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A Shoutout Across the Pond to our British EMS Bretheren

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Mark in his British Paramedic Uniform

If you don’t know Mark Glencorse by now, you’re either very new to the EMS blogosphere or have been living under a rock. In addition to being a fine paramedic by all accounts, Mark runs the EMS blog www.999medic.com which is a member of the www.FireEMSblogs.com family of which I also am a member. Mark has a comfortable, familiar style of writing that brings you right there next to him as you read his articles. It’s almost like you’re running the calls with him, experiencing the joys and pain of a British Paramedic as he experiences them himself. He’s one of my Best Blogger Buddies and I’m proud that I can call him a friend. I read most everything he writes.

I hadn’t been to his blog for a few days though and thought that today would be a good time to catch up on what he’s been writing. He’s got some good stuff up lately, but in addition to some of his more educational articles, I found some things that just floored me.

We here in the United States can learn quite a bit from our brethren across the pond. They have aspects to their system that could be very valuable for us here in the states. Their EMS system is similar to ours in a lot of ways, not the least of which is the fact that they respond to largely the same types of calls that we do, but is also vastly different in terms of initial education, pay, respect, and capabilities.

I’m going to explore three of his recent posts here and see if other fellow US paramedics and EMTs will be just as floored as I was. Here goes:

“The Clash of the Assessments” – 999medic.com

This post explores some friction that he and his fellow paramedics have been having with “Walk In Centers” (WICs) that have sprouted up all over his country. He describes these clinics as such:

“In the UK over the last few years, we have seen hundreds of NHS Walk in Centres (WIC) sprout up around the country. These are primarily Nurse led units that are placed strategically in various towns and cities to provide care for those residents who are suffering from either minor injury or illness. They most definitely have a place in the wider primary health care environment, but ask any Medic what they think of them, and most will tell stories of picking up patients from the Walk In Centre to take up to the Accident and Emergency department who clearly do not have any specific life threatening or emergent need, and who, in the paramedics opinion should have been treat and discharged from the Walk in Centre.”

This sounds pretty familiar to me. Here in the US we have plenty of Urgent Care Centers that have sprouted up all over the American Healthcare landscape. They are staffed sometimes by a Physician, but are largely staffed by Physicians’ Assistants (PA-Cs) and Nurse Practitioners (ARNPs). They handle minor medical complaints and urgent-but-not-emergent medical conditions. Most of these centers are perfectly adequate for treating most patients with day-to-day illnesses and minor injuries. They cost much less than an emergency room visit and help save the ER from having to handle all of these minor cases. I fully support urgent care centers and their use in the spectrum of healthcare. However, my fellow medics and I can all point to times where we’ve responded to urgent care centers for complaints that we did not believe to warrant an emergency response and subsequent transport. I can emphasize with Mark and his coworkers about their problem with these kinds of transports.

Here’s what Mark describes as the “Rant” he’s trying not to have:

“My service has direct referral pathways to the Walk in Centres. If I have a patient who I think fits the fairly strict criteria for assessment and treatment at a WIC, then I can contact one of the nurse partitioners on the phone and discuss my patient so that they know what I am bringing in and more importantly that they know they are suitable for their level of care and will not need to be shipped out to the A&E department at a later time.”

Wait… What?

“My service has direct referral pathways to the Walk In Centres”

Dude!! We have been practically begging for that here in the US for some time! That’s AWESOME that the British can do that! Alternate treatment and transport pathways are one of the cornerstone ideas for EMS 2.0. This practice would save a great deal of healthcare dollars, would lessen the burden on the overcrowded ERs, would be remarkably more convenient for the patient, and would help keep the ERs available for the more serious of illnesses and injuries. This is a slam-dunk that we here in the US just can’t seem to figure out for ourselves and here we see the program is already active in the UK. We should steal that data and use it to help justify our own programs.

