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Well, that was stupid

It can be confirmed with the Mrs that I have a problem keeping on task at times. I often get distracted today about tomorrow, neglect this week because I’m worried about next week. You get the idea.

This morning I was my usual self and it put a lot in jeopardy.

It is also widely known that Mark’s and my families sacrifice a whole lot to do what we have sought out to accomplish. Sandra and the boys more so than Kim and my girls. This was Mark’s FIFTH trip to the USA for Chronicles business and you remember what happened last time, right?

Well, this morning when we left to take him to the airport, I wasn’t concentrating on the task at hand and he agreed to be dropped off at the BART station instead of me driving him all the way in, which I should have done.

While off with my girls I got a call from Mark, “I’m gonna miss my flight!”

And he did, because of my and my inattention to the task at hand.

Luckily, using his British charm he was able to arrange an alternate itinerary that puts him back home only an hour and a half later than anticipated…provided he isn’t delayed further.

To Mark and his family I apologize.

Posted by Justin Schorr on June 16, 2010 • Filed under: Administrative • Tagged: Chronicles of EMS

Meeting the NEAS Executive Team – My UK EMS Conclusion

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chroniclesblog It all comes down to this meeting doesn’t it. The entire project, everything I hoped to learn comes down to sitting with Mark’s supervisors and policy makers in the UK and making a solid impression that American EMS is not awash in profit driven patient care.

But then again, we kind of are.

I started the meeting starving hungry from my hours in the dispatch center downstairs and was told this would be a kind of working lunch meeting.

Sandwiches and various appetizer type dishes were brought in and my personal favorite, fresh coffee. The conference room at the NEAS appeared to have been recently remodeled or redecorated as there were literally dozens of legal sized computer generated signs reminding those reading not to place cups directly on the table.

So what do I do?

Yes, and luckily I had Peter right behind me to place a saucer beneath the cup and shoot me a “Hey stupid” look. It was in this framework that the rest of the administrative team made their way in and began a presentation on the stats of the NEAS. Population, call volume, etc.

It was made clear to me ahead of time that Fiona, the Chief Executive’s aide, had prepared the presentation and Simon Featherstone gave credit where credit is due.

Mr Featherstone, the aforementioned Chief Executive of the NEAS, seemed like any other person I had met on my travels so far and that made it very easy to listen to him discuss his system.

A few slides in he turned to the dozen or so folks in the room and suggested we do more interacting. This was, after all, common knowledge to all but one person in the room, me, and they wanted to hear from me, not their Chief Executive.

I went into a brief overview of my system in the SFFD and also explained other systems around the country. Much time was spent, and not surprisingly, with their fascination with the idea of for profit ambulance services.

Each member present asked a number of questions about billing and a person’s ability to pay and I had to remind them many a time that that doesn’t come into play until well after the call, but does drive policy decisions in the end, therefore changing our field care decisions.

Each time I snuck a bite to eat another question would have me or Mark discussing his observations of the system as well as his tales of life in a San Francisco Firehouse.

When it came to Mr Featherstone asking what differences we have observed patient care wise, I brought up CPAP and cardioversion and that those are widely used skills in the US. Pacing and cardioversion along with adenosine surely more common than CPAP, but it is such a wonderful tool more services should invest in it.

In true executive fashion Mr Featherstone turned to his clinical care person and said, “How soon can we look into doing these things?”

Bang.

Right then and there, slightly leaned back in his chair, the Chief Executive might be moving forward on something that can directly benefit the patients Mark encounters as well as giving him tools to help more people.

The meeting ended with handshakes and wishes of luck, but very little was said regarding the lack of Ted Setla and the Chronicles of EMS team in the room to record all of this fantastic learning and sharing of best practices.

But I understand that. England is a far less litigious society than the US, but they still have to concern themselves with the appearance of the service and those who function in it.

Everyone reading this post knows Mark and his blog are a source of incredible knowledge and a commitment to improving himself through new pathways. If Mark wrote a book about EMS I would buy it. If he had a radio show I would listen to it, but until those things happen (If he had a TV show I’d watch it) I will follow the media he uses to become a better Paramedic. Right now that is his blog http://999medic.com, twitter @ukmedic999 and on facebook. All media that is growing not only in popularity but usability and relevance to what we’re trying to do in the pre-hospital care fields.

I don’t expect every service in the world to be open to bloggers sharing patient care and contact stories, regardless of permissions, and the few that value the following some EMS bloggers have are doing so very carefully.

One of the things Mark and I hope to work on in the years to come is acceptance of new media and new ways to share information that still respects a patient’s privacy while allowing those doing the care to share insight and best practices in real time.

A unique airway solution is discovered in Australia, blogged about, read by an ECSW in England who passes it along to their Paramedic who posts a link to twitter where I read it. Suddenly a technique that 5 years ago would wait months to get considered for a trade journal has been seen by thousands of caregivers who are about to share it with their friends and co-workers, and all in minutes, not months.

After a morning of listening to the Pathways system work in the dispatch center, then seeing the openness of the Executives to concepts and treatments, I think Mark is in a good place with the North East Ambulance Service.

In Conclusion-

The NEAS provides a high quality service in a straightforward manner to a well informed population. Powers rest with the Paramedic at the scene to determine transport, not the patient ahead of time like in my system. Front loading and getting eyes on a patient is a reliable way to handle system resources and gauge response.

The service is not reliant on insurance companies reimbursing for the services rendered nor are their paramedics passing perfectly capable ERs to reach a certain carrier’s preferred spot.

Mark Glencorse was a gracious host and everyone I met from A&E tech to Chief Executive was welcoming and asked great questions about American systems and I did my best to represent all of us in a professional and knowledgeable fashion.

The food was great, the coffee we can work on in future visits.

Will the NEAS model work in San Francisco? I won’t know until tomorrow when I get a tour of the Tyne and Wear Fire and Rescue Service by Station Manager Peter Mudie. Fire readers, this is the post you’ve been waiting for. But like most of what we do, EMS comes first and accounts for 80-90% of what we do. Why should my UK story be any different?

Posted by Justin Schorr on June 14, 2010 • Filed under: Administration & Leadership, Administrative, Command & Leadership, EMS Health & Safety, EMS Topics, Funding & Staffing, News, Training & Development, technology-communications-ems-topics, the Project • Tagged: Chronicles of EMS, the Project

“RTB for a cuppa” I’m allocating in the UK

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chroniclesblog RTB means Return to Base. A cuppa is slang for a cup of tea. Allocating is something I very much wanted to see first hand.

On this morning in Newcastle, my second to last, Mark has arranged for me to meet with the executive staff of the NEAS at their headquarters.

Before meeting with them, however, I’m downstairs in the bullpens. I’ve got 2 hours to sit in the dispatch center and do a “Sit-along.”

When you tell a guy who loves talking theory on systems allocation he gets to see the system work from the nerve center, he gets a touch giddy.

My first chair was at a call taker’s desk and I got plugged in.

BANG, less than 10 seconds, not even a chance to introduce myself to the call taker I’m with the first tone is in my right ear.

Before she can answer the call a timer has popped up on her screen 8:00, 7:59… the clock is running.

“Ambulance Service” she answers and begins reading from the screen the pre-ordained triage system called Pathways. As I’ve mentioned before, this dispatch system makes no attempt to diagnose the problem, but the physician designed questions can dial up or down the response in real time as the call taker asks the questions.

While she is asking and answering, a small red circle has appeared on the screen, then, a bit away, a purple one. Later I would learn that one is the location of the caller and the other the closest vehicle assigned to the call. When that vehicle arrives on scene, the timer now passing 6:15 will stop. This is their target and they take it very seriously. As I’m listening to the call, it is a very straight forward sick call and the caller is honest about it. It is then I see the benefits of the flexible front loaded system. The rapid response car, the closest resource to the caller, has been stood down since there is not an emergency at the caller’s location.

The vehicle, or cot transport capable ambulance, is continuing, however, and the target is no longer 8 minutes, but now 16 from the time the call was answered.

As more questions are answered and the system confirms the lack of life threats, a simple screen gives instructions for the caller until the crew arrives. The call taker then scrolls around her GPS monitor and finds the vehicle, then advises the caller about how far out they are. The caller thanked her and the call was terminated. Less than 3 minutes passed from the answering of the call to the triaging and confirmation of appropriate response.

At no time did a supervisor step in to augment the call taker’s classification, nor did the system err on the side of caution by upgrading the response, putting rescuers’ lives at risk, “Just in case.”

In the hour we were together I learned more about the desk I was at and the number of calls she answers in an average shift. We took mostly non-emergent calls, details of which would obviously violate privacy, but I can share with you the CALLERS.

When I explained how folks abuse our service by calling from a cell phone miles away about a person they think might have been either unconscious or sleeping, she smiled. Then, I went on, our criteria based dispatch system considers the caller’s inability to confirm consciousness to be unconscious and their inability to confirm breathing to be apnea, and 7 people are now responding code 3 for nothing.

It was just when the call taker was explaining some of the loop holes used that a care facility called to request an ambulance.

They were not with the patient so unable to observe their mental status, efficiency of breathing or if there was any bleeding. The system took this information and kept the RRC responding. Each time the call taker asked a question, the caller was already answering, knowing exactly which question comes next.

She later explained that folks have learned that if they take a cordless phone around the corner and call an ambulance, the crew arrives faster than if they honestly answer the triage questions.

“Same callers, different country.”

It was later in the morning across the room with the allocators that I saw the strength and weakness of the NEAS.

Mark and I spoke at great length about being honest but respectful when offering our observations and suggestions to improve each other’s systems. Mark was an example of this when he met with SFFD Chief of EMS Pete Howes for a kind of exit interview before leaving. I hope I can meet that example with the following paragraphs, but each time I write it it comes off preachy, so here goes.

Sitting between the allocators I watched them constantly on the radio with numerous vehicles and cars in various states of service. Each color on their screens meant something different, from enroute, on scene, RRC, vehicle, on post etc, but it was the clipboard they were passing back and forth that caused them the most frustration and, more than once, delayed allocation.

