This month I tried to gather up posts on the theme of “collections” since the first post I wanted to share was Rogue Medic’s collection of podcasts and blogs. He has curated an excellent collection of blogs and podcasts to keep up with EMS and emergency medicine research.

You can eat better in 2012. Fire Engineering has a great article that connects nutrition with line of duty deaths. Learn how several New York State fire departments are changing their destiny through healthful cooking.

The Social Medic reminds us that “Basics” always matter. He points out that EMT Basics make up 2/3 of the EMS workforce, but too often conferences, CE, and more are focused on advanced providers. How are you going to make sure the basics matter in 2012?

In January I have been involved in many conversations about the importance of paramedics having a college degree. My friend Trevor, an expert in leadership and organizational behavior, reminds us that a degree doesn’t make one a leader. If leadership is not about the degree then what is it about?

Everyday EMS Athlete Brandon Mulnix is a minimalist shoe ultra marathon runner. He has just started a field trial of a minimalist work boot. I know people that collect shoes. Brandon collects shoes that are barely shoes, at least not in that same manner I define shoes.

The Edumedic accepted the 12 ‘n 12 Everyday EMS reading challenge and has posted the first of twelve book reviews. He started his challenge with one of my favorites, the Non-Conformist’s Guide to EMS Success.

Steve Whitehead, author of the Non-Conformist’s Guide to EMS Success ran a nice post about why we should all belong to NAEMT (Introducing the NAEMT). I belong. Do you? You should.

The Unwired Medic attended the Consumer Electronics Shows and picked lots of great products that have application to EMS. Read his collection of products and events at CES Day 1, CES Day 2, and CES Day 3.

In the midst of the NFL playoffs and at the height of Tebowmania many EMS bloggers wrote on the topic, “If Tim Tebow was a Paramedic.” At Medic Madness you can find a collection of all of the Tebow as a Paramedic posts.

With EMS Today a month away this post on 20 Ways to Connect After Conference from Christa Miller’s Blog.

Lifehacker shared a great collection of free online education courses in all of the big academic areas.

Finally, Mark Glencorse bid farewell to EMS earlier this month. You might be able to take Mark out the ambulance, but he will always be a paramedic. I appreciate his efforts as a tireless advocate for paramedics and promoting the possibilities to learn from one another. Thanks Mark.

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Medical Author Chat

A new episode finally dropped on the Medical Author Chat. I talked to Clif Castelman about his book, the Comprehensive Guide to Wilderness First Aid.

Early in the month I also issued a 12 n’ 12 Reading Challenge. Can you read 12 books, one per month, in 2012?

Western Pennsylvania Hospital News

The Western PA Hospital News is a newspaper. As in an actually printed on paper reading device. In Issue No. 11 I contributed an article titled “Using Social Media as a Recruiting and Listening Tool.” The article can also be found online at wphospitalnews.com, page 28.

CentreLearn Blog

I am looking forward to presenting two sessions at EMS Today on Thursday, March 1. Find out more about the sessions and my EMS Today plans.

We also announced a new course on Understanding Excited Delirium in January.

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This article in the New York Daily News describes a legislative effort in New York State to earn a bachelor’s degree within 10 years of becoming a nurse. This article sparked a spirited discussion on the National EMS Managers Association (NEMSMA) list serve. It also was a topic on the EMSEduCast and EMS Garage.

EMSEduCast Episode 126: Improving EMS Education in 2012

EMS Garage Episode 154: BS for Paramedics

What do you think? Does a BS degree make for a better paramedic?

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This is a guest post from Rom Duckworth, paramedic and educator that follows-up on this post about my experience in the CIRC trial. If you want to guest post or review on this blog, check out the guidelines here.

CIRC Trial and IBP ALS

Having had the opportunity to attend the ACLS Guidelines roll-out in Chicago in October of 2010 I noticed something profound in both the recommendations and the research (though not the ACLS algorithms or course, but that is another topic). In the process of evaluating the science behind the guidelines four things became apparent to me.