The next two articles I’m going to explore are pretty entertaining. Mark was selected to ride along in a multi-disciplinary unit of both civilian and military police officers in a busy urban center that has been having problems with alcohol and young people trying to mix too often. The set-up is pretty cool. He rides around with the police officers, helps them with what he is able to help them with, and is available to handle any medical problems that might arise with a 2 to 3 minute response time. The program sounds great, actually and I think that it could probably be employed with some success in many areas of the US… but read this account of his first EMS call while with the PD:

Mark (Right) with the rest of the British Team

“Less than a minute later, a police van turns up outside of a bar, the side door slides open, and out jumps a paramedic!” (Apparently it’s novel for the Police to be around with the Paramedics there)

“After a few quizzical looks, I get on with doing my usual job and assess the patient. He has a small cut to his forehead where someone punched him whilst wearing a ring. It is a minor wound but will need either stiching or gluing. There was no loss of consciousness, he has no other apparent injury and his observations are fine. Its still early in the night and he has only had a couple of drinks and doesn’t appear intoxicated.”

Man… so the patient is drunk and has a head injury… All you US paramedics know what that means. Here comes an ambulance in to transport the patient to the hospital. He can’t refuse because of the ETOH on board coupled with the head injury, and you know you don’t want to be sued… Let’s see what Mark did:

“I advise him that he needs to be assessed at the local hospital so that the wound can be closed. After dressing his forehead, he promptly jumps into a waiting taxi and heads off to the hospital less than 10 minutes away. I complete my paper work, Dave completes his log and we are off again.”

“From time of call to patient leaving scene – 8 minutes!”

WHAT!? OH COME ON NOW! That’s just not fair! You mean to tell me that Mark was able to use his clinical judgment, assess the guy for his injuries, and make a common-sense treatment and transport decision? He put the guy in a Taxi??

That would be a potentially career-ending move for a US paramedic. The Brits do it regularly. Could you just imagine what the ability to make those kind of decisions would mean for the US EMS system? Could you just Imagine what that would mean for EMS 2.0?

Let’s see what happens with the next patient encounter he describes:

“As we are sitting outside one of the shops, Dave hears one of the door staff calling for police assistance. He has been assaulted and has a head injury.”

“Again we are on scene in less than two minutes. This time the wound is a bit worse and is still freely bleeding. A dressing, some direct pressure and a quick assessment later and he is sitting next to me in the back of the police van whilst we drive him the short 5 minute journey to the local hospital. Again, no need for an ambulance, just transport to the hospital. In this case, and many others, the team are happy to use the police van instead of calling an ambulance into the town centre. It is a real benefit having the hospital so close to the centre of the town!”

“Even though we transported this patient to the hospital, we were again back in the town centre and patrolling in under 20 minutes from the time of the call.”

Apparently this is British Medical Control

So he brought the guy to the hospital in the Police car. Actually I’m familiar with the fact that they do this over there. Mark is regularly staffed to what they call a “Rapid Response Car” which is part of their “Front-Loaded Model” where they send a paramedic first to emergency calls to determine what the best course of action would be for the patient. Many times they don’t send an ambulance until the paramedic makes the transport decision. One of those potential decisions is to simply transport patients in the car with them instead of the ambulance.

You can find Part One of “Working A Police Medic Shift” – Here

And you can find Part Two – Here

I’m no fan of socialized medicine, but I have to give credit where credit is due. The US EMS system could learn a lot from the British system and I just can’t get over the fact that so many of the things we speak of for the EMS 2.0 movement here in the US are being done right now by our brothers across the pond. It would stand to reason that we could use the data that they’ve collected and created right now, steal a lot of their ideas, and begin to implement them right here in the good ol’ US of A.

Wouldn’t it be great if there was some kind of “Project” where an a British Paramedic could come to the US and explore the US EMS system? How about where an American Paramedic could come to the United Kingdom and learn about their system?

Oh wait, there is. The Chronicles of EMS has been doing just that very thing. If you’re a regular reader I’m sure you’ve already heard of it. If you’re not familiar with it, you should go right now to www.ChroniclesOfEMS.com and learn about it. It’s an amazing thing done by both Mark Glencorse and Justin “The Happy Medic” Schorr. If you’re an American EMS person, you really need to know about this and show them as much support as you possibly can.

And while you’re at it, check out some of the other fine British EMS Bloggers:

Insomniac Medic – http://insomniacmedic.blogspot.com/

“A Life in the Day of a Basics Doc” – http://basicsdoc.blogspot.com/

Pop! Changes the Industry… Here We Go!

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Are your coworkers, friends, and colleagues following the Chronicles of EMS?

I ask that, because I’m wondering something. You, the person reading this blog post, are special. You’re probably a Fire or EMS professional that came to my blog site to read up on your profession. That makes you part of an elite and growing group of industry professionals who cares just a little bit more than some of your peers do. I’m guessing that you’re excited about your profession and I’m also guessing that you wonder how excited your colleagues and friends are about this stuff that you’ve been seeing online and in a few other places as well.

