Skip to content


Archives for

See all posts in the network tagged with

A true close call

View Comments

broad street bulliesIn my confused and sleep deprived state I neglected to include an article in this month’s Handover from one of our favorites, Lt Morse from Rescuing Providence. An oversight I have come off of my break to rectify.

“It’s a three mile trip from the Rhode Island Hospital Emergency Room to the Allen’s Avenue Fire Station. ETA six minutes. I could probably make it. Everything was going great, light traffic, perfect weather conditions, no road construction in sight. I could see the promised land in the distance, a little more than a minute away. I started to relax.”

Only the hardcore providers among us have been in this situation and survived. I once ducked into a patient’s bathroom to puke, but I had been feeling bad all day and the timing was right. But never have I been a block from release only to be…well…read for yourself.

And then read all about the Lt’s movie situation, and follow along to see if I play the love interest, the cranky Captain or cross the street in the background.

This was almost a letter in my file.  Phew.

the Handover – Close Calls Edition

View Comments

Last call for the HandoverThis month’s handover draws from our friends across the interwebs stories of close calls. Times when they or their patients, colleagues or family almost didn’t make it. I was inspired to make this the theme not just because of the holiday weekend here in America, but to remind us all that we are fragile and put ourselves out there sometimes. Hopefully one of these links rings back when you’re in an unsafe or curious situation.


Found with the Where did the angry guy go files-

“What do we do?” asked Eric, his eyes wide.

“I don’t know about you two,” I said, “but I’m about to jump through that window over there.  I don’t know if that guy’s getting a gun or what.”

by Buckman who runs Gomerville

From the I don’t think you should be driving file-

“I was overwhelmed by the dreadful realization that I had just accepted a ride from a highly intoxicated snowmobile rider and we were hurtling through the dark northwoods at 70+ miles per hour.”

from Greg Friese of, among many, Every Day EMS Tips.


From the Thank God you’re driving category-

“This was a serious incident. This was no routine, boy, we almost had an accident. This was my death.

I don’t know if my partner would have stopped on his own if I hadn’t shouted. Maybe. Maybe he had it all under control and was already getting ready to hit the brakes.”

from Peter Canning, a new contributor to the FireEMSBlogs family, at StreetWatch:Notes of a Paramedic

In a section titled simply Gulp

“Jill and I found him lying on the floor, fully clothed and in a coat, eyes shut, but eyelids flickering. An almost certain sign of pseudo-unconsciousness. A fake. I took a step back and called out to him. Jill was still standing by the front door, uncertain how to proceed. Something still felt wrong, so I asked her to go and call for police back up. With hindsight, I should have gone with.”

writes Ben Yatzbaz, resident Insomniac Medic


Found in the Basement selection

“This moment, this intense moment, was where I made a decision the likes of which I hope I never have to make again. I knew that if I stayed more than a few moments longer, I would suffocate and burn to death right there on that floor.”

from our pal Chris Kaiser at Life Under the Lights


From the lost in the snow pile-

Dear God, they’re working a search pattern. Please, not tonight. It’s not mutual aid to another fire department; they’re working a grid search with the police. I grab my boots, then pad to the garage to check the fluids in the IV warmer. Anyone caught in this weather without shelter will be near death, if not there already.”

by Mack505 at Notes from Mosquito Hill


From the trust your guts file-

“I give my partner the “time to leave pronto” hand gesture. “Code 3, hurry up”. I give a little oxygen and attempt the IV enroute with no success. I realize that something is not going well for this patient and I don’t have the means to diagnose or fix the problem.”

by Rescue Monkey of Paramedic:Life on the Streets


From the Old School section-

“The smoke level now was to the floor as I grasped the hose line to find my way out. The urge to rip off my mask was strong but my training had taught me this would be fatal for sure.”

by HMHQ Contributor the Angry Captain


and finally, from the Hmmm…that looks wrong category

“A back board was brought up and one of the other Paramedics on the engine teams attended to him pulling off his jacket.  Justin asked us if the building was still on fire. We we told him that yes, it was still on fire, he asked us to put his jacket back on. Not completely out of it.”

from yours truly and the event that launched me into the blogosphere.



Next month’s handover will be hosted by Ambulance Driver, theme TBD, watch his space for details as they develop and, above all else, be safe.

HM Clear.

the Handover dead line draws near

View Comments

Last call for the Handover

Pass the word far and wide, the November edition of the Handover is calling for submissions of your favorite EMS/Nursing/Rescue/Fire and pre-hospital care blogs.

This month’s theme is “Close Calls” and revolves around a time when you or one of your patients almost didn’t make it.

But if you haven’t got a tale like that, feel free to pass along a post on another topic.  You can submit an article or post by sending a link to thehappymedic@gmail.com.  If the post is not your own, make sure you let me know your name and why you like that blog.

Submissions are due by 10PM Pacific Time wednesday November 25th.  This is so I can edit the post on my flight back from England to publish it on time.

 

The December edition of the Handover will be hosted by one of my favorite EMS bloggers Ambulance Driver, topic TBD.  If you are reading this AD, drop me a line with the topic and I’ll hand it over on Friday the 27th.

Ask not what what your service can do for you…

View Comments

You know it’s a good meeting when the Chief Administrator of the North East Ambulance Service turns to you and says, “What do you need from us?” Points at the senior managers, “How can we help you?”

