Howdy Everyone!! It’s Ckemtp, your friendly neighborhood EMS and Fire blogger with a few things I’d like to bring to your attention. I’d like to talk to you today about politicians. Not the politicians that are doing such a great job at managing our collective money on the national level… I want to talk to you today about the local ones, the ones who do the important work of making sure our traffic lights aren’t burnt out, that our roads are pot-hole free, and that our sewer systems don’t back up and discharge raw sewage into lakes and rivers and stuff.

Specifically, I’d like to talk about Local Politicians and public art.

My favorite writer, the legendary Humorist Mr. Dave Barry, wrote a piece about public art a few years back that you just have to read before continuing on with this post. It’s actually one of many of his articles that include things about public art, which he defines as “Art that is purchased by experts who are not spending their own personal money” it also involves the phrase “a naked man the size of an oil derrick” and has references to nuclear weapons and alcohol. I love Dave Barry, I really do.

Read this: “Does Public Art Make Sense” – Then come back once you stop ROFL’ing 

This is "Art" I think... Oh I know! It's a bus stop

Then, g’head and read THIS ARTICLE from Michigan Capitol Confidential which talks about the REALLY SMART city of Ann Arbor, Michigan… which is planning an $850,000 piece of public art. It’s really interesting to me that they’re planning this… and I really hope it isn’t made of flammable material because the city is “Facing a multimillion dollar budget deficit” and is planning on laying off firefighters to handle the budget crisis.

Here’s that article again: http://www.michigancapitolconfidential.com/13219

Yes, Ann Arbor, MI, the REALLY SMART city that it is, is laying off firefighters while spending $850,000 (That’s EIGHT HUNDRED FIFTY THOUSAND DOLLARS) on a “three piece public fountain”.

Oh, right… if it’s a fountain, it probably won’t burn down. That makes sense. Of course it might get filled with trash, since they’re laying off the city’s “Solid Waste Coordinator”. Y’know… the guy who oversees the trash pickup for the city. On the other hand though, they are hiring an “Art Coordinator” to, I don’t know… look at the art maybe? Maybe he’ll pick up the trash from the fountain.

Taxpayers, I’m talking to you here. Inefficiencies and, in this case, abject stupidity in local governments are killing us. If I was having trouble keeping up with the maintenance and mortgage in my own house, the first thing that I would do would not be to buy new paintings to hang on the walls. I certainly wouldn’t buy paintings at the expense of paying for trash pick-up, sewer service, or portable fire extinguishers. I think that I would pay for necessities first and niceties second. Responsible people take care of the whole Maslow’s Hierarchy of Needs thing; Food, clothing, and Shelter first and buy pretty things after that. You do the things you HAVE to do well before the things you’d like to do.

At least responsible, SMART people do that… and apparently that’s not the kind of people that the voters in Ann Arbor, MI think would make good city council members.

Or do they?

Maybe they can call this "Art"

I’d like to ask a question to all of you medical-type folks out there, and for this one I’d like other healthcare professionals to weigh in, not just EMS. Of course, Paramedics and EMTs are encouraged to answer this question, but so are Physicians and Nurses (RN and LPNs), as well as CNAs and Techs. 

A conversation I had on Twitter regarding administration of 10% Dextrose IV (D-10) as opposed to 50% Dextrose IV (D-50) for hypoglycemic ambulance patients has me wondering something about how we paramedics can create major savings and improve patient care in a short amount of time. We need to look for more “Low Hanging Fruit”.

It is common practice for known diabetic patients presenting with low blood sugar (hypoglycemia) to receive a treatment with IV D-50, IM Glucagon, oral Glucose, or even with the “Kaiser Cocktail” and then sign off with an AMA refusal. The patients are encouraged to eat something containing protein and complex carbohydrates and are usually left in the care of one of their family members and/or friends who can watch them for a while and make sure they’re ok.