Well I’m wondering the same thing.

For all of you Paramedics and EMTs that have been hoping for the industry to spring forward into some of the awesome, groundbreaking things that we’ve been talking about like I have, this could be your moment.

No really, there’s plenty of people out there that are going to tell you “It’s never going to happen”, “It’s all been tried before”, and, “That’s never going to fly here in anytownistan”. I’m not one of those people. I’m one of the people that is going to tell you that those kind of people are wrong… and not only am I about to tell you that, I’m also about to get on a plane so that I can show you.

While the Chronicles of EMS are just sooooo very cool, they’re standing on the pinnacle of a lot of work. If you’ve paid attention on Twitter and Facebook, you might have noticed that there are some big names coming out for this. These names belong to people you might have seen in magazine articles, textbooks, journals, television shows, and in lots of other places. I am going to the Chronicles Premier party and I get to meet some of the people whose names were printed on my original EMT-Basic textbook. These people are as committed as I am to the work that Justin Shorr, Mark Glencourse, and Thaddeus Setla have put in to the Chronicles of EMS and you should be too.

But what if you can’t make it all the way out to San Francisco for the premier party? What do you do then to show your support? Well first off, look online at Chronicles of EMS for the live feed. Watch it. But, before you do, tell your coworkers, friends, and extended colleagues about it. Even if they might think that it’s a little geeky, please do it anyway.

That’s just it. We need you out there plugging in your hometown just as hard as we are out there in San Francisco (swilling martinis, and) plugging this whole EMS 2.0 thing. If you bring in your friends and coworkers to the wider conversation and have your own local conversation to interface with everyone else we’ve all won. The more people we bring in, and the more people YOU PERSONALLY pull in to this, the better off we’re going to be. I pledge that I’m not going to quit trying to improve our profession and I know that my buddies out there aren’t going to quit anytime soon either.

We need you to be just as passionate. As soon as we energize everyone out there, the sooner we all look up and go “Wow! Look at that!” Please, please, please help us spread the exciting message that EMS WILL CHANGE FOR THE BETTER in the very near future. Bug your coworkers. Get the word out.

Heck, if I get an e-mail at ProEMS1@yahoo.com or a tweet at http://www.twitter.com/ckemtp I will personally mention you live on the show, give a link to your service’s website, and might even send a special shoutout. So if you organize your own local premier party, please let me know.

You all Rock, let’s get flying!

P.S: Want behind the scenes access?? Follow my wife Gkemtp(IT), @ginakaiser on twitter too. She’ll be with me and will be tweeting about cool stuff like how awkward I am when I meet my heroes.

Why I am Passionate about the Chronicles of EMS

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If you’re an EMS professional, you should be paying attention to the Chronicles of EMS.

I think every person involved in EMS on any level needs to pay attention to the work of three of the profession’s upcoming giants, Mark Glencourse, Justin Schorr, and Thaddeus Setla. Their collective project is a warp-leap forward for how our profession is presented to, judged by, and thought about by our internal and external observers, customers, and colleagues. With their efforts come Hope… Hope that one day soon EMS will take its rightful place as a true profession; Hope that our profession will get the paid the attention that it deserves; Hope that our educational standards, resource needs, and compensation will finally be improved; and Hope that we will be able to improve our total service to our patients and our community through shedding a new light on our profession.

If this works… everything could change. Everything could change quickly, incredibly, and wonderfully. Imagine if EMS became “cool” and the public finally thought about who we are, what we are, and what it is that we do for them. Imagine if people demanded that their community leaders pay as much attention to EMS as we need them too… Just Imagine.

EMS needs a strong, unified message. The Chronicles of EMS can be that message. It is a professional, smart, and uber-cool message aimed straight at where we want to be going. It is not lip service, it is not Hollywood glamour, and it is certainly not dramatized for profit. It is being prepared by industry-experts who are still working the same streets that we are everyday. Everyone involved is one of us. Everyone involved is passionate. Everyone involved wants this, and they want it as bad as you do.

