Tuesday March 31st 2015

Posts Tagged ‘ambulance’

Not IF but WHEN? Response to violence Episode 42

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It seemed that the world came to a stop when 26 people, mostly children, were shot dead at the Sandy Hook Elementary School in Newtown, Connecticut. Ten days later the Nation was shocked again when 4 firefighters were shot, 2 killed, responding to a house fire set by a deranged gunman lying in wait.

Although mass shootings and the targeting of responders are not unheard of, the timing of those 2 events along with others within the past couple of years have really brought safety of the public and responders to the forefront of discussion.

Join Rick Russotti, Eric Dickinson, Eric Richenbach (EJR), Dan McGuire, and Kyle David Bates as they discuss violence against responders, response to known and unknown events, situational awareness, and the psychological impacts that events such as these have upon responders.

This Episode is dedicated to the victims of these 2 horrible tragedies:

West Webster Fire Department

Tomasz Kaczowka Tomasz Kaczowka

Michael J. “Chip” Chiapperini Michael J. “Chip” Chiapperini

 

Sandy Hook Elementary School

Learn the names of the victims, forget the name of the shooter.

 

LEARNING OBJECTIVES

At the completion of this podcast, the listener will be able to:

  1. Identify and discuss recent mass shootings and violence against responders;
  2. Discuss the role of the media;
  3. Discuss safety measures and techniques when responding to known and unknown events of violence;
  4. Discuss the psychological impact of events as such upon the industry.

SAY WHAT?! Communications. Episode 41

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Live! From Dufferin County EM Conference in Orangeville, Ontario, Cananda we address communications, technology, and how Steve is old. 

Join Kyle David Bates, Steve Murphy, Alex Buchanan, and Doug Allport as they discuss some new technologies in the area of communications. 

Masas.ca 

The 4 ‘Ws’ of Pain Management: a discussion – Episode 40

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Why do we manage pain?

What do we use to manage pain?

When should pain be managed?

Who gets pharmaceutical pain management?

Join Brad Buck, who through an unfortunate Skyping accident we lost, Tim Noonan, Wilma Vinton, Roland Rolfsen, Kyle David Bates, and Dr. Laurie Roming (the good twin) as they have a lively discussion addressing the 4 ‘Ws’ of pain management.

Learning Objectives

The listener will be able to:

  1. Discuss why pain management is important.
  2. Identify different methods of managing pain.
  3. Argue for the management of pain based-upon the patient.
  4. Identify and discuss possible considerations in the delivery of pharmaceutical pain management.

References

Truth Hurts 

Intranasal.net

Fentanyl in the out-of-hospital setting: variables associated with hypotension and hypoxemia.

 

EMS Safety Foundation @ RettMobil 2012, Episode 39

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This month we make a return trip to Fulda, Germany with Dr. Nadine Levick and the EMS Safety Foundation. Join Kyle David Bates, Chris Fitzgerald, Dr. Levick, Jim Foster, and Neil Blackington as they discuss industry safety from a world view but with RettMobil as the foundation. 

Click below to learn more about each!

 

 

Trauma Criteria: preventative medicine? Episode 37

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Over-triage to trauma centers? Poor EMT skills? Paramedics in the way? Care inhibited by the QA/QI process? Anatomicological?! These are some of the topics discussed on this episode of the First Few Moments.

Join Kyle David Bates, Tim Noonan, and Steve Murphy as they talk with Patrick Lickiss about a recent blog post he wrote discussing if Pre-Hospital Trauma Triage are Effective.

Objectives

At the completion of the podcast, the listener will be able to:

  1. Identify problems with current trauma triage criteria;
  2. Identify possible practices that may prevent proper care;
  3. Give solutions to proper triage and care.