I’d say that calls like this make up a fairly large percentage of all calls for an ambulance. While I have no statistics to back me up, I would guess that it could be something like 5% or better. This complaint and resultant treatment pathway is something I do quite frequently in my own practice. Judging from my own experience, I would say it happens quite frequently in most other paramedics’ practices as well.

The question about administering D-10, as brought up by my twitter peep @un_ojo, is if all patients getting treatment with D-10 as opposed to D-50 should be transported to an Emergency Room. My answer was that I believe a 100% transport policy in this case would result in a lot of people being transported to an ER when they probably didn’t really need to be. This would result in a large population of non-emergent ambulance patients going to the ER who in the past would have been “treated and released” (at least under the guise of an AMA refusal) by EMS crews.

And that got me thinking about this question:

If paramedics did not currently have the means to treat hypoglycemia and every one of those patients were being transported to the ER, how much of a burden on the emergency healthcare system would be removed simply by giving paramedics D-50? Probably quite a bit, right?

What other common medical cases would be as appropriate for field “treat and release” (or “Treat and AMA”) care by EMS? If we save a few hundred trips to the ER by being able to sweeten-up and then release common hypoglycemics, what other conditions might we be doing the same for as safely and effectively?

Would this require some easily attainable training? What about new medications and/or equipment?

I look at this as the “Low Hanging Fruit” if you will, of EMS 2.0, and also of healthcare reform. I am a proponent of EMS crews handling more primary care duties, or failing that, of at least having more options in regards to treatment pathways.

That’s what I’m looking for here, folks. What could we do within six months that would make a big impact?

Please discuss in the comments section, and feel free to shoot me an e-mail at ProEMS1@yahoo.com. You can also weigh in on the LUTL Facebook page if you’d like.

Also, would you do me a favor and invite some of the other healthcare people to the party? I’d love to get some of their opinions on this.

The title says it all… MAN have I been a busy guy. It’s summer and the boy is just fun as heck. We’ve been fishin’ and swimmin’ and boatin’ and doing the things that a father and son are supposed to do in the summer time. Plus, as is my style, I’m working around 70-80 hours per week and I’m trying to cram in as much quality family-man time as I can.

Soooo… my posting frequency??? Yea, that’s suffered a bit. I’ll get back to it. I’ve just been busy. Plus, MARDEK3 came out and I’m such a nerd

So, howsabout a rerun? I don’t want to change the permalink, but I think this is a good post.

http://lifeunderthelights.com/2009/11/the-day-i-didnt-die-firefighter-close-calls/
Be back soon, y’all.

By now you’ve all heard of the flap that is happening in Mass. regarding the 200 or so EMTs and Paramedics that had their licenses suspended or revoked for running a non-existent training program or for falsely representing that they attended non-existent training classes. If you haven’t heard about it by now, you’re probably not following EMS news as much as you should.

Here is one of the articles on the subject from JEMS.com

The issue has been discussed quite a bit around the EMS blogosphere. Some big name bloggers have written on it, and I even discussed it a little bit on the EMS Educast the other day.

Here’s TOTWTYTR’s take on this: I’m Not Very Sympathetic

And here’s Rogue Medic’s take on it: (this is a part-2 that reiterates the first)

Here’s the episode of the EMS Educast where we discussed the issue briefly

Other than for speaking about the issue briefly, I’ve been avoiding writing on it. My job is usually to report positive things that are happening in the EMS world and this is definitely not a positive thing. In fact, it’s a disgrace to us all. Rogue Medic has it right when he asks the question “Why do we Encourage such apathy in EMS?”

And that’s what this is. It’s not just that it’s apathy for the boring destruction of brain cells that we call “Continuing Education” in most areas of EMS, it’s the apathy for the whole process. The apathy where we as a profession have let the standards get to this point.

I mean, really. How many of you feel that the continuing education you receive is anything more than something you have to do in order to keep your license up? How many of you feel that your regularly scheduled, mandatory, continuing education classes are of any quality? How many of you feel like they’re actually doing anything good for you?

