

This is one of the reasons why you will find some vastly different protocols across the country. What works well for some areas may not work well for others, and what works well for some patients may also not work well for others.

In My Experience

It’s important to understand that I am New York State Certified, so my experiences are limited to working within NYS Protocols. On the fifth page of those protocols under the Introduction heading appears this paragraph:

God bless the New York State Department Of Health Bureau of EMS.

The Continuing Problem

Unfortunately, even with that paragraph there, it still leads to problems. EMT recruitment is as easy as checking the ABCs. If you’ve got a pulse and can breathe you can become an EMT. The current education is centered around the protocols and complying with them as opposed to independent thinking with good clinical judgement, because by not following them you run the risk of being held liable if anything goes wrong with the patient.

Why is that 90 year old patient with osteoporosis strapped to a backboard after falling out of bed? Protocol.

Why is that hyper-ventilating patient suffering from an anxiety attack wearing a non-rebreather set to 15 liters per minute? Protocol.

Why is that patient sitting on a roadside construction sign (next to the car he was in when rear ended ever so slightly and obviously got out of) being strapped into a soft Spinal Immobilization Vest? Protocol.

Burn The Protocol Book, Care For Them All, Let The Triage Nurse Sort It Out

I once had a paramedic who would always refer back to the protocol book. If you were turning cyanotic and gasping for breathe in the tripod position in front of him, he would take a minute to look it up in the protocol book before giving you some much needed oxygen. This over reliance on protocol is a bad indicator that our education model needs to be revamped, our recruitment methods are not working, and that we are more concerned with the potential lawsuit down the road than we are the patient in front of us.

If that paragraph didn’t exist in the NYS Protocols, I probably wouldn’t be in EMS anymore today. Heck, I probably wouldn’t have made it out of my first year because strapping down 90 year old patients with osteoporosis is just not something I think I could actually do with or without legal “justification”.

Which is another thing I blame protocol for. EMTs and Paramedics use protocols as justification for providing treatment that doesn’t benefit the patient, but benefits them. Such as taking the patient to the nearest hospital as opposed to the hospital the patient has a doctor at. Sure in a perfect world hospitals would be able to share records, test results, and other information… but right now they can’t. It’s a major shortfall of the healthcare system that we won’t be able to solve, but for that specific patient we may be able to alleviate that issue as well as some anxiety by simply taking them the extra mile (or five) to where they already have received treatment.

Finally, I hate protocol because so many people think that providing patient care is a black and white issue when it is far more complicated than that. Sure protocol can provide you guidance on the basic treatment a patient should receive, but it doesn’t provide you with a methodology or the tools to provide exceptional patient care. As I said before, there is a difference between treating and caring for your patients. Which one would you rather do? Which one would you rather be on the receiving end of?

I say burn the protocol book, care for them all, and let the triage nurse sort it out.

This post is solely representative of my own opinion and using my local protocols as an example. It’s important to educate yourself on your own local protocols and adhere to them as required. I am in no way advocating violating protocols just for the sake of it.

It is important to understand that I think having passion for something is a very very good thing. Passion can be an energizing driving force that motivates and can inspire you to do things you might not have thought possible previously.

However passion, just like The Force in Star Wars, also has a dark side. Passion can blind you with an emotional rage. This rage will cause you to react to a situation, instead of intelligently respond. This out of control passion was on full display yesterday in the EMS Blogosphere.

The emotional eruption came to full steam between Medic 22 and Timothy Clemans. I am not going to be expressing an opinion on the actual topic, but rather how passion can be a problem in Social Media.

Welcome To The Dark Side… We Have Cookies

Timothy laid the bait at the opening of his blog post when he wrote:

The following is my take on a discussion with Medic 22, a very angry EMT and paramedic student who works for a BLS private ambulance company in South King County.

Whether Medic 22 is angry or not really has no relevance. That’s a personal swipe that was totally uncalled for and is a prime example of baiting a passionate person for that emotionally charged rage type of reaction. In Medic 22’s blog post he fails to take the proverbial high road and writes the following as a closing statement:

Timothy, I called you an idiot in my IM conversation, and that stands. I also stand by the statement that you need to gain some experience in the field, even as an EMT, before you start to judge what is right and wrong with EMS today. You need to see sick and injured people before you can make blanket statements about treatment modalities.