The reason I write about EMS is because I want to improve our profession and our service to others. I want to make this better so bad that I can taste it and I’m willing to work as hard as I have to. Our patients and our communities deserve the best we can give them and I believe that key to fixing EMS is communication and the spreading of our message. This blog exists for that reason and so do the other blogs in this genre. The other bloggers, authors, speakers, and writers I’ve met have all spoken to me of the same goals. Our profession exists to save lives and alleviate suffering and improving our profession help us save more lives and alleviate more suffering in our communities. EMS does indeed make a difference out there in the world and we’re the ones doing it. The Chronicles of EMS is a great beacon of hope in our collective quest.

EMS Deserves More. Our Patients deserve more; Our Families deserve more; and yes… We deserve more. Mark, Justin, Ted, and everyone involved in the Chronicles of EMS are working hard to give us just that. They deserve our support and our attention.

I’ll be in San Francisco on March 11th for the premier of their pilot episode. I wouldn’t miss it for anything. Look out world, EMS is moving forward.

Swinging a Sledgehammer and Thinking about the UK… Strange times

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So here’s the good news. The ambulance service I work for up North, “Ambo’s R’ us” has finally taken the leap and is getting us a new station. Yep, that’s right folks. I will no longer be living in squalor whilst working up here in the vast frozen wastelands.

Except for one little hitch in the gittyup.

In big ambulance services, when one gets a new station, usually the service employs people to work on the station, build and/or remodel the station, and move the stuff from the old location to the new one. Not so in a small, rural ambulance service. Nooooo…. Here, a paramedic is expected not only to work on the ambulance during their shift, they’re also expected to put on their tradesman hat and get their hands dirty.

So, yep… today Ckemtp was not *just* a paramedic. Today yours truly was a demolition man, a moving man, a wall-paper remover, and a carpenter’s apprentice. All of my crew mates were today too, as were the crews yesterday, and so will be the crews who are unlucky enough to come work ambulance shift any time in the next couple of weeks.

But here’s my mea culpa confession folks: I’m not handy.

There, I said it. I am so not handy that hardware stores actually have my picture up on their walls stating that I must ask for staff permission to enter their premises. Apparently they want someone to follow me around with a fire extinguisher because there’s a concern that I might come into contact with a carriage bolt or something and the resulting sparks will start a fire. I, like most of my colleagues, became paramedics because we’re generally not handy enough to get a good paying job in the construction and/or “real job” industry.

What’s that you say? You’re a full-time paramedic/EMT and you own/work/watch a construction business on the side? Well good for you. I don’t. I write stuff about stuff and ride ambos.

The dreaded “other duties as assigned” clause in my job description is being stretched so thin here that you can hear it singin’ in the wind. I didn’t sign up for this. It’s actually very hazardous to my health and well being for me to be doing anything remotely construction or “handyman” related.

There’s a lot of reasons why, the risk of fire, explosion, and/or structural collapse being amongst them… but they’re not the real reasons that I’m so worried about this. You see, I have a lovely wife named Gkemtp(it) who is the absolute light of my life. However, together we own a home which happens to be the scourge of my existence. Like EVERY guy who owns a home, my home is full of things that are disintegrating at an alarming rate. There’s ALWAYS something that needs fixing and they rarely respond to an IV, o2, and monitor. Heck, even my clock radio didn’t do well with defibrillation. I can’t give my clothes dryer Epinephrine to get it started again, my clogged drain didn’t respond to a heparin bolus, and my leaky faucet leaked right through an occlusive dressing. I just don’t understand my home and its malfunctions the way I understand humans and their maladies. It’s awful.

So my wife knows that I am the opposite of the handyman… and she’s pretty ok with it, lest she nag and have me end up breaking something much, much worse than it was before I tried to fix it. I *like* that she’s ok with it… And I don’t need her to think that I came to work, built us a shiny new ambo station, and learned how to be Bob Vila with an NREMT-P patch. It’s bad enough that I clean toilets, vacuum, and do dishes here at work. If she found that out, she might make me do more of that at home.

So I’m stuck here. I’m destined to make anything I fix much worse than it was before, I’m destined to demolish something I’m not supposed to demolish, and I’m destined to make an egregious wiring error that’s going to burn the place down while I’m sleeping inside of it and I won’t even get to go to the fire because I’m on ambulance detail!