Preconceptions were answered for and systems were compared.  I brought up the countless stories we seem to hear about ambulances here leaving old women in the streets for hours and the mandatory meal breaks.  I asked about the fire brigade responding to assist and the rapid response cars being sent before a call is classified.

And I got answers.  From the Chief Administrator.  And they weren’t the usual political safe answers so common back in the US.  He spoke of peeak usage times and limmited resources available in crtain areas, not unlike in the US.  Mandatory stand down times CAN be broken into, it just means the crew gets paid more.  Circumstances such as the ones reported are investigated very seriously and performance standards from call takers, to dispatchers to field crews are all monitored very closely.

While in the Headquarters building I was given the opportunity to listen in on call takers using the new NHS pathways system which differs from Criteria Based Dispatch in an amazing way: It does not classify based on a differential diagnosis, but by specific questions pertaining to the severity of certain conditions.  This allows the computer to narrow down the proper response or treatment pathway the same way those little compters play 20 questions with you.  On one call I listened to never in the conversation or the screen did “Heart Attack or Stroke” come in except for the question about past history.

The car was assigned as the call came in and the call taker could see the unit travelling on the GPS screen and update the caller as to how far away they were.  When you hear all the things about the 8 minute target by the way, that’s from the time the call is answered, not from time of dispatch.  The call taker has a buzz in their ear and the line is instantly connected.  Before she had time to say “Ambulance Serivce” the clock was ticking and doesn’t stop until a vehicle able to transport arrives on the scene.  As the call is coded, if appropriate, the car can be stood down and reassigned wile the ambulance continues, or the caller can be advised to call their Doctor.  Yes, you read that correctly, the person who calls with the stomach ache who answers pertinent negative questions is referred to their Doctor.

 

In the end, the meeting had a simple message to all of you reading this or thinking about changing your systems:

Patient outcome.  Not magic response times, not little yellow cars or big red trucks, but the desire to do what is right for the patient.  If you arrive on scene in 8 mintes and 10 seconds instead of under eight minutes, but made a life saving intervention, shouldn’t that be a success instead of a failure?  How many systems in the US are tracking their staff this way?  Granted it is a hard metric to judge, but with the electronice collection of data, we can now look at more than response times, so let’s do it.

Mark’s administrative officers were also discussing a possible trial of Syncronized Cardioversion, something the system does not currently offer but we in the SFFD do.

And all because two bloggers felt like getting together.

the Project updates/Writer requests

View Comments

Still in England, trying to gather as much as I can about a different way of doing what I do. We just finished a video update (vlog Im told to call them but that sounds too Klingon) about some of the differences between us, from radio communications to resource allocation to treatment and transport decisions. I feel bad for you guys when I get back and settled and write this all up. I’ll have to break it into a number of posts spanning weeks.  The video is loading to youtube as I type, it’s almost 9 minutes long so may take anywhere from 6 weeks to 10 years to upload.

UPDATES-

We finished our third day on the rapid response car today and are due one ambulance day later next week.  The car is a neat resource to have if staffed by the right kind of pro-active Paramedic who can be trained and trusted to recognize when a person doesn’t need to go.  Now we just need a system willing to trust their paramedics to make those decisions.  We don’t need more ambulances, we need less patients.  This system is operating with more medics but less ambulances than similar US communities, and yet no response from the fire resources on medical calls.  This system is not locked into the antiquated BLS before ALS response model adopted by so many communities.  The current system is front loaded and allows the best allocation of resources based on a highly trained person first in the door to make the next decision regarding response, whether that is to cancel the ambulance based on presentation or to continue the ambulance.

Unfortunately, this model does have it’s limitations and sending the car or ambulance based on proximity to the call could be doing good to meet response times but may not be the best decision for the system.  I think another car and another ambulance could provide excellent coverage in this area, but that will cost money, one thing that all emergency services are hurting for.

The car model should be evaluated by rural areas or any volunteer ambulance or squad running Paramedic Fire Resources.  You can get a medic in the door and make the determination as to how the ambulance should respond, instead of so many persons put at risk running lights and sirens to what will likely turn out to be a non-emergency.

I’ll be learning more about the Pathways triage and redirection system tomorrow and hope to learn hoe this system can triage callers away from 999 and to the appropriate persons in the healthcare system.

But I know what I want out of this, what do you want? Im over here as your eyes and ears and this is your chance to learn about Mark and this system just as much as me, only you dont have to sufferthe jet lag and 5 AM starts (9pm my body keeps telling me)

So I ask you to email me what you want to know while Im here. What are you dying to ask someone over here but never get the chance? The chance is here, take it.

Weve gotten requests on Twitter to have a look around the rapid response car in a video update, thats coming up.
Ive also been asked by some of my fire service readers to bring up the high pressure low volume tactics emloyed here. Believe me that will be a big part of my discussions on Wednesday with Swalwell Station Manager Moodie who will be giving me a tour of the fire resources in the area.

thehappymedic@gmail.com

We’ve got pulses! – TRAUMA re-ordered

View Comments

trauma-nbcI awoke this morning in the UK to news that NBC has ordered three more episodes of TRAUMA.  Before you go groaning about how bad you thought the show was realize the opportunity we have as a Profession.  Everyone talks about the show being up against better shows in their time slot.  Mark and I even had a chance to visit the set of a filming while he was in San Francisco and even the folks there mentioned the tough time slot.