Not by a definitive amount, we’re talking 3-5 seconds, but it was the constant flipping of pages and radio traffic related to the one thing that I think the NEAS needs to change for the betterment of the system.

No more breaks.

I can hear the UK medics now “Hell no.”

Let me elaborate for my work straight through the shift American friends.

The NEAS, as a portion of their labor agreement, provides their crews with certain breaks depending on their daily activities. When they have been on post for an hour away from station, they get rotated back to the station. This was commonly referred to on the radio as “Return for a cuppa.” The basic premise is simple enough, really. People need clean bathrooms and a chance to eat since eating is not allowed in the cars or vehicles, nor are they allowed to sit down and eat in an establishment while on duty. This was evident when Mark was nervous enjoying some Pho in San Francisco.

In the car and vehicle this didn’t seem to be a big deal, we’d get a message to return to base, or that we were clear for meal break. The meal break can be interrupted, should the allocators need the resources, but they avoid it since the crew interrupted gets paid quite a bit for it and the allocators, although they wouldn’t elaborate, appear to be held accountable.

Sitting between the two allocators on the desk that morning, 50%-75% of their time was arranging rotation station breaks or ensuring crews got their meal breaks. These variables also added more color codes to the dispatch screen. This car is on dinner, this vehicle is on base rotation…etc, etc.

When a call came in they shot a quick look to the clipboard showing who gets a break when and dispatch decisions are based off of that. I did not witness it make a difference in response times, since that information is streaming in real time on giant monitors overhead, but these folks are scrambling to keep everything running smoothly.

With my limited dispatch experience it seemed like a simple change, since on the days I was on rotation in Newcastle we never had a point in the day where we were unable to reach a bathroom or food.

My head was trying to process all the information these women were basing their allocations on and one of them turned to ask me, inbetween moving a car back to base “for a cuppa,” “How do your dispatchers handle your breaks?”

When I explained we (listen to me, like I’m still in a rig), THEY are gone for 10 hours, no breaks, they froze.

It was passing the clipboard back and forth that I saw the only 2 seconds they both held still: glaring at me. It was clear I was not to repeat that statement for the rest of my time with them.

“That would make, ‘Go ahead 405′ this so much ‘thanks and to base if you please’ easier.”

Yeah, 2 conversations at once. I have trouble typing and listening to music or TV at the same time.

Mark had some family business to attend to while I was meeting the voice on the other end of the radio and he returned just before dinner time to collect me. It was an eye and ear opening experience to see the chaos that a simple concept like breaks caused the folks moving units around.

Something I completely neglected to mention over lunch with the executive team.

Told you I couldn’t screw that up. My conversation with the folks hopefully getting Mark cardioversion and CPAP, and where to put your coffee when the table is literally covered in signs that say “DO NOT PUT CUPS ON TABLE, USE SAUCER” soon.

Yeah I did.

Posted by Justin Schorr on June 13, 2010 • Filed under: Administration & Leadership, Command & Leadership, EMS Topics, Funding & Staffing, News, Training & Development, Vehicle Operation & Ambulances, Vehicle Operations & Apparatus, technology-communications-ems-topics • Tagged: Chronicles of EMS, the Project

On the Ambo in the UK

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chroniclesblog

Subtitle for this post: Can you reach that for me?

Coming off a superb time on the Rapid Response Car, nappy time aside, we’re on the vehicle today. The vehicle is what you and I would call an ambulance, but since anything that can take people to the hospital is an ambulance, it needs to be narrowed down a bit.

The car is certified as an ambulance since it can take people.

The vehicle can, as that is the main purpose of it.

But hiding around town, and just out of camera range as we drove by were swarms of non emergency ambulances, almost buses in their capacity. When asked their function, Mark and our ECSW Becky (more on her later) informed me they take folks to their appointments, get tests and from one facility to another.

Collecting my jaw from the floor I explained to them and reminded Mark how many times we activated 6 people to do just that. Becky shot me a look from the driver’s seat of the vehicle and asked a great question I still can’t answer.

“Why not just give them a ride in a van or bus? Why send the ambulance?’

Why indeed Becky, why indeed.

I could try to explain to her how, in America, people have become so expectant of lights and sirens whenever they want them that they’re willing to sue if they don’t get them. Regardless of the condition, reason or outcome, folks will threaten a lawsuit and managers will blink and change protocol. Why inconvenience the few when we can just take them and inconvenience the many, right?

That was the start of my shift on the vehicle. I’d love to tell you that life on a UK ambulance is so much different than in the US. But when it finally gets to comparing apples to apples in these systems, having someone in the back is it.

Previous posts have covered my impressions of the ambulance layout and ways I think they can be improved to benefit patient care and provider comfort and safety.

Mark had difficulty accessing most of his equipment from the cabinets. Everything he needed he got to, but not without ducking around the patient, around the family member, then leaning over. The trash was also oddly placed, lying directly behind the family member so that to dispose of bloody mess you have to ask them to lean aside.

But that being said, with the current layout based on “safety” there is no other place to put these things.

Mark described to me the regulations in place to protect the persons traveling in the back of the vehicles and it makes perfect sense. Until we have to actually do patient care.

After my description of the ambulances in a previous post I was contacted by an ambulance manufacturer who wishes to remain anonymous, I’ll call them Box inc. Box inc wanted my thoughts on what makes the perfect ambulance and I told them I have yet to see it. But, Box inc had some new ideas about making your ambulance more versatile when on post, more on that another day. But Box inc will still take a van or pickup truck, rip off the back, slap on a place for a cot and make it flash, there really isn’t another option at this point.

But back to Newcastle and the McDonald’s parking lot.

Yes, we’ve found our way to the parking lot at the McDonald’s, on post if you can believe that, so I snuck in for a coffee. It’s an addiction, I know. We had a chance to talk on camera about Becky’s role in the NHS and what an ECSW is. But as we talk about it, a few points to look for first.

I am sitting on the cot and Mark in the chair for family members. The pass through to the cab behind him has a small door on the top that leads to the trash bin behind that seat he’s in.

The cabinets behind us and between as as we talk contain all of Mark’s equipment. Just from the layout you can see how challenging it could be to access them with a poorly patient in the back.

When I said that Becky was above an EMT, the comments section at youtube went insane. What I meant was that she can give pain relief without medical direction. She can do something I can’t do, mainly because I’m told I need more education and training to deliver pain gas to those in need. Becky is proof I do not. So when I said she is above an EMT, I was referring to her ability to medicate them in that manner. An EMT can transport, Becky can not. Apples and Oranges folks.

Our jobs on the vehicle were similar to what Mark and I saw on Medic 99 in the City, moving folks with this complaint over there and that complaint over here.

It was on the vehicle that we encountered the only person, out of dozens, who demanded transport.

As you all plainly know, my clients demand transport 90% of the time and need it 5% of the time. Newcastle respects their Paramedic’s opinions, likely because they can get in and get seen outside the A&E in a reasonable amount of time compared to here in the US.

This person activated 999 to report an assault and we entered the house cautiously. It was quite a bit reassuring knowing that the occupant was most likely not carrying a weapon that could mow us down from 40 feet away. I’m no ninja but I’ll take a clipboard to a knife fight over a knife to a gun fight any day.

The local police were close on our heels, again, without firearms (hard to get used to) and the scene was more than secure. Very secure the police confirmed, poking holes in our patient’s story. Then there was the recounting and description of the event given and none of that matched what we were looking at.

Clearly there were behavioral issues in play and the decision was made to transport based on the inability to confirm normal mental status. We’ve all been there and trying to communicate with eye movements and physical gestures must have appeared as though Becky and I were flirting.

My eyes said “Look at the door, the things piled in front of it, it opens inward, no one broke in there.”

Her eyes said “What?”

My body, arms crossed, said ‘Over there, look, the door!”

Her body, arms raised to the side and shoulders up said, “Huh?”

Mark’s eyes said “Stop it!”

Mark does not ring down, or pre-alert, the hospital himself, but relays it through his control center. When I saw what the control center did the next day, I decided that was unnecessary. If your service relays patient reports trough a third person you are introducing another player in the telephone game and just another chance for pertinent information to get lost. I would love to be able to forward my report to that point to the hospital and they can move that information to a bed and await our arrival.

Oh, did I nod off?

Right now my service gives audio radio reports to whichever nurse lost the coin toss that day and has to answer the radio. I tell them what I have and why, vitals and hang up.

Many Americans may shudder at the idea of waiting 2 hours for an ambulance but I met a woman who disagrees.

Mary, I’ll call her, fell down on a friday afternoon and injured her hip. Being of a stoic generation, she didn’t want to bother anyone with her trouble, so she hobbles through the weekend until her doctor’s office opened monday morning. She called the office and spoke to her doctor who advised her to go into the A&E to be evaluated since his office had no x-ray capabilities.

The doctor called the ambulance and the call was classified as an “urgent” meaning there was no life threat, but still a need for a transport. This call is then put in hold in the system with a maximum wait time and an ambulance is assigned as soon as the system has the available resources.

Mary met us at the front door and walked us in with a slight limp, dressed and ready for her trip to the A&E like many of my lights and sirens patients. We took our time making sure her medications were gathered and the stove turned off, then into the chair and down to the ambulance.

Because this trip was arranged her medical records were waiting at the hospital, as was a bed reserved for her and she was seen as soon as she arrived. I asked her if the 2 hour wait was too long and she looked at me as if I asked her what color the sky was.

“I waited all weekend to call, another few hours wasn’t going to kill me, son.”

I wanted to hug Mary right then and there.

After a day of back and forths on the vehicle and torturing Becky with the American and the camera duties, we were close to finishing our shift when that dreaded job came in.

The late job.

We were planning on meeting some of the rank and file for a social evening and this job would put us over our shift and we’d be late.

We screamed through the streets of Newcastle, pushing old women off the road and opposing traffic wherever we could. OK, not really, we were sent on a common case that would later bring out our common response “Same patient, different country.”

With the patient on board and her friend safely secured we made our way through the evening traffic to St Farthest, all the while talking and keeping our patient in good spirits.

The day went fast in retrospect. Traffic still doesn’t get out of the way when you’re rolling lights and sirens, you still have to go hunting for the extra blanket at the hospital and the nursing staff is still often glad to see you when it counts.