Maybe I should move to the UK and work with my good buddy Mark Glencourse, of Medic999 fame. One of the biggest things I took from the Chronicles of EMS, his and Justin Schorr’s (The Happy Medic) foray into cross-national EMS exchange (Soon to be an AWESOME TV show!!) is that UK firefighters DON’T CLEAN THEIR OWN STATION! Yes. They FREAKING HAVE CLEANING CREWS THAT COME IN AND CLEAN UP ALL BUT THE MOST SUPERFICIAL MESSES! Hell, they even have a bona-fide chef to cook for them.

And here I am, scrubbing toilets and swingin’ a sledge hammer here in the ‘States.

So, I’ll keep toiling until I break something so bad that they make me go post somewhere where I can’t hurt myself, and Mark will keep living in the lap of luxury.

Maybe being a Limey isn’t so bad.

Changing the EMS World – The Chronicles of EMS

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Man, my arm hurts. I think I pulled something over the weekend… which is funny because it was Medic 999 who was the one handing me my hindquarters in an arm-wrestling match. In my defense, the sun was in my eyes, the gravity was especially strong on his side of the table, and um… the… (There’s gotta be another plausible excuse for losing to a limey… There’s not? Oh well)

The weekend I spent with my lovely wife Gkemtp(it) in San Francisco to go visit my buddies The Happy Medic and Medic999 could be summed up in one word: “Awesome”. I could say it was profound, I could say it was “Bitchin”, and I could also say that meeting the two biggest EMS bloggers and the other fantastic people I met changed my world view and reenergized me on this profession. The word “Awesome” just seems to fit though.

Seriously, between the time I got to spend with Justin and Mark, The Angry Captain and Justin’s wonderful family, the time I spent talking to some wonderfully dynamic people at the Tweetup, and the time I got to spend meeting Thaddeus Setla and The ‘Dridge something changed in my world view.

It’s hard to say that someone like me can become cynical to something that I love so much. I don’t know if you can tell it in my writing, but I really do love EMS as much as I say that I do here on the blog. It’s just that someone like me who really and truly wants the profession to change for the best can become disillusioned when it feels like they’re constantly and consistently hitting their head against brick walls. I had recently asked one of my coworkers if anyone actually cared about EMS anymore. Sure, I get a decent bit of traffic here from people who obviously are caring and concerned about the profession and their patients, but sometimes a guy just needs a face-to-face meeting with people who are just as committed and share the same goals.

And well, folks, I got that.

Today’s headline on the blog could read: “Ckemtp heads off to San Francisco for Chronicles of EMS: Becomes reenergized. Finds no Rice-a-Roni and no limits either. Thinks he can change the world and knows we can do it.”

I haven’t felt this energized, this positive, or this good about EMS since I was a brand new paramedic with a brand new paramedic card. I tweeted that if I could make every paramedic, EMT, and other EMS person feel the way I feel about EMS after the Tweetup, that our profession and whole society would change for the better overnight.

So hold on to your hats folks, because that’s just what I intend to do.

Justin and Mark, The Happy Medic and Medic999 respectively, are two stand-up guys who really are just who you expect them to be. Their blogs really are what the medium truly should be, a place where they communicate to their readers their true thoughts, feelings, and emotions so much so that you feel like you really know them. Meeting them face-to-face, I felt like we were friends who’d known each other for years already. Even though Mark has a nearly incomprehensible accent. (Wait, wait… no, we settled that. Per the arm-wrestling outcome I am obligated to say that his accent is perfectly fine)

Thanks guys, you’re an inspiration. Thanks to everyone who came out to see us at the tweetup and to everyone who watched live over the interwebz. All of you showed me that there really are people out there who care about EMS just as much as I do. This is fantastic. I intend to help leverage this collaboration and cooperation between us to help us change the profession together. I know we can.

So hold on to your hats folks, from here on out it’s going to get interesting. From where I sit there just aren’t any walls out there anymore that we can’t smash through. I’m truly excited and I intend to change the world. With your help, there’s no stopping us.

It’s just plain awesome.

Justin, have fun over there in England with Mark playing in their funny looking sickly lime green ambulances professional and sharp looking equipment with Mark’s ­limey coworkers. I’m figuring it’ll be a hoot! Mark, take good care of him like I know you will. I can’t wait to see what you guys turn this in to. You’ve got my full support! For what it’s worth… now that I can’t really move my right arm.

