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

- Rogue Medic

Confessions of An EMS Newbie podcast interview with Dr. Bryan Bledsoe

Tue, 05 Oct 2010 15:11:05 -0400 by
– 

For those who disagree with what I wrote in I am not the only one saying EMS education is Broken, go listen to the Confessions of An EMS Newbie podcast interview with Dr. Bryan Bledsoe.

Dr. Bledsoe is explaining the feedback he received from his publisher on why some people do not want to use his paramedic textbook –

Bledsoe’s book’s too sophisticated – the reading level’s too high – we don’t need to know that much stuff –

In other words, we are not trying to use the best textbook. We are dumbing down the curriculum and avoiding the textbooks that require thinking students and thinking educators.

–

He is going to paramedic school. I asked him what book he’s using. He said, Not yours . . . The instructor said that your book’s just too hard. I can’t understand that. There’s more detail, but it’s written at an 11th grade reading level.

Dr. Bledsoe’s book is written at a level so that it can be understood by people who cannot yet graduate from high school. That is considered just too hard?

How is reading and understanding at the high school student level too hard?

We should not be asking, How low should our standards be?

We should be asking, What do our students need to understand to be able to take care of emergency patients safely?

We are worried about staffing and graduation rates and other nonsense.

Yes, these are nonsense, when compared with the only thing that matters.

What is best for the patient?

–

This is the future of EMS.

Dr. Bledsoe points out that one of the problems with textbooks is that they are at least 5 years behind the current research, because of the amount of time involved in textbook writing, review, editing, publishing, and distribution to schools in time for the next semester class. This is EMS education training, we do not use fancy words, like semester. That thinking stuff is for those evil intellectuals.

If the textbook is expected to take at least 5 years from concept to classroom, then we need to have paramedic schools start demanding better textbooks now – that is if we want to have better textbooks in 5 years.

The current dismal state of EMS education training is the fault of the paramedic schools.

The paramedic schools are catering to the lowest common denominator.

We need to throw these incompetent administrators out of the paramedic schools.

These incompetent administrators are killing patients by churning out dangerous medics.

–

At the end of the podcast, Dr. Bledsoe has some nice things to say about me.

Thank you, Dr. Bledsoe. I learned a lot of what I know from you, not from people saying that knowing just a little bit is good enough.

.

Filed Under: Ambulance Driver, Confessions of An EMS Newbie, Critical Judgment, Education, Heresy, OLMC Requirements, Pain Management

Join and Make a Difference. Repeated for a good reason.

Sat, 27 Sep 2008 05:00:00 -0400 by
Why repeat this post?

Was the writing that good?

Certainly not. My lack of imagination in rewriting it. My distractability. My recommendations have not changed.

And this from an NAEMT email:

As a voting member of NAEMT, you can still make your voice heard in the elections that are going on right NOW to elect NAEMT officers and members of the Board of Directors.
Please take the opportunity to VOTE today!
Voting will end at midnight EST on Sunday, September 28, 2008.

I have never been much of a joiner. I have a bit of a Groucho Marx approach to membership in organizations. “I don’t care to belong to any club that will have me as a member.” It is not surprising that these organizations often agree.

There are some things happening that have encouraged me to change my mind a little bit. One is Ambulance Driver can be like Jiminy Cricket in his ability to make me feel guilty about things. In his post Announcements for you EMT Types…, he points out several good reasons for joining the NAEMT (National Association of EMTs).

However, I am not good at just doing things the easy way. Ike and Tina Turner pale by comparison when it comes to doing things “nice and rough.”

There is another organization that may be much more important in representing your voice as a patient care provider.

EMSunites.com

EMSunites.com does not have a huge number of members, but does listen to what you have to say far more than the other organizations out there. Perhaps the Jiminy Cricket of EMS. Membership is quite affordable – it is free.

EMSunites has some very brief surveys. How else do you find out what your members want? Take a few minutes to read the relevant position papers for any organization that you have joined (these are also brief) and tell EMSunites.com what you think.