The evening was a night out with some of Mark and Sandra’s co-workers, we were fashionably late after some creative dropping off and ride sharing. I got to talk to them about Mark without him listening and their opinions were high and genuine. Mark is a respected and admired Team Leader in his station and his system.

Posted by Justin Schorr on June 11, 2010 • Filed under: Administration & Leadership, Administrative, Command & Leadership, EMS 2.0, EMS Health & Safety, EMS Topics, News, Vehicle Operation & Ambulances, technology-communications-ems-topics, the Project • Tagged: Chronicles of EMS, the Project

The Car, The Wall and The Game – Day 3

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chroniclesblog

England recap, Day 3.

The alarm seemed to be timed better this morning and I was bright eyed and bushy tailed for my second day on Mark Glencorse’s Rapid response Car in Newcastle. The coffee was ready when I got out of the shower and I watched a bit of news while getting ready. When I was in England a frightening wave of flooding was literally washing away parts of the western side of the country and numerous Fire and Rescue resources had been mobilized. It was a topic of conversation in passing throughout the morning with the Vehicle (ambulance) crews we saw and hospital staff we talked to.

The check out on the car was much quicker since my first day orientation and away we went to our first post. On the way Mark asked if I was hungry and I had to remind him I don’t often eat breakfast. In the back of my mind was another McDonald’s run but in the front of Mark’s was taking my for a proper Geordie breakfast. The term Geordie refers to the people or speech from the Tyneside region of England, which is where Mark is from and where we were. Similar to referring to someone as a Lonestar or Southerner here in the US, a dialect of speech and set of stereotypes is set into your mind.

The car weaved through the light morning traffic to a take away trailer in a light industrial park. The aroma from this man’s trailer was like heaven. The odor of bacon, along with other smells, changed my long standing no breakfast clause and my mouth was watering.

As with many of our other adventures this day, Mark in the car had folks wondering where the emergency was. No one thought he was the Police coming to get him…until they saw me in my navy blue. When Mark ordered my meal and the fellows standing nearby read the back of my jacket, which said “Firefighter/Paramedic SFFD” they were curious to ask all the questions we’ve been asking each other for months.

“Is it true you have to pay to go to the Doctor?” “yes.”

“If you can’t pay do they send you away?” “No, you get a bill later.”

“What about an ambulance? Is it true you’ll leave me to die if I can’t pay?” “No, we’ll help you out no matter.”

It was a great conversation with locals about their neighborhood and town. Keep in mind this town has been here more or less FOREVER. It’s not like some guy wandered through 200 years ago and started a farm. There are castles and churches still standing despite centuries of wars.

It was in the middle of a talk about a nearby castle that my breakfast was ready. Mark’s smile widened as he handed me what can only be described as heaven with a side of LAD.

Bun, mushrooms, brown sauce, black pudding, eggs, sausage, bacon and it was glorious! Along with a true cup of coffee and some good conversation it was a wonderful way to start the morning.

But like so many things on this job, wouldn’t you know it a motor vehicle accident has been reported just a few blocks away. Chomp, gulp, a thanks and away we go to the 2 car accident. There was an initial need for extrication so Mark called in the Brigade.

The ambulance arrived quickly, as did the brigade and everyone went to work doing their pre-determined roles. It was refreshing to see firefighters not distracted by assisting with patient care, but simply having a task and seeing to it that it was done. This scene was more what I was used to. Ambulance, fire engines, police, a proper job. Although the injuries minor and the damage to match, the resources in the community worked seamlessly together to get the job done. After the patient was transported I had a quick talk with the firefighters about their roles and responsibilities on this assignment, since there was not the usual bickering or fighting for the glory of the jaws that I have seen all throughout my career. The firefighter assigned to cribbing was working just as carefully and quickly as the two sets, yes I said two sets, of hydrolics that were being prepared. We discussed my role as dual trained and they gave a polite smile. I think just below that was two distinct thoughts. First, “That’ll never happen here” and the competing, “Oh God, what if they do that here?”

My photographer for the day obliged for a photo of the brigade that responded drawing my caption, “One of these fireman is not like the other…”

After a couple more jobs we were released from our roll area and directed north to the Arsenal/Sunderland football match. The trip started as a chance to show a lifelong soccer fan a proper football match in his adopted country, but it would turn out to be an EMS learning experience.

But first, Mark had something special planned for me. We grabbed our sack dinner, lovingly prepared by Mrs999, and hit the road to see the proper section of the old Roman Wall I was so interested in. The drive through the countryside was amazing. Rolling green hills hiding in the fog, unchanged since ancient times, save for the occasional 200 year old farmhouse with it’s trailing smoke from the chimney proving someone still inside. The park rangers (or the UK equivalent) came out of their warm office to meet us when the RRC pulled up and we got out. They wondered if a hiker had been hurt on the wall, why else would the ambulance be there on a foggy, rainy afternoon?

After a climb and a brief hike I was able to take some video and one of my favorite pictures from this adventure. smaller Then I got to do what my Grandmother never did, stand on Hadrian’s Wall, where her hero Arthur may once have stood. There was a connection with that place I can’t really describe. I have the book she was reading when she died, Stories of King Arthur, a book she received as a child from her grandmother and I display it proudly in my living room, bookmark still in place and soon a photo of this part of the wall will accompany it.

It was an experience I hope to share with my young girls when they are old enough to appreciate what the wall means to the family. Folks have been known to walk the whole length, camping as they go, and I plan to do the same in good time.

And now for something completely different. If you’ve made it this far, I thank you. Like Mark has said, so much happened on this trip, so many interesting and exciting things we shared with each other and with all of you, these day by day accounts are long winded. If you skipped this far to read about Event EMS you are truly a Fire and EMS nerd and I salute you for that.

The Sunderland stadium can hold, at capacity for a football match, 45,000 impassioned fans. The perception of many of you in the US may be “Soccer Hooligan” and the stereotpye is fitting in many cases when it comes to premier league football. I was treated to not only the game, but a tour of the medical facilities made available for players and fans alike.

The stadium has an impressive command center encompassing the EMS team co-ordinator, Fire safety specialist, CCTV team and the police commander, all in two large rooms. From this unified command center a response can be co-ordinated and a plan followed by radio. The CCTV cameras also allow the leader to call in extra security if it appears an EMS fly team has unrest around them. Help can be on the way before they even notice what is happening. There were 4 teams on staff, dispersed around the stadium with assigned seats and radios, ready to respond as well as 2 pitch or field teams ready to respond to an injured player or person on the ground level.

Behind the scenes are two levels of care. The teams have physicians on staff to deal with injuries to their people and outside the stadium, tucked in with the snacks and beverages are a number of doors marked First Aid. Behind these doors are the service I know little about from my travels there, St John Ambulance. (Not St John’S ambulance, St John. I learned that one real quick.) In these almost clinic areas are basic care givers, EMT’s, Paramedics, RNs and an entire medical community, all volunteering to help out. While Mark and I sought refuge there to eat our dinner before the game, a woman came in, was assessed, treated, medicated and released, all in the span of 10 minutes, all by the St John staff. It all happened before I could finish my Dr Pepper.

Upstairs in the control center I had a chance to peek at the emergency response plan and these guys have it all figured out. I learned later that a number of previous events led to a mandate that each stadium have an action plan and the resources in place to react to those emergencies. We also talked about rotating the teams if more than 1 fly team was mobilized, the extent of the St John involvement, their ability to staff a team and a number of other things most laymen would have fallen asleep thinking about.

The match was brilliant. We stood just outside the command center, which was near the visitor’s seats. Arsenal fans are passionate fans. When I applauded a good play, which is common in this sport, Mark grabbed my hands just as one of the visiting supporters turned to see who was clapping. Just what I need 4,000 pissed off drunk football fans chasing the American who clapped because the home team goal keeper made a nice save. Tragedy averted. And good too, because we were heading out on the town later.

We’re meeting Mrs999 and Fiona for a night on the local scene to give me an idea what Geordies do when the sun goes down. Well, a while after the sun goes down. OK, late at night. I was treated to some local color and had a chance to talk to Mrs999 and Fiona about the person I was shadowing this week. We talked, danced, twittered and had a wonderful time. Mark loved his new iphone, since the old one died in San Francisco and at one point he fell asleep updating all the Chronicles of EMS followers. OK, not really, but it made for a fun twitter update.

As the evening continued on the famous Millennium bridge over the river Tyne, I had a chance to reflect on where I was and why. It was a big deal to be where I was, with Mark and the NEAS, learning how to deliver care in the front loaded model. We should have called it a night there, but we had one more stop.

Bachelor and bachelorette parties in Geordie country take themed dressing to the extreme. In Las Vegas, the girls may dress in pink shirts with the bride to be in some kind of white head dress and veil, letting all the single guys know exactly what she is celebrating. But here, the entire group dressed to match. There was a group of guys dressed as 20′s gangsters, pinstriped suits and fedoras. Why? Stag party. Groups of girls wearing matching tight shirts all wishing their engaged friend luck in cleverly worded phrases on the front. Why? Bachelorette party. In came a group of girls wearing black and their names on he back of their shirts. One of them we know. Steph Frolin is the name my co-workers use to alert me to a scene that is not what it seems. Imagine we are investigating a person who says they just came in from a terrible car crash. As I’m assessing them my partner discovers witnesses in the next room who can confirm no such thing ever happened. They will refer to me by my BS name: Steph (Pronounced Steve) Frolin. as in “hey Steph, can you have her describe the car again?” Now I know something has changed and that I need to speak to the partner ASAP.

So Mark turned on his ambulance charm and talked the poor girl into standing with the only guy wearing a jacket for some reason involving an American and a blog. No doubt she has erased this moment from her own memory.

As I mentioned earlier, we should have cut the evening short at the bridge. The jet lag, the drink, Mark’s dancing, a long day and an early alarm clock would spell disaster early the next morning for our last day on the car.

Taking it easy on the drink is a suggestion that carries through all situations and this one is no different. Not that I went to excess this night, no where close, but the combination of the time change, new diet and excitement of the Project would lead Mark to getting me off the streets the next morning. And I’m glad he did. Details on my nap next time.