1)     The overall scientific strength of the guidelines (not every recommendation, but the guidelines taken as a whole).

2)     The specificity of what works, what doesn’t, and what needs further evaluation.

3)     The difference in success rates between comparable EMS systems (rural to rural, urban to urban, etc.) throughout North America. Read as “room to improve”.

4)     Potential for the continuation of obsolete practices and paradigms among healthcare providers, even those attending regular BLS, ACLS and PALS recertification programs.

These four items led to me picturing an equation of:

(local implementation of guidelines) + (Time) = (Real Lives Saved)

This equation motivated me as an EMS Coordinator and educator in a small regional system to see what changes I could begin in my own service and then, hopefully, propagate throughout the rest of our region.

Initiative for Best Practices in ALS Education Program

I put together an education program that addressed the five areas of a systemic approach to improving resuscitation.

1)     Early CPR and Defib

2)     True high quality CPR

3)     Uninterrupted CPR

4)     Meaningful Medications

5)     Post ROSC Care

Unfortunately the project would be restricted not only by time and money, but it could also deviate only minimally from our current Regional Paramedic Protocols.

So in January of 2011, with more focus on the process than the name of the project we began the Initiative for Best Practices in ALS (IBP ALS). With the support of our department’s Chief and our Medical Director we placed our community-based ALS service as the hub of a program with five spokes.

1)     Early access to CPR and defibrillation was improved by providing community stakeholders with educational resources and grant materials as well as updating the training for ALL dispatchers and first responders in proper BLS.

2)     The quality and consistency of CPR was improved through education programs that emphasized the WHY (affective) of BLS as much as the HOW (psychomotor) in order to eliminate low quality and outdated BLS practices. We also stressed the importance of continuous EtCO2 as a tool to monitor effectiveness of CPR, airway management, and achievement of ROSC.

3)     In addition, our service worked to minimize interruptions of CPR through the use of mechanical CPR devices, automatic ventilators and a modified airway protocol.

4)     While we couldn’t move completely away from general administration of algorithm based medications during resuscitation, we did implement a drastic change (for us) to using Vasopressin and Amiodarone as “One-and-Done” meds rather than the “rinse and repeat” of epi-lido-epi-lido-epi-lido. We also emphasized medics evaluating and addressing the patient’s underlying problem through history and assessment, as opposed to primarily following an algorithm until arrival at ED was achieved.

5)     We put protocols and education in place for immediate-post ROSC BP maintenance, 12 lead acquisition and transmission and eventually, hypothermia.

Lessons Learned

As we wind up our first year of the program I’ve been surprised by some of the lessons learned.

1)     Trials and special programs give focus: Many participants in our IBP ALS program were invigorated just by the fact that our service was a part of something special.

2)     Direct Follow up: I too believe that face-to-face follow up after each call helps to improve the quality of care not just in the types of calls addressed in the project (for us, resuscitation) but positively affects all aspects of EMS care in the system.

3)     Rise of the machines: While some complain that machines haven’t proved to be the be-all, end-all of resuscitation, I can tell you for certain that in our system they have dramatically improved our ability to provide continuous, high-quality CPR.

4)     Save lives with your MIND, rather than your HANDS: If I had to choose the central concept of the IBP ALS program, this is it right here. Do I believe that we’ll save more lives because Vasopressin is such a great drug? Nope. But I DO believe that paramedics will save more lives when they’re focusing on evaluating and addressing correctable problems, rather than just watching the clock for the next “rinse and repeat” med administration.

5)     Change attracts attention: Our program required a change in the ambulance load-out. I (very subjectively) believe that this stimulated better rig-checks as the crews took the opportunity to review the new equipment.

6)     And more change: We took the opportunity to attach other small changes to the program not directly related to resuscitation. Some change lends itself to improve in ways you might not have previously considered.

