Skipping School

I just found out about this blog because someone posted a link to an article by this young woman.

http://skipping-school.com/

I love it.
She sounds so much... like us.

Plus, she's a decent writer.

Time for a change

Been considering this for a while.

This blog started out as one thing, and has somehow morphed into something else.

It is time to separate things out a little.  Even while noticing how very connected they are.

For now, I'll leave this here, for anyone who wants to read back through the archives- including myself.

Most of the fencing-related and teaching-related stuff will appear on our new collaborative blog, The Swordmaster's Grimoire.

The EMS stuff will be on my new, actually-an-EMS-Blog blog, The Lonely EMT.

So whichever of those you are interested in, now you know where to go.

I don't know yet if I'll end up continuing this blog or not. There might be some things that don't really belong on either of the other two, but I don't know yet.  I'll know if and when it happens.  I kind of expect that it will.

Alcohol Related

Had a talk with some of our students this morning.

It went basically like this:

College is an interesting time in your lives.

It's a time to get away from your parents, from your family of origin, and start to make your own way in the world.

It's a time to learn many new things, to make new friends and connections that will last a lifetime.

And it's a time to make mistakes, and do stupid things. Some of which you'll look back on, years from now, and wonder why you did.

Please don't let one of those "stupid things" be drinking yourself TO DEATH.

Two local college students (different colleges, and as far as I know completely unrelated circumstances) died this past weekend.

Official reports say the deaths are "alcohol related."

I don't know what that means, exactly.

Except it means it was a total waste. A tragic loss for the families that was brought on by the choices made by the individuals.

I can't help but notice the frequency of calls for ambulances because of someone drinking him or herself into a stupor.

And every time I hear that, or see that, I always wonder about the families. I wonder if the parents realize that they are paying through the nose for their kid to get an education, and what they are getting is stupid drunk. Not just ordinary drunk. But enough that they need a trip to the ER.

I did a lot of stupid things when I was younger.

I imbibed my fair share, or perhaps a few peoples' fair shares, of alcohol.

But never have I done so in such away as to need emergency medical care, or even close.

Seems to happen all the time now, in some places.

The cause of this stupid behavior- I started to be politically correct, and say "unfortunate," but let's face it, it's stupid- could be argued at length, and I'm sure there are a variety of contributory issues.

I don't really care what the cause is.

I care about the results.

Lives wasted.

So please.

Whoever you are.

Wherever you are.

Don't do this to yourself.

Just don't.

It's an ugly, ugly way to go.

Ambulance Driver's blog post today

I almost never do this, but I have to, this time.

Go read this post, entitled "On Teaching, Mentoring and Stewardship"

Talk about the perfect crossover between my two worlds, of teaching and EMS.

AD really gets what it's about.

I'm envious of anyone who has been or will be precepted by him.

Split Personality?

Feeling like I have a split personality these days.

On the one hand, I'm researching and working on writing my fencing master's thesis. That's a lot of reading. And a lot of writing. Teaching classes, and otherwise focusing and refocusing on the whole fencing thing. Writing for the new blog. Working on my own training. It's good.

On the other hand, I'm excited about going to EMS Today. Enthusiastic about the opportunity to learn some stuff, get some decent training, and network. Making preparations for applying to the local ambulance company, where I've wanted to work since my first ride along. Looking forward to getting more into the whole EMS thing once I get my youngest a little older, so I can work long hours without feeling like I'm being negligent.

Seems like two totally separate things, pulling me in different directions.

But it isn't.
Not really.

There is a lot of overlap.

One big area of overlap is something I've been thinking about a lot lately.
It's more than just "customer service."

Something fencing and EMS have in common in a HUGE way is the necessity to be able to create rapport. To connect with the student/patient in a very personal, immediate way, without distracting from the technical things you must also be able to do.

Knowing how to get my student to focus where I want him/her to focus, and to stay connected with me, is a HUGE help in being able to help my patient focus where he/she needs to focus, whether it's on something like his/her breathing rate, or something- anything- other than what is happening around him/her in a crisis.

Being able to give a technical lesson, and perform the skills I need to perform, while giving constant verbal and non-verbal feedback to my student, is a huge help in being able to treat my patient AND keep communicating.

Knowing how to use my voice to keep my student focused is very much like using my voice to calm my patient.

Maybe my personality isn't as split as I thought.

Worth a thousand words?

When I first joined the fire service, one of the things I did on scene was to take pictures.

Some of these were used on the fire company website.

Some have been used for fire investigation.

Some have been used for training.

As I became trained to do more things on scene, my ability to take pictures decreased because I was simply too busy doing other things that needed to be done, to be available to take pictures.

Back when I took a lot of pictures, I was always careful about what kinds of pictures I took. I never took a picture of a patient. Didn't take pictures of things that might cause any patient or homeowner embarrassment or grief. Any pictures that I took that showed identifying information such as license plates, I didn't publish.

