Monday, February 8, 2010

Online Scanner for EMS and Fire in Franklin County, Vermont

I recently came across a website that has a scanner feed for our EMS district. You can also access many other areas of the state and the US by searching the site.

I've noticed that there is a significant delay, at least a minute between what we hear on our radios and when it comes across on the online web player, but its still pretty cool.

Be forewarned, any of you readers not from this area: It can be a pretty quiet feed at times, but it also does have its moments!

Here's the link: Franklin County, Vermont EMS and Fire Scanner Feed

Wednesday, December 9, 2009

Why I Love Being an EMT

Why I Love being an EMT:

Because for the brief time I am with my patient, MY troubles go away, my worries about bills, my children, my relationships, all the little (and big) pieces of clutter that weigh on me, they go away and I am blessed to be given someone else's crisis, quite likely a crisis bigger to them at that moment than all of my cares put together. During the half hour I may have with my patient, I am given the gift of not only losing my worries, but of being the one that is there, that knows what to do, that tells them or their loved ones, "I will take care of you", and then doing it.

Shit folks, it doesn't get any better than that.

Saturday, August 9, 2008

Rural EMS... Staffing the Rescue Squads in Rural Areas

The following is a letter that I sent to the St. Albans Messenger, our local daily newspaper in regard to an article they published on Aug. 5th. No further introduction needed I guess. Read on.