Earlier today, I was pretty pissed when I saw that this kid took a private conversation we had and turned it into blogfodder, than I remembered he’s just a goofy kid sitting at a PC in his mom’s basement typing away… and I realized I don’t give two shits about what he thinks.

Now in all fairness to Medic 22, he felt that a private conversation had been unfairly taken public which spurred his emotional reaction. I can understand feeling this as a violation of… something… but it’s the nature of the electronic beast that what we say on the Internet can outlive us. I look at that as a learnable moment for Medic 22, because you can’t have a reasonable expectation of privacy in what you do on the internet.

However his reaction is still very unprofessional and belittling of another person’s opinion. Sure it would be nice if everyone who judged EMS actually had experience in EMS. How many Mayors, City Council Members, Senators, and lawmakers judge EMS and create budgets or legislation for it without stepping onto an ambulance? While their numbers have increased over the years, how many medical directors have actual ambulance experience? How many people, who have influence over their local EMS has Medic 22 now alienated from being aligned with our needs from his emotional rant?

It may be none.

It may be many.

We may never actually know… and that’s the scary part.

Don’t Feed The Troll

I think debate between open minded individuals willing to listen to each other and challenge the idea instead of attacking the person is not only healthy but necessary. We as a community should not estrange someone who we think may not be as “experienced” to comment on a situation, but rather take that opportunity to bring them closer and educate them as to why we feel this way and try to understand their point of view. Chances are that there are others with those same beliefs and if we can understand where the misconceptions are originating from then we can identify the source and render a solution.

Everyone has something to contribute to the conversation. We need passionate people to be able to really effect the kind of culture change we want to see in EMS. We need to respect the passion that other people have even when their opinion differs from our own, and keep our passion professional.

However it is important that we recognize someone who is failing to listen to the discussion and is more interested in creating controversy than contributing substance for what they are.

An internet troll.

My advice when these creatures appear is simple… don’t feed the troll lest you run the risk of becoming a troll yourself.

Be responsible with your use of Social Media. Learn the Responder Do’s and Don’ts of Using Social Media while working that I published in July of 2009. For a better understanding of Social Media Best Practices, sign up for the E-mail Bootcamp at PIOSocialMediaTraining.com

One of the things I found myself talking to John Mitchell about last week in Baltimore was the fact that the blogosphere is actually comprised of alot of different spheres filled with all types of blogs. There are the obvious Techie Blogs, the Foodie Blogs, the Craft Blogs, the Political Blogs, the Humor Blogs, the Personal Blogs, the Photo Blogs, and of course the Mommy Blogs… and that is really only just scratching the surface of the blogosphere as a whole. We, as public safety and public health professionals, are a very small percentage of the greater blogosphere and it’s important that we recognize great contributions of content and share it. So here are some really great posts from the EMS Blogosphere that appeared over the previous week:

• Rogue Medic continued to provide a clearer picture of the Pittsburgh EMS situation by responding to anonymous comments from those who don’t do the job. Additionally TOTWTYTR hits the nail on the head by pointing out that Public Safety Director Michael Huss continues to throw around blame instead of accepting responsibility. I can think of no other bloggers I’d want backing my social media less department at such a time, and maybe someday one of the trade magazines or publications will take a stand for a department and write an original story instead of just reposting the Associated Press drivel. Chief McCaughan, my offer still stands
• Sean Eddy from Medic Madness asks a very important question… who do YOU work for? The answer may surprise some of you… and it may just make you rethink how you care for your patients
• Ms Paramedic has an inspirational post about making thunder as opposed to stealing it. I can relate to that post on a number of levels. Everytime I think I may have pushed the boundaries or have backed a lost cause, I am reminded of a saying my mother once told me: Every mighty oak was once a nut that stood its ground. Nuts make thunder, just in case you didn’t know…

And finally…

• I would be remiss not to mention Steve Whitehead’s fabulous monthly February Roundup in case you missed anything during that month…

Have a safe week!