So, here is where the nice and rough part comes in. If you go to the web site for NAEMT they describe their New Member Incentive Program, but the Membership Application page is not set up for the Member Incentive Program to work, yet.

They state that there are 2 possible ways for you to join. On line on the secure application page or to print out an application and mail it in with a check.

Of course, I joined a third way. I called (800)346-2368. For those of you who like the lettering it is (800) 34 NAEMT. The number is listed on the web site as well.

Why do I do things differently? Not just because I can, but I want the incentive for the new membership to go to someone who can do some good with it. Lou Jordan volunteers his time for EMSunites.com and this can help support his efforts. Lou Jordan has been around almost forever and is no stranger to the people at NAEMT. When I asked the person handling my application if he is a member, she didn’t even have to think about it an answered “Oh, yes he is.”

If you do not apply over the phone – which means using a credit card – they do not have a way to get this extra benefit out of joining. This allows you, in a small way, to be able to tell the NAEMT that you are supporting what Lou Jordan is doing to promote EMS. There is a partial biography of him here. I have never met Lou Jordan and am not affiliated with EMSunites.com except as a member. I am just encouraging you to become a member as well.

NAEMT is having elections up until midnight EDT September 28, 2008, so your membership will authorize you to vote. There is a delay entering the membership information into the computer, so allow yourself a couple of day before September 28 (which is now only one day). The email that confirms your membership has a pdf attachment, so don’t be confused when you do not see a member ID number. It is in the pdf. If you don’t have the ability to read pdf files on your computer, it is a free download from adobe.com. It is very useful in reading documents on line, or in printing out accurate copies of the documents.

Of those running for NAEMT office, I have the same recommendations as AD, Julie K. Scadden and Daniel R. Gerard. I have had conversations with both of them on line and they are people who want to see EMS improve. I probably have met Dan, since we used to teach at the same hospital, but I have a horrible memory for names and faces. Dan does have a new blog.

Paramedic’s Logbook

Give it a read and make whatever comments you feel are appropriate.

NAEMT lists their membership benefits. One of the benefits of NAEMT membership is not listed on that page, but is on the home page. That is a discounted subscription to Prehospital Emergency Care – the most important EMS research available anywhere. There are not many publications that provide good research relevant to EMS, but this is the only one that is devoted entirely to EMS. Prehospital Emergency Care only comes out 4 times a year. There is no acceptable excuse for your medical director to not read this. The same is true for anyone who has any say in policies or protocols. Medical directors who do not read Prehospital Emergency Care are (insert your own adjectives for dangerous and incompetent, feel free to be creative) and should be eliminated.

If you do not trust my opinion, then consider that Prehospital Emergency Care is the official journal of all 4 of these organizations:

Every site that I mentioned has a link on the side of my blog. That does not mean that they support, or have even heard of, me. It means that they are good resources to use, in my opinion, even if we may not agree on a lot. I expect you to be able to make decisions about what works for yourself.

.

By Rogue Medic
Filed Under: Ambulance Driver, EMSunites.com, Heresy, NAEMT, Paramedic's Logbook

More Medics Means More Medical Misadventure – commentary

Wed, 18 Jun 2008 05:48:00 -0400 by
30 year FF/Medic in the Southwest US wrote a comment that I could not easily answer with just a comment. Here is the original comment broken up by my responses.

Sorry, kind of late to this party.
No wonder AmbulanceDriver links you. He seems to dislike fire medics also.

I do not think that Ambulance Driver dislikes fire fighters, but he can speak for himself.

I do not dislike fire fighters. I would like to see administrations find sensible ways to meet staffing needs. This FF/EMT-P idea is bad fire fighting and bad medicine. Having fire fighters make medical decisions is as bad as having medics make fire fighting decisions. Having EMS run by FD and having FD run by EMS. Both are bad ideas.

I think fire fighters should fight fires and paramedics should provide medical care. It seems that most of the fire fighters I know do not want to have anything to do with EMS. They want to fight fires. In the midatlantic states fire departments have to require minimum amounts of time working as a fire fighter, before they can be released form that obligation and be just fire fighters.

