Travel Medic 101

Since the onset of the COVID pandemic, there’s been an increasing number of opportunities for EMS providers to take deployment or travel jobs, in some cases with significant financial incentives.

I’ve heard many people ask if they could be a travel medic, and what will the work be like?

Assignments typically range from 2-13 weeks. Some have “normal” work schedules, typically with some element of planned/expectedOT - working 5-6 8+ hour days, 3-5 10 or 12 hour shifts. Some are 24x7 duty with no official downtime.

Common roles:

~COVID Testing/Vaccination

~Infusion Center for Monoclonal Antibody Therapy

~ED/ICU Tech

~Ground Ambulance staffing:

~~~Upstaffing an existing company (IFT and/or 911)

~~~FEMA / GMR Ground Ambulance Deployment (Typically IFT, can be 911 as well)

Most commonly now, assignments are posted only a few days before they start. That means you may not have a ton of time to make a decision, or get required certifications taken care of. Some agencies or contracting authorities specifically want AHA classes - so if you can get AHA cards, it’ll open doors. Also work on making sure your affairs are in order so you can go - Do you have family responsibilities you are needed for - or can you disappear for weeks? Do you need a plan for pet care? Someone who can get the mail for you? An inexpensive place to park your car? Do you have appropriate luggage? (Plan on one checked bag, <50lbs, and a backpack)

Some things to make life easier? Get a folder together with all your carts. Have an electronic file as well - Most places are going to require you to upload these things online, and having a dedicated folder to quickly grab all your cards will make that easier.

When assessing compensation, look at what the employer is paying hourly, as well as per diem. Also look at what the total hours paid per week will be. Pay attention to what you’ll be responsible for paying for (hotel? Rental car?) and have a plan to ensure you can cover those costs within the allotted per diem. Per Diem is NOT taxable, so a contact that splits out a daily per diem may actually be better than one that has a higher hourly rate.

Common certification needs for contract positions:

~EMT:

~~~NREMT, CPR (preferably AHA).If on an ambulance: EVOC/CEVO, HazMat Awareness, and ICS/NIMS (IS-100.C,IS-200.C,IS-700.B,800.D)

~Paramedic:

~~~NR-Paramedic, CPR/ACLS/PALS (preferably AHA). PHTLS, and all the above

For ANY new job, expect to complete:

~Drug Screen

~I9 (DL + Social Security card, or Passport)

~Direct Deposit

~Physical (May be waived, especially if you have one in the last year)

~PPD/T-spot (May be waived, especially if you have one in the last year)

Almost all COVID-related roles will require a complete COVID vaccine, potentially with booster.

#Paramedic #EMT #TravelMedic #Advice

Grammar

Those of you who know me, know that I am active on several different EMS forums, including serving as admin staff over at www.EMTLife.com and a few EMS-focused Facebook groups.

One of the things that makes me cringe on a regular basis is the grammar and spelling used by entry-level members of my profession. This has become clearer as I spend time reviewing PCR's at work and at volunteer agencies. Today, I was on a conference call for work, and an executive pointed out that word choice and PLACEMENT matter quite a bit.

For example, lets look at how one can open their narrative: 

"Arrived to find patient lying in bed w/ FD medics."

vs.

"Arrived to find patient lying in bed, with FD medics providing care."

 Which makes you sound intelligent, and which makes you laugh? Is grammar more important now?


And, now for some levity, I give you Weird Al, a guy who's built his life around playing with words:

John Hinds and #ResusWankers

For those who read my smaccUS Day 1 blog, you know how much of an impact Dr. John Hind's lecture on a resuscitative thoracotomy had on me.

I was beyond shocked when I woke up on Saturday morning to find out (through Twitter, how else) that he had died. One of the last things I did before walking out of McCormick Place on Friday, at the end of SMACC, was to get a chance to shake Dr. Hind's hand. I actually walked partially out of the building with him, and I explained how he had changed my opinion of a local EM Physician who did the same procedure in our local ED. I can't claim to have known him well, but I do know he will be sorely missed in the FOAMed community.