7)     Teamwork: While I encountered initial resistance to Pit-Crew CPR concepts (“We get everything done that needs doing! Why change?”), I emphasized that the idea here is, as when you work with a great partner, with Pit-Crew CPR’s pre-assignments, things don’t just “get done”, they get done automagically. Less effort+improved CPR=happy crews.

So if you have the opportunity to participate in a research or pilot program, by all means do so. Even better, you may want to start one yourself! Yes, it will take a great deal of work, but you’ll be contributing quality data to pre-hospital medicine, and you may find yourself surprised at the return on investment for you and your service.

A passionate emergency responder and recognized speaker and educator on leadership and emergency services living in Connecticut, Rom Duckworth has more than twenty years of experience working in career and volunteer fire departments, public and private emergency medical services and hospital based healthcare systems. Connect at www.romduck.com
or the www.RescueDigest.com blog and podcast.

No related posts.

Wire to Wire, 2011 has been one of the best years of my life. Of course there were some challenges and disappointments, but as I look back it has really been amazing. Some of the things (in no particular order) that made 2011 AMAZING!

• New TV installed just in time for 2011 Rose Bowl featuring the Wisconsin Badgers
• Packers winning the Super Bowl
• 3 trips to Las Vegas (all work!)
• Running two marathons (Green Bay and New York City)
• Family vacation to Arizona and a long camping weekend
• Long weekend vacation with my wife in New York City
• Watching the Packers play a road game, even though they lost (there only loss in 2011)
• Running with my son in his first 5K
• Helping coach T-Ball and Soccer
• Watching my kids dance and music performances, soccer games, t-ball games, and hockey games
• Reading lots of books (my last count was close to 45 books)
• Posting nearly every day to this blog
• Meeting lots of you at EMS and Fire industry conferences
• Swimming in the Atlantic ocean while visiting Miami Beach
• Running the Bellin 10K with nearly 20,000 other people
• Receiving an EMS 10 Award
• Recording dozens of new episodes of the EMSEduCast
• Presenting with Kyle Bates at NAEMSE
• Seeing my friends Michael Fraley and Kevin Collopy present at EMS World Expo
• Completing two 100+ mile bike rides
• Watching the first 4 seasons of Mad Men
• Reconnecting with many of my cousins
• Restarting my regular column for EMS1.com
• Being told by a paramedic that something they learned in a CentreLearn CE lesson helped them save a patient’s life
• Working with NAEMT to finish the Safety Course instructional design
• Working with NAEMT to design the online materials for PHTLS
• Writing exam items for the NREMT basic exam
• Preparing to watch the Wisconsin Badgers play in the 2012 Rose Bowl
• Eager anticipation of the Packers making another run at the Super Bowl
• My wife getting a new job
• My son logging more than 1400 minutes of reading in November
• Running 1375 miles and biking 1500 miles
• Financially supporting many organizations that believe in
• Spending lots of time with my parents, in-laws, and other family

I hope 2011 was a good one for you and 2012 will be even better for all of us. I am genetically pre-disposed to optimism and have high hopes for what we can accomplish together in 2012!

Crossing the finish line of the 2011 ING New York City Marathon

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After a visit to British Columbia two paramedics from Hong Kong discuss why they are paramedics and their experience. I am trying to contact these paramedics to be guests on the EMSEduCast – the podcast by and for EMS educators. Incidentally, we are always looking for EMS educators from outside North America to be show guests.

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Blog.CentreLearn.com – My day job is being the Director of Education for CentreLearn Solutions. I add about two posts a week to the CentreLearn blog and manage our social media accounts.

Top Questions about CL Courses for Firefighters, Paramedics, and EMTs

Build your own Online Training Content

FDA Drug Safety Communication on Zofran – this article was contributed by paramedic Steve Cole. It is packed with information.

Medical Author Chat – on the EMSBlogs.com network I host the Medical Author Chat podcasts. Episodes are infrequent. When I can I also add posts related to my enjoyment of reading and writing.