 

References

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6101a1.htm?s_cid=rr6101a1_w

http://www.cdc.gov/fieldtriage/pdf/DecisionScheme_Poster_a.pdf

http://510medic.com/2012/02/08/are-prehospital-trauma-triage-criteria-effective/

http://burnedoutmedic.com/2012/02/its-the-damage-stupid/#.TznUWlwS0uc

 

A Change of the Dogma: If it helps only one? Episode 36

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**This podcast is not meant to change YOUR current practice, only your medical director can do that! …but nothing says you can’t try to convince them ;) – KDB**

Whoa! Look at that mechanism of Injury! Hope they C-spined her!

A common EMS practice that goes back to the days of Johnny and Roy is that of spinal immobilization…er…ah…spinal motion restriction I am now told. However this skill, which we have spent countless hours learning and practicing is starting to fall out of favor? Why is that? Well, simply put the research says that a) it may not be effective and b) it may actually be harmful. Get that? Harmful!

Join Dr. Laurie Romig, Tim Noonan, Russell Stine, Bob Lutz, Kyle David Bates, and Kelly Grayson as they reference an article written by Kelly regarding spinal immob…oops, spinal motion restriction.

Learning Objectives for this episode:

The Listener will be able to:

  • Discuss the reasonings behind the changes to spinal immobilization

 

 

A Zombie Apocalypse! Episode 34

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No Really! Would you be able to handle 240 zombies at a football stadium? Well Delaware County, Ohio found out this past October when they held a disaster drill in which people were turned into, well, um…zombies! But it is not completely their fault…the CDC started it all.

We also discuss a more traditional disaster drill but on a geographically larger scale as well as a one that deals with public preparedness. Which is better? Which is more effective? Which is more fun?

Join Assistant Chief Mike Schuiling from Delaware County EMS, Brain Galligher of Delaware County Office of Homeland Security and Emergency Management, Steve Murphy, Jeremiah Bush, and Kyle David Bates as we talk about disaster preparedness evaluation.

That Doesn’t Happen Here: Oslo Norway Episode 33

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On July 22, 2011 life in Norway changed forever when a bomb rocked Oslo killing 8 and then  followed by a mass shooting on the island of Utøya in Tyrifjorden, Buskerud killing 69 attendees, children.

Join Steve Murphy, Tim Noonan, William Random ward, Chris Montera, and Kyle David Bates as they discuss this event with Ronald Rolfsen from Oslo University Hospital in Norway.

Learning Objectives

At the completion of the podcast the listener will be able to:

  1. Discuss response to a potential terrorist attack.
  2. Discuss safety concerns when responding to a potential terrorist attack.

When We DON’T Go: Live from EMS World Expo 2011, Epiode 32

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The First Few Moments podcast did record a show at EMS World Expo 2011 in Las Vegas, Nevada despite the fact that FFM host Kyle David Bates was home helping his wife with their new baby. Guest Host Scott Kier, aka MedicSBK on twitter and elsewhere, steps in and takes over for the day. He is joined by Natalie Quebodeaux (host of the GenMed Show).

The discussion kicks off with a chat with Sarah Wilson from episode sponsors EMS1.com. Sarah is the Grants Manager at EMSGrantsHelp.com and talks with Scott and Natalie about what services they provide and the availability of grants for EMS services and organizations. Later, Sam Bradley, federal disaster preparedness educator joins the show to talk about disaster preparedness and training for EMS services, agencies and individual EMTs and paramedics.

All of the ProMed Network podcast episodes on Day 2 at EMS World Expo 2011 were produced from the Medtronic Foundation Heart Rescue Project sponsored podcast studio. You can find more recorded coverage from the event here at the ProMedNetwork.com site and at MedicCast.tv.




Will Twitter Replace the Siren? Episode 31

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In this episode we discuss one municipality’s attempt to decrease intersection collisions by using various technologies. We also discuss, again, driving as there has been continued news feeds of horrible crashes. Finally we end the episode talking engineering controls to improve ambulance safety.

Join Robert Raheb, Steve Murphy, William Random Ward, and Kyle David Bates as they discuss these various topics.