And that’s the system in which we function. TOTWTYTR made the statement that he sits through boring traning classes all the time because those are the hoops he has to jump through in order to maintain his licensure. I do too, of course. I sit through probably as many or even more classes than anyone reading this article because I am a practicing paramedic with National Registry and licensure in three states. Sometimes the training from one state carries over into the next, and sometimes it doesn’t. At any rate, I get to listen to unmotivated speakers read flat material whilst sitting in an uncomfortable chair on a very regular basis. We all do.

However, I feel that I keep up my continuing education quite well on my own through other means such as extensive self study and non-credit medical education. Keeping my professional skills sharp is very important for me because not only am I proud of my professional skills, but I am well aware of the fact that the quality of my skills translates into the quality of life for my patients. If I keep myself sharp, I’m a better paramedic. If I let them get dull, well then I’m an apathetic paramedic who isn’t doing my duty. Duty is important to me. So are things like Pride, Professionalism, and Honor. In fact, those three words are more than just the slogan for my blog, they are how I think that I and other EMS professionals should live their lives and careers.

Others have been quick to demonize the 200 suspended EMTs. Others have been quick to defend them. The ones defending them have said that these people are apt to lose their incomes, their livelihoods, and that the punishment is unfair. Well, for that part I disagree. The punishment is indeed fair. You could have killed someone by being untrained oafs with lackluster skills. You never proved you were otherwise. However, if you were to ask me if I thought that a state EMS agency – ANY state EMS agency – was competent to manage such a program, I would laugh at you.  Every state has made an attempt to regulate continuing education and I agree that there is a good reason for them to do so. I would also agree that the prospect of regulating a group of EMS people in their continuing education efforts is a daunting task. I would say that the perfect system has yet to be developed and that a good number of the 200 were simply “playing the game” and thought that since their states EMS continuing educational system was a joke that they could make a joke out of it as well.

Here’s the most biting apathy of all to me. If you believe that a system that you work under is a joke. If you believe that there is a better way to do something. If you believe that what you’re made to do is pointless and obsolete… then why the heck haven’t you done anything about it?

I’d like you to look at this issue from this perspective, folks. Sure, not everyone in that group of 200 were caring, competent professionals. I’m sure some of them were jackasses. (And yes, I said “Jackasses). However, I’m also sure that there is a percentage of them in that group that sincerely care about being the best they can be in EMS and they simply got caught up in the mob mentality. I’m sure that some of them had just given up. I’m sure some of them were good people who just became apathetic.

I hate apathy.

If what, say 50% of that group were of the caring kind, that leaves 100 people who thought that the system was broken. Did it not occur to any of those 100 people to try and change it? Did they not try and band together to improve the system? Could one person do it? Could 100 people do it?

If we are to be regulated and controlled by obsolete and ineffective bureaucratic systems, then it is our duty to rise up and change things. Sure, that sounds melodramatic… but how many times have you thought that your state regulations were stupid. One of the defining aspects of a Profession is Self-Regulation. Look at your states “Bar Association” for Lawyers, or the states “Medical Association” for physicians.

Is there any state out there that has a “Paramedic’s Association” that has any teeth to it?

No continuing education system or relicensure processes is even close to perfect. That’s because of a few reasons, not the least of which is because the government is the one running it. The other reason could be because it isn’t being policed by the paramedics who care about it the most.

I’ve said it before, I’ll say it again. It’s time for us to take ownership of our profession. Stand up and make this the profession it deserves to be. Stamp out apathy and band together to let your voices be heard. If you don’t start the process of meaningful change, who do you expect to do so?