Posted by Justin Schorr on June 10, 2010 • Filed under: Administration & Leadership, Command & Leadership, EMS Health & Safety, EMS Topics, Fire Rescue Topics, Technology & Communications, training-fire-rescue-topics • Tagged: Chronicles of EMS, the Project

Reflections on Day 2 – the Project

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Originally posted on November 20th, 2010

Today was my second day in Newcastle, UK but the first on the streets with Mark. It is indeed a different world here. the video from the end of today is linked at the end of this post.

We started early this morning and grabbed a coffee at the McDonald’s, then off to standby in a local neighborhood where we pulled out the laptops and discussed the day.

I was able to have a quick interaction with some of the Firefighters assigned to the station with Mark and the Ambulance crews, nothing more than a quick introduction between calls, but it was later in the morning when I learned I don’t have it nearly as good as I thought.

While heading out to the pouring rain, I bumped into the station cleaning crew mopping the floors. The fireman don’t do the big housework. No wonder mark was so surprised when I gloved up and cleaned toilets back home.

Later in the morning still, I met the Station’s French Chef. They don’t cook their own food either. These are two things I think identify the firehouse as a home. It seemed more like a school than a fire house.

But, I have yet to see it through the eyes of one of the firefighters, that comes next week.

As far as impressions on the ambulance, I can say that some of my expectations were met while others missed completely.

For example, Mark can honestly tell people when they don’t need to go, then leave them at home to recover. He can not only let them drink water, but take pain meds. He can cancel the ambulance and drive patients into the clinic.

He also has to wait in the middle of the highway for a second ambulance when he has 2 patients in C-spine precautions. You see, the European style ambulance is abundant on space on the inside, but so much of it is unused. There are two chairs and a cot in the back of these rigs, no room for a second patient. When we had 2, almost 3 patients to board, we had to wait, when most US services have the bench seat that can be used for that second patient.

He also gets to watch the fire brigade going the other way on that highway just looking. They did not respond to the traffic collision. Had I not been there he would have been alone, but I’m sure done fine. The police and highway department arrived and had a cool hand with the traffic, no safety issues or requests to reopen the highway sooner. In fact, where some of the agencies I have worked with would open the lane next to the accident, these folks kept it closed since we were close to it.

It is hard to draw any conclusions from a 12 hour shift in one station, but at first glance I want to have Mark’s training and options when encountering patients who don’t need an ambulance and I think he needs my ambulances to offer a better service to his community.

Deploying rapid response cars within the SFFD may not work after all without the clinical routing options he has at his disposal, not to mention an ENTIRELY different view of what it means to call an ambulance. Each and every person I encountered today listened to Mark explain their situation, condition and options whereas most of my clients demand transport regardless of their condition.

The internet here in my hotel is not included, like their website would like you to believe so I am using Mark’s mobile USB adapter which uploads a single photo in 8 minutes, so the updates from here will be mostly in text, but I’ll film my video and give it to mark to upload at home each night.

And for those of you who think I’m in the bag for socialized care, I favor it because it makes more sense but I will be honest about what I see here. Believe that.

The Day 2 Roundup Video

Posted by Justin Schorr on June 9, 2010 • Filed under: Administration & Leadership, Administrative, EMS Health & Safety, EMS Topics, Technology & Communications, technology-communications-ems-topics • Tagged: Chronicles of EMS, the Project

The Good and the Bad – Continuing Day 2

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chroniclesblog I left off soon after our first job on the car which had me wanting to see the versatility of Swalwell 405, our Rapid Response Car. I was beginning to wonder if I had built it up into more than it was when the universe stepped in and answered my questions, as always.

A school child was ill with a unique condition that was familiar to the child’s brother at the school as well as the mother who had arrived on the scene before us in the car. When Mark had determined the non-emergent condition of the 10-18 year old (not a little one is the point) the ambulance was canceled. There it was, the front loaded model in action. A trained set of eyes able to determine no need for a two person gurney transport, so the unit is canceled ASAP. Should transport be needed or requested (which it never was, save once over there) the patient was appropriate to sit in a car, seat belted, and driven to the A&E or clinic.

Through the course of the evaluation Mark and I both asked a variety of questions trying to get to the center of what the unique condition was doing to our patient. In the end, Mom decided she would follow up with their Doctor later that day and she will let the child rest at home, something that usually helps when the child feels this way. Mark offered to follow Mom back to their house just 5 minutes away just in case something happened. Not sure exactly what that might be I was even more excited when he said, “Or I can just take her in the car and follow you home. Would that make you feel better?”

The mother smiled, blushed and sighed. “Would you?” Mark smiled and assured her it was no problem at all and we escorted our patient to the car and drove her home. There was never a point where this patient needed a hospital, let alone an ambulance based on the mother’s description of the unique condition and other factors revealed at the scene. In San Francisco I would have had to transport the child or send them home with Mom. In my experience both parents are often working and unavailable to respond to the school, and that’s IF they even answer the phone number given on the emergency contact card.

5 minutes and a car made a huge difference for resources in the area. I was sold on it right there and then and a number of other calls re-enforced the benefits of the RRC. The old man with the hurt wrist who we gave a ride to the clinic, leaving the ambulance available. The baby with a cough who we gave a ride, strapped in her seat with Mom along for the ride. None of them needed an ambulance but had no other way of getting evaluated for their chief complaint. In San Francisco a 4 person ALS engine and 2 person ALS ambulance, 6 people and$600,000 worth of apparatus to do the job of 1 man and a ford station wagon. It was reading through the real estate section looking for a house to buy that a call came in that would change my mind about the current NEAS system. A certain resource issue that is.

This is the section Mark has been waiting for. All through our experiences he has been wondering what my real opinions were/are/will be and I kept telling him, “I already told you.” But I have to share with all of you or else this is all for nothing, right?

The ambulances currently used by the NEAS are inefficient when it comes to treating a patient enroute or dealing with more than 1 patient. I use the term carefully since when a rider is placed in Mark’s ambulance and a patient is in the cot, half of his kit is inaccessible. The large gurneys load into the open space in the rear of the ambulance and latch into a sliding platform that can move the gurney from the wall to the center of the floor for the simple reason of accessing the patient’s left side. This removes space for a bench seat and moves the patient a good deal away from a practitioner in the back. I had difficulty imagining Mark working a proper patient, rolling blues to the hospital and being able to access anything quickly and safely. This photo is from Swalwell Vehicle 214, which we worked on later in the week, but show the head of the cot and the fold down seat for a family member or rider. the cabinets slide out of the wall so when they are closed they are secure and not accessible. More on that when I discuss working in these Vehicles.

That being said, I did like being able to almost stand up completely and have all the light and vent controls in an overhead consul instead of buried back in the corner near the shelf near the captain’s chair like in many type IIIs here in the US.

Working a motor vehicle collision with more th 017 an one patient opened my eyes to the benefit of multiple hands on the scene. We arrived soon after the police and began assessment. An ambulance had already been dispatched and when they arrived I had my first glance into one. Whoa.

The crew opened the doors and a large lift was raised and the gurney loaded onto it. Then it was lowered to the ground and removed to our location. In all less than 2 minutes, but still seemed like a long time. I’m an immediate satisfaction type of guy.

When the first patient had been boarded and was being loaded I saw Mark reach to his radio and request another ambulance. I stopped, looked around the crew loading the first patient in and that is when I saw there is no bench. No place to put a second patient on a board. Neither of the patients needed critical care interventions, just C-spine precaution, routine medical care and assessment, something I’ve done to 2 LSB folks often.

It was an awkward wait in the middle of the highway for that second ambulance. During that wait, on the other side of the highway went a fire engine. In service, staffed, yet not dispatched to the motor vehicle accident on the highway. The first emotion was confusion as in, “Why can’t they respond to assist?” which gave way to frustration, “Lazy brigade won’t even hang a u-turn and check on us?” then reality sank in, “They couldn’t help right now if they wanted to.” No fluid leaks, no fire hazard, the road was already safely blocked by the highway department and all we needed was a place to put a patient on a backboard.

My plans to move over were put on hold. For all the benefits there were indeed drawbacks. Of course there would be. But so far, the only thing missing was that ability to take a second backboarded patient and have access to all the equipment in case of a proper patient. Especially since Mark spoke of having to do CPR and push drugs alone in some cases.

But what is the answer? The NEAS used a Chevy type III years ago and it didn’t work out. From what I’ve been told I think it was a combination of politics and underpowered motors, not necessarily the patient care compartment. That conclusion is drawn from a number of conversations with a number of NEAS folks.

It was made clear to me when I brought up my observations to Mark that the governing bodies mandate the secured nature of all the equipment in the ambulance and that repositioning it would not only take a completely new vehicle, but changes in rules and regulations country wide. So the work is cut out there. However, to be fair, Mark took one look into the back of medic 99 and nearly passed out. Nothing secured, supplies behind flimsy plastic doors, no cot lift, it was a recipe for injury in his mind and the mind of his regulators.

Is there a middle ground? Wheeled Coach, Medstar, there are so many different manufacturers just here in the US, what are they using as the basis for their designs? And what about Mark’s ambulance manufacturer? Are they deciding what is best for us or are we? I have yet to work in an ambulance where I thought to myself, “This is perfect!”

See Mark, all things I told you when I was there. We even discussed it in a video report later in the trip.

A few more jobs and we were back to the station for end of shift.

The spot on swooning British nurse impression Mark does was not actually spoken, but he was told repeatedly that I looked “nice” in my station uniform. Funniest thing was, I was cold and wearing my coat most of the time and he had me remove it before going in. I think he’s angling for a different style of uniform.

The end of my first day on the RRC brought smiles from me and from Mark and a look forward to another wonderful evening with my extended UK family. Tea with Margaret, Sandra and the Boys was my family time. Had I had the time to bring Mark the hour home with me each night here in SF, I think he would have had a much better experience and I now regret not being able to share that time with him.

Back to the hotel and a warm shower and inviting bed. Tomorrow would be another big day on the car and an afternoon of local heritage, discussing Event EMS and an explanation of this photo:

Steph? Steph Frolin is that you?