We are united in grief at the passing of one of the best. RIP @DocJohnHinds pic.twitter.com/1FVa9cEjSY

— Saint Emlyn's (@stemlyns) July 4, 2015

A few points.
#1: John had been campaigning for an Air Ambualnce for Northern Ireland. There is a Change.org petition to push for the same thing, as a fitting memorial to him. I know online petitions are mostly useless, but this one is a great cause, so go ahead and sign it HERE.

#2: EmCrit has a podcast up with some never-before-heard audio from Dr. Hinds. Great stuff.

In Memory of our friend: Podcast 153 - @docJohnHinds - On How He Ran His Unit http://t.co/m6UcOM43Ga pic.twitter.com/WEhP4s10gZ

— Scott Weingart (@emcrit) July 5, 2015

#3: SMACC has put up the video for Dr. Hind's SMACC lecture on "Crack the Chest, Get Crucified". Go watch it.


#4: The RAGE Podcast (Resuscitationist's Awesome Guide to Everything) has re-posted John's 2014 smaccGOLD talk "Cases from the Races". Here is the audio combined with the slides in a video format. Fantastic lecture.

Post-smaccUS

My time at smaccUS is done. I flew home yesterday. Spent the day working today.

I've been to a LOT of EMS-focused conferences. I've never had more fun than I did in Chicago this week. The social network aspect was amazing, and I made a BUNCH of new friends. I had a fantastic time, and I've already booked my room for SMACC in Dublin next year. I would encourage all who are on the fence to come and join me in Dublin in June 2016.

While #smaccTAT may fade, the memories of #smaccUS will last forever. #emswolfpack #PCDS pic.twitter.com/aXoRiRn08R

— Jon B. (@JonEMTP) June 29, 2015

Yesterday, I spent the day playing tourist. I saw the Field museum (which I hadn't seen during my previous visit to town). Yes, I'm a nerd, and I really enjoyed the exhibits. Even got a T-Rex Selfie!

#TRexSelfie pic.twitter.com/tpcLXJ6gew

— Jon B. (@JonEMTP) June 27, 2015

One of the funniest moments was when I tweeted I was on the plane headed home. Several folks pointed out that my first name was spelled wrong on my name badge. My response? I didn't really care - they got my Twitter handle correct, that was the most important!

Headed home from #smaccUS. It's been a LOT of fun. Now home to Philly, work in the AM. #EMS #paramedic #emswolfpack pic.twitter.com/SEgyUuLm9Z

— Jon B. (@JonEMTP) June 28, 2015

smaccUS - Day 3

Day 3: The Last day.

Again, too many talks to sum up each one, and so many good talks going on at the same time. I can't wait for all the podcasts to come out so that I can catch up.

The most interesting lecture for me was Haney Mallemat's (@CriticalCareNow) discussion on fatigue and sleep schedules. It was discussed that commercial truck drivers have FAR greater restrcitions on their work hours than EMS providers do, yet us medics drive emergency vehicles, with greater risks than a long-haul trucker.

Of course, Simon Carley (@EMManchester) talked of Dunning-Kruger, and gave me an opportinity to insert one of my favorite memes into the #smaccUS discussion.

And 5 min into the talk, @EMManchester has already talked about #DunningKruger #smaacUS pic.twitter.com/8PCVtHuRwt

— Jon B. (@JonEMTP) June 26, 2015

.

The afternoon continued with a musical interlude - Cups song and a Frozen parody. Can't find the video, but I'm sure it exists.

At the end, the SMACCFinale was amazing. Set up as a game of Family Feud, with 70's era costumes. I've never seen two teams more intent on NOT winning a game, though. And there was this bombshell from the folks behind the conference:

#smaccUS actually lost money. They don't do it for profit. They do it to bring medical minds together. Best conference ever! @smaccteam

— Goldilocks (@ERGoddessMD) June 26, 2015

Finally, there was a last shot of the #EMSWolfpack roll call. I put the hashtag up on the board to see if anyone noticed. Notice it they did. 22 folks claimed membership in the group on the board, and I think a few more were around.

