Monday, January 20, 2014


Today we celebrate the birthday of Martin Luther King

I have great respect for the man and what he stood for. I also think it's a shame that politicians like to put words in his mouth after his tragic death. Oh, and I think his monument in DC really doesn't fit him.

Anyway - 3+ years ago (December, 2010), there was a huge stink at my alma mata, West Chester University.

Someone hung fliers for a proposed meeting of a "White Student Union" on campus. School responded by saying "there isn't a group", rather than discussing the root issue - that there are a host of groups on campus that are, by name, racially oriented.

Here's my letter to the editor, in its entirety. 
To the Editor, Recently, all students were sent a communication by the “Campus Climate Intervention Team” regarding an apparent attempt on campus to form a “white student union” on campus. I do not live on campus, and the first time I became aware of this alleged group was from the University’s email stating that such a group did not exist. As a practicing Jew, I’m deeply concerned about the overt Aryan undertones in such a group, and I feel that I have as much as anyone else, if not more, to fear by a group that espouses “white power.” That being said, I also see the potential for discussion that the appearance of these posters on campus creates.
West Chester has a host of organizations that, by their very name, represent a selection of the university’s population by skin color. The obvious list includes the Black Student Union, as well as the Latino American Student Organization, The Black and Latino Greek Council, the Asian Student Association and Black Men United. I acknowledge that many things have changed in this country in the last 50 years, and that, yes, racism still exists.
My grandfather was present at Dr. King’s march on Washington, and he was arrested in the south in the sixties, as a white Catholic man from Massachusetts who felt he was morally responsible to help fight racism, and risked his life and livelihood to travel and support those in need. I think now, we do a disservice to those who fought in the civil rights battles if we gloss over this incident in the name of political correctness.
Embracing the potential for discussion that exists, I challenge that for the university to not allow such a group, in light of the other groups that already exist, is a morally incompatible position. I acknowledge that the school wants to promote diversity, however for this school to truly be “inclusive,” any group that exists to divide the student body by skin color alone does everyone a disservice.
Link to WCU's paper

Wednesday, January 15, 2014

Plain Speech

“Medic 3 to Dispatch”…
“Medic 3 to Dispatch”…
I look at my partner… “why aren't they answering.”

My partner says: “why are you calling them Dispatch? Try calling County”.Terminology… the downside to my nomadic life.

Post 9/11, everyone in public safety went to “plain speak”… we no longer use obscure 10-codes, and instead use regular speech. Sounds like a great idea. Except there are still plenty of regional differences.

What do you call your communication center? Depending on where I am, they are County, Communications, or dispatch.

What’s a “Medic Unit”? – In most systems I work, it’s an ALS ambulance. In one, it’s specifically a dual-medic unit, and in another, it’s a single medic in a chase car.

What happens when you get cancelled from a call? Depending on where I am, I’m either cancelled or recalled. One place, I document that I was “placed in service.”

As part of my company’s response to Hurricane Katrina, I had the opportunity to work with providers from across the country. We noticed that for describing a single unit, we had 8 different words, Unit, Squad, Truck, Ambulance, Medic, Bus, Rig, and Car.

Working with 4 different dispatch centers can be entertaining. I often find myself hesitating before speaking on the radio, making sure I’m using the correct version of plain speak for that service.

Plain speech isn't a one-size-fits-all solution. In any area, plain speech can be its own code.

Thursday, January 09, 2014

Seen in the Hospital - Lion King?

One of the local ED's is using the Exergen thermometers, like this:

Anyone ever seen them?

Random thought - but they remind me of the opening of The Lion King, when Rafiki draws on Simba's forehead.

Monday, January 06, 2014

Just "a little trouble breathing"

Dispatched for "Difficulty Breathing".

It's a fall night, and the call is down the street. Response is quick and uneventful.

On arrival, I find a 40's male lying in bed. His son says he called 911 against his father's insistence that he's fine. The son says his dad doesn't look right, and seems to be in more distress than he's letting on. I look at the patient, and the son is right... He "looks sick" and says he's having some shortness of breath, and notes he was out in the yard raking leaves all day. Lung sounds are clear, initial B/P ia on the low side of normal but not below 100 systolic, and his heart rate is running at about 90 fora relatively   healthy male lying supine. I ask if he's having any chest pain. He denies it. I press further, and ask if anything else is bothering him. He says his chest feels "tight" and it's uncomfortable to take a deep breath.  I ask him to rate his chest pain on a 1-10 scale, and he remains insistent that he's not having any chest pain.  Sure. Fine. Just tightness. So can you rate your tightness? "7/10". Gee. Now I'm getting somewhere. 

I run a 12-lead. The monitor alarm kicks on saying "acute MI". I look at the strip. Massive ST-segment elevation in V3 and V4, with other changes. Ding Ding Ding. The monitor is, shockingly enough, correct. The patient appears to be having a MI.

I silence the alarms, we package the patient and get him to the truck. Patient gets an IV, some nitroglycerin under his tongue with minimal response, and asks "what's going on".

My response? Sir. You appear to have a blockage in an artery that feeds your heart - a heart attack. I'm going to try to give you some medication to make you feel better, and we're gonna get you to the Hosptial, where you're likely to be undergoing a cardiac cath pretty quickly.

