Monday, and a good mood!

Happy Monday! It’s 73 degrees, going up to 80+ today. I’m wearing shorts for the first time this year, and sitting in the office at the University. I’m supposed to be catching up on paperwork – my owed charts, and QA in general. The office door is open, and I can’t seem to focus. This weekend was nice overall. Worked as a Medic Saturday daytime – did 2 less than acute calls, including my first legitimate ALS release (never had a reason to before). Saturday night on the BLS squad, doing a “rent” shift, with the GF riding with me (she’s a member, too). It was miserable… 2 more patients that I like trying to throw up on me, and no real sleep. Slept in Sunday AM, then took the GF to the range for the first time ever… She tried my pistols (need to find something that better fits her hands), and I dropped the .22 conversion into the AR… she loved that. Then I had a meeting for Alpha Phi Omega at school… a late dinner with her, and she headed home. So, I’m in a good mood this week. School is over in a few weeks – that will be my first priority, to make sure I finish my class obligations. I’m trying to balance school, work, volunteer, and personal obligations, and I think I’m doing a better job than I have been. EMS on the Hill is in less than a month, and I can’t wait to see all my EMS 2.0 friends again. On the State side, House Bill 40 (Castle Doctrine) is supposed to go for its final vote in the State House today… then on to the Senate for their approval. We are getting there. Anyway – That’s all I’ve got for today!

Pins and Needles

I'm in a dark room, with a one-armed man. I'm trying to find an IV so I can give Nitro and Morphine for his chest pain... I search and search for a vein. I've got one, but it's resting on fatty tissue, with nothing to put tension against to hold it in place. I swing... and a miss. Clean the site and try the other side of the AC. Swing and a miss. Again... back at the first site. I get flash, but can't advance the catheter. I try to float it in. It blows. I swear in my head.

We load the patient up, and once in the truck, I find one more vein on the arm that I think I can get. I pray. I miss. I look at my partner and say “Just go”. I talk to the patient on the way to the hospital. Trying to keep his mind off things. It doesn't really work.

At the ER, we place the patient in bed. I explain that I can't get a line. The nurse looks at me and incredulously says “Are you a paramedic?” I doubt myself. I think I stole the patch and don't deserve to wear it. I say Yes, but inside I wonder.