#emswolfpack roll call 4/4. Who's 2nd from bottom? @tingles005 @EMS_Junkie @emscritcare @parabrod pic.twitter.com/5iDl1a7wgv

— Jon B. (@JonEMTP) June 27, 2015

smaccUS - Day 2

Alright. Day 2 at SMACC, and I'm starting to get the hang of it. LOTS of folks who are HUGE in the FOAM scene, and many are VERY cool about it. This phenomenon, of course, has a hashtag (#smaccSquee) I got to talk with John Hinds and Mark Wilson after a session this afternoon, and both seemed genuinely interested in interacting with us mere mortals. J.

Like yesterday, I'll do my 3 big takeaways:

1. Impact Brain Apnea is a thing. While I'd never heard the term before, I've surely heard the phenomenon described. now, perhaps, I'll not write it off as simple bystander hysteria.
2. Some EM docs, even from "GREAT" hosptials, still don't understand what EMS is, what EMS does, and what tools we actually have. That was midly depressing, BUT quite a few EM docs in the room took to Twitter to defend "us", so things aren't really that bad.
3. Ultrasound looks REALLY REALLY cool, and I REALLY need to learn how to use it, because it's clearly the future of medicine, especially in the emergent environment.

The conference closed for the day with SonoWars, a combination of education and contests for folks who know about ultrasound. As much as I KNOW I know nothing about ultrasound, I still found it VERY interesting. It's fairly clear that ultrasound technology is only going to become more portable and less expensive, and will likely continue to be embraced as a prehospital diagnostic tool.

Like many things at SMACC, there was a song:

Apparently these #smaacUS folks love their #ultrasound pic.twitter.com/i6xQfO3m3k

— Jon B. (@JonEMTP) June 25, 2015

SMACC 2016 has been announced as Dublin, Ireland. There are so many variables at play, but I'm going. This has been so much fun that I can't imagine sitting on the sidelines and just watching next year. Come join me! There's already been talk of the #EMSWolfpack doing an AirBNB share or similar, recognizing we are all poor medics, and if we save money in housing, it gives us more money to play tourist.

Looks like I'm going to go to Dublin next year. Guess I need to start saving now. #smaccDUB #smaacUS pic.twitter.com/1JOFt1jzJS

— Jon B. (@JonEMTP) June 25, 2015

After the conference proper, there was a gala dinner on Navy Pier. Live band, food, alcohol, and lots of SMACC-Talk made for a fun time. A highlight of the evening was seeing my old mentor "Sparky" (@EMBasic) and how much a part of FOAMed he is, specifically with the EMBasic blog and podcast. A bunch of the "#EMSWolfpack"crew ended up hanging out outside by the Blues Brothers car. Of course, I wasn't there, but after meeting up with a few others, we met Henrick from Sweden, who's a nurse anesthetist that works in EMS. We had a short discussion on nurse-based EMS vs. medic-based EMS, and decided that we pretty much do the same thing J.

#emswolfpack found the Blues Bros-mobile at #smaccUS gala. pic.twitter.com/1S96sOwjGH

— Josh (@pcpJosh) June 26, 2015

So a chunk of the #emswolfpack was hanging out and met @wessman1022 #smaacUS @DaveWakely @medic4900 @madmedic809 pic.twitter.com/7BfKLjtxh1

— Jon B. (@JonEMTP) June 26, 2015

Anyway - Today is the 3rd and final day. Please follow the hashtags and partcipate at least a bit. Once this is over, much of the material will be condensed into podcasts and other forms of FOAM.

Previous Coverage:
smaccUS Day 0
smaccUS Day 1

smaccUS - Day 1

Yesterday was an absolute BLAST in Chicago for SMACC US. Literally, a blast - the show opened with a confetti cannon!