 

Does anyone watch TV when the shows are live anymore?  I have weeks of my favorite shows backed up on the DVR, including TRAUMA and we only watch certain shows live.  The rest we watch when we have a chance.  So put away all those arguments about the time slot.

Also, realize that we’ve been heard by the writers and producers about the characters and call types, the show is getting better with each episode.

Enough about the unrealistic medicine.  Of course it’s unrealistic, but how many of you demanded ER be cancelled for the same reasons?

 

TRAUMA is the first real vehicle for bringing our job into the light.  I’ll be it it’s a dim light for right now, but we need to take anything we can get and change it when it gets here.

Besides, until Chronicles of EMS gets picked up, this is the closest thing to what we do on TV.  Unless you want Baywatch back.  Don’t make me get that one out.

 

So let’s get our patient loaded and transported.  This might just be an epi rhythm, but stranger things have happened.

What do you think I just did?

View Comments

This is a message to some of my clients who seem to think every bump and scrape requires a 911 ambulance ride to the emergency room.  In case you’re new and not sure what client means, a client is a person who perceives themselves to be a patient even though, based on a thorough assessment, they have no condition that warrants even a BLS ambulance.

You were sitting at your desk and felt a sharp pain in your wrist while typing.  Instead of rubbing the wrist and taking a break, making an appointment with your doctor, you’ve called 911 and reported an odd tingling.  You also decide to mention you’re sleepy and overworked, hoping your boss is listening so you can have the rest of the day off.  My dispatchers combine sleepy and tingling arm and (magically) dispatch a full medical assignment to a possible stroke.  6 lives are put at risk driving lights and sirens (A whole other debate) to your wrist.

When I arrive you are alert, oriented and all your vital signs are normal for you.  I examine your wrist and find no edema, discoloration, decreased range of motion or anything else indicating an injury, let alone an emergency.

Then you say my new favorite line:

“I think I should go in and get it checked out.”

When I take a deep breath and say, “Can you drive or call a friend to take you” while screaming in my head “What do you think I just did?” you reply that no, you know your rights and have insurance so you’ll be going in the ambulance.

Riding your bike in the park can be nice.  When you miss that crack in the sidewalk and fall off your bike, scraping your elbow, you should get back up and ride along.  Instead you’ve called 911.  The magic dispatch computer is once again sending the world because you used the words bike accident and headache.  When I get there you’re on the phone with your brother who is telling you to go in and get checked out.  I check you out and give you the self adhesive bandage common in most homes and tell you to be more careful.  Then you hand me the phone and the brother tells me all about the actress who hit her head and died the next day, then demands you go in to get checked out.

“Did you hit your head?” I ask the rider.

“No, just landed on my elbow, but do you think my head might be hurt anyways?  You never can be too careful.”  He replies.  Then removes his pristine helmet.

“You can be too careful actually.”

“I want to go with you and get checked out.”

You are a Medical Doctor.  You run a successful practice here on the 5th floor of the medical building across the street from the ER.  911 was activated when one of your patients arrived with a rash on her ankle and wanted a cream or salve to help with the irritation.  It was 5 minutes after 5 PM and you called 911 from the elevator lobby to get her transported to the hospital across the street.

“Is this a transfer, Doc, or is this a 911 activation for a rash?” I thought it was a perfectly fair question.

“Do your job and take her over to get checked out.” Was his answer.  I didn’t have the confidence back then to remind him that checking her out was actually HIS job in the first place.  I also later learned that driving people to the hospital is not my job.

“Do I really need to get in the ambulance?  I can just cross the street on my own.” The woman told us.  And we didn’t stop her.  I know now we would advise her that if she can, come back to the doctor’s office in the morning with a big smile on your face and ask to be “checked out.”

Point being, friends outside the business, is that what I do when I arrive on the scene of your “emergency” is check you out.  When I take a deep breath, stand up and ask you what you think you should do, that is your cue to say, “I guess I don’t need an ambulance.”  Because if you did, I’d have you at the hospital by now.

Want to go get checked out?  What do you think I just did?

I’m on a boat

View Comments

Willa, Mark and Justin hamming it up on the dock.Mark’s last day in the firehouse in San Francisco flew by today and filming went great.

We were lucky to be assigned to the Fire Boat Guardian, since that is one of the responsibilities of Engine 13.  A group of school children arrived for a tour and a cruise and we got to come along to staff the boat.  Mark and I, and the Dridge, had a wonderful cruise along the embarcadero, off under the golden gate bridge, then around to Alcatraz Island.

It was a beautiful clear morning and, now that I think of it, it hasn’t been cold or foggy since Mark got here.  I think he finished with 3 videos and 60 some odd pictures, all available on the flickr link.

It wasn’t really “Paramedic” related, but this was part of my regular day, so away we went.

 

It was a somber mood on the set of Chronicles of EMS today with the England filming still in the air with 72 hours until I depart.  It was also a little difficult scheduling wise this week since the original schedule prepared months ago was thrown out do to a new policy here in the SFFD.  Not a huge deal, we just had to call in each day to find out what the schedule was for the next day.  But then again, that’s how I get my schedule on regular days.

 

I want to prep you guys for amazing news and bad news.  I’m not sure which to tell you yet, because I don’t know myself, but I want to say something ahead of time.  When Chief Hayes-White walked into the conference room a week ago, she had a 5 minute notice that Setla Productions would be filming.  She walked in seeing me, Mark, Ted and Chris and rolled with it.  So did Cheif Howes.  That being said, since Ted got funding at the last minute, we were still unsure of whether it would be filmed until halfway into the meeting when we realized they hadn’t stopped the filming.