Posted by Justin Schorr on June 9, 2010 • Filed under: EMS Health & Safety, EMS Topics, News, Patient Management, Technology & Communications, Training & Development, Vehicle Operation & Ambulances, technology-communications-ems-topics • Tagged: Chronicles of EMS, the Project

Swalwell 405 – Day 2 in Newcastle

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chroniclesblog

This is a continued retelling of my adventures on Part 2 of the Chronicles of EMS, the one we weren’t allowed to film.

Day 2 in Newcastle, Day 1 on the car.

The iphone rang so early I thought I was still dreaming. Sure it said 5:15 AM and Mark would be along to pick me up in 30 minutes time, but I felt destroyed. My body still thought it was 10 PM and was gearing down for night.

NO! I yelled to myself and turned the lights on.

This was going to suck.

I got cleaned up and dressed, then went to make a cup of coffee. Coffee in England is different than in America. In America you get a nice drip brewed cup of joe from perhaps a Peet’s, or even a Starbucks or gas station. In room 501 of the hotel, my HMHQ for the week, there was a water kettle and a baggie of freeze dried coffee. A taste I choked down at first and then missed as soon as I was on the plane ride home. I had come prepared for the coffee situation, however, as you may recall from this video I posted later in the day:

Mark took me over to his station, the sun yet to rise. Inside I met a few of the night shift going off duty in the ambulance room of the Fire and Ambulance Station. It immediately took me back to microwaving 25 cent burritos and drinking tap water during my internships. There was a TV in the corner, 4 very nice green chairs (green is the color for EMS there) a couple of side tables, small kitchenette with sink and a microwave. We really are the same.

Craving more coffee I went to fire up the kettle and prepared another cup of the freeze dried goodness as Mark took me out to the floor and to Swalwell 405, our Rapid Response Car for the day.

It was exactly as I had imagined. A ford station wagon, appointed with safety markings, emergency lights and the ever important aspect to the RRC, the label “Ambulance.”

The RRC with the Appliances at Swalwell Station

Mark led me on a quick overview of the equipment kept inside and what I could carry on a job and what I should stay away from. We talked about interventions I could perform, such as assisting persons to stand or to walk, the basic stuff we all do, but at no time was I to use his giant Lifepack 12 to cardiovert someone in unstable SVT.

As soon as we were checked out we were sent on a system status post in a nearby neighborhood. Not to get Mark in trouble, but I needed more coffee (some have cocaine, others a hobby or “life”, I have coffee, let it go) and the only place that pours a cup is a place I hadn’t been in over two decades, the McDonald’s.

We were on post for an hour when we were called back to the station. You see, Mark and his co-workers are given a rotation back to the station each hour for bathroom trips, food and what not. When we left our area, another vehicle or car would fill in. This seemed simple enough at first, but a few days later, while watching the allocators try to juggle all the breaks and rotations, I wondered just how important that 1 hour mark was.

At the station Mark’s point to point radio came alive. I had trouble understanding the accents at first to decipher our assignment and there was no station alarm or alert system. Perhaps it would have awakened the firefighters upstairs? We climbed in the car and away we went, blue lights flashing to a reported fall victim. Specifics aside this was the perfect first call for me to see the NHS in action.

I in my station duty uniform with badge of office and Mark in his now famous green jumpsuit made our way in and found a run we EMT and Paramedics handle all the time, a minor muscular injury. Mark went into his comfort zone, patient care, and I handed him the BP cuff and placed the stethoscope across his shoulders to have it in reach. That got me a look I often saw as a small child when I would break something expensive. No one over there stores their stethoscope around their neck. I only do it on scene, mainly so I don’t lose it, but throughout my trip I never saw one ‘scope around one neck.

As I recovered from that faux pas a walking Saturday Night Live memory came through the door. The patient’s neighbor was a Scotsman, a true Scotsman, and when he found out I was American he began to tell me a story about an American he knew back in the 60s. I know this because Mark translated for me later. I could only make out a few words here and there, no unlike watching TV in a foreign country.

The Scotsman was ignored when I heard Mark tell the woman she should take some Peracetamol and the ambulance will be along in a moment. He is allowed to let his patients medicate themselves for new conditions. Now, I can create a gray area and make it work, but imagine telling the receiving facility that you let your patient dose up on Tylenol (acetomeniphon/paracetamol) for a new injury. The ambulance crew arrived and away the patient went and we were back in service. Nothing extraordinary, a simple run of the mill job we both encounter all the time. The only difference was arriving at the scene in a car, and alone (without me) would be challenging at first, but some days, with some crews, I am kind of am responding alone.

In my next post I’ll describe the odd moment when we were waiting in the middle of the highway for a second ambulance as a fire engine drove by, not assigned to the accident and something I think the NEAS needs to change immediately to better serve their citizens.

Posted by Justin Schorr on June 9, 2010 • Filed under: EMS Topics, Patient Management, Technology & Communications, Training & Development, Vehicle Operation & Ambulances, the Project, training-fire-rescue-topics • Tagged: Chronicles of EMS, the Project

My first day in Newcastle

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chroniclesblog After following Mark’s day by day adventures, I’m dragging you right along on the second week, the one not covered by the Chronicles of EMS cameras.

But why is this going up at 11PM your time Happy? Because that is 7 AM Newcastle time. Wrap your head around that one and let’s get started.
Mark’s San Francisco adventure covered 10 days in total and he was clearly as exhausted as I and likely more. I last saw him at the BART station on the way back to the City and then to the airport.

I wouldn’t see him again for 48 hours.

In that time I let my girls crawl all over me, literally and figuratively, all the while packing and preparing for my England trip. When the time came to board the plane emotions were high. The littlest one giggled when I gave her a kiss, the older one asked me to say hi to Mark in England. She seemed to be taking this experiment remarkably well considering the enormity of it and her comparatively small understanding of the world. The Mrs was understandably emotional and supportive, something she does very well. I had already given 10 days to this project rarely seeing the girls awake, if at all, and was about to give 10 more.

Into the airport I saw the car drive away and took a deep breath. This was not going to be easy.

The plane was packed. I had one of the window seats, but they neglected to tell me the foot room is severely restricted thanks to the new video on demand units. I had been to Seat Guru, but it seemed every seat sad that. In exchange for a place to put my feet I had dozens of movies to watch to take my mind off the tingling in my lower extremeties.

The time difference was 8 hours ahead. To help deflect the impact of the time change I knew I would have to get on the plane, eat and get to sleep as soon as possible, then sleep most of the flight. The last time we flew across the Atlantic I fell asleep during the safety video, then not a wink the rest of the flight, I was exhausted 20 hours later.
Imagine my surprise and pride when I finished dinner, put on my headphones and fell asleep. Then again we medics have been known to fall asleep in odd places at odd times.

I was awoken an unknown time later (6 hours I discovered) to the following conversation:
(This was an Air France flight)
“Keep heir on ze oxee-jin and we can moove heir to zee floors.”

Oxygen? Moving someone to the floor? This sounds like a job for…
…the flight crew.

Watch this video from my layover in Paris to find out what happened next:

After a quick commuter flight from Paris, we landed in cloudy, rainy, windy Newcastle, met by a somewhat rested Mark Glencorse.

Newcastle International Airport

I was whisked away to mark’s home and welcomed as family. It was nice after a long flight to sit down on a couch surrounded by familiar names and voices. We enjoyed a wonderful dinner (Tea, I was told to call it, the evening meal if you prefer) and the perfect start to what would become an exhausting week.

Even though my family was far away, I had a new one just a few minutes down the road.

I had shared a family story that my late Grandmother was fascinated by the King Arthur legends and that recent research believes Arthur to have been a Roman General defending Hadrian’s Wall from Northern Invasions. I had mentioned this in passing on an episode of EMS Garage and Mark and Fiona had heard me. Fiona scheduled a dinner meeting at the Swan Inn in a town called Heddon-on-the-Wall who’s cathedral was built with stone from the wall.

I was hoping for a brief time during the trip to go out to see the wall my Grandmother spoke of, but didn’t expect much at all. Little did I know that, on the drive back to the hotel, we passed by part of the wall there in the middle of town. Mark made it a nice surprise and swung the car around, parked and said, “There’s your wall, Mate.”

I froze. I had trouble moving for a moment. It was kind of like meeting someone you admired. I climbed out of the car into the cold night air and took a deep breath. I could hear my Grandmother’s voice as if she was right there with me. “He stood here. He garrisoned here. This is history.”

It was a small section, only 6 feet wide, maybe 30 feet long and a few feet tall, in a protected grass area near homes, but it was the wall she spoke of.

I took a few photos and a quick one of me on the wall before heading back to the hotel to rest. As is now a Chronicles of EMS custom, the internet was pay as you go, so uploads were going to be difficult.

Mark dropped me at the hotel and I went straight past the pints in the lobby and straight to bed. The first day on the Rapid Response Car was waiting for us early the next morning and I wanted to be ready for it.

That story, and video of what I look like before coffee, next time.

Posted by Justin Schorr on June 8, 2010 • Filed under: EMS Health & Safety, EMS Topics, News, Technology & Communications, Training & Development, Videos, the Project • Tagged: Chronicles of EMS, the Project

Look out Newcastle!

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For you new people who are following Chronicles of EMS, did you know I went to England too? For reasons I could tell you, but then have to cardiovert you, the cameras weren’t allowed. However, I did document the heck out of my experiences in Mark’s system and wanted to share that with you again.

Over the next week, in the lead up to the next installments of Chronicles of EMS: A Seat at the Table, I’ll be “re-releasing” my England experiences to give the new followers a chance to see what this series could really do for us all.

I have posts in 2 parts. Posts from in the moment will be out each day at 8 AM pacific, 4 pm GMT and my later recap post of that day after reflection and checking notes will go live at 8pm pacific or the ever inconvenient 4 am GMT. Enjoy.

Originally published November 19th, 2009:

I arrived in Newcastle earlier this afternoon and am eager to get out with Mark and see what he has to show me.