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For more positive discussion on EMS, check out the comments section in “Negativity? You Won’t Find That Here” or for a description of two real-world moral and ethical dilemmas in EMS, check out “Two Cases, one letter. From one paramedic’s struggles, change can come”

Die hard Sporksters, that's who

However, I digress. What I’m trying to say is that the spork, the half-breed malformation of a spoon and a fork, has its place as a substitute for either when it is not economical to provide both. Like its lesser known brother the “knork”, it is a natural idea and a somewhat cool concept. However, there is a very clear reason that the spoon and the fork are separate utensils. There are specific purposes for the design of the spoon and the fork and good reason to have separate tools that are suited to the kind of tasks that they’re used for. The spork is the watered down version of both. It can somewhat perform the tasks of its parents, but not well. It is the “Jack of all trades, Master of none” if you will.

And that is why I’m writing about our humble friend the Spork in my usual rotation of EMS topics. A conversation I had on Twitter the other day with my tweeps @pgsilva and @rescue_monkey brought up the spectre of why exactly ambulances aren’t staffed with nurses and physicians’ assistants and are instead staffed with Paramedics and EMTs. PG and The Rescue Monkey thought that the conversation would make that vein pop out of my forehead like it does sometimes when I get enraged. They were mistaken. It doesn’t make me angry. In fact, I informed everyone that I would write a post on what exactly it makes me think about. This is that post.

The “Why don’t nurses and/or (insert title of healthcare provider here) staff ambulances debate” has a clear answer for me. Here it is:

EMS providers are sporks. We’re also not sporks. We exist in the realm of both the specific and the generalized. We are jacks of all trades and the master of the non-specific. EMS providers are generalized in nature and that generalization is specialized into the random nature of the work in which we perform.

Or women with sporks, you know. That too.

Are you confused? Well that’s understandable. Let’s look at it this way. The ultimate healthcare provider has always been the physician. Since the beginning of western medicine, the physician has always been the healer that people have turned to. Physicians are learned professionals who seek to learn and apply knowledge to the human condition in the name of healing. Physicians are “clinicians” in the fact that they make a clinical diagnosis based upon an examination of a patient and then devise a proper treatment path to treat a patient’s diagnosis. They physician assesses a patient, makes a diagnosis of the patient’s condition based upon their knowledge base and ongoing research, and then uses that same knowledge base and research in order to devise the best treatment possible for the patient. It’s the definition of a clinician.

Nurses, and their modern incarnation as the Registered Professional Nurse (RN) developed as the ultimate assistant to the physician. Their goal was to be the caregiver, the person with enough medical knowledge to continue the care plan and treatment that the physician determined with the compassion and the ability to meet the ongoing needs of the patient. While the physician devoted their efforts to learning and education, the nurse required less education and more compassion. Medical technology and knowledge has expanded greatly and has required the nurse to develop a vast array of knowledge and a myriad of specializations, but their basic function has remained the same. They care for patients in the long term during their convalescence from an illness or injury.

Physicians and nurses have worked in concert. They have developed a system where the sick and injured are brought to them so they may take care of them using the resources they gather together. Each of them performs their role with the goal of making people get better. As knowledge of medicine has increased, different types of physicians and nurses have developed into specialties. The general practitioner acts as a gatekeeper to specialties and treats the most common maladies and is assisted by nurses qualified to care for the largest population of patients. Specialists, such as Cardiologists, Oncologists, and Surgeons, have developed to allow patients the benefit of having people treat them who have sought out to become experts in exactly the illness that the patient may have. The nurses have adapted and have become specialized in their own right, with nursing specialties that complement the specialties of the physician.

However, there is a drawback to all of this specialization. When you have a malady that affects your feet, you would benefit being under the care of the podiatrist. However, you wouldn’t get the best care possible if the only physician available were a cardiologist. The same holds true for the oncologist that attempts to treat your pulmonary condition or for the proctologist who treats your sore throat. While the basic concepts are there, the specialization of focus is not. To be sure, while a person who has graduated from medical school may be able to treat pretty much any condition that you may have at a level that is basically adequate, specialists have devoted their time in the quest of knowledge in their specific area at the possible expense of their knowledge of other areas. This is a good thing, and it’s the reason that pretty much every hospital is full of people with vast arrays of knowledge in singular topics. This system wasn’t designed. Like capitalism the system designed itself. It works and works well, most of the time. However when economics dictate a limited number of available specialties, certain conditions may be left out.