Franklin County Fire and Rescue Squads Face Staffing Shortages Too

As an EMT-I with Enosburgh Ambulance, the bold headline on the front page of Tuesday's Messenger caught my eye (Rural fire depts. struggle to recruit). "At last", I thought, "a timely story about a major challenge facing Fire and EMS squads here in Franklin County". I was surprised and disappointed, however, to find that the story was not written from local interviews and research, but was from the AP wire with a dateline of Big Springs, Nebraska.
Recruiting and retaining highly skilled emergency medical, firefighting, and rescue personnel is difficult in all rural areas of the U.S. In fact, the communities in Franklin County and throughout Vermont are facing this issue as well. Why couldn't the Messenger inform its readers of the importance of this issue by looking at the situation right here in Northwestern Vermont?
As the AP story points out, the ranks of rural fire and rescue squads have traditionally been made up of volunteers from the local community. The majority of these services in rural areas still rely on non-paid first responders to fill their fire departments and rescue squads. Significant changes in our society over recent years, however, have made it tough for people to find the time to commit to these essential organizations. Today, many people travel away from their communities to work. Once home, family time is at a premium. While many employers support employees' efforts as firefighters and EMTs, jobs located 30 or more minutes from their town make it impossible for the crewmember to be available to respond to an emergency call during regular work hours. Volunteering, especially in the public safety realm, requires a big time commitment.
The education and training required even at the most basic level is a large time commitment. Scientific and technological advances have made firefighting and pre-hospital emergency care safer, more effective, and more reliable than ever before. Of course the days of the bucket brigade for fighting fires is long gone. Likewise, ambulances are no longer simply transportation to the hospital. The seven ambulance-equipped EMS organizations in Franklin County are all, as required by law, staffed by certified EMTs, many of whom are trained at the advanced level, and provide life-saving care and treatments to patients while en route to the hospital's ER. Getting and maintaining the required State of Vermont certifications involves hours of classroom and hands-on training. EMTs must re-certify every two years by passing written and hands-on exams, and must also have earned a minimum of continuing education. Furthermore, in the aftermath of large-scale tragedies such as 9/11 and Hurricane Katrina, more and more is being asked of your local police, fire, and rescue organizations. In order to effectively manage future large scale incidents, the federal government, through FEMA has mandated that these groups implement specific systems when multiple agencies work together in response to an incident. To put this mandate in place, squad members are required to take classes in command structure and multi-agency interaction. Squads whose members are not compliant risk losing federal monies for equipment and training. Fire, police, and EMS must also periodically work together on large scale training drills aimed at putting the new systems into action. Learning new skills and training to stay proficient at these skills takes a lot of time, usually weeknights and weekends, in order to avoid work-place conflicts.
Of course the reason behind all the study, training, and preparation, is to be ready to climb in the truck and respond when the tones go off. Here in Enosburgh, a typical 911 ambulance call can take two hours, from the initial dispatch, until the crew returns to quarters after transporting the patient to the hospital in St. Albans. Fire departments can spend a whole day or more at a structure fire. While the firefighters and EMTs that I know are passionate about their roles in helping their communities, the candle can only be burned at both ends for so long before something has to give.
If squads can't retain experienced first responders, or recruit enough new ones, how will we assure that these essential services are available when we really need them? As a result of staffing and recruiting shortages, more fire and rescue squads are now starting to pay EMTs and firefighters, either on a per-call basis or as hourly or salaried employees. The EMTs at Enosburgh Ambulance (EAS) work regular shifts and like a handful of EMS organizations in our county, are paid professional rescuers, not volunteers. EAS staffs around-the-clock crews, the majority of whom are certified at the most advanced care level available in our EMS district. In addition to serving Enosburgh, EAS also responds to 911 calls in Sheldon, Berkshire, and Bakersfield. Recent staffing shortages at Montgomery, Richford, and Franklin Rescue have resulted in frequent gaps in coverage for these towns. Enosburgh Ambulance now provides many hours of emergency ambulance coverage, as needed, for these communities as well.
More often than not, small rural towns are run on a very tight budget. Adding the cost of payroll for services that have traditionally been volunteer will likely be a hard adjustment. To make this change even harder to swallow, towns may go days at a time without having to call EMS, and it could prompt some to argue that their tax dollars are paying for nothing. But emergencies can and do happen around the clock The number of calls a squad responds to is generally proportional to the population of their service area. Rural areas experience fewer emergencies than large urban systems, but whether a squad responds to 100 calls a year or 10000, if the call involves you or your loved ones, you want trained first responders to be there quickly. I like to think that I get paid not so much for my skills in first aid or for transporting the sick and injured, but to guarantee that I will available and ready to quickly respond to an emergency.
Thankfully, as individuals we seldom need to call for the fire department or EMTs. But like the insurance we keep on our cars and homes, when we need them we should be confident that they will be there. Having at least a core group of full-time staff on salary is keeping the problem at bay for a good portion of Franklin County, at least for the time being.
This is one of the bigger issues regarding fire departments and EMS in our area. These groups certainly face other challenges. If the citizens of this region could be better informed about the public safety system we have, they will likely be better served in the years to come. Perhaps at some point, the St. Albans Messenger will consider investigating this and giving their readers a story from local sources before they grab something off the wire and plop it on the front page.

Wednesday, June 25, 2008

Help Out!

Our job is all about helping others, especially those who need someone with the skills to manage an emergency. Recently I had the opportunity to discover again that helping others can be accomplished other than in the ambulance.

A colleague of mine teaches CPR and EMT classes and recently asked me to help out. Yesterday we taught CPR to a group of high school juniors involved in a local project called MedQuest. The students spend a week learning about and shadowing various medical professions, including EMS. We spent about 4 hours with them and I was pleasantly surprised to find out that several of the students had already had CPR and were interested in EMS. I was able to put in a plug for our local squads by telling them to be proactive...if you want to volunteer or work for your local squad, let them know. Even at age 16 or 17, there are some squads that will let you ride and use your skills up to your cert level, and at 18 you can move up to EMT or beyond. The squads rarely have the time for recruitment, but almost always have a need for additional members.

I also got to help out at a "final class before testing" EMT-B class last night. Sure, I was lured there by the promise of a barbeque (which was excellent!), but I ended up helping them practice practical stations and reviewing what they'd learned. What a great way to beef up those BLS skills as well as helping others in EMS. Here's some pics from that class, held in Georgia, VT.