Tonight I was welcomed in his home and felt at peace there. The more time mark and I spend together, the more we feel like old friends, and we mostly are.

Tomorrow starts at 530 AM, 8 hours ahead of Pacific time by the way, and then it’s 12 hours on the car. We’re having the worst luck with internet connections, with the signal in the hotel here an additional charge, even though the hotel site says Wi-fi. I guess they forgot the “for an additional fee” part.

I am a bit nervous to see the response times here, with Mark often waiting a bit for an ambulance to back him up. But we’ll see. On a lighter note…

On the way back from Mark’s house tonight, he made a quick turn not 3 minutes from the hotel and pulled the car over.

“There’s Hadrian’s Wall there Mate.”

newcastle day 1 009 And here’s me standing on the ancient Roman Wall just blocks from the hotel.

Posted by Justin Schorr on June 8, 2010 • Filed under: EMS Health & Safety, EMS Topics, Fire Rescue Topics, News • Tagged: Chronicles of EMS

EMS Week happenings CoEMS style

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ems2point0pin

Also clogging the bandwith at Chronicles of EMS.com

Not content with one party, Chronicles of EMS Co-Creator and Jedi Master Thaddeus Setla has organized a three city LIVE premiere event to raise awareness for our cause as well as the new film FIRESTORM.

From the website:

“Every minute in the United States, an ambulance gets turned away from an emergency room because hospitals are simply too full. In Los Angeles, where the wait time in some ERs is as long as 48 hours, the entire 911 system is being challenged in ways that are alarming.

FIRESTORM follows Los Angeles Fire Department Station 65, located in South Los Angeles, a neighborhood with a largely uninsured and undereducated population. The LAFD handles all emergency medical services for the city of Los Angeles, and currently 82% of the department’s work is medical, rather than fire-related. Eleven hospitals have closed in just five years in LA, and the challenge of delivering more than 500 patients per day to a shrinking number of hospitals is overwhelming to the LAFD. With resources strained, and 911 being used for everything from heart attacks to stomach aches, LAFD paramedics have become virtual ‘doctors in a box’.”

If you are on the west coast, your event is at the Gordon Biersch Brewery in San Francisco, CA, #2 Harrison Street on the Embarcadero. 6pm

If you are on the east coast, your event is at Fado’s Irish Pub 1500 Locust Street, Philadelphia PA. 8pm

Fret not midwest, the Fado in Chicago, IL 100 West Grand Ave. Chicago, IL 7pm is your location.

For more details and how you can participate in your own way, join the Chronicles of EMS community HERE and follow the facebook group for updates and additional cities when added.

If you want a party in your town, stop waiting and get out there and get proactive and make one.

And don’t forget that OTHER EMS show you can share during EMS week:

Chronicles of EMS – Reality Series (Teaser) from Thaddeus Setla on Vimeo.

Posted by Justin Schorr on May 9, 2010 • Filed under: Administration & Leadership, EMS 2.0, EMS Health & Safety, EMS Topics, Fire Rescue Topics, Funding & Staffing, News, technology-communications-ems-topics • Tagged: Chronicles of EMS, EMS 2.0

Discovery Channel

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Please go over to the facebook page for Discovery Channel and let them know what you think about Chronicles of EMS.

Ted officially submitted the show and we’re hoping to get their attention in the way we know how.

Thanks for your continuing support, see you all next week.

Back to the books.

Posted by Justin Schorr on April 15, 2010 • Filed under: Administration & Leadership, Administrative, Command & Leadership, EMS 2.0, EMS Health & Safety, EMS Topics, technology-communications-ems-topics • Tagged: Chronicles of EMS

Mile High Opportunity

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Right smack dab in the middle of my crazy 30 days was an opportunity to come here to Zoll Summit and present the first position argument for EMS 2.0.

As much as it has been pulled apart, scrutinized and criticized, the core message of looking at why we do what we do was very well accepted by the audience here in Denver. Supervisors, Chiefs, practitioners, designers and marketers all sat down and listened to that crazy blog guy and his UK buddy explain what EMS 2.0 means and why it has a chance to work this time.

Mark did a great job relating social media to the mission of improving EMS and the discussion that followed ended with one of the attendees asking where they could find a “user guide” on how to approach social media policies for departments. Mark and I shared a “Well, duh…that’s a great idea!” moment and went on.

Soon after our session and the discussion we commandeered the main ballroom and it’s twin 25′ screens to fire up the first episode of the Chronicles. It was after the last session so not too many folks turned out, but many times it isn’t the quantity, but the quality.

Soon after the show and a quick look at A Seat at the Table (thanks for the reminder Mic Gunderson) we found ourselves face to face with CEO of Zoll Rick Packer, our sponsor. Fearing a “I never approved this” moment, we were welcomed with a warm smile and a hand shake, followed by a long discussion of the concepts we discussed in the show.

Zoll has been more than gracious in helping us spread the word of EMS 2.0 and Chronicles, even if I should be back in the room studying for the promotional exam.

This week has seen us debating EMS systems allocation with friends, Chris Montera and Steve Witehead to name a few, and sharing the idea of improving EMS.

Later today Mark and I will be attending a networking event where we hope to share the message even more. Sorry for so few updates, we’re working on it!

Posted by Justin Schorr on April 14, 2010 • Filed under: EMS 2.0, EMS Topics, News, Uncategorized • Tagged: Administrative, Chronicles of EMS, EMS 2.0, Zoll

A lot to do in 30 days

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Happy Medic and the Chronicles of EMS message are headed to Indianapolis for FDIC April 22nd-24th. I was hoping to make some of the H.O.T. Classes earlier in the week, but Mrs HM is already tapping her foot about my Denver trip this week.
This full time work, full time web site thing is tough to balance.

But so long as I have the chance, I’m off to meet the other side at FDIC.

There is a meetup on Friday night at Rock Bottom Restaurant and Brewery just blocks away from the Convention Center at 10 West Washington Street, beginning at 8 PM.

I will be on the convention floor, meeting as many folks as I can to talk about Chronicles, FireEMSBlogs.com and social media in general. I’ll be the one in the CoEMS T-Shirt.
If you find me on the floor at FDIC and tell me “Mark Glencorse is ruggedly handsome” I’ll give you a free #CoEMS phone sticker (while supplies last or until I’m tired of hearing about the Brit.)

Thaddeus, Mark and the rest of the Chronicles gang will be recovering from the first EMS 2.0 position presentation at Zoll Summit in Denver. That presentation is on Tuesday and the gang will be meeting this weekend to put together something I think you guys are going to love. We hope to premiere something at EMSExpo later in the year that will take Social Media in public safety to a whole new level.
But I’ll let them tell you more about it when they iron it out.

So Denver, then Indy, and all with my SCUBA certification in between, followed by the surf rescue course, and then some time off.

Heh, time off.

During National EMS Week, while Thaddeus and the team are here in the states working, I will be off the grid for a few weeks getting some time away with the wife. I think that’s why she was OK with my booking Indy, she knew this trip was coming. We’ve been planning it for years.

And then this news that just dropped today.

My service is administering the Paramedic Supervisor’s exam the week after I return from our trip away. Now my escape will be turned into a study trip.

That means it’s time for one of those blogger breaks that we usually take for a few days, then wander back when the urge strikes, but I may need to force myself to focus on the exam prep when the materials are published.

Hell yes I’m taking the test!

But I’ll still be your Happy Medic if I get the job, and just as happy if I end up right back where I am now.

More to follow,
HM

Posted by Justin Schorr on April 9, 2010 • Filed under: Administrative, EMS Topics, Fire Rescue Topics, News • Tagged: Administrative, Chronicles of EMS

Chronicles Schedule

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chroniclesblog Updates for April are up at Chronicles of EMS

Have a look.

Posted by Justin Schorr on March 22, 2010 • Filed under: EMS 2.0, EMS Health & Safety, EMS Topics, Fire Rescue Topics, News, technology-communications-ems-topics • Tagged: Chronicles of EMS

Chronicles of EMS: Episode 2

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Also posted at Chronicles of EMS .com chroniclesblog HERE

This is mainly to get everyone to stop sending me emails on how to watch Episode 2 of the Chronicles of EMS.

We haven’t made it yet.

That isn’t to say there isn’t one, but keep in mind it costs nearly $10,000 to film an episode and Setla Films put together a knockout punch premiere for far less than that.

We have a ton of footage of me and Mark in the fire station, riding the engine and having in depth conversations about calls we showed you. So in essence, if we put together a second episode from the SF adventure and held it to the same standards I would have to go back into the studio and re-record a lot of voice over to cover set ups and explanations of what was happening, otherwise it would be the Justin and mark interview show, which is currently under the name A Seat at the Table.

You have all been so wonderful in your acceptance and spreading of the first episode and it was indeed an amazing experience to make it, help prepare it and then release and share it with the world.

To put things in perspective, you are all the happy first time parents of this baby, the Chronicles of EMS, and we just rolled over for the first time.

You’re excited, the calendar has been marked and you’re calling all your friends to tell them what just happened.

Do you want to see us roll over again or start to crawl?

Crawl or walk?

Walk or run?

Run or race?

This is the beginning of a lot of firsts for us and for you the audience. Feel free to keep emailing your thoughts and concerns to me (thehappymedic@gmail.com) and to Mark(mglencorse@yahoo.co.uk). We not only welcome your comments but demand them because, after all, this is about community above all else.

We made 2000 facebook fans in 3 days while filming and the ning site is still gaining members.

Keep the word spreading and when the next episode comes out you won’t have to help us spread the word, just sit back, relax and enjoy.

So, in summation, we’re rolling over, you like it and we’re doing more and more every day. (Wait until you see what we’re trying to do for EMS Expo! I’ve said too much already)

If you want to see a new episode sooner, get on the phone to your ambulance salesman, equipment supplier and union rep to get in touch with us about sponsoring a trip to your system or a system you want to see. You’d be amazed what magazines are charging these days for an ad that gets looked at once, then put away. We offer a part in the future of EMS, all they have to do is think like Pepsi.

Posted by Justin Schorr on March 15, 2010 • Filed under: EMS Topics, Technology & Communications, Uncategorized, technology-communications-ems-topics, the Project • Tagged: Chronicles of EMS

Haaaaaave you met Ted?