This episode’s curriculum

The listener will be able to:

  1. Discuss and debate whether if technology can help make EV operation  safer;
  2. Identify and discuss engineering controls that can make operating in an ambulance safer;

References

Helmet use by EMS

High-Tech response

NIOSH Ambulance Safety Bulletin

The Rumbler

Slide, Don’t Lift: Episode 30

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Bending, lifting, twisting and essentially turning yourself into a pretzel in a car is how we often work at the scene of an MVC. However are we destined to “just deal with it” or are there some adjustments we can do to make moving and extricating patients safer for us?

Join Scott Kier, Kyle David Bates, and Jeremiah Bush as they discuss this topic with our Australian friend and renowned ergonomist Chris Fitzgerald.

Episode Curriculum
The listener will be able to:

  1. Define ergonomics;
  2. Appreciate the importance of proper body mechanics;
  3. Discuss how typical operations at the scene of a motor vehicle crash can increase your chances of injuries;
  4. Discuss engineering controls and how to alter their habits to work safer.

References

Lifting cushions

Curved transfer board

More lifting cushions

KFRS casualty extrication highlights

 

Check Your Pee! Episode 29

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Oftentimes we talk about provider rehabilitation only during times of extended operations such as with structure fires. However with the arrival of summer, working on the hot blacktop at the scene of an MVC or during a cardiac arrest in a hot environment can quickly lead to heat-related illness and/or injury.

Join Mike Mcevoy, Russell Stine, Jeremiah Bush, Dr. Jeff Myers,  Steve Murphy, and Kyle David Bates as they discuss essentially how not to end up on the business end of an IV catheter while working at any scene during warm weather.

JEMS article: More Than Just a Standard: NFPA 1584 defines the rehab process

EMS 1: Mike McEvoy: EMS vitals during firefighter rehab

This week’s objectives the listener will be able to:

  1. Define REHABilitation and PREHABilitation;
  2. Defend the importance of Rehab and Prehab;
  3. Perform a self-hydration assessment and care;
  4. Identify situations when rehabilitation may be necessary.

Who is TIMA? Episode 28

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Roadway safety isn’t a new topic for emergency responders. People dying, being injured, or damage to vehicles is not new either. So how come we are kicking and screaming when it comes to making our roadway scene operations safe? Why do we only address roadway safety on large highways and during motor vehicle crashes? Why don’t we address roadway safety more often on residential streets or during medical operations when the big blocker truck is not there?

Join Tim Noonan, Brad Buck, Kyle David Bates, and Scott Kier as we discuss these topics.

LEARNING OBJECTIVES

  1. The listener will be able to argue the need for roadway safety.
  2. The listener will be able to identify when to employ roadway safety techniques.
  3. The listener will be able to discuss and employ engineering controls to make operations on the roadway safer.
  4. The listener will be able to define and discuss the importance of situational awareness while operating on the roadway.

RettMobil Day 3: Ergonomics, Episode 26

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This week we return to RettMobil in Fulda, Germany as the guest of Dr. Nadine Levick who is the founder of the EMS Safety Foundation, to discuss ergonomics.

We sit down with Chris Fitzgerald, the EMS Safety Foundation’s world-leading ergonomist, and well as Andrew and Daniel Ronchi of Pro-Active Medical to talk about the research and data gathering that they are doing to help make EMS safer. We also look at some best practices in terms of patient transfer that are quite common abroad but have yet to catch on in the States.

Also, click on the EMS Safety Foundation logo above and it will take you to their website where you can access the fascinating pre-recorded webinars, including one that shows the work Chris, Andrew, and Dan did while at the EMS Safety Foundation’s booth.

RettMobil Day 2: Ambulance Design Ep 25

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First Few Moments was honored to be the guest participant in the EMS Safety Foundation’s 2011 Rettmobil Delegation to Fulda Germany lead by Dr. Nadine Levick, who established the Foundation.