(That's me with the NRB on. Love that high flow O2!!)

Thursday, May 29, 2008

EMS and Stress relief

If you've been on duty for much time at all, you know that stress, sometimes a lot of it, goes with the job. Sure, we can spend hours lounging around quarters and goofing around with our crew mates, but when the tones go off, we might just be thrust into a situation where we are face to face with someone else's life or death struggle and we are the only solution at that time and place. Stressful, even if everything goes right and things turn out OK. So how do you deal with it? I'm asking any readers to drop me an e-mail @ and let me know. I'll post your responses on here if you'd like.

One solution to the accumulated stresses of this career is being enjoyed at an open field adjacent to our quarters here at Enosburgh Ambulance. Several of us have started flying electric powered RC airplanes and have formed sort of a club, although it is very informal. We come around when off duty and fly and have something to talk about with each other, other than EMS. It is great fun. One of our guys started a blog about it and it is really fun to look, pictures, and friendly jabs at each other's flying abilities. You are welcome to check it out at:

I'd love to hear what you think of the RC blog too.

Stay safe out there!


Friday, February 15, 2008

Don't Shoot, I'm Only the Piano Player...or A Pianist by Any Other Name

Ya gotta love EMS. In the midst of the misery and suffering we see on a regular basis, you can usually count on one thing: Your partner is as twisted as you are and will likely share some of the whacked out ways that we EMTs see the world.

We were en route code-3 to a shortness of breath call at one of the local nursing homes. On just about every call there's someone on the road who seems to have forgotten what to do when they see a large vehicle with flashing lights and siren. I dunno about you all, but my partner(s) and I have come up with some pretty descriptive nicknames to yell at these jokers, knowing all the while of course that they can't hear us. I suppose it makes us feel better anyway. So this car seemingly goes out of his way to cut us off and the first thing out of my mouth is "NICE JOB YA P*NIS!" I felt better and my partner got a chuckle out of it.

Soon afterward we had the patient in the ambulance, and while my partner was getting vitals, I reviewed the paperwork supplied by the nursing facility. The patient was having a hard time communicating and I wanted to get as much info on him as possible. The first page listed name, DOB, etc. but also listed this elderly person's previous occupation: PIANIST. Being a part time musician myself, I leaned over and said " I see you're a pianist, that must have been a fascinating career, I don't think I've ever met a pianist before."

Without missing a beat, my partner looks up from the monitor, and in a voice just loud enough for me to hear says, "Whatya mean? We just saw one on the road a few blocks back!"


Monday, February 11, 2008


Called out this AM to a possible untimely. These calls can be depressing, and sometimes I wonder why EMS should be called. I guess our medical training lets us tell if the person is really dead. Nearly a half hour down time and cold to the touch... confirmed. No CPR done before we arrived. A quick chat with the on duty Medical Director fulfilled our legal angle on things.

A case of giving care, respect, and consolation to the family when nothing can be done for the patient. As I've said before, perhaps our most important role is just showing the people we deal with that somebody cares and will do what we can to help.


Saturday, February 9, 2008

24 at EAS

No details are forthcoming in this post about my recent misfortune, but as a result I get to work more often here at Enosburgh Ambulance. I'm on a 24 today. EAS is a relatively small, very rural service that responds to 911 calls in Enosburgh Town, Enosburg Falls, Berkshire, Sheldon, and Montgomery, VT. We have great equipment and good EMTs, and even though our call volume is fairly low, we get some tough calls, long transports. It's not uncommon to spend the better part of an hour with the patient.

Pretty slow today, just one call, a basketball injury at a local high school. We have snow coming and the scanner has picked up with the local sheriff's department getting busy. Maybe we'll get something happening later.

Take care ya'll.

Search Engine

I just put a spot on the top of this blog that allows the viewer to do a web search directly from this site, while also allowing a seacrh of this site only as well. I'm hoping this will allow me (and other readers) to look through the blog for specific content a little more efficiently. Sometimes I remember writing about saomething awhile ago, but can't remember when. This should allow a quicker search for info.

