As reported by WPTY in Memphis, Memphis Fire EMT Kenneth Montgomery was assigned to a unit transporting a patient.  Instead of completing the transport he steered the unit to Firehouse 16, parked and went looking for a relief to take the rest of the job.

Kind of a no brainer to me and I hope to you too.

Finish the job you’re sent on.  That’s a letter in your file and in case you thought this would get you off the ambulance, think again.  Unlike many folks on Facebook, I’m not asking for your resignation, your EMT card, or anything else.

Why not?

The video posted at the news website includes certain “details” that got my memory spinning.

You see, I’ve been on this call 100 times.  I’ve even been on the call that is the 1 in a million like this, but I know that wasn’t an actual emergency and I’ll tell you why in a moment.

Using my amazing holistic detective skills I can tell you this was a morning run to a rehab center for chest pains.  I would honestly be surprised if they had to look at the map book for this one.  999 out of 1000 times the chief complaint does not match the signs and symptoms, someone will start to hospital shop, refuse a 12 lead ECG etc.  Treat every job like that 1 in a million until proven false.

I have no details as to the patient care or condition in this circumstance so don’t even comment that I’m not being compassionate.

I do have one set of details that, had it been happening, the press would have mentioned it for sure:

No lights and sirens to the hospital.

We can debate the benefits of playing Paramedic Pinball code 3 to the hospital, but it can tell us a lot about what may or may not have been happening in the back of that ambulance.

Had this been a code 3 return Mr Montgomery would indeed be facing harsher punishment from the likes of me, but having recently taken a promotional exam that dealt with similar situations there are a number of statements I need to gather before passing on a recommendation for disciplinary action:

1. Interview the call taker and pull the E911 tape to confirm the call.

2. Interview persons at the scene as to the disposition of the crew.

3. Obtain admission condition and discharge condition of the patient.

4. Interview Paramedic in charge of patient care.

5. Interview Mr Montgomery as to his thought process and justifications, if any.

and most importantly,

6. Were there actually any rules or regulations broken?

Is there a rule in your system that mentions being required to go straight from the scene to the hospital?  Even something as vague as “Timely Discharge of Orders” might stick to the wall, but my guess is Memphis is about to get one of those rules that can be traced to a name.

Mr Montgomery, what you did may not have been right, but it brings us into focus in a way we don’t need.  I’m sure private ambulance companies will be mentioning this event at the next system bid for sure.

Justin Schorr, FF/NREMT-P, WhO.C-arES

Emergency Services seem to thrive on certificates.

I’ve got some paper on my wall, I’m very proud of it.  At times I mention it behind my name when trying to gain credibility for what I am writing, saying or presenting.  People pay more attention when they know you are trained in what you are about to tell them, right?

But looking through some old files a few days ago I came across my last college paper “Shortening the Chain of Survival” in which I studied and showed the importance of, wait for it, early ALS intervention.

What bothered me right off the bat was how hard I was trying to establish myself on the title page.  I included my rank at the time, my NR status, my MICU cert and 3 more abbreviations I had earned at school.

I sure was trying hard to prove that paper legitimate, perhaps not relying enough on the paper itself.

Wandering through some recent issues of the leading EMS magazines and articles on leading EMS websites (blogs excluded) we can see folks doing the same thing.  An article is submitted and, as if to make us believe they’re an expert right off the bat, the letters start to get added to the name. RN, NR (Which I just noticed mirror one another) MD, BSN etc etc.

As a struggling profession it is as if we are clinging to any semblance of formal education to catch up to the MD, RN, BSN, PA etc, sometimes without reading through the things we propose to let them stand on their own merits, just like that paper I found.

Talking with a father and son Firefighting family at FDIC, I saw a generational divide on the perception of the letters after the name.  The father, near retirement, wanted to hear more about the letters I had earned, while the son seemed more interested in what can be learned on the job.  Book smarts vs street smarts all over again.

There aren’t many high school kids writing policy these days, however, no matter how much it seems like it, so maybe a touch of credibility is warranted.