We start transporting. It's a 20 minute ride to the ED... I transmit my EKG and give the ED a phone call advising of our impending arrival. I start a second IV, give more nitro, some saline, Zofran for nausea, and then finally some morphine to ease his pain, which starts to fall a little.

On arrival in the ED, they did a repeat 12-lead (per their protocol) and then we went right upstairs with the patient still on my stretcher.

I gave a report to the arriving cath lab team, transfer the patient to the table, and then left. In follow up, the Pt. received multiple stents but was discharged without incident. Calls like this are "wins" for EMS - we recognize the problem and seek the appropriate treatment.

Thursday, January 02, 2014

What Gun should I buy?

Working in a gun store has been a lot of fun for me. In the past 6 months, I’I've met a lot of cool people, seen some really cool guns, and helped more than a few people get into a hobby that I enjoy.

One question I get asked a LOT is “I want to buy my wife/girlfriend/mother a gun – what do you recommend?” I've been through this with a few friends and even my own mother in the last few years, and there’s only one good answer – and it’s simple – if you aren't sure, don’t buy her anything…yet. Instead, take her to the range and let her try a selection of guns.

Last month I had a friend tell me she wanted to get a gun, and was wondering what to get. After an afternoon at the range, we came away with some good conclusions. She was uncomfortable shooting a Glock, and found that my full-size 1911 was too big for her hand. She enjoyed shooting my XD’s and M&P’s, and we came to the conclusion that her first purchase will likely be an XD Compact, probably in 9mm. We also tried a snub-nosed .38 and my LCP – She found both to be extremely unpleasant and summed up that they were “not fun” to shoot. Oddly enough, I have the same opinion… I don’t enjoy shooting them, but I am proficient with them and carry both occasionally.

Worst way to teach someone to shoot? Buy them a compact gun (especially one that happens to be pink) and expect them to become proficient with it and it alone. Want your girlfriend to never want to shoot again? Start her with that Scandium J-Frame with +P ammo, or a .380 pocket pistol, with no other instruction. My bet on the results? She might put a dozen rounds through it, then her hands will be hurting, she’ll be frustrated because the sights aren't great, and she may never want to shoot again. Just because a gun is pink doesn't mean it’s a good gun for a female.

Short-barrel handguns like a J-Frame revolver or a pocket .380 are “compromise” firearms. For the sake of concealment, weight and barrel length have been reduced. The short barrel and reduced mass result in an increase in perceived recoil compared with their larger siblings. Shooters will usually be more successful if they learn the fundamentals on larger firearms. Once comfortable with the basics, give the LCP or .38 a try again, and while it may be uncomfortable, the shooter will likely be more successful and comfortable with the gun for carry.

Once she’s selected something she likes – then yes, feel free to buy your wife a gun and surprise her with it. If you’re not married, you’ll need to get her a gift certificate, because you can’t transfer a handgun to your girlfriend in PA without it going through a dealer anyway.

On the topic of “pink guns” – Most modern striker-fired semi autos come in one color – Black. Sometimes you can get a stainless slide, or a gun in a neutral tan/coyote color. If you must have flair, there are some options. First – check out Brilliant Backstraps – I have no affiliation with them, and have never bought their products, but my friend Annette over at Beauty Behind the Blast likes them, and they are an easy way to personalize a firearm. Another option? A permanent coating like Cerakote or Durakote. They can do a lot of cool things to truly personalize your favorite firearm.

For more information related to firearms from a female perspective, check out Kathy Jackson’s website: over at Cornered Cat. If you’re local – stop into the store and I’ll gladly show you some options, too.

Wednesday, January 01, 2014

New Blog Title!

Happy New Year!

So I'm starting the new year off with some change. After much thought, I've decided to change my blog title from the current "Earning Money Sleeping" to "EMS Nomad"

Earning Money Sleeping is one of many farcical bacronyms used to define "EMS" for humor within our community. I chose it as a blog title for many reasons – Biggest is that EMS, the Fire Service, and within hospitals are the only places where people truly are allowed to sleep when they are “on the clock”. The ability, and even expectation that we will sleep makes us DIFFERENT from many other professions. It is not without issue, though. As I was talking about DCFD last year, I discussed the hazards of shift-work sleep disorders. I can speak from first hand experience – I’ve worked some long shifts without good sleep.

That said, I think it doesn't really describe me, and I want to make a change. So here goes.

Why EMS Nomad?

Right now I'm a college graduate (B.S., Health Sciences) paramedic that works 4 part-time EMS jobs to make ends meet. Some days I feel like I'm constantly wandering from job to job. I also volunteer at 2 services, one BLS first responder agency, and a fire-based EMS system where I'm working on becoming an ALS provider. One of those days I'll find a full time job where I'll be comfortable long-term. Until then? I'm a nomad, and I actually don't mind it. The experience across my different jobs is varied and complimentary.

I work some interesting jobs - 2 small-town suburban EMS jobs, a city-based IFT/CCT job, and an occasional shift in an industrial health clinic. I also work at a local gun store, which I find is a nice break from working EMS, and is just plain enjoyable.

I made a joking comment a few weeks ago to a co-worker that I felt like a nomad, living out of my car (because all my work stuff lives in my SUV)... and I decided it would make a decent blog name.