After registering the patient, I peek in on my way out the door. The nurses are on try 4 or 5 themselves, with no more luck than I had. I walk out with my head just a little bit higher, recognizing that it wasn't JUST me.

~~~~~~~~~~~~~~~

I hate IV's in my own arms... it hurts. I cringe when I stick my patients. I don't dig for the vein, because that trick never works. I hate turning my patients into pincushions, but sometimes they have NOTHING for veins, and I'm desperate to get a line so I can push drugs to make them feel better.

EMS Today Recap

Life’s gotten very interesting this past month, and there have been some changes – mostly positive.

I’m still playing catch-up from EMS Today – Be it in my college class, sleep, or getting back into the saddle with work. I promised myself I’d blog more… and so I am trying.

EMS Today was amazing – I got to meet and/or re-connect with some great folks. And I actually added a blogroll of some of the best.

In addition to the core #CoEMS crew - @Setla, @SamBradley11, and @TheHappyMedic (http://happymedic.com/), I got to
A quick run-down:

Russell Stine / @HybridMedic, A firefighter/Paramedic and allaround good guy from Memphis: http://hybridmedic.com/

Scott Kier / @MedicSBK, a Paramedic Supervisor from Mass. We met in May 2010, and he was one of my first contacts into the wide world of #CoEMS on Twitter: http://2010ems.blogspot.com/

EpiJunky / @GingerMedic – A paramedic and great gal http://pinkwarmdry.com/

Kelly Grayson / @AmboDriver – A medic and author from Down South – Wish I’d had a chance to talk with him more: http://ambulancedriverfiles.com/

@MsParamedic – Because she’s awesome: http://msparamedic.com/

Chris Kaiser / @CKemtp – Some Guy That Writes Some really good Stuff: http://lifeunderthelights.com/

@Medic61 – http://samtheemt.com/

@MedicTrommashere – http://lookingthroughapairofpinkhandledtraumashears.com/

Kevin / @NJDiveMedic - http://njdivemedic.blogspot.com/

And if I missed you – My apologies – I met so many folks, and I’m sure I’m missing a few!

Conferences 101

In the next month, I have the privilege of attending two national EMS conferences The first is the NCEMSF Conference (National Collegiate EMS Foundation http://www.ncemsf.org/), in my backyard, Philadelphia, PA. The other will be the JEMS Conference, EMS Today (http://www.emstoday.com). I'm getting to be an old hand at JEMS, especially in Baltimore, but I've never been to the NCEMSF Conference before, so that will be a new experience.

On Twitter, I've seen some folks comment that they've never been to an EMS Conference before – so I figured I'd write a bit of a guide for new folks going.

First – What to wear:

Comfortable shoes are key. Between wandering the exhibit floor, walking between spread-out classrooms, and walking to lunch and evening activities, you'll spend a LOT of time on your feet. If you don't wear comfortable shoes, you'll be looking for the on-site EMS coverage folks for band-aids and moleskin for your blisters. Oh – and make sure the shoes are broken in... or you'll have the same issues with blisters.

Every year, I see a wide range of attire, from suits and ties to ripped T-shirts and torn blue jeans. There are also more than a few wearing “Absolute EMT” t-shirts and squad uniforms. I tend to try to appear professional – collared shirts and khakis or nice jeans.

As for uniforms: I may wear a jobshirt or sweatshirt with a department logo, and that's as far as I'll go. I never understand the folks wandering around in full duty uniforms (excluding the ones there staffing a booth for their department), and why do folks insist on wearing their pagers or turnout coats?

What to do:

The reason I get to go to the conference is education. That means that I try to pick topics that are interesting, and that I'll get something out of. Networking is a great benefit to an event of that scale, and I'm looking forward to seeing folks I met last year, and meeting new folks, too. Some folks go to these events looking for new employment possibilities, and there are a host of companies there recruiting.

As for sessions – Go to ones that interest you. Just because you signed up for one session doesn't mean you can't change your mind and go to a different one. Be aware of the continuing education restrictions, though. For example, even though I'm a medic, as a condition of me going last year, my sessions had to be approved for BLS con-ed. Be aware if you have similar restrictions. Steve Berry happens to be my favorite lecturer, and his sessions are ALWAYS standing-room-only. Get their early to get good seats. Bring a notepad and be able to take notes. I'm not a huge note-taker, but there will always be something of benefit to research more later.

Networking is great, and sometimes occurs in the exhibit halls and corridors of the convention center. More often than not, though, it occurs over food and drink at lunch and in the evenings. There are sales reps from many companies present, and some of them will offer to buy you dinner or drinks. Remember, they are trying to sell you something, and accepting free meals from them may violate an anti-kickback or ethics policy at your work place. Be careful, and remember, there is no such thing as a free lunch. That being said – meeting with sales reps is a natural occurrence at a conference like EMS Today – just be careful that you don't jam yourself up.

Additionally, if you are of legal age and partake in adult beverages, use caution. First, you are representing your service(s) and the profession as a whole, so don't make the rest of us look bad. For those of you that are perhaps networking for better employment, everything is an interview! Then again, it is natural to let your hair down a little bit with friends new and old, and some of the best education occurs when talking to folks with different experiences over a glass of good beer. Just remember to drink in moderation. If you do drink too much, you'll feel like SH*T the next morning, and perhaps sleep though sessions. I need to demonstrate that I attend the sessions so my conference fee gets paid for, but even if you are paying your own way – it's a shame to miss good sessions because you can't control your behavior.

Philadelphia and Baltimore are both big cities. They make an effort to make the downtown area “safe”, but bad stuff still happens. I KNOW Philly, and I'm comfortable with the Inner Harbor of Baltimore. When traveling, if possible, travel in groups. Don't go exploring areas off the beaten path, and don't be afraid to ask a Police Officer for assistance. Use some common sense, and recognize that even though it's the safe part of the city – it's still the big city.

Anyway – Have fun, and if you're at either conference, I'd love to meet you.

The things I carry