Do you want someone taking care of patients who does not want to be taking care of patients? Yes, It does happen with burn out and everyone has bad days, but this is intentionally recruiting from those who have to be forced to sign a contract just to have the chance to fight fires later on.

Are either of these jobs so simple that we want to force people, with no interest in the job, to be the ones who are responsible for life and death decisions?

“The silliness of sending a fire engine to a medical emergency deserves a post on cluelessness all to itself.”

OK, how about 515 sq miles to cover and no one to do it?
When you have the 10th largest city in the country land wise, and someone codes or yet another 2 yr old drowns, I don’t have a problem getting on my fire engine and having an *average* response time of 5 min.
Why would you??
They’re in the neighborhood. Why not utilize them?

Having a person become a medic, because the person is already in the neighborhood performing another job, is a bad staffing decision. Hire the right number of medics for the EMS workload. Hire the right number of fire fighters for the fire fighting workload. Don’t complain if some of them are not busy.

The comment you quoted was about the waste of sending an engine just to transport personnel. Why do you need to send the big truck out on a shoe run? Why not get a utility vehicle and leave a driver at the station to rendez vous with the rest of the crew at the scene of a fire – if a fire call comes in?

Why put all of that wear and tear on such an expensive piece of apparatus?

Engines sure don’t maneuver better than much smaller trucks. They do not decelerate as well, when required to. They do not accelerate back up to speed well, either. In some places they avoid this problem by just blowing through the lights without slowing.

There was an accident in Baltimore, in December 2007, that demonstrated this problem.

“Fire department policy requires a truck operator to stop before proceeding through a red light. But in this case, the truck was going 47 mph at the time of the crash.“

“The fire truck was third in a line of four emergency vehicles and reached the intersection eight seconds after an ambulance had safely gone through it, officials said.”

That all of the fire apparatus sped through the red light tells you that this is not an unusual occurrence. This appears to be the common practice. This is one of the problems of driving a truck that is so difficult to slow down and to speed up. They were responding to a report of smoke, so this is not an EMS call, but would they have responded any differently if it were an EMS call. We are supposed to be protecting the public, not endangering them.

And this article does not describe an isolated incident.

I just don’t understand the fire bashing. I get along great with the private ambulance company medics that I run in with.
I run in with them because we’re closer to some of their calls and we don’t stop at some line on a map if someone needs help.

As medics we all have to wade through the same blood and puke and put up with the same nurses and docs don’t we? So why the attitude?

How do medics benefit from being fire fighters, other than through the stronger union representation? How do fire fighters benefit from being medics other than a bit of perceived job security?

We shouldn’t cross-train people in unrelated fields. These two jobs are not complementary. Being a good fire fighter does not help you to be a better medic and being a good medic does not help you to be a better fire fighter.

I am not trying to bash fire fighters.

If my home is on fire, I want fire fighters to respond to put it out. I do not want somebody cross-trained in other unrelated jobs. My life, my child’s life, my neighbors’ lives may be on the line.

If there is a medical emergency affecting me, my child, or anyone else I care about, I want a medic to respond to provide medical care. I do not want somebody cross-trained in other unrelated jobs. My life, my child’s life, the lives of the people I care about may be on the line.

Cross-training is a way for taxing entities to save money. It is similar to Walmart putting pressure on suppliers to produce products more cheaply. Eventually the production will be so cheap that it is not worth the cost savings.

The problem is requiring that people be trained for roles that are not compatible. Fighting fire and providing medical care are not connected, except by the lights and sirens.

“The large number of medics needed to meet the “everyone is a medic” staffing criteria, seems to encourage those, who should be providing oversight, to overlook patient care instead of overseeing patient care.”

If I’m reading this right, that is a problem with the training program and the preceptors. Or there is someone who should be doing quality control that isn’t. Either way, I don’t see it as the medics fault. They need someone with experience to tell/show them the way it should be done.
The bad medic is a symptom of the disease the higher ups have.

Signed,
30 yrs and counting

In that part of my post you have understood the point I was trying to make.