For those who don't know - SMACC stands for Social Media and Critical Care. It's a conference put on by folks who are very active in the FOAM (Free and Open Access Meducation) movement. They blog, they podcast, and they present at conferences. The conference style is something I've never seen before - mostly panel presentations, with various speakers stepping forward to do a brief (15-25 minute) talk on a very focused topic. It's something akin to TedTalks for FOAM. All questions are asked via Twitter to a designated Twitter Moderator, and the lecture halls are FULL of folks who are listening while using electronic devices to tweet and comment about the topic being discussed.

The day was full of educating moments. My top 3?

1. John Hinds talking about the fallout of a resuscitative thoracotomy outside of a trauma bay  (inspiring the hashtag #ResusWankers). 
2. Scott Weingart presenting a fairly compelling argument against protocol-driven trauma resuscitation, and in reality ALL resuscitation/emergent medicine
3. Amal Mattu presenting a humor-filled talk on how working in Emergency Medicine is tied very strongly to the Princess Bride. (Inconciveable!) 

The biggest thing, though, wasn't the lectures. It was the attitude. When talking to folks while waiting in line, or over lunch, it became clear that no one viewed me as "just" a paramedic. In fact, I was simply viewed as another confernece attendees. Among other things, the confernece name badges don't have titles or post-nominal initials, at all, and that is FANTASTIC. You know what they do have? Twitter handles!


Anyway - Continue to follow #smaccUS and #EMSwolfpack for conference events as they happen, and I'll post about day II on Thursday morning.

smaccUS - Day 0

The last few weeks have been a whirlwind of preparation and working extra shifts so that I could afford to spend this coming week in Chicago for SMACC:Chicago/SMACC:US (#smaccUS) - SMACC stands for Social Media and Critical Care. It's a combination of bloggers/podcasters/twitterers who have put on an annual conference in Australia, with a focus on Emergency Medicine/Critical Care. Best part? They open their doors to folks who aren't attending physicians - residents, interns, nurses, social workers, and even paramedics!

Anyway - I flew into Chicago on Tuesday, got checked into my hotel, and then met up with some folks I knew from Twitter to have dinner/drinks with the #EMSwolfpack: Apparently it's a thing. As best I can tell, it was started by a couple of Aussies (@jrparamed, @paramedickiwi, @paramedic_al, and @KablammoNick)

Not only was it "a thing" - It was an amazing tweetup with great international connections made. There were Aussies, Canadians, Americans, and I think even a couple of folks from New Zealand).

#emswolfpack @ChiPublicHouse #smaccUS pic.twitter.com/fixqwFCzKY

— Alex Mckenzie (@paramedic_al) June 24, 2015

In short, a bunch of folks who had never met each other had an evening chatting like we'd known each other for years. We compared protocols and scopes of practice, we swapped a few war stories, and we complained about the same things all medics do. And we had 50+ prehosptial practitioners get to know each other.

Anyway - As the conference continues, watch the #smaccUS and #EMSwolfpack hashtags for plenty of ongoing entertainment.

Blue Lights and Volunteers

Over the past few days, there's been a Change.org petition circulating to expand the privileges of volunteer firefighters and EMS personnel who use "courtesy lights". Here in PA, those lights are blue (and ONLY blue) and give you NO legal right to do anything more than an average driver.

In all my years in Fire/EMS, I've never used blue lights to respond to a call or a firehouse. Many of my volunteer originations have staffed the station in readiness for calls, and I've had no desire to spend money on lights for my car.

Anyway - the petition is here: https://www.change.org/p/pennsylvania-general-assembly-change-the-laws-regarding-volunteer-firefighters-courtesy-lights-in-pennsylvania - it calls for volunteer vehicles with "blue lights" to get the rights and privileges of emergency vehicles, and be able to use sirens/horns as warning devices too.