This is the first episode that we actually broadcasted from the show floor of RettMobil where Kyle David Bates gives a brief overview of the show and tries to talk with some responders that, well, do not speak English. Then join him with Jonas Liden, an industrial designer from Sweeden, Gary DeCosse of Crestline, USA, and Ronald Rolfsen from Oslo University Hospital in Norway as they compare and contrast European ambulance design against those of North America. Dr. Nadine Levick then steps in at the end to thank Gary DeCosse and Crestline Coach, LTD for being a Corporate Partner.

RettMobil Day 1 Episode 24

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Fulda, located towards the middle of Germany, is an old, small town where for the 11th year responders involved in mobile medical care converge. This year there is an expected attendance of over 30,000 people from across Europe to look at the latest in mobile rescue, vehicles (air and ground), extrication equipment, and even a speed track.

This year we are honored to be asked to join the EMS Safety Foundation delegation led by Dr. Nadine Levick, a leader in EMS safety research and information transfer. Join Kyle David Bates as he sits down with Dr. Levick to talk about the Foundation as well as Rettmobil.

“Ya got what ya got!” Rural Disaster Management Ep 23

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Once again we are at the 17th Annual Interior Region EMS Council Symposium in Fairbanks, Alaska where we talk with Yvonne Howard from Eagle EMS about 2 major disasters in her area.

Imagine being one of a few responders caring for numerous injured passengers of a tour bus that had crashed. Now imagine being with them alone for hours with only 1 ambulance and its supplies. This is first topic we discuss.

The second disaster Yvonne tells a heart wrenching tale of how Eagle was essentially wiped out by a solid tsunami of ice in May of 2009 and how they have yet to recover.

Join Wilma Vinton, Steve Murphy, and Kyle David Bates as they talk with Yvonne about how small rural communities deal with such disasters.

Our podcast also opens with the winner of the 1st Vendor Sponsorship Drawing, Clint Bodily of Laerdal.

 

What do you mean ‘Load & Go’? Go Where? Episode 22

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Join us again in Alaska as Steve Murphy and Kyle David Bates talk with Rusty Lasell from Tri-Valley Fire Department in Healy, AK about wildland fires, earthquakes, and response to other such disasters in a rural area. We also discuss tourist season, 6-8 hour ambulance runs and how that impacts volunteerism.

Rural Alaska Healthcare Episode 21

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If you think that driving an hour with a patient means that you are working within a rural community you have yet to visit Alaska. This week we are at the 17th Annual Interior Region EMS Council Symposium in Fairbanks, Alaska.

Join Steve Murphy, David Akin, Wilma Vinton, and Kyle David Bates as we discuss response in this rural area, the health aide system, and the development of a system.

 

Why We Do What We Do: a view from the ROUGE Medic Episode 20

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Ok, so this is a little late getting out but it is quite worth it!

This week’s episode was recorded LIVE at EMS Today 2011 in Baltimore, Maryland. Scott Keir, Dr. Jeff Myers, Tim Noonan, and Robert Rehab all stop by to discuss  why we do what we do or what we don’t do. We talk about justifying our treatment, contacting and utilizing medical consultation, and conclude with our ever so popular topic of driving safety and training.

…and yes, we did spell it R-O-U-G-E for a reason….love ya Tim!

My Wife is the IC! “The Incident Coordination System” Episode 19

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This week we address the Incident Command…no Management…no Comm….oh I don’t know, that system we establish when at the scene of a disaster. Should we go away from the terms management or command to one of coordination? Is all that NIMS training worth it?

Join Brad Buck, Russell Stine, Scott Kier, Robert Lutz, Dr. Jeff Myers, Steve Murphy, Rick Russotti, and Kyle David Bates as they delve into and dissect the use of ICS/IMS.

University Disaster Research Center

N.Y. Trooper Cites Fire Chief for Blocking Highway

Some things to think about… Episode 18

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This week as we discuss how an Oregon hospital refused to care for a patient in cardiac arrest in their very own parking lot and how the first responders dealt with it.