Is There Anybody Out There?

My first post since September. I'd gotten several comments and e-mails with positive feedback on this blog, and I feel like letting it drop for so long to be a disservice to my readers.

That said, I believe I may have alluded to (though very ambigously) that I have been going through some tough stuff recently. Well, as we say here in Vermont, most of the stuff I was expecting to happen has "sugared down". I am not comfortable sharing with cyberspace the exact nature of what went down and what continues to be a very stressful part of my life, but I am back and hope to continue with the WayOutEMS blog. Hopefully I haven't lost my readers, but I guess as it says in the header, I write this stuff to help me get through the day to day in EMS, and I suppose even if no one reads this, at least I'm getting it out of my head.

Good news is that I broke down and bought myself a laptop with wireles access, and so I have access to the web a lot more often now than I have had in many months. I think one of the factors that makes blogging so successful is to be able to write and publish whenever you feel like it.

So, is there anybody out there? I'd appreciate an e-mail or comment from anybody. I suppose getting back to this is gonna help me work through the crap going on now, and a little encouragement from my fellow EMTs would mean alot to me. Hope to hear from you soon!!

Monday, September 10, 2007

Some action shots...

A local firefighter and former AmCare employee, Ron Robtoy, likes to take pictures on scene when he happens to be around for good calls. He's put together quite a collection of pics. I am posting some here.


Called to a man with difficulty breathing Saturday night. We arrived to find this guy on the floor, barely breathing, audible wheezes, full blown asthma attack. The patient and the only bystander were no help as to patient history. I got on the radio immediately and as I was setting up the nebulizer I was asking for albuterol. My partner is getting the stretcher and everything else ready. The radio operator from the hospital gets on asking for vitals. I told her what I knew: pulse 100, resps about 40 and very labored, bp forthcoming, "I'm more concerned with the "B" from the ABCs right now..."just then the OLMC doc jumped on and gave the order for the neb. The guy was 100% better after 30 secs. of the treatment. He says to me..."I thought I was gonna die"... A good call.

Saturday, September 8, 2007

Saturday 24

I'm on today for 24. There's just 2 crews on Saturdays and my experience has been that its either hit or miss. Either you both end up running like crazy (usually no good calls), or you get nothing. Actually, nothing on Saturdays is pretty nice, as the weekend shifts are a lot more laid back in terms of getting chores done at quarters, etc. Its usually a good day to watch movies. There, I've managed to jinx us for the day.

I hope to touch base here later with an update on the day's events.

Thursday, August 30, 2007

Dealing with the Heavy Stuff

A recent double fatality call prompted a CISD (Critical Incident Stress Debriefing) to be held for local responders involved in the call. I wasn't on that call, but fellow crew members were and from their casual discussion of it at quarters and while riding other calls, it was clear to me that it was a tough one. I attended a CISD for a call a couple years ago. I found it helpful. The team seemed professional and supportive, and structured a session that allowed an outlet for the images that stay with us after a bad call. I noticed that most of the attendees were responders that are volunteers: that is they don't see this stuff as often as a full time EMT or firefighter.

Which leads to my main point. Whether volunteer or paid, first responders see a lot of stuff that is just plain nasty. Stuff that makes you think and that can stay with you for longer than you want it to. The more calls you do, the more likely you'll experience stuff that sticks with you. What's the first part of the newspaper we go for? The obits. Why? For me, its a way of getting some closure. Its an opportunity to learn about the person whom you only got to know as a patient. Sometimes the obits is the only place you can find out if your patient survived.

We transport a lot of very elderly, very sick people. We even get to know them at some level. We see their names and life stories in the obits at a rate of three or four a week.

Critical Incidents? I guess not, but nonetheless, a part of the job.

How do you deal with this part of the EMT's life? Comments??