Recently, the fire company, in a fit of I-don't-know-what announced a new policy regarding taking pictures.

I found this a little amusing, considering no one had taken any pictures on scene for quite some time, even though there is a company camera in one of the apparatus for just that purpose.

The policy, as I remember it (there has been no written version) is that no one is to take any pictures on any scene. Pictures are only to be taken at training, or for the purposes of a fire investigation. This is a policy recommended by "the company lawyer" for liability reasons.

Whatever.

So a couple of weeks after the announcement of the new policy, there we were, at an accident scene, and one of the assistant chiefs was taking pictures with his cell phone. He then asked if the company camera was available, and asked someone to use it to take pictures.

That's interesting.

Seems to be in direct violation of the company policy.

But this scene was unusual, and in my personal opinion, pictures of it would be very helpful for training purposes-and, for the most part, that is what I have always thought scene pictures were most useful FOR, so that they could be looked at later, and information gained that wasn't necessarily noticed at the time. So I heartily support the idea of pictures of this particular incident- it was unique.

At the next training, when we did a post-incident analysis of the event, the pictures taken on scene were shown. As they needed to be. And there was a big notice written on the white board in the training room, saying that these pictures were to be seen inside the fire company ONLY, not to be shared with the public. A reminder of the new policy, or at least related to it in some way, considering that it isn't, exactly, in accordance with that as-yet-unwritten policy, which didn't mention anything about sharing or not sharing pictures, but I digress...

A sensible consideration, a reminder not to be spreading the images around far and wide, if there has been a decision by the company not to do so.

Fast forward a while.

Imagine my surprise, to find out, by chance, that those very same pictures were sent to someone, who shared them with a large number of people outside the fire company.

Okay. So maybe I wasn't that surprised.

And, for the record, I think the people who saw the pictures SHOULD have seen them. That's not the issue.

The point is that it seems to me to be counterproductive to have the officers announce a new policy, not to put it into writing, and then to violate that policy themselves almost immediately, not only by taking pictures, but by sharing them around town. What was this policy about, exactly? Is it, or is it not, company policy? Is it policy for some, but not for others? Or what?

At the very least, I think the "policy" should be reconsidered- but I thought that the moment it was announced.

I have the same problem with a "no pictures" policy that I have with parts of HIPAA. Neither takes into consideration how VERY useful information can be in training.

That I am limited in how much information I can find out about a patient after they leave our care, means that I have no feedback on the care I provided. If I don't know how effective I am or am not, how can I improve the quality of the care I provide?

If we can't share pictures of unusual situations- the condition of a vehicle, the location of a patient, etc- with other EMTs in the company who weren't at an incident, how can we share what we have learned from any new experience? How can we use it to train and practice for future events?

Any thoughts on this? Does your agency have a "no pictures" policy? Do you think they should?

I know that there are places where there have been issues with people being stupid about sharing photographs that they shouldn't have shared, but I don't think prohibiting pictures at all is the solution.

EMS Today

I applied for a scholarship to EMS Today, thinking I'd never get it, and never be able to afford to go.

The application info said they would start notifying people on Feb 1st, which came and went, not a word.

I assumed I hadn't gotten it, no surprise, and pretty much stopped thinking about it.

Some of the folks who are going were tweeting about it and posting about it, and knowing I wouldn't be able to go, I passed over those comments, with a feeling of sadness for myself, while being happy for them.

It's not like I have nothing else to do. I'm pretty busy, and have plenty to keep me occupied.

It's not like I can't work on continuing my education in other ways, like the variety of books I've been reading lately.

And it's not like I can't still read EMS blogs, and learn from them.

But still.

EMS Today.

The premiere EMS conference, incredible opportunities all in one place, people I'd love to meet in person, educational sessions galore, and the whole exhibit hall. And it's not that far away.

Worth ever penny, it would be, no question.

I just don't have the pennies. :-(

A couple of days ago, we were getting ready to go out dancing, when I checked my e-mail just before leaving.

And there was an e-mail, with the subject heading "EMS Today scholarship."

I assumed it would begin with something like "Thank you for applying, but with so many qualified applicants, it was difficult to decide who to give a scholarship to. Unfortunately, it wasn't you."

It didn't.

It said "Congratulations! After careful review of your scholarship application for EMS Today, you have been selected to receive a Gold 3-day passport to this year’s conference!"

!!!

I think I screamed.

I'm not a screaming person, in general.

Suddenly, I'm scrambling to choose which sessions I want to take (all of them! Aaahhhh!), I'm looking for a hotel room somewhere near the convention center, and I can barely contain my excitement at actually being able to GO!

I'd like to thank JEMS for making the whole event possible, and for making it possible for me to go.

I'd like to thank all the EMS bloggers for inspiring, educating, and entertaining me. I'm very much looking forward to meeting some of you!