The cost of providing well trained medics with aggressive medical oversight is more expensive than many wish to consider. ALS on the cheap is a bad idea, but that is the motivation behind cross-training. There are some people who will do well when cross-trained, but I do not believe that this is true of most people. You will end up with many who may be good at one job, but are dangerous at the other.

Do you want to go into a fire with someone who is a bad fire fighter, but the bosses need that person’s medic skills?

Do you want to be cared for by someone who is a bad medic, but the bosses need that person’s fire fighting skills?

If the person is not going to operate in the other role, what is the point of being cross-trained in the other role?

This is not a match made in heaven, except for some who may be very good at both jobs. This is calling out for an annulment, so that the various emergency services can specialize in what they are supposed to be doing.

Administrations pitting fire fighters and medics against each other is just a way to take attention off of the real problem. Doing the job right costs money and requires a focus on the job – not a focus on a couple of different jobs, or a few different jobs.

.

By Rogue Medic
Filed Under: Ambulance Driver, Cross-training, Heresy

How EMS Manages Pain

Tue, 20 May 2008 14:13:00 -0400 by

In my last post Burns and Pain and Little Kids, I wrote about a case of bad pain management.

The comments included a lot of discussion of how EMS handles pain management.

I was talking with another medic and the topic of pain management came up. Not the first time that has happened.

One of the problems in EMS is that medics are trained to believe that morphine is some dangerous, magical drug that will sneak in on little cat paws and steal your patient’s breath away. This is told to us by doctors, nurses, and other medics – even non-medical personnel.

We frequently treat respiratory depression in EMS. And we often overreact when we do.

Overreact?

Read Ambulance Driver‘s article on EMS1.com – The Airway Continuum. The comparison between airway management and police use of lethal force is a useful one. Why do we automatically leap to the most invasive approach to airway management?

Conversely, why do we leap to the paranoid expectation of respiratory depression and respiratory arrest, when dealing with pain management?

This is an EMS version of an Urban Legend.

A site that is devoted to finding the truth about urban legends is Snopes.com. We have some people who provide the EMS version of urban legend debunking. AD does that, but he does not go far enough in this article. Not that he might think he exhausted airway management in this one article. AD could go on for days with only a pause for something to whet his whistle. And it would be entertaining, even if he does occasionally plagiarize himself.

Airway management is far more complex than “Intubate ‘Em All and Let Respiratory Sort ‘Em Out.” EMS protocols often do not acknowledge this.

Another problem with the use of morphine is the rush to use naloxone when there is any uncertainty about the patient’s respiratory status. This questionable nature of the respiratory drive should encourage a much more conservative approach. AD discusses this in Naloxone: The Most Abused Drug in EMS.

Pain management is also a far more complex treatment than “One Dose Fits All.” It is also something where “One Drug Fits All,” does not apply. Morphine is commonly used to manage pain, but it is far from a good drug for EMS. The big thing morphine has going for it is Tradition!

But the worst tradition associated with morphine is the dosing. If you are good, you may receive orders to treat an adult with 2 mg morphine. If you are really good you may receive orders to repeat that dose One Time. At least from some OLMC doctors.

The Danger.

The Peril.

The Horror.

There are some big problems with this approach. Pain management is not about rewarding paramedics with aggressive doses for good behavior. These doses that aren’t really even close to aggressive.

Pain management is about providing appropriate care for the patient.

Why is it that paramedics have to fight with some OLMC (On Line Medical Command) physicians for permission to appropriately treat patients?

Why are some doctors such vigorous opponents of appropriate pain management?

Why are some doctors such vigorous opponents of appropriate patient care?

Opponents of appropriate patient care? How can I say that about doctors?

A patient in moderate to severe pain.

A patient with no real contraindications to morphine (if hypotensive, no real contraindications to fentanyl).

A patient who will benefit from the treatment.

A patient too often denied appropriate pain management.

A patient too often denied any pain management.

Now, back to my talk with my friend.

He had a patient with a probable hip fracture. His partner insisted on calling OLMC for orders, even though they have standing orders. OLMC gave orders for 4 mg of morphine – much less than is available on standing orders.