We also discuss a recent fatal ambulance crash in Brighton, NY and why we continue to crash our units. We expound on this topic through discussing crash prevention, driver training, and other methods we can do to help reduce these libelous actions.

Join Russell Stine, Scott Kier, Kyle David Bates, Justin Schorr, and Robert Raheb from FAAC as we discuss these issues.

Justin Schorr is driving distracted!

To Cut or Not to Cut? Episode 17

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It sometimes seems that we become preoccupied with our tools when trying to get someone out of a vehicle. “Cut here…no here…get the spreader…let’s try…” are all phrases that are often heard while “extricating” a patient.

But what determines the extent of extrication that is required and what techniques should be used? I think that depends upon is the person entrapped or simply just confined? Either way, should we consider an alternative route of removal? Should we consider having the patient just simply step out of the car?

Join JD Graziano of the EMS Standing Orders podcast, Wilma Vinton, Russell Stine, Andrew Rossow, Kyle David Bates, and Rick Russotti as they delve into this topic and stress that communication is the key.

This episode is dedicated to my paramedic preceptor, Mark Falkenhan, who was killed in the LOD fighting a fire on January 19, 2011. Our hearts and prayers go out to Mark’s family and all of my friends and colleagues in Baltimore County Fire.


Our sponsor for this episode is:

The Mitigation Journal podcast: Unique Perspectives on Civil Preparedness and Emergency Response for your Ears


Candy Cane BLEVE w/ Gingerbreadization – Episode 15

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How would you deal with an MVC of a high-profile bowl-full-of-jelly bariatric patient involving multiple small patients as well as nine caribou-type animals?

Using some tongue-in-cheek we look at the role of the Public Information Officer (PIO) in regards to media relations, extrication of the bariatric patient, arriving safely, establishing a safe work zone, alternate fuel vehicles, START triage, and briefly discuss dealing with injured animals. We also look at the hazardous material Christmas Magic, reindeer droppings, looting of presents, and the defibrillation of Rudolph.

So from Rick Russotti, Robert Raheb, Allen Bubel, Kyle David Bates, and Chris Kaiser we wish you a safe and joyous Holiday Season. Merry Christmas!

On a serious, sad note we dedicate this episode to EMT Laura Elizabeth Pullam, 29, of Lowndesboro, Alabama who died after being struck by a passing car on December 15, 2010. Our thoughts and prayers go out to her family.

Opening song, “Santas too Drunk to Drive” by The Hot Rods and found on Music Alley.

Let’s Get A Head! Episode 14

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Head injuries are common injuries that we encounter at the scene of an MVC. Rapid assessment and proper management may make a difference in the injured’s prognosis.

Join Scott Kier, Mat Fults, Steve Murphy, Kyle David Bates, and Dr. Jeff Myers as they put their heads together to discuss this topic.

Brain Trauma Foundation

Mini-Mental State Exam (Wiki)

Folstein Mini-Mental State Exam

Keep Your Toque On! Episode 13

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…and give one to your patient while you’re at it!

With the colder weather moving in we address the environmental factors that we, and our patients, will face at the scene of an MVC. In this episode we discuss how the cold effects responders and patients as well as how to help delay the onset of hypothermia. Our panel gives suggestions such as using hats for triage and parachutes to create a warmer environment.

Join Steve Murphy, Jeremiah Bush, Wilma Vinton (our REALLY cold weather expert), Kyle David Bates, and making his debut on the FFM podcast Matt Fults as we discuss and give insight into cold-weather response.

An email that Wilma received regarding the heaters that they use:

We have 2 different Fresh air heaters.  We have a 500,000BTU Frost Fighter Heater on Squad 62.  It uses a 4000 watt Generator to run the blower and controls.  It burns diesel fuel which is contained in an auxiliary tank.  The second heater is mounted on E-66.  It is a Herman Nelson 500,000BTU heater and is directly plumbed to the truck’s fuel tank.  It uses electricity supplied by the trucks onboard diesel generator.  We have both 12″ and 6″ inch flexible heater hose and one manifold to attach additional lines.