Across the Waves (EMS to the Rescue) Part 2

We eventually figured out that the state park people were waiting for us at the dock on the mainland with a boat, and that the Town Fire Dept. would be about 10 minutes behind us with their rescue boat, leaving from their dock (which is closer to the station). We rolled up to the small picnic area at the end of the point, being directed by bystanders toward the docks. Our second ambulance was well on the way by then, so we parked our rig as close to the dock as we could and started grabbing gear.

Knowing the general nature of a call before rolling up on scene allows us to grab the gear we might need as we exit the ambulance. Additional gear is usually just a few short steps away if it turns out we're gonna need, say a stair-chair or scoop stretcher. When you leave your ambulance behind while you race away on a boat, however, you just gotta think of everything with the first grab. Thinking Cardiac Arrest, we grabbed the jump bag (essentially a combination Code 99/trauma bag: O2, BVM, combitube, airway adjucts, suction, IV supplies, and just about everything you'd need for bleeding control), the ALS bag (meds, airway, IV stuff, pulse-ox, stethoscope, BP cuff, glucometer), a backboard, c-collar (who knows?), headblocks, extra blankets, gloves and more gloves, and last but not least our trusty Zoll (12-lead ECG, and defibrillator). The boat operator, who works for the State of Vermont Dept. of Parks, turned out to be cool under pressure, willing and able to help with gear, and an absolute pro behind the wheel of the 24' Boston Whaler he had idling there for us.

Between keeping tabs on the radio chatter, making sure the gear was in the best place to keep it dry and secure, and holding on for dear life, the ride to Burton Island went quickly. It was a warm evening, and I told Kari that "we ought to get out boating more often", to which she replied "yeah, without the 30 minutes of CPR we have to look forward to, this wouldn't be bad." As the whaler approached the small island marina, we could see a pretty good sized gathering at the dock. A green State of VT issue pickup truck was at the edge of the dock, ready to carry us on the next leg of this unusual call.

Our craft's captain maneuvered expertly around the mix of private and state-park boats, including the big ferry used to trundle campers between the island and the mainland, and stopped smoothly at the dock. A handful of park workers and bystanders helped with the gear, lugging it the 20 or so feet to the back of the waiting pickup. Kari and I jumped in the back and the truck sped off down the gravel road towards the campsites. We turned this way and that, leaving the open of the dock area and heading into the heavily wooded campground. I was surprized at the size of this island-park, thinking that this leg of the trip alone would have been tough if I had it to navigate with only a dispatcher's directions. Finally the truck ground to a stop near a small gathering of tents and leantos which looked out over a rocky beach. A woman ran up to us and started rapid-firing details about the patient and the situation, while leading the way through someone's campsite and toward the water.

EMTs develop a sense that usually tells us at the first glimpse of the patient, how serious the call is going to be. Considering it was at least 20 minutes from the time the call was dispatched to my first look at what I was expecting to be a pulseless and apneic person, I was shocked and relieved to see, supine on the beach, surrounded by a small group of family and friends, a man in his 40's with his eyes open and a look on his face that told me he was aware of what was happening! Now I often use humor (when appropriate of course) to help ease the patient's fear and apprehension they must feel when they are sick or hurt enough to need an ambulance. I may have overdid it a bit this time, however. My first words to him as I knelt down and checked his pulse were, "Man, you don't look anywhere near as dead as we thought you were gonna be!" Luckily Our guy took it very well, even producing a small smile.

Not a code, but our patient still needed immediate treatment and transport. I didn't like the look of his vitals and knew we had a way to go to get him to definitive care. Suddenly, we were joined by a small army of Town firefighters and first responders. Getting the patient backboarded and moved to the pickup truck went smoothly with the extra help.

We ended up taking the Town Fire boat back and were greatly relieved to find our back-up ambulance at the dock, complete with crew. They had everything ready, so the transfer from the boat to a stretcher, to the ambulance went smoothly. As we cruised on toward the hospital, our pager went off, notifying us of a transport to Burlington that was pending, the anti-climax to an exciting and unusual call.