They could just have easily told us to turn off the cameras and tell Mark he wasn’t welcome, then keep me around to show me my pink slip.  All these actions seem extreme, but not outside the realm of possibility.

 

You guys have been following along behind the scenes of the Pilot pisode of the Chronicles of EMS but have seen none of the actual show yet.  I think Ted said they have 26 or so hours of film for the show and a number of Mark and I talking about the patients we saw and the differences, but I think tomorrow’s exit interview will be the real deal this is all about.

The Dridge, camera man and all ’round cool dude, will be there to capture it for the show and for all of you.

 

Now, about England.  The Project is a go, Chronicles might not make it, this time.  Think about the timing and the costs for flying international with all this camera gear with 3 days notice.  If they can’t make it, don’t panic or get angry or try to blame someone.  I don’t want to see any posts about somone who’s “fault” it is they don’t make it.  The last thing we need is to fall apart now.  If we start bickering and complaining those who control this machine we’re trying to fix will excuse us as a bunch of dreamers and complainers.

We are neither.

Mark and I are learning a great bit from each other and I get frustrated when he asks me, “Do you always have to…” and my answer starts, “To avoid litigation…”

 

Hang in there guys, I have Ted’s flip camera, the one he used to update all of you and I’ll be using it to send updates whenever I can.  Just keep in mind I’ll just be one person if the crew can’t make it this time.

More tomorrow after I send Mark along.

HM

the Handover – Call for Submissions

View Comments

Have to get in a bit about the Handover before I pop along to England next week.

 the Handover - 8th Edition

This month’s blog carnival the Handover will be hosted here at Happy Medic Head Quarters.  For those of you not sure exactly what in the world we’re handing over, one of our good blog buddies, 999medic.com, founded a blog roundup of sorts called the Handover.  It started as a collection of favorite posts collected by a volunteer host and is now the largest and widest read blog carnival for and by pre-hostipal EMS and ER staff.

 

Past hosts include

  • Emergiblog
  • Happy Medic Headquarters
  • Life Under the Lights
  • Medic999
  • Rapid Response Doc
  • Rescuing Providence
  • Trauma Queen
  •  

    For November’s theme I have chosen “Close Calls.”  The theme is inspired with my own close call, which I have mentioned as the driving force behind starting this therapy experiment we now call the Happy Medic.  I want you to send me a blog post you authored or have read that made you say, “Wow, that was close.”  Perhaps a time you caught a patient right before something happened, maybe a time when you almost got hurt or, perhaps when you did get hurt but it could have been worse.  And as Mark introduced a bit back, feel free to send in anything EMS or ER/A&E related you wrote or enjoyed.  Share.

    A little different than other months, I’ll be busy with Mark for a few more days then off to the UK for my turn in the passenger seat, so get your submissions in early.  The deadline for submissions will be Novmeber 25th, and i will save all submissions to my handy new laptop before boarding the plane home to the USA.  I will arrive home on Thanksgiving, hopefully with a good group of posts to share and be thankful for.  it will be published on the 27th of November.

    the Project rolls on!

    View Comments

    Got to pose for the scenary!!
    I had no idea it would be this hard to share ideas with a Geordie Paramedic.  Not the accent, or the socialized Healthcare system, but the sheer time we have to spend moving to and from, not to mention all the side stuff.

    I’m currently typing while being interviewed by EMS1′s Shannon Eliot as Mark snaps a photo.

     

    A week ago this was going to be a simple ride along and exchange between friends.  Since then the social media has exploded and we’re shooting background shots, intros and interview footage for the Chronicles of EMS.  This program is the one you’ve always been wanting.  Whereas all the other shows gloss over the “mundane” and “abuse” calls, the Chronicles of EMS embraces everything from the mornign rig check, finding clean restrooms when on post and cleaning toilets in the firehouse.

     

    It has been very hard to get the laptop out and update you since Mark and I are sharing so much so fast.  it’s early mornings and late nights here.

    I can tell you that a number of persons we encountered in the past few days have given permission to use their faces, names and specific conditions in the filming.  For example, Roxane wanted to share with me, Mark and the cameras how she called 911 and reported chest pain, then when we arrived just wanted a ride across town.

    That’s good TV.

     

    So here I am at Station 13, engine driver leaning over my shoulder and Ted Setla hovering.

     

    Thank you to all the folks donating their own hard earned money to make tthis happen.  When we rallied the troops for Epi it was amazing beyond belief, this is right up there.

     

    I know you’re all clammoring for detials on what we’re learning from each other and i want to tell you everything, but time is short.  For those of you not on twitter: Get on twitter.  It’s easy and all you have to do is follow #coems.  The guys and I are doing   constant updates there with pictures and descriptions of the experience.

    For those of you who refuse to join, I’ll try to catch you up, bt if we get a call, I’m hitting publish and considering this the update.  Fair enough?

     

    Some of the highlights:

    Mark’s first call was for a regular who everyone knew.  I couldn’t recall his name first off, but like some people remember odd detials about people, I recalled this man had an odd inferior infarct.  When I printed it out i remember saying, “There it is, right where I left it.”  when we made it to the hospital, all he other crews waiting to get triaged said hi to the patient, and even a passing Doc welcomed him back.