Nurses have done much the same. While the basic concepts are the same pretty much across the board, a School Nurse would have trouble transitioning into the operating theatre as much as the Oncology nurse would have trouble transitioning into public health. Both of them can probably change a bedpan, start an IV, pass medication, or lend a caring smile in the same manner but the oncology nurse would be much more well versed in the management of chemotherapy drugs and chronic pain management than a would be a surgical nurse.

This brings us to Paramedics and EMTs. We are a profession born out of necessity and forged in battle. Really. We can thank Napoleon for bringing forth the first example of the “flying ambulance” which was a brigade of horse-drawn ambulances staffed by medically trained soldiers. They appeared on the battlefield during the Napoleonic wars and boasted that “No soldier lay with undressed wounds for more than a quarter of an hour”. Battlefield “Medics” have always been on the forefront of emergency acute care in the field. While some examples of ambulance care available to the civilian population exist, in the US it wasn’t until after the Vietnam War that civilian emergency ambulance service became popular and seen as a need rather than a nice thing to have. While physicians often made house calls where they travelled to the patient to provide care, in the interest of efficiency they began to confine themselves in clinics and hospitals where they could more efficiently care for larger patient volumes. With the publishing of the “EMS White Paper” entitled “Accidental Death and Disability: The Neglected Disease of Modern Society”  in 1966, the attention of the public was focused on the need for an effort to extend care out of the walls of the hospital or clinic. The white paper laid out statistics of trauma, stated the need for injury prevention and education, and stated the need for standardization of emergency medical training. The US. Dept. of Transportation took up the mantle of the new Emergency Medical Services system due to the alarming number of fatalities on the burgeoning highway system and modern EMS was born.

"Stick a Spork in me, I'm done" should be part of your daily speech patterns

The EMT and the Paramedic are the equivalent of sticking a spork in the problem and calling it done. EMTs were cheap to train, cheap to employ, and could be widely distributed out there in the field. At the time, it was the perfect solution. Train people in how to perform in the first few moments of a severe injury or acute illness and give them the ability to safely transport a patient to a hospital where the physicians could work in concert to help heal the patient. The nurses, in their role as the assistants to the physicians, stayed in the walls of the hospital or clinic and developed within their specialties. The system grew and developed as the innovators in the field saw more and more acute treatments that could be performed by these new breed of healthcare providers and as the EMTs and Paramedics proved themselves in service.

EMTs and Paramedics are clinicians in the sense that we evaluate a patient and develop a treatment plan that we follow to help them. Our specialty is in the acute, the treatment of disease in the here and now. If it’s happening to a patient and it is directly threatening their life, chances are that an EMT or Paramedic can intervene in a meaningful way. Our specialty is to stabilize and stop the progression of the acute disease process or chain-of-events in an injury that will eventually lead to death. We plug holes and we do it with a knowledge base taught to us by physicians. Our generalization is across the entire spectrum of possible patients, from field delivery of neonates, to jumping in to help stabilize patients in outpatient surgery centers, to taking care of the elderly in nursing homes. Whether a patient is crushed in an industrial machine, is trapped in a rural car accident, is having a heart attack on a baseball diamond, or whatever happens to a person wherever it happens to them, the Paramedic or EMT is the person most specialized in coming to their aid. We gain knowledge and hone experience not just in the treatment of our patients’ medical conditions, but also in the environmental circumstances in which we find them. We may be generalized sporks when it comes to treating any possible injury or acute illness across any patient population, but we’re highly specialized utensils when it comes to treating emergency conditions anywhere at any time.

"Sporks and Phasers" would be a good name for a Rock Band

No other healthcare provider fits into our role… and that seems to make us a full-fledged utensil in my opinion. We are unclassifiable into any other role yet indispensable for our own.