New Frost Fighter heater’s cost around $5300.00.  A compliment of hoses will run between 500 and 700 dollars depending on sizes.

Let me know if there is anything else you need to know.


Captain Andrew Rossow

Steese Fire Department
Fairbanks, Alaska

Some resources that we spoke of:

Let’s Sort Things Out! Episode 12

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Ever look at your partner at the scene of a motor vehicle crash and say, “Well…who goes first? When you DID make a decision what did you use? Your gut instincts or any one of the multiple triage methods out there? Did you use START, Sacco, SALT, SMART, or maybe a mixutre of them all.

Join Rick Russotti, Chris Kaiser, Kyle David Bates as they get in-depth about triage with Dr. Lou Romig, the developer of the JumpSTART triage method.

Mass-Casualty Triage: Time for an Evidence- Based Approach

Abstract: Comparative analysis of multiple-casualty incident triage algorithms.

Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline

Is Assessment Dead? LIVE! at EMS Expo Episode 10

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Watch the video of our podcast from Dallas. Thanks to Jamie Davis, the podmedic, over at the ProMed Network

The question that we pose this week is, “Is patient assessment dead?” Have we become robots, applying treatment and VOMIT to our patients without really ever touching them? Have we become to dependent upon technology?

Join us this week as we discuss this topic in front of a live audience while at EMS Expo in Dallas, Texas on Thursday, September 30, 2010. Our panel consisted of Brad Buck, Scott Kier, Jason Thompson from Rapid Deployment Products, Kyle David Bates, and Rick Kendrick.

Yes, the Rick Kendrick! The inventor of the K.E.D. joins us the second half of the podcast to give us his insights into the decline in patient assessment AND to answer some questions that people have about his invention.

EMS Expo Bonus Material

EMS Inventor Rick Kendrick Demonstrates the K.O.D.E 2

Kyle discusses EMS Expo with Jamie Davis and Chris Montera

And….if you stay tuned until after the closing theme you can catch some of our opening outtakes where we almost lose the camera AND rub in the fact that Team FFM beat Team EMS Garage in darts!

Our EMS Expo podcast was sponsored by

Mechanism of Injury or Idiocy? Episode 9

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There seems to be a trend to transport patients to the trauma center, possibly by air, based solely upon the mechanism of injury. The question that we address is do we put too much into the MOI? Should we be looking more at the patient? What about the ‘Golden Hour’ dogma?

Join Dr. Jeff Myers, Rick Russotti, Scott Kier, Tim Noonan, and Kyle David Bates as they discuss the subject of mechanism of injury.

Expect the Unexpected! Episode 8

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The response to an explosion can be difficult, but have it at an airport and across the street from your EOC can really make things interesting. We use this case to delve into scene management and hazardous materials.

Now the response to this is pretty obvious, but what about the call for the guy sleeping in his car? When you arrive he appears unconscious. Is it a heart attack, hypoglycemia, or stroke? Do you throw open the door and begin assessing? 99 times out of 100 you’ll do this and be OK, but what if his unconsciousness is really death? What if his method of killing himself was a chemical suicide? These are growing in prevalence and by quickly trying to get in there you may actually be putting yourself in danger.

We finally conclude our podcast by expecting the unexpected. Was the MVC a result of poor driving or was the patient overcome as the result of chemicals? If your first EMT drops, do you send in more?

Join Wilma Vinton, Brad Buck, Steve Murphy, Charlotte Crawford, Tim Loucks, David Rockney, Kyle David Bates, with Rick Russotti from the Mitigation Journal Co-Hosting!

Sad to report but a veteran Connecticut State Trooper,  Trooper First Class Kenneth Hall, was killed in I-91 accident on September 2, 2010.

On Tuesday, August 31, 2010 Air Evac 30 out of Arkansas crashed killing the 3 crew members on board. Pilot Ken Robertson, flight paramedic Gayla Gregory and flight nurse Kenneth Meyer Jr. were all killed.

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