Here are the standing orders for isolated extremity trauma:

ANALGESIC MEDICATION OPTIONS
(Choose one)
Fentanyl 50-100 mcg IV/IO 6,7 (1 mcg/kg)
may repeat ½ dose every 5 minutes until maximum of 3 mcg/kg
OR
Morphine sulfate 2-5 mg IV 6,7
(0.05 mg/kg)
may repeat dose every 5 minutes
until maximum of 0.2 mg/kg
OR
Nitrous Oxide (50:50) by inhalation 8

If we assume that the patient weighs 50 kg (110 pounds), then the standing orders would allow for the patient to receive 10 mg of morphine before having to call command for orders to give any more pain medicine. Not that those orders are likely to take into consideration that the patient is still in pain after 10 mg of morphine – only the “recklessness” of requesting to give more than 10 mg. This is the world of EMS pain management. Pain management isn’t about the patient. Pain management isn’t about appropriate care. Pain management is commonly about treating medical command for discomfort.

If only medical command were familiar with research on EMS pain management, such as I described in Public Perception of Pain Management.

Look at the standing orders again. In the system where he works, the medical director does not allow them to carry nitrous oxide or fentanyl. The medical director does not appear to have any plans for EMS to carry these drugs. The medical director does not encourage the use of the pain management standing orders.

One way that the medics are discouraged is by being labeled “Too Aggressive.”

I once did some ride time with them and was told that they did not want to hire me because some of the medics I rode with said I was too aggressive and others said I was not aggressive enough.

My interpretation of that was that I am Goldilocks’ porridge. Their interpretation was lacking in literary reference. They probably would have labeled me an Upstart.

You can see where the problem is in EMS. When it comes to pain management, it isn’t about patient care. There are several other things that are considered before the well being of the patient is considered. The other things that are considered can all veto the standing orders.

Then there is the problem of pain that is not due to an extremity injury. If the pain is not from an isolated extremity injury, then the pain is categorized as “too risky” to treat.

Not that this is based on research, these are doctors after all, their expert opinion is to “That’s the most foul, cruel, and bad-tempered medicine you ever set eyes on!” and “Look, that morphine’s got a vicious streak a mile wide! It’s a killer!” and “He’s got huge, sharp… er… He can leap about. Look at the breathing!”

It is true, the bunny in Monty Python and the Holy Grail was a killer. At times morphine can produce respiratory depression that can be a killer, too. Just not when well trained medics use it to appropriately treat their patients’ pain. Titrating the dose to the patient’s pain. The well trained medic is the Holy Hand Grenade of Antioch that counters the respiratory depression from a larger than appropriate dose of morphine, or any opioid.

If only the medical director would insist that the medics be competent in the use of the medications that the medics carry, instead of discouraging the use of the unpopular ones.

.

By Rogue Medic
Filed Under: Airway Management, Ambulance Driver, Burns, Critical Judgment, Fentanyl, Heresy, Medic X, Morphine, OLMC Requirements, Pain Management, Physician Oversight

Join and Make a Difference.

Thu, 17 Apr 2008 21:01:00 -0400 by
I have never been much of a joiner. I have a bit of a Groucho Marx approach to membership in organizations. “I don’t care to belong to any club that will have me as a member.” It is not surprising that these organizations often agree.

There are some things happening that have encouraged me to change my mind a little bit. One is Ambulance Driver can be like Jiminy Cricket in his ability to make me feel guilty about things. In his post Announcements for you EMT Types…, he points out several good reasons for joining the NAEMT (National Association of EMTs).

However, I am not good at just doing things the easy way. Ike and Tina Turner pale by comparison when it comes to doing things “nice and rough.”

There is another organization that may be much more important in representing your voice as a patient care provider.

EMSunites.com

EMSunites.com does not have a huge number of members, but does listen to what you have to say far more than the other organizations out there. Perhaps the Jiminy Cricket of EMS. Membership is quite affordable – it is free.

EMSunites has some very brief surveys. How else do you find out what your members want? Take a few minutes to read the relevant position papers for any organization that you have joined (these are also brief) and tell EMSunites.com what you think.