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I apologize in advance for the formatting on this post, I worte it on the plane and wordpress’s HTML coding sucks so in the interest of spending more time with my now 4 year old, I give it to you raw.

“Have you met UK Paramedic Mark Glencorse?”

“Have you met Ted Setla?”

I have never before tried so hard to talk to people about something other than getting in the ambulance. It’s not easy to be a barker at these conventions.

Paul, who’s last name I am either forgetting or omitting for my own safety, from Zoll was the leader of the demonstration of the Zoll Rescue net system, who’s presentation was before Mark’s and my own.

He had great one liners and provoking questions that made passersby stop and wonder what the guy in the blue shirt was talking about. That was nice.

Just wandering the aisles at a trade show can seem awkward I’ve learned. As you wander, the folks from all the booths seem to come at you, quickly reading your name badge and asking you some strange question you’d rather not answer.

“What C-Collar does your system use?”

“Well, shoot, it seems to change all the time, why?” and they’ve got you. And they’re good at it, that’s why they’re there.

At EMS Today Baltimore, the Chronicles of EMS team was invited by Zoll to speak about the reality series and where the movement might go.

Charlotte, our Zoll contact, had arranged for a large amount of T-Shirts to be available to conference goers and they were a big draw. Trouble was we didn’t have a space in the booth, or any booth for that matter. Not sure exactly what we were, how we were to interact or what to do, we did what all Paramedics do, improvise and adapt.

A false wall curtain moved, literature stored and a quick ironing of a half dozen shirts up on hangers and POOF! Chronicles of EMS “booth.”

We were in front of the previously hidden storage room for the Zoll folks and they were constantly coming in to get more handouts and materials as they were quite popular.

So Mark and I took position in front of the 5′ wide gap in Zoll products and readied ourselves for the storm.

And this is where the really great part of social media comes in.

As faces approached we tried not to look at the name badges, but just introduce ourselves with a simple “Have you seen the Chronicles of EMS, the new EMS reality series?”

Surprisingly, most folks who wandered by said they had heard of it, or seen something about it, and not in that “Oh, sure I’d LOVE to see pictures of your great grand children” way, but in a “Finally someone can explain this to me” way.

So right there in the booth Mark Glencorse had wrangled a power source and extra monitor to show the episode on a loop. And folks took a look and asked more about it.

A 17 year old EMT student from New York State saw it.

His father, a retired Firefighter and social media skeptic saw it.

And they both wanted to learn more about it.

That is huge.

What else was huge, in my book at least, was the number of bloggers who made the travels to gather in Baltimore for the largest Fire and EMS Blogger meet up in the history of man.

At one point a familiar face wandered over and extended a hand and I shook it. The voice that came with it was none other than Ambulance Driver. Before I had a chance to express my joy in meeting a true beacon in EMS blogging he stepped aside and introduced me to another beacon, Too Old to Work, Too Young To Retire (TOTWTYTR or TOTW). My jaw was on the floor. Having my face all over the show makes me rather easy to spot, but some of the most closely kept secret identities in blogging came forward and said hello. It was amazing.

Even more amazing though was how they stepped back when folks would approach Mark and I and say “I read all the blogs and meeting you guys is so cool.” Mark and I shared an inside glance, then looked 10 feet back and wanted to say “Do you know who is standing right behind you? TOTW and Ambo Driver! Look quick!”

On the morning of the second day I was hurrying through the lobby of the hotel on my way to meet Mark to head for a full day of wrangling folks into the “booth” and share Chronicles. Coming my way through the throngs of high school students gathering for the Model UN Conference was the internet’s Red Headed EMS Stepchild, Chris Kaiser. As I said hello to him an oddly familiar face appeared behind him.

And something happened that would happen over and over again that day:

The second introduction.

You see, we really do live double lives. As I looked to the beautiful (and tall) woman I suddenly realized I was introducing myself to an old friend, Epijunky from PinkWarmandDry. We shared a smile and a hug as if we had not seen each other in years even though we had never met.

Friendships were not made here, they were experienced on a different level.

I offered a hand to a fellow approaching the booth with purpose, another man close behind. It was Fire Critic and Fire Daily, themselves having only met face to face after months of co-hosting a radio show together.

NateEMTB from twitter stopped by to say hello, as did MyrtLife and literally dozens of others who introduced themselves first with their names, then their identities. The names got a polite smiles, the identities a welcoming embrace.

Yes Mrs999 and MrsHappy, we did a lot of hugging. It comes with the territory.

But then there were the other folks stopping by the spot we carved out of the convention floor, a space not even big enough for 3 people to stand, so we stood in the aisle.

It was in this aisle that I had the first of many “Are you freaking kidding me?” moments.

“Hi Justin, Hi Mark. I really like what you guys are doing” said the brown haired man in the striped shirt.

“I’m Bryan Bledsoe.”

I’ve said it in this forum a good deal of times, but this truly was a

blink…blink…

moment.

And I was a fanboy all week. Dr Bledsoe wandered by a number of times during our stay and always had a smile and a handshake to say hello.

It may be a bit late, but if you hate name dropping and fanboyism, you should go read Motorcop because I am about to go 14 year old on you.

I carried my Firegeezer mug on the plane so the baggage handlers wouldn’t damage it. I carried it and a red permanent pen each and everyday on the off chance I would bump into Mike Ward or the Fire Geezer himself to get it autographed. And I did. Both of them. Yup, I’m THAT kind of fan.

Throughout the show, we met people involved in all aspects of EMS and each level seemed interested in what we were doing, both in the show, with the blogs, EMS 2.0 and just saying hello and talking to folks.

I can not select a single moment that was my favorite but I have collected a few that stand out from EMS Today in Baltimore:

Meeting the inventor of the KED, over a beer.

Introducing myself to the Chief of EMS for FDNY who replies, “Yeah I know you guys.”

Talking systems allocation theory with an 18 year old EMT student from New Jersey (I forgot your name but if you read this email me, our talk is not over!)

Being interviewed by THE Dave Statter of Statter911.com who refuses to put me on channel 9.

When a twitter friend, 2 of them actually, accompanied other new friends to an Irish bar in the cold night air near closing time and then not letting me buy them a drink (I owe you squirrel and NJ)

Watching vendors realize the power social media has.

I can’t wait until Denver in April.

Posted by Justin Schorr on March 7, 2010 • Filed under: Administration & Leadership, Command & Leadership, Uncategorized • Tagged: Chronicles of EMS, EMS Today

What a Weekend

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What a weekend indeed. As our regular readers are aware, it appears those 26 exhausting days back in November were worth it after all. Even though only the first half of our Project was turned into the Chronicles of EMS, the entire experience has changed the way I view my system.

This screen shot will take you where you can watch the show.

This past Friday saw the World Premiere of the Chronicles of EMS Reality Series in San Francisco. Mark and I arrived a bit early at the request of Producer/Director Thaddeus Setla and were quickly aware of the extensive set up on site. Multiple large TVs are linked to laptops and cameras, all relying on a tiny ethernet cable to stream it all live around the world.
The chat room got a bit colorful at times but we did notice those of you out there reminding visitors to keep things clean, even if they refused.
Before we knew what was happening, Mark and I were at a table talking with magazine reporters, investors, friends and readers, all excited to see the first episode.
Although we had a really nifty schedule of events, technical troubles and the wave of people in the Hotel Frank made that schedule difficult to keep.

Keep in mind this is all being put together by Paramedics, not professional live streaming folks. We can’t afford them yet.

But when the show went live, the room got quiet and I went to the back of the crowd to gauge reactions. And the were 100% positive.

Thank you all so much for taking your own time and money to help us show the world what we did and what we learned.

The following morning Ted loaded up the cameras, Mark and got a few folks from out of town we usually talk to over skype or email to sit down and talk with us. We fired up the cameras and filmed a sister show, A Seat at the Table.

It was more fun to film than I expected and we talked about a lot of issues. You can watch the show link for information on future table discussions and how you can join them live, each show has a laptop open to the chat room which has it’s own place at the table.

Whenever we travel with the Chronicles team, we hope to gather folks around the table and open the dialogue even more.

Thank you again for all your positive comments about the show, we hope to live up to your high standards in the future.

Posted by Justin Schorr on February 15, 2010 • Filed under: Administrative, EMS 2.0, EMS Health & Safety, EMS Topics, News • Tagged: Chronicles of EMS

Caption Contest Winner

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The internet’s most popular caption contest ended with a thud and a lack of fanfare. I was meant to tell you who’s caption made me happiest at the Chronicles of EMS Premiere, but alas I couldn’t get to the camera.

So, the winner of the Chronicles of EMS T-Shirt is…

…drum roll please…

frumpydumples

“She’s got HUGE…tracks of land, Boy!” from reader cjordan.

He may have cheated since he knew me long ago, but knowing I’m a python fan came through in the end. So Mr cjordan, if that is your real name, send me an email with your T-shirt size and soon in the mail to you will be your very own Chronicles of EMS T-shirt.

Thanks everyone for commenting and even more for your support in our endeavors with the Chronicles.

Posted by Justin Schorr on February 13, 2010 • Filed under: Administrative, News • Tagged: Chronicles of EMS

The Premiere Party is LIVE!

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chroniclesblog

Come join us in the ustream premiere of

Chronicles of EMS – Live now until 7 PM Pacific.

See you there!

Posted by Justin Schorr on February 12, 2010 • Filed under: Administration & Leadership, Administrative, Command & Leadership, EMS Health & Safety, EMS Topics, Fire Rescue Topics, Firefighter Safety & Health, Funding & Staffing, News, Patient Management, Technology & Communications, Training & Development, Videos, technology-communications-ems-topics, the Project, training-fire-rescue-topics • Tagged: Chronicles of EMS

A Seat at the Table

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Buried within all the excitement of the premiere of the Chronicles of EMS Reality Series is another premiere I’m proud to be a part of.

Over the years EMS has been serving their communities we seem to be finding ourselves out in the cold when budgets are doled out or reimbursement tables adjusted. The practitioners on the street, in the patient’s bathroom, bedroom, living room, deepest darkest days are largely ignored when industry heads meet to discuss where the trade may go.