A Motivational EMS Article Geared towards Newer EMTs

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The following article is what I submitted to my Fire/Rescue/EMS department’s monthly newsletter for this month’s EMS column. It has a readership of every one of the the 110 or so members of the department, their families, and a good percentage of the 30k or so people in our district. They know me personally as someone who (Imagine this) likes EMS.

If you like this article, feel free to steal it and use it for your purposes. All I ask is that you keep the links intact and give byline credit. Shoot a comment to me too so I can see if it indeed does go anywhere.

Oh, and here’s a thought. If you would like a short EMS related piece to put into your department’s newsletter, shoot me an e-mail at proems1@yahoo.com I’ll be happy to come up with something.

————————————–

It’s well known around the department that I like the ambulances and EMS in general. I do, and I’ve always been proud to be a part of (My Department’s) EMS program. I think that the level of dedication and professionalism in our department is second to none and that our program is certainly one of the best in the region and in the state.

With that said, in EMS there is never a time to slow down and rest on our laurels. The science that drives our brand of medicine is constantly evolving and the only constant is change. In my EMS career, I’ve seen “The Right Thing to Do” for my patients change more times than I thought possible. Continuing education, reinforcing the basics, and studying the latest research is key in keeping oneself in step with how best to care for our patients. As with any community based Emergency Medical Services provider, our citizens are our families, neighbors, and friends. We have the responsibility of being the first line of defense against the very worst times in peoples’ lives and it is our duty to be at our best when we are called to make a difference. The people we care about most are depending on us.

Just as in firefighting, in EMS, the little things make the biggest difference. It really is the Basic Life Support care that makes everything else work and our calls run the smoothest. Patients do not necessarily perceive the skillful application of Advanced Techniques or medications given to them, but they certainly appreciate the attention given to treatment of their ABCs, their comfort on the cot, pain relief and stabilization through proper splinting techniques, the compassion of the care providers, and the cleanliness of our ambulances and equipment. It has been said that “Perception is Reality”, meaning that the way someone perceives you or your organization affects their own reality. In EMS, good perception actually has been shown to provide for better patient outcomes. Really, if you have more confidence in the skill or effectiveness of your medical provider or a technique, you’re statistically more likely to have a better outcome.

It is so important for us as healthcare providers to focus on providing the best care possible for our current patients, but also to keep an eye out for future patients. Start now by making sure that the ambulance is thoroughly cleaned at the start of every day and after every call. Make sure that your equipment is ready to go and that you’re an expert in its use. Read something educational every day to keep yourself in the right mindset and to keep your skills sharp. Pull things out and practice with them. Come up with questions to ask the more experienced providers and don’t be afraid to ask them. It is every EMTs duty to become an expert in prehospital care and you are the only one who can expand your knowledge enough to become one. Study every day.

Here are some resources I use every day, they teach me something every time I use them:

-          Http://www.happymedic.com – A San Francisco Firefighter/Paramedic and his adventures in EMS.

-          Http://www.999medic.com – A British paramedic working EMS with our neighbors across the pond.

-          Http://www.theEMTspot.com – Educational tidbits, tips, and tricks from a Colorado Paramedic.

-          Http://www.EveryDayEmsTips.com – A Social Media, training, and EMS guru with daily tips to improve your care.

-          Http://paramedicine101.blogspot.com – In-Depth Educational Articles for EMS providers.

-          Http://www.LifeUnderTheLights.com – Your’s Truly’s random musings on the EMS.

Of course, getting your hands on a copy of JEMS or EMS Magazine is great too. Learn something every day, take pride in yourself, your service, and the care you provide. Your next patient could be your loved one, make sure they’d get care that you’d be proud to give them.

Enough: EMS 2.0

1 comment

Your Happy Medic, one of my favorite EMS bloggers who is waaay better at this than I am has written a great post that I’m linking to: HERE

In response, Medicblog999, our buddy from the UK wrote a response, that I’m linking to: HERE.

Happy states that there are parts of the UK model that would work well here in the US. Medic999 points out that he’s right, but that the education and confidence in the provider is the key to success with the program.

You won’t find any disagreement from me.

Happy has come up with the term “EMS 2.0″ to describe the changes that He believes EMS should make as an industry in order to become a true profession and meet the challenges that lay ahead. I am going to champion that cause on this blog and I envision that the EMS blogosphere will follow suit.

Hang on folks, this may be the change that we can believe in, and I don’t mean the kind that just wins elections.


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