And we need to get out there and let everybody know just how special that role is. Nobody has developed the breadth of knowledge in our specialty that we have. We have made the spork our own.

And that, folks is my answer to why no other healthcare professional can quite full our role. While as a paramedic I am competent in the basic skills needed to say, work in a endoscopy unit, I would not function there to the level of a person experienced and knowledgeable as an endoscopy nurse. Neither would they be able to manage a traumatic airway upside down in a crushed automobile at night as well as I would. It’s my specialty to do the latter, not the former, even though the basic skills may be the same.

For more on this, g’head and read “Any Random Person” an older post of mine. Then get out there and shine up your sporks.

Some of you may have noticed that my posting frequency has dropped off as of late. It has. While I try to shoot for 3 to 5 posts per week I’ve been barely making one for the last couple of weeks. Don’t worry though; I have a ton of good ideas for articles floating around in my head lately. They just haven’t made it onto the pages of the blog as of yet.

One of the things I struggle with as a blogger is how I want the site to be perceived. Am I an article site? Should I concentrate on the big articles and big ideas that can get up to 2k views in a day? Or should I fall back upon the more personal style of bloggery that the greats such as AmboDriver and TOTWTYTR use? I realize that this is my forum and that I can do what I darn well please with it, but I do want my readers to get something useful from the site. That’s the thing. I have always thought that people come here to read this blog because I’m just some guy who writes about paramedicine from the front of his ambulance. And that’s still the case. I almost always write things whilst on-duty and my various jobs have been pulling me in a lot of directions as of late which has been slowing me down. I can write when I’m home, like this post, but I enjoy playing with the boy and I think that the wife’d skin me if I didn’t keep up with my part of the house chores.

At any rate, please don’t give up on me. I love having a blog and I have always been surprised and appreciative that people actually come here to read what I have to say. It’s a great feeling to be able to think of an idea, jot it down on a keyboard, and have people come and read and comment on it. It is even better when the subject matter is something that I truly love as much as I love EMS. While I could see myself writing a blog about other subjects I’m passionate about, such as Barbeque or Tibetan Dance, I’m glad that I chose EMS. It’s much more entertaining to write things about calls I run on than it would be to write something every time I sear a steak to perfection or smoke the perfect rack of ribs (like I did last night, I might add)

So today, I’m going to be working on writing the big articles that I’ve yet to finish and I’ll be scheduling them to run during the week. I’ve sent some things to the magazines and if you’d like you can read one of my more formal articles up on EMS Magazine’s page or you can hop on over to www.EMSeducast.com and hear a podcast I was on regarding high school students in EMS. Tonight you can go and listen to the Happy Hour on the www.FFnetcast.com or you can go listen to the great things they’re doing at www.genmedshow.com .

Yes, this was a disjointed article, but for just under 600 words it took me three cups of coffee, two phone calls, a bathroom break, two kiddie wrestling matches, a few “Dad!! Look!!’s” and an hour and a half to write. Bear with me folks and thanks for reading. I’m going to write today, I promise…

However, I could  go fishing…

The good folks over at EMS Magazine and Http://www.EMSresponder.com have seen fit to publish some of my EMS type ramblings in print format. It’s an article on Partnering With your Community as an EMS agency and if-I-do-say-so-myself it’s got some useful information in it.

So take a trip on over to have a read at http://emsresponder.com/print/EMS-Magazine/Community-Partnerships/1$13742 

Or, you could go ahead and wait till your magazine arrives in the mail of course… you do subscribe, don’t you?

Today I overheard an ambulance service somewhere out in the sticks get dispatched to a “Car Vs. Pedestrian” on a rural backroad. This particular backroad is known to be a real rural speedway, where cars just fly down the road far from any prying eyes of the local traffic cops. Any vehicle/pedestrian interface on this road would be sure to be a real messy call and the rural ambulance service that got dispatched to the call made a pretty good turn-out time.