They’ve talked of minimizing standards to maintain a constant flow of low paying jobs and EMTs eager to step on the gas and run the lights and sirens. Study after study showing one way is wrong so another can get a bigger market share. All the while our pagers are going off and alarm bells are ringing.

If we’re lucky enough to have a voice in the discussion, we are looked at as an afterthought. A nod and a smile greets our suggestions for improvement, often with a “we tried that before, it didn’t work” which is the EMS version of a pat on the head.

Various committees and organizations sprung up with a spot for us, among dozens of others, making sure we had no chance to be heard. EMTs and Paramedics were never given a seat at the table.

So we made our own.

Social media has us sharing ideas and concepts in a way they never saw coming. Research can be done from home instead of at a far off conference of owners and Chiefs all striving to prove themselves as having the best system. We can now call their bluffs, and they can call ours.

A Seat at the Table takes one element we discovered while filming the Chronicles of EMS Reality series and expands it into a format rare in our industry: Video. This element was the civil discussion of differences by street level EMS personnel who took the time to comment about what Mark and I were learning from one another.

There are plenty of EMS videos available for viewing online and by purchase, but never before has a filmmaker with a vision and a background in EMS taken up the challenge to document what we’re talking about.

Take a look at this snippet Ted Setla and I shot to explain to investors the power of Chronicles of EMS:

Chronicles of EMS – The purpose from Thaddeus Setla on Vimeo.

The Chronicles of EMS:A Seat at the Table is a table top discussion program filmed in the round and is scheduled to include as many people involved in the future of EMS as we can find.

Each time the Chronicles team travels, A Seat at the Table will be close behind to take advantage of the unique people we might meet and want to hear from.

Not only will we be sharing ideas, but getting answers to questions from those in charge of where we’re all going. Mark Glencorse and I will be there but you will be as well, following each episode as it is filmed HERE in the ustream chat room (scroll to the bottom). When you listen live to the filming, Mark and I will be monitoring your comments and questions for the panel and including them in where the show goes.

That chair you’re sitting in will now be at the table, a voice in where our young profession leads.

Watch the Chronicles page for updates about filming in your area and if you want to be in studio with us, let me know. thehappymedic@gmail.com.

Bookmark the link to the Seat at the Table page as upcoming episodes, topics and guest lists could change suddenly as we’re sent all over the world exploring how EMS systems operate.

See you there.

Posted by Justin Schorr on February 9, 2010 • Filed under: Administration & Leadership, Administrative, Command & Leadership, EMS 2.0, EMS Health & Safety, EMS Topics • Tagged: Chronicles of EMS

Fire and Rescue, UK style

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My EMS adventures in Newcastle upon Tyne had come to an end and I had but one full day left in England. Swalwell Station Manager Peter Mudie has arranged for me and Mark to take a bit of a tour of the capabilities of the Tyne and Wear Fire and Rescue Service, so we’re up early and he’s taken us for a road safety class.

Not for me, thank goodness, but for a group of young drivers to impress upon them the importance of not drinking and driving.

Many of us have been to these presentations before. A middle aged expert prepares what to them appears to be a hip multi-media presentation and the attendees seem less than interested. I was the same way at 16, we all were.

Enter the Happy Medic and UKMedic999 and the class is now wondering what just happened.

The presentation was actually one of the best I’ve seen including some racy videos that in the end have a message about driving safely. The kids were really paying attention then. Mark and I had a chance to impress upon the gathered youth the importance of seat belts and driving safely. I think my “accent” kept their attention more than my content.

Even the locals were cold. Mrs HM knit me two hats, so I shared.

Then it was off to the yard behind the station for an extrication drill to show the new drivers what happens when cars collide.

Set up down the hill were two cars and two students were chosen to be the victims.

To say it was “balls cold”, as one student put it, would be an understatement. I’m a 6th generation Californian, 50 is cold for me. This yard was cold. Wind blowing, snow falling and me with no gloves.

The kids watched as their friends shivered in the cold while the fire appliances pulled up and began their task. I mentioned in passing to the instructor that I would have let the kids go back inside and he suddenly had a point to make to the youth suddenly more interested in each other than the hydraulic tools freeing their friends.

“AYE!” He shouted to the huddled, hooded forms, “You’re here wearing your coats and gloves, hats and whatnot, but what if you were heading back from your mate’s place and were wearing only a shirt and crashed?” He was moving around in front of them, almost pacing like a drill sergeant, “Laying in the snow, cold, tired and hurt? You wouldn’t last very long would you?”

He had their attention the rest of the morning.

The extrication was straight forward with the only difference being the use of the smaller ladders to brace the car on it’s side.

After a lunch cooked by the station’s french chef (Yes, the chef is not a firefighter) it was off to Tyne and Wear Fire Headquarters.

What an impressive building and training ground they have!

A grand foyer greets the visitor and many small groups of men are sitting in plain clothes discussing this and that. One of them, the only one wearing a shirt and tie sees my SFFD Firefighter/Paramedic jacket and does a double take.

As I surveyed the enormous complex I would assume candidates are intimidated when they enter to get their employment packets. Peter led Mark and I on a brief tour of the lower level and the man in the tie wandered over and said hello. Just a casual greeting, he seemed like a regular guy in a sea of white embroidered uniforms and street clothes.

Chief Bathgate, Yours Truly, Peter Mudie

The man in the tie wandering the lobby is none other than Iain Bathgate – Chief Fire Officer for Tyne and Wear.

blink. blink.

He offered a hand and I shook it. There I was in my uniform shirt, but buried under a sweatshirt and a jacket. Had I known I was going to meet the Chief I would have at least donned my cap and tie to show respect.

Turns out he was more interested in the back of my jacket than what wasn’t around my neck.

“You do both then?” he asked me.

“Not often at once, but yes, I am proficient in both skills” I replied, wondering if I should go into further explanation. As we spoke the other men were taking interest in the fellow with two titles on his jacket their Chief was talking to. He immediately suggested a tour of the training grounds, something his face glowed about, he was proud of it.

Through the main lobby and out another set of large glass doors was their training facility, easily 5 acres and including a wide variety of props.

11tower There was a standard training tower that, since once at the top one could peer over to the automobile manufacturer test track next door, was rotated and modified to keep wandering eyes away.

11highangle

Next to that was a high voltage power line tower prop for high angle rope drills. Under construction nearby was a large two story collapse house that can be dropped and rebuilt quickly to simulate rescues.

A number of burn buildings stood ready for recruits and in service crews alike, one of which was in service when we visited.

But the piece of equipment that caught my eye as special was their train rig. Over behind the airplane prop and the piles of wood was a full size train car half in a man made tunnel. 11tunnel I wish we had one.

Half way through my tour, Mr Bathgate dismissed himself and went back to running what appeared to be a well funded and well respected organization.

Mark, Peter and I finished the tour and the Department had a photographer come down and snap a few pictures of us in front of some of the appliances. then a few minutes later she rushed out with a stack of nice photos for me and Mark to remember our visit.

The only comments Mr Bathgate made regarding the wording on my jacket was, “Oh, we’ll not be doing that here” which is something I’m not unused to hearing from the Big Red Machine.

Same System, Different Country.

I’ve got a few more posts worth of observations and anecdotes that I’ll be saving until after the Chronicles of EMS premiere on February 12th.

Posted by Justin Schorr on February 5, 2010 • Filed under: Administrative, Command & Leadership, EMS Health & Safety, EMS Topics, Fire Prevention & Education, Fire Rescue Topics, Firefighter Safety & Health, Funding & Staffing, technology-communications-ems-topics • Tagged: Chronicles of EMS, the Project

EMS Today in Baltimore

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chroniclesblog Thanks to the Chronicles of EMS, both Mark Glencorse and I will be attending the JEMS EMS Today Conference in Baltimore, Maryland, March 5th and 6th.

It’s a big deal for us to be able to spread our message to as many people as we can and there is no better way to share ideas than face to face. Even though we can communicate here in the internets machine, Mark and I didn’t really see what each other meant until we stood shoulder to shoulder in each other’s systems.

Since it will be a little while until we can get to everyone’s systems and learn from everyone how best to deliver EMS, heck even what EMS means anymore, we’ll travel as much as we can to meet you and keep the dialogue open.

That’s where our sponsor ZOLL Medical comes in.

SFFD Zoll Rep Roy Kniveton was kind enough to give the Chronicles of EMS team a run down of things coming from Zoll and let us put the new E Series through some quick tests. Not any of that scientific lab type stuff, but medics dragging it around a room type tests. Roy even offered to let the 100′ aerial ladder truck run over it to show it’s durability.

The truck officer declined the request.

But aside from coming in and letting us see what was new, Roy actually listened when we told him about our growing following. He was genuinely interested in the EMS 2.0 movement and did some quick searching to see what we were interested in getting from our equipment in the future.

We must have done something right because our near future included a generous sponsorship in our pilot episode and flying Mark and me to Baltimore for EMS Today. We will be Zoll’s guests at their booth and we’re looking forward to meeting all of you and answering questions about the Chronicles show, new concepts coming in social media TV and anything else you want to talk about.

I’ve never had anyone fly me anywhere before.

And to EMS Today no less. Check out the web page HERE and look for JEMS Editor in Chief AJ Heightman to wander in to give you the details on all the exciting things happening around me and Mark. Yes, there will be more than us ruggedly handsome frumpydumple fellows.

If you get a chance to make the premiere of the Chronicles of EMS in San Francisco on Feb 12th, we’d love to have you, sign up to let us know you’re coming HERE. And a special thanks to EMS1.com and AAM Consulting (Randy Africano) for sponsoring the premiere event at the Hotel Frank. More about them soon.

See you in SF.

See you in Baltimore.

Posted by Justin Schorr on February 4, 2010 • Filed under: Administration & Leadership, Administrative, EMS 2.0, EMS Health & Safety, EMS Topics, News, Training & Development, technology-communications-ems-topics, the Project • Tagged: Chronicles of EMS, the Project

Preparation for tomorrow

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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