I'm sure I'll have a lot more to say once I'm there, and when I'm back home again.

Sure of it

My daughter has lived with us EMTs a few years now, and is reaching the age where she can take the class and join us. She has been riding with the rescue for the last year and a half, and has been very helpful there, fetching and carrying, etc. Now that she is getting ready to become certified herself, she has started paying more attention to the patient care.

We typically use the time on the way to the scene to go over our plans on arrival, and to remind ourselves of any pertinent information we may have about a patient's medical conditions, or any special needs. If appropriate, we review any intervention we might need, etc. Sometimes, we are close to the scene and don't have a lot of time. Sometimes, there isn't anything in particular that we need to review.

The other day, we were on our way to a reported accident with no injuries, expected to be a sign-off. The proverbial "wants to be checked out." It happened that the call was on the far end of town, so we would have a longer drive than usual. Plenty of time to go over whatever we wanted to go over, but little that we really needed to review for that particular situation. Basics. Scene safety. BSI.

But because my daughter was with us, and had been talking about starting her EMT class, I decided to go over trauma assessment. From the beginning. By the numbers. In addition to scene safety and BSI, mechanism of injury, number of patients, need for resources, spinal stabilization, general impression, level of consciousness and etc, on down the line. An excellent exercise, one found around the house every day. Literally, at our house, but I digress...

We arrived on scene to what turned out to be a two car accident.

We all know how accurate dispatch can be.

But true to what we had been told, there were no real injuries, just a little redness from an airbag. No problem. It's all good. Just hanging out, waiting for the wrecker. A relatively pleasant call, albeit in unpleasant weather.

Ever have one of those days where suddenly, everything changes?

Yeah.

Not far up the road, a sudden collision (is there any other kind?).

Bad.

Real bad.

As in "What is that in the road? How did it get there? It doesn't look like anything I've ever seen before. Oh, shit. That must be a car."

We hustled.

Called for more resources.

Major trauma.

Good thing trauma assessment was so fresh in our minds.

I had never seen a car in that condition before. It was literally ripped apart.

I was sure there would be fatalities.

There weren't.

It was nothing short of a miracle.

Great teamwork all around.

Patients extricated and packaged in an unbelievably short amount of time.

And my daughter?

An impeccable job, staging gear and assisting us.

Kept her head in a very stressful situation.

She's going to be a great EMT.

I'm sure of it.

On a Roll

Went over to the Fire Academy last week to return a book to the library.
The librarian- who is the best librarian I've ever met- pointed me towards some books that she just got in, from another library that closed.
I found several that looked interesting, but only brought one of them home, since my reading time is somewhat limited.
Turns out that the one I brought home was of enough interest that I started looking to buy a copy.
Ended up also ordering the other two I had looked at, and some others I found online. I'm on a roll.

Here's the thing.
The fire department I'm in offers no EMS training at all. None. I think they think they do, but they don't know enough about training to realize that what they are doing isn't training, at all.
A prime example occurred just this week.
The scheduled training was for the EMS Director to give a presentation on cold weather emergencies. He has no training to teach, at all. (I could write a whole post about that.) His "presentations" are last minute rambling about some subject, with little to no preparation.
But if that isn't bad enough, what actually happened is that he didn't show up.
He handed on old EMT textbook to another person, who also has no training to teach, and told him to "cover this."
So that person read from the old textbook.
And that is what happens when they even attempt to provide training. Often, it just gets canceled.

For a long time, I felt some sympathy for both of these people, who are being asked and expected to do something for which they have no training, and less skill. They do "the best they can." But the longer this goes on, the more I realize that it is their responsibility to step up and say "I do not have the training or ability to do this; let's bring in someone who does." And they don't. I don't know whether they are embarrassed to admit they can't do it, or whether they don't realize they can't. Either way, it's bad.

And this isn't good enough. Not even close.
So after three or four years of this, now that I have SOME experience, as little as it is, rather than NO experience, I'm doing the only thing I can reasonably do.
I'm finding training opportunities elsewhere, as much as I can, and I'm organizing training for myself and the other EMTs, without relying on the fire company to do so. I have years of teaching experience, and training people is what I do. Shifting those abilities over to include EMS is inevitable, although I didn't intend to be forced to do so this early. I won't be attempting to teach new skills; that is beyond what I can claim to be able to do. But I can run drills, and I can go through scenarios, and we all can learn a lot from a wide variety of sources.

Why am I mentioning this?
These books I've started accumulating are mostly EMS education books.
Some, clearly designed to be used as such, and others, perhaps written more for sharing experiences, rather than outright teaching, but they can also be used to great benefit.

As I read through them, I'll share here what I find interesting and/or educational.
It might be medical information that I didn't know.
Or it might be about teaching, itself, more than about EMS, in particular.

I would also welcome recommendations for resources other people have found useful, both on the EMS front, and about teaching.