When we present something, an idea, a new protocol, procedure or concept, perhaps one set of letters is appropriate, but let’s call it good there, shall we?

Today was my second day helping to set up the newest Engine Company in the SFFD, Engine 51 in the Presidio. Today was day 4 of the new services provided and the contractors working at the old firehouse are flying. Last I saw the house it was still dirty and disorganized. Today the painters were touching up while the flooring folks were starting on the final rooms.
I’m collecting photos to put together in a before and after post, so keep an eye out for that.
My next scheduled day on the Engine is after we are all moved in, so that will be interesting for sure!

New paint, new flooring, clean cabinets and bed frames.

The rest is up to us.

Not “us” the SFFD, but “us” the 15 Firefighters, Paramedics and Officers staffing the Company.

This morning we heard word that some of the other firehouses around the City have pledged to donate extra pots, pans and some plates and cups to us to help get us going.

It really is like one big family out here.

And in related news, some of the firefighters previously employed by the Park Service started an abbreviated SFFD Academy this morning.

HM

Break out your green and yellow backgrounds everyone!

“Welcome Back” doesn’t seem right since you were never really gone, just on a long job.  Now you are back home.

In 1915 the home of General John Pershing, famous for leading Montana’s Buffalo Soldiers, burned  killing 4 of his family members.

As with most fire tragedies in the early 20th century, no organized Fire Companies existed until it was too late.

Pershing’s home was withing the grounds of the Presidio (Spanish for Fort) on the North end of San Francisco.  This fort was built during the civil war and most of it still stands today.

You can read all about the history of the Presidio here.

In 1917, the Presidio built a Fire Station, which I went to today.

In 1994, when the National Park Service took over areas of the Presidio, that station became the first and only 24 hour fully staffed Fire Station in the Park Service.

It closed yesterday morning at 7:30.

For political and funding reasons I won’t pretend to understand, the Park Service chose the SFFD to staff the station.

At 8AM yesterday morning all the political leaders and managers gathered at the temporary home of the new Engine Company for photos and introductions.  At the same time, the off going firefighters were cleaning out their station, the one manned since 1917.

There was a nice addition a few years back, more on that soon.

Later in the day we had the opportunity to go by and orient ourselves with the station, the grounds, and the Presidio itself.

This is going to be a long process, we are essentially starting a Fire house from scratch.  No desks, no dishes, no supplies.  The owners of the station are cleaning, installing floors and painting and we hope to live there in the middle of the week.

I’ll do my best to keep you up to date on our efforts.

What I won’t do is take a stand on the reasons for the change, the politics involved, nor will I allow any negative comments about the circumstances.

The company there was identified as Engine 51 and our engine will keep that designation.

HM

Over the next few weeks you’ll be hearing from me about the Tak Response Conference in San Jose coming up September 14th-16th.

Chronicles of EMS was invited to be a part of this collaborative training opportunity that will bring the best of all fields together to network and learn from each other.

This conference combines nursing, Fire, Haz-Mat, law enforcement, SWAT, EMS, public works and a number of other disciplines together, since when we all arrive on scene we have to work together.

Let’s start to train together.

Tak Response is not only a chance to learn from other disciplines where you fit in at “their” scene, but to network socially with your fellow providers before the you know what hits you know where.

Imagine a scene where the Battalion Chief, Patrol Officer and EMT all already know each other and what each agency expects from the others.  That’s a smooth running scene.

Here’s the episode of Seat at the Table where we meet the organizers of the Tak Response Conference and run the concept by paramedics, firefighters and even a cop.

The 3 AM building alarm.  This is the Fire Service equivalent of an abdominal pain from a month ago.  Thing is, when it’s in a retirement home, all bets are off as to what might be going on.

THE EMERGENCY

Audible and visual warning devices triggered by an automatic alarm, water flow indicated.

THE ACTION

When the bells strike at work, I always get out of bed and sit on the corner and wait for 2 distinct dispatcher comments:

1. “Unit dispatch…” Which means it’s a medical job and I should continue waking up, OR

2. “Units stand by for the box…” Which means we have a report of smoke or fire in a building.