This past Friday I got my large French Vanilla ice coffee light with cream and with four Splendas, set my iPod to listen to podcasts, and hit the road to Baltimore for the EMS Today Conference in Baltimore. The trip was pretty uneventful, making one stop at the Walt Whitman rest area for… well… rest, and arrived in Baltimore around 12:15.

I parked by the M&T Bank Stadium (where parking for conference attendees was free) and walked the 4 or so blocks over to the convention center. Once there I checked in to get my conference badge from Lauren who was extremely helpful and answered all my important questions… namely where I could find the restroom. Did I mention I drink large coffees? So of course right after that break, I got an ice coffee from the lobby Starbucks, where I was glad to see that the decline in customer service at Starbucks was not just a New York City phenomenon.

Once done there, I descended to where the exposition hall was. Going down the escalator was what looked to be an 8-10 foot tall banner from Zoll touting some of their exhibits… including a panel for The Chronicles of EMS. I have to say that it is great when innovators support innovators, and that was just one of many examples of that I saw while there.

Entering into the exhibit hall I went left and began going up and down the aisles checking out vendors and their products. I’ve gotten pretty used to doing exhibitions, so I walk in the middle of the aisle unless I see something I’m interested in. If a vendor throws a hook my way in an attempt to real me in, I’ll generally start off by asking, “What’s the price point?” which usually makes them wince. I’m not a fluff kind of guy, I’m all about the bottom line. This is kind of my way of really saying “I’m not interested in your product which is probably overpriced, but thanks anyway,” and most of them back off. I was pleasantly surprised that there weren’t very many of those at all.

Finally I reached the Zoll booth which was actually right by the entrance only in the complete opposite direction from where I had headed when I first walked in. As I looped around the booth grabbing some literature and checking out the latest Zoll innovations, I found myself looking at none other than Ted Setla (@Setla).

So I approached him and said, “Hey, I know you!”

He looked at me with a slight look of fear before there was that spark of recognition… and thus began the rush of meeting face to face those who I’ve been conversing with over the past 11 months or so. Ted and I talked briefly about his set-up and what was going on so far at the show. He explained that Justin and Mark were down the aisle at the live podcast for EMS Garage (@emsgarage), and then I was able to turn an old partner of mine who spotted me there onto Ted and the Chronicles of EMS.

Leaving Ted to continue to swoon the passerbys at the Chronicles of EMS Booth, I wandered down to where the EMS Garage was doing a live podcast. It was a standing room only crowd, so I stood off to one side in order to get a good view. Then I worried that I might be violating fire code by blocking a fire lane because it was pretty crowded for the podcast, and I moved closer to a a beautiful tall redhead who I completely accidentally bumped into. She turned to me, turned away, and then quickly turned back and said, “Oh my god. I know you.” I had literally just bumped into soon to be Paramedic Epi_Junky of Pink Warm and Dry. Imagine that coincidence!

The live podcast was featuring Justin Schorr (@thehappymedic) and Mark Glencourse (@ukmedic999) who had to depart mid-stream for their presentation back at the booth Ted was holding down. The host Chris Montera (@geekymedic) then called up Jamie Davis (@podmedic) and… of all people… me to come up and join him!!!

You can watch the video that was live streamed of the podcast by clicking on the picture above

After extolling the virtues of Social Media for EMS Agencies and soliciting fertilization for my farm in Farmville, I finally had the opportunity to actually meet Jamie and Chris who are incredibly passionate about EMS and Social Media. There can be no better advocates for that marriage than those who are turning out high quality content… and those two are definitely at the top of the list.

While basking in the afterglow of the live podcast I also was finally able to meet the fabulous Chris Kaiser (@ckemtp) who I constantly find myself nodding in agreement to his blog posts and I found myself doing the same thing in his presence as well. I was also afforded the opportunity to finally meet Rhett Fleitz (@firecritic) who I’ve corresponded with numeorus times about all sorts of issues and his podcast partner John Mitchell (firedaily). This was closely followed by meeting Justin Schorr and having a nice conversation with him about the going ons and how word about #CoEMS is spreading. At this point, pretty much everyone went their own way with plans to meet up later that night at the big Blogger/Tweeter Meetup… and I once again found a restroom. Did I mention the Starbucks Coffee was large too?

