EMS Today

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Leveraging ePCR Data to Identify the Risk of Post-Traumatic Stress Disorder

This special episode of "Sacred Cows & Data Cubes" was recorded at the HCA (Hospital Corporation of America) EMS Kansas City Symposium in November 2021. It features an emotional anecdote of post-traumatic stress and recovery by Atchison County (KS) EMS captain and retired Fire Chief Rob Brader.

There is safety in numbers: both the math and statistics — and the herd, where one stay anonymous by choice without worry that exorcizing the demons of Mobile Medicine will result in persecution for the dark thoughts that inevitably spawn of this emotional work.  

“Let the numbers do the talking” is a core tenet of the approach first revealed to Jonathon Feit, chief executive of Beyond Lucid Technologies by Ron Nichols, director of Chambers County Emergency Medical Services in Texas. Ron uses a questionnaire to see sparks of mental health stress among his personnel in a manner similar to how others might identify infections (say, COVID-19) before they spiral out of control. His crew members have to write an ePCR after every call; and any member of the crew can catch a bad call. He recognized that this offers two opportunities for insight:

1. The ePCR not only offers details about what happened on the call, it also offers details about what the crew experiencedduring the call;

2. If every member of every crew completes a wellness survey after every call—or even after every call involving specific sentinel events—then the requirement to complete a mental wellness or trauma impact survey becomes, by definition, randomly distributed.  There is no longer a need for anyone to “step forward” because everyone has the same requirement. Anyone can catch an unfortunate call.

The result is compelling: The data in ePCRs become vital to crews’ mental wellness and health.  No longer are ePCRs mere busywork; no longer should they be despised.  Instead, they become something akin to a recurrent Rorschach test for each member of the crew, revealing how they are doing call-by-call, and in aggregate — inviting management to pay attention.  At the end of this discussion, we’ll ask: Can agencies really afford not to step in to help, especially amid a talent crunch?

If the analytics can be automated and tuned to examine ePCRs over time, then they can reveal who needs help without a crew member saying anything.  This empowers watchful management to step ahead of a health crisis in-the-making, bolstering agency morale and resiliency, satisfaction and safety.  ePCR data—maximized to their potential and strung together over time—therefore go beyond the collection of legal, billing, and NEMSIS data.  They become a tool to safeguard Mobile Medicine’s most precious resource: its professionals on the line.

Jimmy Pierson

How does a family-owned private ambulance company progress in a competitive 911 system? How can private EMS industry promote mental wellness, and what does a chief operating officer (COO) do to maintain his personal stress level during critical incidents? Hear from Jimmy Pierson of Medic Ambulance in Solano County, California.

Invisible Contracts & Provider Wellness: Leadership as Mobile Medicine Changes

No topic is off-limits in this multi-party podcast featuring three renowned leaders of Mobile Medicine -- Scott Moore (Moore EMS Consulting, LLC / Workforce Dynamics, Inc), Art Groux (Bennington Rescue Squad, Vermont) and Sean Kukauskas (Spaulding Rehabilitation Hospital EMS, Boston).

The discussion goes far beneath bumper-sticker messages, seeking root causes to develop practical solutions in highly impactful areas of Mobile Medical education, economics, provider mental health and wellness, and management of people and processes. We even discuss issues related to the churn of personnel in and out of the industry — and the associated shortage of qualified new people.  

All against the backdrop of the power of data to inform decision-making that elucidates the “invisible contracts” that operate all around us: assumptions made but infrequently clarified, which can lead to strained relationships in an industry that is built on trust. TRUST is perhaps more critical now than ever as Mobile Medicine seeks to navigate changes from all directions, forcing an evolution of the key skills required of both field crews and managers alike.   

LODDs, Vulnerability and Collaborative Teams

In the debut episode of the EMS Improv Podcast, Host Eric Chase sits down with Hanover (VA) Fire/EMS Chief Jethro Piland and Firefighter-Medic Craig Bodette. Piland shares his thoughts on LODDs, vulnerability and collaborative teams. Bodette, the department’s peer support coordinator, discusses how collaboration helps build a robust team and response during crisis.

License To Innovate: Part 1

Welcome to Real Life Rescues, a podcast that goes behind the scenes and takes an in-depth look into the operational and personal accounts of EMS first responders from Israel’s largest fully volunteer EMS provider, United Hatzalah. The podcast is hosted by EMT-P Dov Maisel and EMT-B Raphael Poch

The world of EMS in Israel has drastically changed in the past 20 years, from the innovation of the ambucycle, to pocket BVM’s, and the creation of an nationwide Uber-like network of first responders who provide emergency medical services free of charge to anyone, anywhere, United Hatzalah has been at the forefront of technological innovations that have been pushing the field of EMS forward throughout the 21st century. 

And the innovations continue. Due to the magnitude of instances where these devices and technologies have saved lives, this episode will be done in at least two parts. 

Topics for this episode include: Socially disruptive innovation and how we used it to lower response times, putting the community at the forefront of lifesaving and small scale innovations at the scene of an emergency.

In part 2 we will discuss our newer innovations from the past year including our new communications and phone technology, the Carbyne system, and co-sharing collapsible cars.