     

    The second call was for a fellow who asked me, “What is this going to cost me?”  Mark’s jaw almost hit the floor.  You could see him almost wanting to say something, but Mark is always a professional.  He later remarked, “That’s jsut wrong.”  We really aren’t worlds apart after all.

    Seeing his fascination with our 100′ ladder trucks is like watching myself as a 7 year old kid sitting out front of Angry Captain’s fire house and watching that Crown Tiller roll ot on a job.  There is no way to look away from them when the tiller driver turns left around a corner and swings out.  I still look, but Mark loves it.  Hopefully we can get him up in the seat on Sunday next to the tillerman.

     

    After shifts we’re both talking a mile a minute about what he would have done, or me.

    “Would you always cannulate a person like that?”

    “Not always, but he was pale and we didn’t confirm the blood loss so the risk of infection was justified I thought.”

    “I agree.”

     

    “Aren’t you going to use an air splint?”

    “No, we’re fashioning one from various other splints, it’ll work.”

     

    We indeed have more in common than different.  The most common phrase so far has been “same patient, diferent country.”  Too true.  Some of the specific differences so far revolve around the deployment of resources.  Mark has asked me repeatedly if i think this is the best way to do what we do and I keep telling him, “I don’t know yet.”

     

    And I don’t think we can answer that qustion until this and other projects are completed.  We may never know what the best way to do this is, but I will tell you one thing, we’re learning from each other in real time and that can only be a good thing.

    There you go, that’s all i have to report for now, other than missing my family, things are going better than anyone could have thought and all because two Paramedics vbelieved in an idea and the scores of facebook, twitter, blog and email followers who have contributed to the Chronicles of EMS who are filming what used to be the Project.

     

    HM

     

    PS – Mark and I still call it the Project when we speak alone, but you can find it everywhere as the Chronicles of EMS.

    Preparation for tomorrow

    View Comments

    I am finally at home after dinner with Mark, sipping a scotch and thinking about tomorrow’s first day on the ambulance.  I am wondering if Mark will be able to contain himself the first time someone abuses the 911 system, or the second, or the third, when he sees we are required by law to take folks in.

    My mind imagines Mark in awe when we apply our CPAP to the woman who would normally need to be nasally intubated and she not only stabilizes but improves.

    What will he think if we get a chance to pace a symptomatic unstable bradycardia or convert an unstable SVT.

    Will Mark search through my kit looking for pain medications when I have only morphine and oxygen for pain management.

    I have so many things I want to show him about the fire based and private tier model we use that I almost forget about the ocean between us in capabilities for patient care.  Fire engine and rapid response car aside we make differences in different ways, don’t we?

    Tomorrow is Mark’s first day on an American dynamically deployed fire based ambulance and part of me is worried he’ll be angry we can’t do the right things for most of our patients and clients.   Another part of me hopes he sees the benefits of some of the things we’re doing he is not.  There is so much opportunity to learn from one another side by side I hope my clients don’t get in the way of our learning.

    This will also be an opportunity, with the Chronicles of EMS filming along side us, to show he rampant abuse of the 911 system in San Francisco.  How can we solve a problem that is not ours?  That’s an entirely different show indeed.

    So I’ll try not to sweat the small stuff and just do my job like I always do with that green jumpsuit close behind.

    We’ll be in the yard at 830 for our shift at 9.  See you on post,

    the Happy Medic

    Thoughts on the Project so far

    View Comments

    It is not easy to find time to get logged on and update you guys about the Project.

    Not Chronicles of EMS necessarily, but Me and Mark meeting up and talking shop.  I apologize to any of you who clicked over on Friday morning looking for my usual You Make the Call segment, or on Sunday for the Sunday Fun, but I felt like the updates were coming fast and didn’t want to bury something else in with all the bits about Mark arriving.

    I did put up the Angry Captain’s Close Call, which happens to be the theme for the November Blog Carnival, get your submissions in early, I plan on writing it on the plane and setting it to publish after I land.  I’ll be sending out the deadline before long.

    Mark and I are hitting it off just fine.  It’s awkward trying to have the conversations we want to have with the cameras about, but it’s a learning curve and an amazing opportunity to bring you along with us in the way we had hoped in the beginning.

    I arrived at Mark’s hotel a bit early this mornign and we had some time alone to just talk.

    Then it was a fast frenzy of Chief’s, meetings, phone calls, twitters and facebook status updates.  I got Mark a local phone, but no data plan, so he’s started borrowing my iphone to make his updates as well.

    Tomorrow is our first day out in the field, on an ambulance, and we’re both looking very much forward to it.  I’m trying to lod up pictures, but Mark’s hotel wifi is useless.  They’re looking into moving him to another hotel now.

    It’s hard to do a project about social media and the internet without an internet signal.  Go figure.

    Tonight is a free night, Mark and I both anxious to get somewhere and talk without the microphones, a chance to be 100% honest about some of the ideas discussed today.  We’re not holding anything back from our readers, don’t think that, just looking to not have to watch our language.

    Mark promises to teach my to swear like an Englishman.

    Keep an eye on the flickr feed on the sidebar for when the internet is back up and running where Mark is.

    Big day tomorrow.

    HM

    The British are coming! The British are coming!

    View Comments

    Paul RevereOK, just one, but I will be calling this out in the airport later today.