About ten minutes after dispatch, the county dispatcher came back over the radio and cancelled the response. Apparently the “Car Vs. Pedestrian” wasn’t Vs. a human pedestrian… it was a Car Vs. Deer. Sure, the deer was probably walking at the time it was hit, but even with as rural as this ambulance service is, they don’t handle veterenary emergencies.

To her credit, the dispatcher made sure to inform the ambulance crew that the “Patient has left the scene”.

Now, you may think that the rural dispatcher was just being cheeky and funny when she informed them that the deer scampered away. However, then you wouldn’t be in rural EMS. The dispatcher, who probably has known every crew member since Sunday School did the crew a favor by letting them know that the deer wasn’t there. Us rural folk know that fresh deer meat out of season is a rare delicacy and that the first person to get there gets the carcas.

I’m not incinuating anything… just sayin.

Yesterday my son and I went and got haircuts together at the hairstyling place where my wife takes him. It’s in a grocery store and she goes there too for convenience. Since I hadn’t been to my old-school barber at “Jim’s Barber Shop and Wisecrack Emporium” for a few weeks since he’s been on vacation, I thought I’d get my hair cut too. She was shopping for groceries while the boy and I got our ears lowered.

The boy’s cute, you know. He’s a very cute kid and the girls at the hair cut place just fawn all over him. It’s an inconvenience to be the daddy of the object of such devoted female attention but it’s a burden that I must bear. He was so good for the haircut, like he always is. He holds really still and doesn’t even whimper when I pretend that I wiggled and got my ears chopped off.  Maybe he’s used to me by now… probably so.

The interesting part to this story is when his haircut was done first and the hair cut lady came to present him to me and show me how he looked. While he was smiling at me, she noticed one stray hair sticking up tall and out of place from her otherwise wonderful hair cutting job and said “Oops! Hold still and let me get that!” She then took a pair of scissors and lopped that uncontrolled piece of hair right off. I saw this as a teaching moment and said “See Seth?? One hair decided to stand up tall among all of the others and the first thing that happened was that someone came and chopped it right off. Life’s kinda like that sometimes.”

I meant it as a joke, of course… but we all know that it happens. When someone tries to stand out from the crowd or to take a different path than do the masses there always seems to be someone running with scissors that wants to chop their original thought right off at the root. I’ve always encouraged The Boy to be an independent thinker, except for when it comes to doing what Mommy and I tell him to do of course, and hopefully it will pay off in terms of his “world-changing” abilities later in life.

So since this cute little personal anecdote happened yesterday, it was fresh in my mind when I went over to my buddy Mark Glencorse’s blog at Http://www.999medic.com and was shocked to see This Post up on the page.

Here’s that link again: Go Read It Please, then come back. Ladies and Gentlemen… we have an inspirational leader down.

I have to say that I’ve met Mark on some of the few occasions that he’s chanced to hop the pond and get over here to the US and even though he lives an ocean away, I know that he’s a good guy and I consider him a friend.  While in the grand scheme of things, I haven’t spent all that much time with him overall…  for a man like that one doesn’t need very much time to realize that he is a great all-around stand-up guy that I’m proud to call my friend (or “Me Mate”) as he might say in his Geordie dialect. He’s brilliant, nice, polite, honest, funny, and genuine. I got that sense of him the first time I met him and if it’s possible to call him one of my best internet friends (“Interfriends”? Did I just coin a word??) then I’m proud to do so. I give him my highest recommendation as a human being, great person, and all-around stand-up guy and so you can imagine how I felt when I read these words in his second to last post:

I know I have people in my own service who read my blog and learn from and appreciate my writing.

I know I have people in my own service who read my blog and wait for me to trip up.

I know I have people in my own service who actively look for things to get me into trouble.

I now know I have people in my own service who have tried to cause trouble for me and this blog.

