Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Podcasting, Critical Judgment, and the Death of Curtis Mitchell Part II


As opposed to what I wrote about in Part I, there is a more thoughtful, more thorough approach to disaster planning covered on both Mitigation Journal and the MedicCast.

Cecil County (Maryland) Director of Emergency Services Richard Brooks is interviewed.

This is a podcast that is very important to listen to.

There are many important topics that people do not understand. For example, if there is the possibility of a disaster, how much preparation is appropriate? When the disaster does not happen, there will be many critics, so some places avoid preparation.

Better not spend too much. That will look bad, if the storm is not as bad as forecast. If the worst happens, we can just blame the medics.

That is an important contrast between Pittsburgh and Cecil County. It is true that Pittsburgh has a lot of financial problems that other places do not have, but this should have encouraged them to call for help earlier. The National Guard has 4 wheel drive vehicles. Pittsburgh needed 4 wheel drive vehicles. The National guard has snow plows. Pittsburgh needed snow plows. The decision to call early should have been easy.

When 911 calls are put on hold for 10 hours, you might want to consider that you are dealing with a disaster. Maybe avoiding dealing with a disaster is their style.

When you have 911 calls on hold for 10 hours, you need to admit that you are overwhelmed. You need to use your brains, rather than having crews wandering around in the snow, doing things that should be done by equipment. The Luddite approach leads to deaths.

Public Safety Director Michael Huss clearly does not believe in using critical judgment. His response was for the medics to tie themselves up on one call for hours by getting out of the truck and walking to the patient. Then possibly endangering the patient by having 2 people try to drag him through the snow and ice. Mayor Ravenstahl seems to be defending his buddy.[1]

We all had ample time to prepare.

– Cecil County Director of Emergency Services Richard Brooks.

In the interview, Richard Brooks describes using critical judgment and encouraging his people to use critical judgment. He describes it as thinking outside the box. I do not like the phrase for a bunch of reasons. One is that it has become overused by so many people. Richard Brooks uses it appropriately.

Michael Huss doesn’t seem to want medics to appropriately use equipment. He seems to want them to just use their legs. If they do that, he seems to think that the lack of preparedness will not be noticed.

Why?

He knows what happened, so he thinks that he knows how to avoid it in the cheapest way possible. He is wrong. Monday morning quarterbacks usually are.

Public Safety Director Michael Huss encourages us to think as Luddites. Technology is evil. Destroy all tools. And blame the medics.

We’re successful because our business, be it fire department, EMS, combination, career, volunteer, emergency management, emergency operation, or in my case emergency services – We have got to be flexible, forward thinking, out of the box type people. That’s when we’ll do the best job.

When people come at you with something that you did not predict, and you can sit back for a few minutes and go, “There’s a way we can deal with this,” and make it work, then refine it for the next time. That’s how we’re going to have success.

– Cecil County Director of Emergency Services Richard Brooks.

That is not the bureaucratic response. The bureaucratic response is to sacrifice low ranking personnel to protect the jobs of their bosses (the ones who really caused the problem).

Cecil County will not have to deal with explaining a preventable death to the media, because they will be prepared for disasters. When their preparation does not lead to an easy solution, they will start trying other things.

How much thought is required to decide to send a 4 wheel drive truck to pick up a patient, rather than have the medics re-enact the Iditarod? If we use the right tools, we are able to help more people. If we use critical judgment, we are able to help more people. If we use the Luddite solution, we endanger everyone.

I am very critical of people who discourage the use of critical judgment.

I think that the only way that the statements of Public Safety Director Michael Huss make sense, is if we abandon the use of critical judgment. We would need to engage in a willing suspension of disbelief.[2]

Reasonable people only engage in a willing suspension of disbelief to enjoy fiction. Fiction, that otherwise would be seen as unbelievable.

Public Safety Director Michael Huss does not even provide good unbelievable fiction.

The official report from the medical director is not fiction.[3]

There is more in Part III

Podcasting on the death of Curtis Mitchell:

From Mitigation Journal

EMS Under the Bus in Pittsburgh – 02/28/10

And in the Mitigation Journal podcast –

MJ156: Winter Storms: Interview with Mr. Richard Brooks, Director Cecil County MD, Emergency Services – 02/23/10

From the MedicCast

Snow Storm 2010 Response and Episode 208 of the MedicCast – 02/28/10

From the EMS Garage

Up to My Pips: EMS Garage Episode 75 – 03/02/10

Writing on the death of Curtis Mitchell:

From Too Old To Work, Too Young To Retire

Trouble Right Here In Three River City – 02/19/10

Comment From Someone In Pittsburgh – 02/20/10

More From Pittsburgh – 02/23/10

Update On The Pittsburgh Story – 02/28/10

And Then I Realized… – 03/01/10

Fertilizer – 03/22/10

Human Sacrifice – 3/24/10

The Tapes Don’t Lie, But People Do – 3/29/10

The Drama Continues In Pittsburgh – 5/12/10

Let The Scapegoating Begin – 01/06/11

Common Sense Prevails – 02/15/11

From David Konig

EMS Blog Rounds Edition 32 – 03/09/10

Why You Need A Social Media Presence: The Case Of Pittsburgh EMS – 02/22/10

Yes Mary, It Is A Transportation System – 02/19/10

From 9-ECHO-1

Pittsburgh…my take on it – 02/23/10

Still Don’t Make It Right… – 03/20/10

From A Day In The Life Of An Ambulance Driver

As usual the truth is somewhere between the extremes – 02/20/10

From Pittsburgh Legal Back Talk

The Power of Saying “I’m Sorry”. – 02/21/10

Medic’s Perspective on Mitchell Case. – 02/22/10

The Need for Evidence Before Assessing Guilt. – 02/23/10

The View from Foggy Goggle. – 02/25/10

I have also written about this here –

City may discipline EMS workers – Public Safety Director Michael Huss – 02/18/10

Where Was Public Safety Director Michael Huss during the Death of Curtis Mitchell? – 02/20/10

Public Safety Director Michael Huss and Others Continue to Blame the Medics for the Snow – 02/22/10

The Need for Evidence Before Assessing Guilt – 02/24/10

Anonymous Comments on the Death of Curtis Mitchell – 03/02/10

Podcasting, Critical Judgment, and the Death of Curtis Mitchell Part I – 03/22/10

Podcasting, Critical Judgment, and the Death of Curtis Mitchell Part II – 03/22/10

Podcasting, Critical Judgment, and the Death of Curtis Mitchell Part III – 03/22/10

What kind of punishment do you get for NOT disobeying dispatch? – 03/23/10

The Scapegoats Will Be Punished – 03/23/10

Pittsburgh – Punishment, not Planning – 03/24/10

Josie Dimon was the Scapegoat of Public Safety Director Michael Huss in the Death of Curtis Mitchell – 02/16/11

Michael Huss – Pittsburgh EMS Only Needs Someone Good With a Shovel – 02/16/11

Links updated 02/16/11.

Footnotes:

[1] Investigation Clears EMS Workers In Snowstorm Death – Mayor Says City Has ‘Higher Standards’
ThePittsburghChannel.
Posted: 4:58 am EDT March 19, 2010
Updated: 5:34 pm EDT March 20, 2010
Article

[2] Suspension of disbelief
Wikipedia
Article

[3] Medical Call Review for 5161 Chaplain Way 2/6/2010
Ron Roth, MD Final 2/15/10
Medical Director, City of Pittsburgh, Department of Public Safety
Medical Director, Allegheny County Emergency Operations Center
Free Full Text

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