    If you are reading this it means that UK Medic Mark Glencorse is on a plane from London to San Francisco to begin the Project, our Trans-Atlantic Paramedic Exchange.

    In case you were wondering how this all started, you can catch up by clicking on the tag “the Project” over in the right hand sidebar.

    This is my last reminder to follow us on Twitter, @ukmedic999 and @thehappymedic, as well as the flickr feed and youtube channel.  Mark’s first update will be tonight, so make sure you’re subscribed to the channel.

    The action starts tomorrow morning with a meeting with Chief of Department Joanne Hayes-White, EMS Chief Pete Howes and PIO Lt Mindy Talmadge, who will no doubt be glad I’m not calling and emailing multiple times a day now that this has started.

    When we finish at Headquarters, we’ll be off on a walking tour of some of the high points of the history of the SFFD.  Many of these can be found in a variety of tour books and at the SFFD Museum, but when I took some of my early days in the City wandering around I found some specific things I find fascinating.  I’m working on a book specifically for visiting Firefighters to enjoy these places, but as you’ve been reading on this blog, I’ve been a bit busy.

    That should wear him out so he’ll sleep well and be ready for our first shift on the ambulance on Tuesday.

    Like the Angry Captain used to say when the lights went down at the movies,

    Here we go.

    the Angry Captain’s Close Call

    View Comments

    The Angry Captain is on sceneThis month’s EMS Blog Carnival, the Handover, will be hosted here and the theme is “Close Calls.”  With November in the US including Thanksgiving, I thought what better time to share an experience when we had that thought go through our mind “I/they might not make it.”

    Send in your submissions about a time when you, a patient, or someone you know had a close call and I’ll put them together to share.  If just one person can use that information to make their job safer, then we’ll have succeeded.

    So with that theme in mind, here is the Angry Captain’s Close Call.

    8:30 pm February 1982

    The call:  Structure fire, “house across the street has black smoke coming from it.”

    It is a cold winter night with temperatures well below freezing; we are in a relief unit that had no inboard seats so I was belted in on the tailboard. On arrival, we found a residence with black smoke pouring from the rear.  Reportedly, no one was home.

    The home is typical for the area in that the base of the home started as a house trailer with several additions around it. As the first engine to arrive, we pulled a 200’ preconnect and forced entry on a side door that appeared to be the entry. The captain and I crawled in below the smoke and worked our way through a maze of doorways to what appeared to be a fully involved kitchen area. The ceiling was flashing over as I trained the nozzle at the base of the fire. Suddenly, my air pack warning bell went off.

    We could not have been on air much longer than 5-10 minutes. I patted the captain on the back to notify him that we needed to back out. He gestured for me to head out and took the nozzle from me. My training from my previous department was never to leave anyone alone in a fire. As I turned, my air pack quit entirely; no air at all.  The smoke level now was to the floor as I grasped the hose line to find my way out. The urge to rip off my mask was strong but my training had taught me this would be fatal for sure. Holding my breath was all I could do as I struggled to focus on following the line out amid my disorientation from lack of oxygen. As I moved along, I remember hearing a loud mechanical sound further confusing my strange journey through this black maze. The sound grew louder as I slowly followed the hose line hand over hand in the seemingly longest moments of my life.

    Suddenly light appeared as the noise grew to a roar, but I crawled out, finally ripping off my face mask, gasping for air, and collapsing in a snow bank. My next memory was lying on the gurney in the back of the ambulance.  At the hospital, they ran blood gas tests and flooded me with plenty of O2. As my color returned to normal (apparently I was quite gray), I was told that they found me outside our entry point where the truck had hung a mechanical fan at the top of the doorway for ventilation. (The loud disorientating mechanical sound.) I am not sure how long it was that I lay there in the snow bank before I was noticed.  But Mrs. AC got the frightening call about 11 pm to pick me up at the hospital….no one likes that call.

    Lessons learned:

    1.       The air pack I was wearing was found to be working properly back in a warm station house and in fact still had about ½ its air. The speculation at the time was that the moisture in the diaphragm froze causing it to stop the air flow.  Had it been checked at the scene, it could have provided the exact problem.

    2.       Never allow a member to leave alone or leave a member alone in a fire. This was long before 2 in 2 out.

    3.       Always follow your training; i.e. following the hose line out and keeping your mask on in heavy smoke.

    4.       Do not block the egress of the hose line with ventilation. Had I been on all fours coming out feeling ahead with my hands, my fingers may have been lost to the whirling fan.

    This was a true wake up call for me and cemented in my mind how important my training had been and how things can go wrong in a matter of seconds.

    Wanna push my buttons?

    View Comments

    Those new nifty colored buttons on the top left of the sidebar will link you all over the interwebs machine to me, Happy Medic, as well as our YouTube and Flickr streams.  If you’re not sure what the little icons mean, feel free to hover over them for a brief, yet informative description.

     

    I know it’s only adding to the chaos that is the top of this blog, but think of it like CNBC, only without Erin Burnett.  I might even add a stock ticker or something.

     

    So now, thanks to reader Capt Tom reminding me to add an email button, you get all six.  Direct all complaints up the chain of command to Capt Tom.  All compliments can be sent in the form of cash to me, no checks please.

    EMS Garage Podcast

    View Comments

    Happy was a guest on the EMS Garage Podcast, Episode 60, which is now up at EMS Garage.com.

    http://emsgarage.com/archives/390

    Come listen to me and Mark talk about the Project as well as the details to the Blogger Meet-up in San Francisco next Saturday!