Interview with Dr. Benjamin Luft about We’re Not Leaving about the initial and long-term response at the World Trade Center on 9/11.

My review of We’re Not Leaving.

Recent reads and news will bring you up to speed on my late summer and early fall reading list. I also announce taking the tablet plunge and pre-ordering an Amazon Kindle Fire.

EMS1.com

How are you doing in EMT Class? Use the ideas in this article to assess your progress. Self Assessment: Tracking Your Progress in EMT Class.

A new Everyday EMS Tip at EMS1.com on using Slideshare for EMS.

EMSEduCast

Rob Theriault and I helped Bill Toon by presenting at workshop for Kansas EMS educators. The workshop was repeated on three consecutive days. Rob recorded our 3rd session which was about teaching EMS and technology. You can view our recorded presentation.

PIOSocialMediaTraining.com

Some ideas on how a public safety agency can use an auto responder email campaign.

Loving the Run Blog

I shared my tips for running while on business or leisure travel at the Loving the Run Blog.

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I am a Craigs List junkie. I am always scouring for my next used bike or some other item of interest. Here are three EMS Education uses for Craigs List.

1. Buy/Sell training manikins.

2. Find free or buy gently used furniture for your simulation lab.

3. Find models with specific medical conditions for photo and video shoots or simulation labs.

Scott Snyder shared on EMSEduCast episode 119 how he uses Craigs List to find models with very specific medical conditions for his case based learning program. Brilliant!

How have you used Craigs List as an EMS Educator or EMS Professional? 

This is how I use an RSS Feed to find items on Craigs List.

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Most times “Sick” will hit you over the head when you see a child from across the room or as you stand in the doorway. Other times it is less obvious and a good way to determine if the child is ill and how ill is to compare your assessment findings to normal.

Activity: What is the child’s level of activity during play with others or alone like compared to normal?

Bathroom: When was the child’s last bathroom activity or soiled diaper? Is the frequency and volume as expected?

Consolable: Are parents or caregivers able to console the child with quiet talk, soothing touch, and or distraction?

Drinking: Is the child drinking normal volume and at a normal rate? Sips, when a child normally gulps, might indicate airway swelling, discomfort, or irritation.

Eating: Is the child eating normal amounts and at regular times?

Fever: Does the child have a fever? Review this tip on infant rectal temperature assessment.

Sick or not sick? Compare normal to abnormal.

ABCDEF … I couldn’t keep the list going, but here are a few other things to consider.

Pain and Discomfort

Look for non-verbal clues about pain which might include eye rubbing, hair pulling, or other self-soothing behaviors. For a verbal child ask about where the pain is located, what it feels like, and use the faces pain assessment scale. For an adolescent use the OPQRST pain assessment questions.

Parent Interventions

Have the parents administering any medications? What, when and how much? And importantly what was the child’s response.

Pedi-U Podcast

Make sure you listen to the Pedi-U Podcast, an amazing informative and free pediatric education resource.

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I also write posts frequently at Blog.CentreLearn.com, the blog of CentreLearn Solutions, LLC where I am the director of education. A few of my favorites from September on the CentreLearn blog:

New online training courses for EMTs, Paramedics, and Firefighters

Kinds words from the Epilepsy Foundation

CentreLearn Morning Mug and PowerPoint Design Tips

Test Security Features in the CentreLearn learning management system

The EMSEduCast – the podcast by and for EMS educators – posted several new episodes in September including two episodes recorded at EMS World Expo. On the EMSEduCast I am joined by co-hosts Rob Theriault and Bill Toon. Check out these recent episodes:

Understanding the Power of Words when setting expectations and achieving goals

Updating education programs and test items to the AHA 2010 ECC guidelines and the new EMS Scope of Practice model

Episode 113 and Episode 114 from EMS World Expo 2011

It has been a quiet couple of months at the Medical Author Chat podcast. I haven’t done a new episode since July. Time to round up some authors and record some new episodes.

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