Saturday, August 18, 2007

Across the Waves (EMS to the Rescue) Part 1

Just as I was fretting about a lack of decent calls recently, I got to take part in a pretty exciting and unusual call a couple weeks ago. Our service area includes quite a few miles of shoreline on Lake Champlain, and its not unusual to get a call at one of the many private camps out "at The Bay". Lake Champlain has many islands, ranging in size from Grand Isle (big enough to have several communities) to little rock outcrops that manage to stay just above the deep waters of this glacial lake. One of the islands is home to a Vermont State Park: Burton Island State Park. It is accessible by private boat or by taking a small ferry that the park service runs. It has a beach, tons of great fishing, hiking and biking trails, and many really fine campsites.

I was working a 24 and the call came in just about at the end of the regular day-shift, when the day crews go home, leaving just our crew for the overnight. The dispatch was to an unresponsive person at the campground. No other information was available. Of course only one thing came to mind: Code 99.

We jumped in our rig and headed code 3 through the rush-hour traffic. We got to the main intersection in town and had just managed to convince most of the drivers to clear the way, when our truck coughed twice and stalled. I looked at my partner (Kari) who was driving and all I got was the "oh shit" look. She tried the key and it was dead. This truck had done this a couple times in the past week and the repair shop assured us that "nothing was wrong with it, it shouldn't happen again." I grabbed the radio and called back to quarters, hoping that someone was still there. I got a quick response and was explaining the situation when Kari got the truck started and accelerated through the intersection and turned onto Lake St. "Better keep a second truck coming", she yelled over the siren, "in case this thing does it again."

On the radio with our boss, I relayed our plan: To continue towards the dock in hopes that we could make it without the truck crapping out again. If we made it that far, we'd head for the island on whatever transportation we could find, and please have a fresh rig waiting for us on the dock when we get back. If the truck did die en route, the second truck (presumably with a full crew) could leap-frog us and get to the dock to take the call. With that plan in action, we rolled on.

With the truck running better than ever, the state park ferry dock was getting closer. Dispatch had Town Fire rolling for med assist (by now we're almost dead sure its a code, even though we still have no more 43 from the scene), and they have a boat. Are we meeting them (at a different dock) to get to the island or are the park personnel on board with this situation? Between the traffic on our channel (getting the other truck with crew rolling), dispatch (getting Town Fire rolling), and all the chatter between the volunteer firefighters trying to coordinate their response, it was just about impossible to glean the info we needed from the din.

The Absent EMT-Blogger

I'm pleased to find out that quite a few people are checking out this blog. I get comments all the time, even on stuff that I may have written several months ago. This (in addition to the lack of therapeutic value I get simply from writing) is why I feel bad about not being as prolific in my entries lately.

I am going through some personal stuff that is also somehow linked to my career as an EMT, and I find it difficult to go to this space and write lately. For good or bad, one way or another, these issues should be resolved in a month, two at the most. At that time I expect that I'll be back at writing a lot more regularly. I may even be able to share with you a bit about what I'm now going through now.

Thanks to everyone who checks in to WayOutEMS...I appreciate the comments. I'm going to try to bust out at least a couple entries this weekend.

Stay safe out there ya'll!!

Saturday, July 28, 2007

Dinner at the Firehouse

I've mentioned in this blog before the relationship AmCare has with the St. Albans City Fire Dept. They respond to all of our calls in the city and are a great help on scene. Tonight my partner and I find ourselves at the firehouse sharing dinner with the FD duty crew. Some barbequed ribs and chicken along with the fixins are on the menu. Last time we did this, we were just sitting down to eat when we got a the city, so we all had to leave our food. Hopefully we'll make it to the after dinner cofee before something comes up. :)

I enjoy these little get togethers, it builds team sprit among the first responders responsible for this area.