    The host’s volume is low and Mark’s accent might throw you for a loop, but it is also a great conversation about using social media to further our EMS missions.

    Special thanks to Chris Montera, Carissa O’Brien, Gary Wingrave, Ted Setla and of course, Mark Glencorse.

    the Happy Medic Channel

    View Comments

    It would certainly be a premium channel, right?

    What got me thinking about this was my recent experience on the EMS Garage, hosted by Chris Montera.  If you’re not listening to this forum, you need to be.  The twitter blitz that was the 2009 EMSexpo mentioned podcasts and videos, but with my trip from the refresher and trying to catch up on work and the Project, I never clicked over.

    <punishment=”bang head on desk”>Stupid, stupid, stupid</punishment>

    Neat video.  I say neat because it reminded me of one of m favorite shows, Attack of the Show.  On AotS two hosts have a great time sharing news and product reviews geared towards a specific demographic, the 18-35 year old nerd. (myself included)

    EMSexpo live produced clips from the show floor clearly designed for a specific demographic, people passionate about EMS.  Each piece is interesting and fun to watch with both Carissa O’Brien and Chris Montera clearly having fun doing it.

    Motoring in EMS the Segway Way! from Thaddeus Setla on Vimeo.

    See what I mean?  Click through and watch the series of videos from EMS expo 2009, Atlanta.  Neat stuff.

    Perhaps this can expand into a “channel” where podcasts become videocasts and learning videos become a learning series?  I can has host bloopers show?

    Now that’s cool

    View Comments

    A Tale of Two Bloggers.

    A Tale of Two Bloggers.

     

    If this doesn’t give you goosebumps, you’re in the wrong line of work.

    OK, I’ll tell you

    View Comments

    Well Captain Tom, you asked…

    “OK HM, It’s November. When does 999 land in SF?”

    …and I’ll answer.  Sunday.

    Paramedic Team Leader Mark Glencorse will be the guest of the San Francisco Fire Department beginning on Sunday November 8th, when he touches down at SFO.  From that moment until he departs on the 16th we will be comparing our systems at the ground level, care giver to care giver.  No “company line” no prepared statements, just two friends meeting and getting the low down on what is really happening in each other’s systems.

    Later this week I’ll be adding links to the sidebar here at HMHQ to help you follow along on our experience.  Follow us on twitter @thehappymedic and @ukmedic999.  The new slideshow on the right hand side there is the Project Flickr slideshow.  That will certainly be added to as we go along.  Daily if not hourly.

    Then there is the youtube channel we established that many of you are already following (subscribed to).  We have decided that the visiting medic will do his best (nights of drinking aside) to do a nightly update as to the day’s activities, impressions and thoughts.  Mark will of course be updating you mostly at first, then I’ll start when I arrive in Newcastle on the 19th.

    We are both not only representing our Departments but, more importantly I think, the power of this new creature we all have come to embrace, social media.  Twitter, Facebook, blogs, online news, flickr, IM, SMS, all these amazing on demand services at our fingertips and we’ve harnessed them for a good cause, making ourselves better care givers.

    So not to make this another boring “the Project is coming” post, maybe something new?

    Since the official SFFD press release went out today I guess it’s fair to tell you who I am.

    the Happy Medic is, and always has been, Justin Schorr, a Firefighter/Paramedic currently employed with the San Francisco Fire Department.

    ems6That’s me with the patches-Photo Credit SF Chronicle.

    I hold a Bachelor’s of Science in Emergency Medical Services from the University of New Mexico School of Medicine where I studied under Larry Cobb and Rick Lynn, to name a few.  I was one of the first 10 graduates of the BS in EMS (no giggling) program there and was one of 4 to first stand within the School of Medicine group to graduate (God they hated that!)

    My career started as a Fire Explorer, then as a volunteer firefighter getting hired at 18 with a small Indian Reservation outside Albuquerque, New Mexico.  Talk about rural EMS.

    I later moved on to a small suburban department struggling to find it’s identity with a strong Public Safety model that relied on fire trained police officers to assist when emergencies struck.  It was there that I learned the best way to confirm a house has been ventilated prior to forcing the door is to do it yourself.

    Now I find myself in beautiful San Francisco and raising my family.

    So there you have it.  The first official, documented privacy violation of the Happy Medic, my own.

    See you at the big one,

    HM

    READ ME FIRST

    View Comments

    This is for all you new people. Here on the interwebs machine, we call you “noobs.”

    Hi, I’m the Happy Medic.  Some of you are arriving here for the first time and might feel a bit overwhelmed.  There is indeed a lot going on on this page.  I mean look at all the colors, shapes, ads, links…Aaaaaagggghhhh!

    Take it easy, we can walk you through this real easy.  If this is your first visit, you can peruse the high points without scrolling or looking around too much at all.  See those tabs just under that fancy Happy Medic banner up top?  The one to the far left is titled “Who is HM?”  From here you can read a bit about me and why I’m here on your computer.  From there, you can click on the other tabs to learn more about some special elements of the blog, all without using that pesky back button on your browser.

    When you’re done reading through the tabs, you can return to the most recent post by clicking on Happy’s smiling face at the top.

    All those red words on the left hand side are my blogroll, or a list of sites I read and follow on a daily basis.  I’m trying to make it so the most recent title shows under the name of the blog, we’re still working on that.