So, here is where the nice and rough part comes in. If you go to the web site for NAEMT they describe their New Member Incentive Program, but the Membership Application page is not set up for the Member Incentive Program to work, yet.

They state that there are 2 possible ways for you to join. On line on the secure application page or to print out an application and mail it in with a check.

Of course, I joined a third way. I called (800)346-2368. For those of you who like the lettering it is (800) 34 NAEMT. The number is listed on the web site as well.

Why do I do things differently? Not just because I can, but I want the incentive for the new membership to go to someone who can do some good with it. Lou Jordan volunteers his time for EMSunites.com and this can help support his efforts. Lou Jordan has been around almost forever and is no stranger to the people at NAEMT. When I asked the person handling my application if he is a member, she didn’t even have to think about it an answered “Oh, yes he is.”

If you do not apply over the phone – which means using a credit card – they do not have a way to get this extra benefit out of joining. This allows you, in a small way, to be able to tell the NAEMT that you are supporting what Lou Jordan is doing to promote EMS. There is a partial biography of him here. I have never met Lou Jordan and am not affiliated with EMSunites.com except as a member. I am just encouraging you to become a member as well.

NAEMT is having elections up until midnight EDT April 27, 2008, so your membership will authorize you to vote. There is a delay entering the membership information into the computer, so allow yourself a couple of day before April 27. The email that confirms your membership has a pdf attachment, so don’t be confused when you do not see a member ID number. It is in the pdf. If you don’t have the ability to read pdf files on your computer, it is a free download from adobe.com. It is very useful in reading documents on line, or in printing out accurate copies of the documents.

Of those running for NAEMT office, I have the same recommendations as AD, Julie K. Scadden and Daniel R. Gerard. I have had conversations with both of them on line and they are people who want to see EMS improve. I probably have met Dan, since we used to teach at the same hospital, but I have a horrible memory for names and faces. Dan does have a new blog.

Paramedic’s Logbook

Give it a read and make whatever comments you feel are appropriate.

NAEMT lists their membership benefits. One of the benefits of NAEMT membership is not listed on that page, but is on the home page. That is a discounted subscription to Prehospital Emergency Care – the most important EMS research available anywhere. There are not many publications that provide good research relevant to EMS, but this is the only one that is devoted entirely to EMS. Prehospital Emergency Care only comes out 4 times a year. There is no acceptable excuse for your medical director to not read this. The same is true for anyone who has any say in policies or protocols. Medical directors who do not read Prehospital Emergency Care are (insert your own adjectives for dangerous and incompetent, feel free to be creative) and should be eliminated.

If you do not trust my opinion, then consider that Prehospital Emergency Care is the official journal of all 4 of these organizations:

Every site that I mentioned has a link on the side of my blog. That does not mean that they support, or have even heard of, me. It means that they are good resources to use, in my opinion, even if we may not agree on a lot. I expect you to be able to make decisions about what works for yourself.

By Rogue Medic
Filed Under: Ambulance Driver, EMSunites.com, Heresy, NAEMT, Paramedic's Logbook

OLMC for President!

Thu, 27 Mar 2008 17:23:00 -0400 by
The justification for OLMC (On Line Medical Command) requirements is usually “Well you wouldn’t want Medic X treating your mother (or daughter, or somebody who owes you money, . . .) without having to call for permission.”
Medic X is a menace, so any mention of this medic is viewed as an example of the problems with medics. Some doctors, especially medical directors, use this example. Some medics use this example, too.

The logic they employ is completely corrupt.

Medic X is a medic.

This is true.

Medic X is dangerous.

Whether this is true is not important to the argument.

Medic X is probably not the only dangerous medic out there.

This is true. Don’t lie, you know it is true.

Therefore, in order to protect patients from Medic X, we will require all medics to call OLMC to ask for permission to use any potentially dangerous treatment.

Before you get swept up in the fervor of the argument of these used car dealers of EMS . . .

What?

You are calling medical directors the used car dealers of EMS?

Some of them.