So, this month's Handover (a blog carnival) theme is “Wearing is Caring.” I've been intending to make an entry for some time now, and keep not getting around to it. This month, the discussion is about what we carry with us. This is a topic I've discussed before, especially over at www.EMTLife.com, as well as in person with friends and co-workers.

I've been an EMT for 9 years, and a Paramedic for over a year now. I cut my teeth as a volunteer with a BLS service, and still run with them very regularly I'm actually a live-in with that agency, which provides BLS-level care, with a call volume of approx. 4500 a year. I run 6 or 12 hour shifts 2-3 nights a week to meet my “rent” requirement. I explain this, because when I'm functioning with them, I'm limited to the Statewide BLS scope of practice. I also work as a paramedic with 3 separate services – 2 suburban EMS agencies, and a urban based, private transport company. Oh, and because I go to the in-town college, I'm also on their BLS Quick Response team.

When I'm around school or the squad where I live, I'm usually carrying a pager and will cover calls as needed. The BLS agency has 2-3 duty crews on station, and if needed, and I'm available, it's expected of me to help cover a call beyond what we have staffing for. So although it's uncommon, I've taken calls in dress clothing, neckties and all, and I've taken calls in a Boy Scout uniform before too... (Joys of being an adult leader). Let me rattle off my “every day carry” stuff:

2-3 ballpoint pens. One isn't enough. Ever. It'll get loaned, lost, or left somewhere. They normally ride in my right front pants pocket. I've had a few leaking pen tragedies over the years, but usually this works for me. I also usually carry a fine-point Sharpie. It comes in handy.

Knife. Currently I'm carrying a SOGZilla folder in my right (strong side) front pocket, clipped to the pocket. That's my standard “utility” knife. If I'm on duty, I'll often replace the standard knife with a Spyderco Rescue folder, with a blunt tip and SERIOUS serrations. Sometimes I keep the other blade on me, sometimes not. Depends on if I remember.

Keys. My personal keys live in my left front pants pocket, and the set consists of: Electronic fob for the squad building I live at, 3 separate keys for various firearms lock boxes, a handcuff key (dating back to when I worked Security as a full-time job), Car key, Key to the University QRS truck, Room key, key to my parent's house, Key to the elevator at the Squad building, mailbox key, 4gig flash drive, and a VERY small CPR mask. It's actually a pretty compact keyring.

Wallet. I use a All-Ett wallet (www.all-ett.com), and it lives in my back right pants pocket. I cite the brand because it's the smallest, lowest profile wallet I've ever had, and I've used them for the last 5 years or so. Carrying a whole stack of cert cards, ID cards, etc, my wallet is pretty full. This wallet makes it thinner than most EMPTY leather wallets.

Nitrite Gloves. At least 1 pair of gloves lives in my back left pants pocket, pretty much 24x7. As I said, I sometimes end up on trucks when I'm not expecting it.

Flashlight. My current flashlight of choice is a SureFire G2L (LED). It often ends up in my left front pants pocket, although when I'm carrying a CCW, it'll end up in a weak-hand belt holster when I have that on.

Phone: My iPhone 4 lives in a pocket, too, because I've never been able to find a belt clip that works for me. Along with it, I always keep a headset, usually a corded earphone/mic system. This way, I can listen to music when doing my rig check, and talk hands free when on a long conversation during downtime. My phone normally rides in a breast pocket of my shirt or jacket, but if that doesn't work, it ends up in my front pants pockets, usually on the left side.

Pager: As I said, when I'm around and available, I end up being on-call. So I almost always carry my squad pager on my belt, at about 3-O'clock. When my CCW is there, it will either go to 4:30, or 9-o'clock. When I'm around the college, I ALSO carry a separate duty pager for their PD to dispatch the QRS.

When I'm off-duty, my apparel tends to be causal, but presentable. 5.11's, khaki's, or blue jeans, usually with a polo or button-down shirt. I rarely wear shorts. For belts, I wear a custom leather belt from Crossbreed (www.crossbreedholsters.com) or The Beltman (www.thebeltman.net). For work wear, It's normally a 1.5” or 1.75” 5.11 Instructors/Riggers belt.

When I'm on duty, I carry all of the above, and some more “stuff”. Normally I'm wearing EMS Pants, BDU's, or 5.11's. My left thigh pocket carries a small handful (usually 5-6 pairs) of non-latex gloves. A pair of black Hatch “duty” gloves goes in my back left trouser pocket. These are good for light protection with vehicle rescues, as well as for various other protection. And trauma shears, if I carry them, go in my right thigh pocket or in a shears pocket on the outside of the right thigh.

Duty Keys – I also carry a separate set of duty keys when I'm working. They currently live on a locking carabiner clipped to my belt or belt loop at about 9-o'clock. These keys consist of: 4 different narc lock keys for my 3 ALS jobs, 4 different electronic fobs, 1 for each of the 3 jobs, and the 4^th for the volunteer squad and college doors. There's also an O2 wrench from www.wantynu.com. I've found that to be the most useful and durable O2 wrench ever. This key ring is a little big, but if I don't keep everything on one keyring, I loose pieces.

Patient paperwork, monitor strips, etc, often ends up in my shirt or jobshirt breast pockets.

And one of my stethoscopes round out the collection of “my stuff.” It doesn't normally live on my person, but I'll wear it during a call, and usually leave it in the truck.

Actually – one more thing. With all but the transport agency, I have some form of rescue PPE on the truck, at minimum, a bunker coat and helmet. In some cases, it's personally issued to me, in others I just grab a coat that fits and have it handy.

Now that I've said what I carry – let me comment on a few things I DON'T carry. I don't normally carry a penlight. There are several in the ambulance, and I'll use my pocket flashlight (or even my iPhone LED flashlight app) in a pinch. I don't carry a big 'ol “EMT Holster” on my belt. Everything I need is in a pocket... or I don't feel I need it. I don't use a radio holster, either. They have belt clips, so they get clipped to my belt when I'm out of the truck on a call. I don't wear a duty belt, either. Used to, and wore one for 5 years working security. Nowadays I keep my duty belt set up for an occasional armed security gig, including a holster.

Because someone else mentioned footwear – My primary boots are Haix Special Fighter US boots... They are NFPA certed for USAR and EMS. They are also the only boot I've found to fit my Size 16 Wide feet. Otherwise, I wear New Balance sneakers.

Anyway – That's a little long, but it's not only the WHAT of what I carry... but the WHY.