    Those words of varying size on the righthand side are the tag clouds.  They are a visual representation of how popular certain subjects are on this blog and the other blogs in the network.

    “What network?”  You ask…well see that neat logo near the top that says FireEMS blogs?  Click on that to learn more about the network.

    But for now, if you seem overwhelmed, take it slow, I’ll help you through this.  And if you have any questions or comments, you can leave them at the bottom of each post/page or email me at thehappymedic@gmail.com

    Happy Surfing,

    HM

    The Magic Number

    View Comments

    blog engineDiabetics, and clients who claim to be diabetic, have remarkably different glucose levels than most folks.  And while there is a lot of discussion in the pre-hospital crowd about treatment levels, I think we can all agree that an asymptomatic 50 and a symptomatic 130 are treated completely different, despite that magic treatment number, mine being   So what to do when the asymptomatic refuses to listen to reason?

    THE EMERGENCY

    A woman is reporting a “diabetic reaction”

    THE ACTION

    Not sure what that could mean exactly, we light t up and catch a private ambulance responding with us at an intersection not far away.  I call it catching because they just fall in behind us as if on a hook.

    In the lobby of the reported address sits our client and a security guard intent on getting my badge number before I make contact.  Someone needs to tell these folks that that information is not necessary for her report.

    The client is sitting calmly in a chair off to the side and blushes as I approach, large bag and monitor pushing the security guard gently aside as our driver for the day takes her aside to explain things.  She is in no distress, no chief complaint, no obvious trauma, so I shift gears and go into my script.

    “Did you report a medical emergency?”

    She hands me her fancy glucose monitor.  I can only assume she wants me to read the number.

    50.

    Nothing earth shattering, just a run of the mill 50.  No symptoms, no problems to report, just a value on a tiny computer screen.

    The ambulance crew went into their questioning and I chimed in when I could, but she demanded to be transported to the hospital for her “diabetic reaction.”

    The best part of this run was the man on the way out who identified himself as a life long diabetic told us he is often below 50 and just eats a turkey sandwich.  I told him we were hiring.

    Sunday Fun – The Friendly Skies

    View Comments

    In preparation for the Trans-Atlantic journey Medic999 and I are about to make, I thought I’d prepare a list of things to keep us occupied on the flight.

    That got as boring as the flight itself will be, so I borrowed a few ideas from the guys at That was funny. This list has been edited, considerably, as to not offend small children, the elderly, Llamas or Antonio Banderas.  Enjoy:

    1. Fart loudly and act shocked, looking around to see who did it
    2. Fiddle around with the emergency exit, then ask a fellow passenger if he has a crowbar
    3. Hijack Ask to see the cockpit and, over the loudspeaker, announce that the first class passengers and luggage are to switch places
    4.Run down the aisle screaming,”He’s got a bomb! He’s got a bomb! I am ‘da bomb!”
    6. Fly into a rage whenever the word “Skymall” is mentioned
    8. Go up to someone and ask loudly if they wouldn’t mind applying Preporation H to your hemrrhoids
    11. Mess up your hair, untuck your shirt, basically look crude, and mingle with a first class guy as if you were long-lost friends
    12. Give someone a coin, saying “Heads, I get your shirt. Tails, I don’t”
    13. Go into the bathroom, drop your pants, then come out, yelling “We’re out of toilet paper! Stewardess!”
    14. Describe your sex life in great detail to the five-year-old next to you
    15. Try to lead plane in song “Oh I wish I was an Oscar Myer Weiner”
    16. Lead a revolt against the first class passengers
    17. Attempt to promote Hinduism among passengers
    18. Moon passing Delta planes
    20. Start a hot dog stand
    21. Steal businessman’s laptop, play solitaire on it
    23. During the inflight movie, ask to share headphones with someone
    26. Tell the person next to you your life story, from DNA to that afternoon
    28. Remark that perhaps you shouldn’t have put superglue in your undies that morning
    29. Pick your nose and pat the person next to you
    30. No matter what the meal choices are, demand rice-a-roni
    31. Show off your Batman underwear
    33. Switch accents and see if anyone notices
    39. Go into the cockpit, flick on the intercom light, then loudly inquire as to why the fuel dial says “e”
    40. Go into the cockpit, ask the pilot in an obnoxious voice “Why do the call it the COCKpit?” then snort as if it’s the funniest thing in the world
    42. Sneeze, using somebody’s sleeve instead of your hand to cover it
    43. Listen to James Brown on your Walkman, sing along (especially the
    “Oooh Oooh” parts)

    44. Snort when you laugh

    46. Wear a hairpiece and switch it often, seeing if anyone notices
    49. Hum the Monty Python theme song
    51. Scream and dive under your seat for no apparent reason
    52. Ride carry-on luggage down the aisle, yelling “Yeee-ha!”
    53. With a desperate look, ask the stewardess where the bathroom is, then look relieved and say “Nevermind. Do you have any towels?”
    56. Bring a microphone and act like Frank Sinatra
    57. Ask someone for their autograph, pretending that you think they’re Kevin Costner or Goldie Hawn (This best when the person looks nothing like the movie star in question)
    58. Start talking Korean
    59. If someone has a bad toupee, whack it off take it.
    60. Pretend you’re flying the plane
    61. With a fellow passenger, Re-enact the disco scene in “Airplane!”