EMS, COVID-19, Staffing and Leadership with Mike McEvoy

This week, Eric, Bradley and David welcome Chief Mike McEvoy to the EMS Handoff Studios for a discussion about the EMS profession, COVID-19, staffing, leadership and a few other topics.

Chief Mike McEvoy is the EMS Coordinator for Saratoga County, New York, and a nurse clinician in the cardiothoracic surgical ICU at Albany Medical Center where he also chairs the hospital resuscitation committee and teaches critical care medicine. Mike is a paramedic supervisor for Clifton Park & Halfmoon Ambulance, a firefighter/paramedic and chief medical officer for West Crescent Fire Department. He is an EMS section board member for the International Association of Fire Chiefs (IAFC) and in his free time, an avid hiker and winter mountain climber. Mike has been a Nationally Registered paramedic since 1983.

Clinician Versus Technician – Part 1

As EMS transitions to a more proactive primary care role in the field, how are we in education creating the context needed for students to succeed? 

Greg Johnson joins us for this discussion. He is the EMT/AEMT Coordinator at Columbia State Community College where he leads a highly successful EMT and Advanced EMT program. He is well-versed in didactic, practical, and clinical development of the EMS student and provides a wealth of experience for this discussion. 

* Clinicians versus skill junkies

* Accreditation Critical Question

* Field Start

* Clinicians over Technicians

* Clinical Early Start

* Simulation Training

* Avocado Pit Poisoning

* Crawl- Walk- Run

* Into the Pass Rate Weeds

* Building the Autonomous Role in 15- Weeks

* Are Textbooks Needed?

* Paramilitary Style Approach

* Closing Words

Resources

ET3 Model

Don’t forget to go to our newly redesigned website at www.emshandoff.com.  Subscribe rate and review the EMS Today Podcast by JEMS and the EMS Handoff YouTube Channel.

…and don’t forget to go to www.thepursueco.com and find the great EMS Handoff Merchandise. 

Karen O‘Barr

What does an acute stress response look like from a critical incident? Should management have the responsibility of recognizing and intervening in their crew's mental health? Hear Karen O’Barr’s story of her mental growth after a severe traumatic incident as a paramedic.

The Rise of the MCI

Welcome to Real Life Rescues, a podcast that goes behind the scenes and takes an in-depth look into the operational and personal accounts of EMS first responders from Israel’s largest fully volunteer EMS provider United Hatzalah. The podcast is hosted by EMT-P (Paramedic) Dov Maisel and EMT-B (EMT) Raphael Poch.

Dov Maisel, in addition to being an innovator, volunteer and world-renowned expert in disaster management, has dedicated his life to saving the lives of others and is one of the founders of United Hatzalah of Israel. Formerly an army medic in the Israeli Defense Forces, Dov served as a combat paramedic in four different wars. He has worked as an EMT, dispatcher, ambulance driver and paramedic. In addition to his duties as one of the leading EMS first responders for United Hatzalah, Dov now serves as the organization’s vice president of operations. He invented what is now used as United Hatzalah’s uber-like GPS -based dispatch system which locates and sends the closest EMT to the medical emergency. Dov lead United Hatzalah’s international relief missions in Haiti, Nepal, Houston and Florida, following the devastating hurricanes of Harvey and Irma, and most recently to Surfside, Florida, following the Champlain Towers collapse.  

Raphael Poch, in addition to being one of the organization’s 6,000 volunteer EMTs, is a member of the organization’s ambucycle unit, Psychotrauma and Crisis Response Unit, and serves as the Gush Etzion regional coordinator of the organization’s Ten Kavod project, wherein EMTs visit elderly people in their communities once a week to provide wellness checks and social visits to alleviate loneliness.

In today’s episode, Dov and Raphael will discuss the organization’s recent operational agenda to implement mass-casualty incident training to all of the volunteers throughout the country in response to the three large-scale MCI’s that took place in Israel this year including the largest civilian tragedy in the history of the country which occurred in Meron on April 30th, 2021. They will take an in-depth look into what parts of an MCI lead to the most confusion and difficulty, how the organization trains to become better at dealing with those critical issues. Later in the episode, they give an in-depth first-hand account of what took place during the Meron MCI and how it was different from pretty much every other MCI out there.

Puff, Puff, Pass

On this week’s episode of the EMS Handoff, Eric, Bradley and David take on a conversation about the changing status and laws around the country on the use of marijuana, hemp and CBD products. As the access to some of the derivatives become more readily available, what are the implications of the EMS practitioner in regards to personal use, and what expectations you have when it comes to being drug tested?

Furthermore, we get into possible cases you may see when it comes to the patients we see in the field. 

* Legal System at Play

* State and Federal Oversight

* THC and CBD Metabolites

* Drug Testing

* Inner cannabinoid system

* Stress and Marijuana

* Hyperemesis Case Study

* Cannabis induced pneumomediastinum

* Final Notes

Resources

Cannabinoid Hyperemsis Syndrome

Is CBD Addictive?

Pneumomediastinum in marijuana users: a retrospective review of 14 cases

Don’t forget to go to our newly redesigned website at www.emshandoff.com.  Subscribe rate and review the EMS Today Podcast by JEMS and the EMS Handoff YouTube Channel.

Don’t forget to go to www.thepursueco.com and find the great EMS Handoff merchandise.