Want to know why the PA State Police and other agencies don't want us to have blue lights, and why we are our own worst enemy? Look at this picutre:

Yesterday, I was driving eastbound on the PA Turnpike. As I passed the Mid-County interchange (76/476) in moderate traffic, this yellow BWM zipped past me in the shoulder with a blue dash light. He then proceeded to weave in and out of the exit lane, causing at least one car to have to swerve to miss him. He then continued east on the Turnpike, again driving on the shoulder (next exit was miles away).

I don't know what the crisis was, but I can't fathom why s/he needed to drive like that, risking multiple accidents. There wasn't an accident on the Turnpike - just typical rush-hour traffic.

Anyway - to those who swear by blue lights, this is your enemy too - s/he makes everyone look bad. Further - think - will your community be safer with moreemergency vehicles driving around for the same number of calls?

2014 PA Scope of Practice Update

On Saturday, 11/29/14, the Commonwealth of Pennsylvania published an update to the EMS scope of practice in the PA Bulletin (Found here). I’m no lawyer, but as the document highlights that IN and IM (Autoinjector) Narcan administration is OK immediately, I’m presuming that the entire scope of practice is effective immediately. For reference sake, (2011 here) is the prior Scope of Practice, dated 4/9/11.

I've compared the old and new documents line-by-line and have the results attached as a spreadsheet

Key below. Anything in RED is from the 2011 listing.

Unchanged	Scope is same or similar to previously standing protocol
Clarification	Scope is similar, but has been changed to a minor degree
Variation	Significant change in scope
New	New scope of practice either granting or restricting
Removed	Present in 2011, Absent in 2014

Here's ALL the changes as a Google Doc Spreadsheet - note the 4 tabs on the bottom
https://docs.google.com/spreadsheets/d/1okvETk991oIDePwWxx4LxjJBWHgwoAd6qP6dMKjArfg/pubhtml

EMS and Firearms - Who Will Carry?

There's one category I will say should be permitted to carry firearms without much thought – that would be Tactical EMS providers, who function with a municipal or regional SWAT/ERT team. They should be trained and meet qualification standards set by the team, and be permitted to at least carry sidearms for defense of themselves and other members of the team.

If it will be regular street providers, then who will they be? Will they self-select? Will the service say that only certain people should be able to carry? Will the service say that certain staff members (supervisors, for example) should carry firearms? What qualifications will be required? What laws apply? Does it change if the service is requiring providers to carry?

My personal opinion would be that the providers should self-select. Carrying a firearm is a heavy responsibility, and something that one really needs to think long and hard about before they do it. Forcing someone to do it isn't really a bright idea.

Many of us elect to carry firearms for self defense off-duty. Likely we would be the core individuals considering carry on duty.

EMS and Firearms - What are the current laws pertaining to EMS carrying firearms?

What are the current laws pertaining to EMS carrying firearms?

 

PA is a rather pro-gun state. Commonwealth Licenses to Carry Firearms (LCTF) are shall-issue, and inexpensively available from every county sheriff. PA is also an Constitutional Open Carry state, wherein carrying of a firearm openly visible in a holster is legal so long as you aren't in a vehicle or in the City of Philadelphia. A LCTF is required to conceal a firearm in public, or carry one openly in Philadelphia.

If you are carrying a firearm as a duty of employment, then you enter into territory governed by the same laws as armed security. That requires some level of training and certification above the “average citizen” in many states.

There are a few places where carry is either legally questionable or prohibited. These include primary/secondary schools, jails/courthouses/correctional facilities, and areas that are federally prohibited, like federal buildings and the secure section of airports. Additionally, many other businesses post signs that indicate they would prefer folks not bring firearms onto their premises.

Additionally, in Pennsylvania, the State Department of Health currently requires that every licensed EMS agency prohibit non-LEO's from carrying firearms on their ambulances. Even outside PA, most ambulance companies prohibit firearms from their ambulances (and often buildings and premises) as a matter of “good business practice”

Oh, and as always, I'm not a lawyer. This isn't legal advice, etc, etc, etc.