Would you buy patient care from Medic X?

No.

Why?

Medic X is dangerous! You’d have to be crazy to let Medic X take care of you!

What OLMC does is allow you to hire medics who should not be allowed to treat patients beyond the basic level – and that is being generous to some of these medics.

After you hire the medics, they need to receive authorization from the medical director to treat patients.

If the pool from which you hire is not particularly deep, you may have a problem convincing a medical director that these new hires should be allowed out in the world on their own.

Eureka – OLMC!

So, how does this protect the patients from Medic X?

Haven’t you been paying attention?

It doesn’t protect patients – it helps medical directors feel that they are protecting patients.

Then why do they do it?

Most EMS systems do not have much of a budget for a medical director.

That’s not exactly intelligent!

You have heard the phrases “You get what you pay for” and “Your life is our hobby”?

So, OLMC is cheap?

Only until the lawyers start to see how easy it is to convince a jury that it encourages bad patient care.

So, people think OLMC is a cheap way to provide medical oversight?

Well, real medical oversight is considered far too expensive.

What do you mean real medical oversight?

That’s a post for another day.

In the latest posting of The Ambulance Driver’s Perspective, Ambulance Driver writes The Two Most Important Words in an EMS Protocol. This gives a different perspective on OLMC requirements.

If you have not already read this, go read what AD wrote.

My other posts on OLMC requirements and Medic X are:

OLMC (On Line Medical Command) Requirements Delenda Est

OLMC = The Used Car Dealers of EMS?

OLMC For Good Medics

Fun with explosives – NTG.

By Rogue Medic
Filed Under: Ambulance Driver, Critical Judgment, Heresy, Medic X, NTG, OLMC Requirements, Physician Oversight

Bizzaro Ambulance Driver?

Fri, 14 Mar 2008 17:04:00 -0400 by
What has happened to Ambulance Driver? Clearly, his post claiming that the Virginia Tech shooting is humorous is just the beginning of a long spiral to Risperdal-dom.

How can he find humor in something that was so painful for the families of those shot?

Let’s read this bit of comedy straight from the horse’s keyboard:

I just noticed on the program that one of the speakers will be James Hyatt, Executive Vice President and C.O.O. of Virginia Tech University.

The title of his presentation? Campus Security and Emergency Preparedness.

The program doesn’t say whether it’s supposed to be informative or humorous, but in any case, it oughta be a short lecture.

Hmm. I’m missing something here.

Where is the inappropriate humor at the expense of the victims?

Where is the lack of compassion?

Where is the Bizzaro Ambulance Driver?

The shooting was a tragedy. Nobody, and certainly not AD, has suggested otherwise. The suggestion of humor appears to be only related to the choice of speaker. Is he the closing ceremony speaker? I could not find information on line about this conference, so I don’t know.

It does make you wonder what they were thinking when inviting the “Executive Vice President and C.O.O. of Virginia Tech University” to speak about this.

With an EMS conference you want to make the topics relevant to EMS. How does this speaker relate to EMS? I don’t think many executive vice presidents and chief operating officers of EMS companies relate to EMS – and that’s part of their job.

If there is a desire to hear about the incident, then the local EMS personnel, those who were in various incident command positions, or dispatchers commenting on dealing with the confusion would be worth listening to.

If this were a conference of school administrators, then Mr. Hyatt might be an appropriate speaker. It isn’t, or has AD been telling us lies about where he is going? Is he leaving EMS for the exciting life of university administration?

Mr. Hyatt may have something worthwhile to say, but in my opinion, the bad taste is that Mr. Hyatt was invited to speak on this topic. I may be wrong. I hope AD has the opportunity to stay long enough to listen to Mr. Hyatt’s speech. It should give him material for a third post that can answer a lot of questions.

No, AD has not lost it.

Perhaps, instead, I should write:

Yes, Virginia, there is an Ambulance Driver.

Although with the success of his diet he is going to have to use pillows to dress up as Santa from now on (or as Barney).

By Rogue Medic
Filed Under: Ambulance Driver, Heresy, Humor, Virginia Tech