But there is a glimmer of hope when the dispatcher calls out a building alarm box because our Truck Company also covers 2 other engine areas.  Sometimes they’re the only ones going out.  Sometimes.

Tonight it’s everyone and we’re quickly on scene to a very beautiful brick 4 story type 3 we drive by all the time wondering what’s inside.

Old people.

We’re met by a security guard who of course is more interested in our supervisor’s name than telling us the situation inside.  A representative from the water department wanders over from a giant hole in the ground surrounded by water department vehicles and informs us they just turned the main back on.

As the pressure slowly built against the sprinkler valve, it likely shuddered and set off the alarm.  We relax and go in to make sure and reset the alarm.

Like in a zombie movie, we enter to see various persons in pajamas and robes wandering the halls and standing on the stairs, all staring at us as we go by.  They say nothing, only watch and slowly begin to come closer the longer we stand at the alarm panel under the grand staircase.  At some time in the past 100 years, this was one hell of a mansion, but now is populated by scores of the aged.

Which is odd, since I’ve never been on a medical run here before.

As we reset the alarm, the occupants begin to slowly shuffle away in different directions, except for one.

He corners the other firefighter and asks her if she knew they had a new elevator installed recently.

“OK, wonderful, thanks.” She says, being as polite as you can at 3:15 AM.

“No, you need a key to use it if the alarm goes off,” he informs her.

“Yes, we have that key,” she says, trying to walk away.

“No, it’s a new kind of elevator, come, I’ll show you.” and he begins to lead her down a hallway.

As much as I wanted to follow and keep her company, she went along as one might go along to look at baby pictures of your third cousin while visiting long lost family.

She eventually emerged, unharmed and still in good spirits, to inform us that it was a standard elevator.  Go figure.  It wasn’t until later I learned that the inventor of the modern elevator, Elisha Otis, died long ago.  I was half hoping that was him, remarkably old and well preserved, in a home for the very old and the very rich.

My Brother from another Mother, Motor Cop, spent another day at his “duck pond” monitoring facebook and scouring youtube for something to ridicule the FD.

He found a video you can watch at THIS LINK and proves that Fireman have all the moves down.

Don’t believe me?  Just compare that video to this one, featuring the REAL Motor Cop.

Village People – YMCA (version originale)
Uploaded by scorpiomusic. – Watch more music videos, in HD!

*No Indians, Manly bikers, cowboys or construction workers were injured in this posting, the Soldier, I’m not so sure.

e4, e6

I was taken aback by this guy at the bar in a T-Shirt with a 8″ EMT on the back and giant star of life.  Add to that the stethoscope around his neck and I was just confused.

My fire and PD buddies were making jokes while I was trying to make the decision whether or not to approach him.

I could start the conversation by asking if he really was an EMT, which I’m sure he is hoping someone will ask, hence the shirt, but it was really the combination of the pants, shirt and especially stethoscope that had me thinking this person is clearly not “one of us,” US being the profession.

He managed to wander over to a table of ladies with his friend who said, “Make room for my EMT buddy,” at which point I had to cover a laugh.

No matter what I said or how I approached the situation, this was not the time or the place to address his lack of professionalism.

He was not in a uniform, but as far as the public knows, he was.  He was not doing anything “wrong,” just not the best thing at that moment.

Mark can tell you that when coming home from riding with him and purchasing an adult beverage at the store, I turned my jacket inside out.  I looked odd, but even in another country I didn’t want to let folks know about that association.

So in the end, I let it go, mainly because I am convinced he would not have understood.

My buddy then, after we left, asked why I didn’t give him a Happy Medic card, then blog about it.

Also not “wrong” but maybe not the best way to approach it.  So in the end, I only did one of the two.

If you said stay out of it, you made my call.

One of the Chronicles of EMS earliest followers Sascha Fehr, who I had the pleasure of meeting in San Francisco months ago, arranged for a Hungarian Paramedic to travel to his system in Germany.

He recently uploaded this video:

Find more videos like this on Chronicles of EMS

Tell me again how we’re not changing the world?