Yesterday, he wrote that he was discontinuing his blog due to pressures placed upon him by his employer and here’s what I have to say to everyone out there listening:

It takes what the college kids call “Cojones” or a good bit of bravery to write an EMS blog. I suppose that many blog topics require some amount of courage to author, but EMS is a touchy subject riddled with lots of “type A” personalities who love nothing more than to throw landmines in the path of those that dare to think outside of the box. Writing a successful EMS blog is no easy undertaking. You must first think for yourself and develop actual thoughts and feelings on issues that others may want to read, you then need to be able to formulate those ideas into a written form that others can understand and think about for their own selves, and you then must be able to defend your ideas against everyone else out there who reads it. Placing an opinion out there in the public for others to read and challenge is a scary thing that takes intellect and courage to do. There is no guarantee that you will get any eyes reading your stuff at all and it takes hard work to get your voice out there. My traffic numbers vary greatly between 200 and 2000 unique visits per day and that’s a long way from when my page languished in the double digits per day. Building traffic and a following takes time, patience, perseverance, brains, and a whole lot of testicular fortitude. Nothing comes easy in this business. Mark understands that and chose to excel at it. His blog has been an inspiration to me and thousands of other EMS professionals world-wide. His thoughts and feelings were positive and brought positive energy to our collective brotherhood of EMS providers. The potential for good that flowed within Mark and his blog is staggering… and it’s a powerful blow that he’s been silenced.

When I see one of the best and brightest among us in this new Worldwide EMS Renaissance having a struggle with what I can only assume to be a small group of even smaller minded people… then well, I get angry. Mark’s my friend and I can assure everyone reading this that if you met him and have read his thoughts like I have, you would consider him a friend as well. He’s an easy guy to respect and it’s an effortless decision on my part to jump to his aid. I may not be able to do anything for him standing over on my continent today… but I can sure go over to his blog and leave a comment on that post I linked to showing my support. I encourage everyone reading this to do the same. In fact, he’s asked you to leave a comment on his farewell post and I darn sure am going to honor his wishes. Please, you do the same if you have not already.

Mark Glencorse has helped shaped the new and brighter EMS reality. His voice is one of calm reason in a challenging world. We need him… therefore we need to support him.

Here’s that link again. Bloggers, please link it. Everyone, please go offer some words of support. He’s a strong man, but everyone could use a kind word now and then. If you’re not following him on Facebook and Twitter, please do so. He’s a friend to EMS and a friend to us all. I am proud to know him.

Thank you, Mark. Your daily voice of reason will be missed. You Sir are an inspiration to EMS and the Men and Women that make us what we are. You’re welcome here anytime and I know that this is not the last we’ll hear from you.

If you would think back a few months ago, you might faintly remember a controversial streak that I had where I posted a few hotly debated topics. One of those posts: Saved By the Bell? High School Student EMS gathered a LOT of responses, both in my commentssection and on the JEMS Facebook Fan Page.

The post looked at whether or not it was a good idea to begin Emergency Medical Technician (EMT-B) training in High Schools and also whether it was a good idea to have high school students actually responding to emergencies. My take was that while I support the idea of first-aid, CPR, and even First-Responder training in high schools, I think that holding EMT-Basic level training there is a bad idea. My thoughts were also that having high-school students responding to 911 medical emergencies was absolutely coo-coo insane.

Depending on your views, I was either a mean and grumpy old man who doesn’t understand just how special these kids are or I was taking a stand to save the profession from the further watering down of our educational standards, professional competency, and pay scale.

Regardless of your opinion, please jump on with Greg Friese and I tonight on the EMS Educast, a LIVE and long-running popular podcast. The show starts at 9pm Eastern, which so I don’t forget is 8pm Central and 6pm PDT. The show is live and I would love to have anyone join us in the chat room and even call in.

Here’s the link: http://www.emseducast.com/live

Here’s the link to the article again: Saved By the Bell? High School Student EMS

The show starts at 9pm Eastern – Join us in the Chat Room and Call In to speak with Greg or myself.

Love my stance or hate it, it’s sure to be a great show.

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Also, if you’re reading this after the show, the EMS Educast and all previous episodes can always be found at www.EMSEducast.com