After using the fine facilities in the exhibit hall, I still had about an hour before me lecture to kill, so I found a nice comfy spot on the second (third?) floor. While I was there checking Twitter and some e-mail, I was approached by none other than the EMS Blogfather Kelly Grayson (@ambodriver) and his friend. I don’t remember exactly what was said, because I was in shock that THE Kelly Grayson had felt the need to come over and introduce himself to me. It was a shocker moment which I shared on Twitter:

My girlfriend was concerned by that tweet, and called me. That conversation went something like this:

Her: Is everything okay?
Me: I just met Kelly Grayson!
Her: Kelly who?
Me: The EMS Blogfather, Kelly Grayson!
Her: I have no idea who that is.
Me: You know the book that sits ontop of my computer? He’s the one who wrote it!
Her: Oh. Cool!

Now I’m not always the sharpest tack in the box, because after that conversation with her I realized that I also potentially met another iconic EMS Blogger who prefers to preserve his anonymity. I happen to have alot of respect for anonymous bloggers because I think others undervalue or overlook their contributions simply because they don’t use their real name. It’s not the blogger’s identity that matters, but the content that they produce. Anonymous bloggers usually have to build a bridge of trust from the ground up by providing solid reliable information instead of the trust that gets afforded to you when you disclose your name and service. So a hat tip to that gentleman for remaining fiercely independent.

So after my session, which ironically (or not) was about Social Media, I headed over to where the big EMS Blogger Meetup was at the Pizzeria Uno. There I got to continue chatting with those I had met earlier as well as finally actually meet Mark Glencourse, and we even shared a Kodak moment that you can see somewhere out there on the internet. I have to be honest, the excitment that Ted, Justin, and Mark have for the Chronicles of EMS is not only off the charts but damn near contagious, and that can be a strong catalyst for the change we need.

I also had the opportunity to meet Mike Ward (@fossilmedic), Chris Eldridge (@thedridge), Sebastian Wong (@sebwong) and Carissa O’Brien (@carissao) who insists that I trademark my eyebrow. The conversation was interesting, the gossip about who else was going to join the “FireEMSBlogs.com” lineup was entertaining, the experience enlightening, and the food was delish.

Unfortunately, the clock struck 10 and it was time for me to make my departure since I still had a 4 hour drive ahead of me after my 1.7 kilometer walk back to my truck. Leaving such fine company was a bit sorrowful. There were conversations that had started online concluded, and in their place new ones arose in person that undoubtedly will be continued online. It served as an important illustration of what effective communication among passionate people can accomplish, and the power that Social Media has in helping that along.

As you’re reading this I’m down in Baltimore, Maryland for the EMS Today Conference. I’m just doing a one day run but I still have a list of things to do:

• Get a large French Vanilla ice coffee with four Splendas and light with cream at Dunkin’ Donuts for the road… because afterall, I am the mayor
• Stop by the Zoll both to meet the Chronicles of EMS team… and hopefully price out one of those credit card accepting monitors
• Stop by the Demers booth so I can drool over the new Mirage EX Sprinter
• Do some serious schwag shopping
• Finally, attend the Blogger Meetup/Tweetup at the Pizzeria Uno sponsored by FireEMSBlogs.com to meet all the fine bloggers I’ve been reading and conversing with for the last year or so

Since I am me, I also have a list of things NOT to do while I’m there:

• DON’T get defensive when the Maryland State Trooper that pulls me over for speeding refers to it as “an Ambo meeting”
• DON’T offer myself as a testing dummy for the newest barriatric equipment without insisting on a helmet
• DON’T admit to being the one sending Aimee Garcia of Trauma flowers wrapped in multi-trauma dressings and band-aid boxed candy while signing the 4×4 cards General Morphine
• DON’T get upset when all the schwag shirts are size Large… because you know, it’s not like obesity is an epidemic that is afflicting more and more Americans or anything
• DON’T criticize the people from FireEMSBlogs.com for putting Fire before EMS in the URL even though EMS comes first in not only call volume but also alphabetically… at least not until AFTER I eat their food…

Wanna see how I do? You can follow me on Twitter @DavidKonig for updates as they happen!

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• Fire/EMS blogosphere meet-up at EMS Today (ems12lead.blogspot.com)