Monday, July 2, 2007

Suicide and Trauma

So he said, "May the trauma gods be with you".... Boy do we ever get what we ask for, huh? My sometime partner (out for awhile with a back injury), said those very words to me as he finished washing his car at the bay last weekend. Besides the three trauma calls we had (anaphalaxis, I know, sorta medical, but it started with a TRAUMATIC bee sting, then a fall off of a roof, and an unrestrained driver who suddenly became real up-close and personal with his steering wheel), we had to confirm a suicide death this weekend too. Something in the water or "the times they are a changin'" cause there's been like 6 too many in the past 4 weeks.

Busy freakin' weekend, followed by a busy Monday. How about this folks? Thurs 6P-6A, Fri 8A-6P, Sat 8A-Sun 8A, Sun 5P-8A, Mon, 8A-5P..and on it goes. Whining? Naw, I actually enjoy it. As my sometimes partner Clem says: "Ya gotta check the "insane" box on the application to get this job in the first place....."

Tuesday, June 26, 2007

My Brothers and Sisters

Today my partner and I had to do a long distance transport, leaving around 2PM and returning around 830PM. It was HOT here today, like 95 and muggy like the northeast can be in the summer. Even with AC in the truck it was a long trip: We returned, just a while ago actually, pretty worn out.

We looked at the log when we got in and saw that the crews that were on duty while we were gone stayed busy too, running a whole stretch of calls throughout the rest of the afternoon and early evening. Plus they had to do chores at quarters for the end of shift, etc. When we walked into quarters there was a note in our mailbox that they had gotten ice-cream sandwiches at the end of the day and had left some for us in the freezer.

Here they busted their butts all afternoon and they thought of us. Now there's no doubt that we can get on each other's nerves around here sometimes, but all in all, the ice cream story is the way we treat each other here. And non EMS people wonder why our fellow crewmembers are called "partners" and why we act like a big family.

Thanks guys!

Testing and Re-Certing

A bunch of us had to re-cert recently. Vermont has 2-year re-certs and this would have been my first. The day of the test I happened to be on the state EMS website and noticed that if you maintained your National Registry cert (through a whole bunch of CE stuff!), that that will satisfy the state for recerting. I also had to submit the required CE credits at the Intermediate level to maintain my VT EMT-I03 cert, but it worked out. I think I was the only one that bothered to keep my NREMT-B cert, so I was the only one (besides a couple crew members that had recerted at an earlier time) that didn't have to test that night! I ended up jumping on a truck and running E-calls throughout the entire evening anyway, so I missed just about everything (except the fabulous supper provided by our testing host). :) Later.


If you've been in EMS for awhile, you've probably been to car-wreck calls where either you couldn't believe how freaking lucky the occupant(s) were, or you couldn't get over the small detail that led someone to a particularly poor outcome.

For example, I can remember a crash last year. My partner and I were called last fall at about 01:00 to a single-car 10-50. The town's Fire Department and their 1st responders headed there, as well as the State Police. When we got on scene, the FD and PD were searching the tall grass and woods adjacent to a smoking heap that used to be a car. A discussion with the State Trooper nearest the scene revealed that there were no occupants in the car, and so far, no one had been found injured or deceased anywhere near the vehicle. My partner and I examined the vehicle to see for ourselves if anyone was in it, and to get an idea of mechanism of injury should a patient be located.

From what we could piece together, the driver was going at a very high rate of speed down a paved country road, lost control, veered off the road just at a spot where a ledge dipped down to road level. The car rode up the ledge as if climbing a ramp, continued on for a couple hundred feet, taking out sections of barbed wire fence and several small trees before careening off the ledge and ending up in a ditch adjacent to the road, on its roof, flat as a pancake.

We convinced ourselves after a pretty thorough inspection that there was no one in the vehicle, and if someone had survived the wild ride, they probably wouldn't have had the space to crawl out and take off. That left only one reasonable explanation: The occupant(s) was/were ejected during the crash and were lieing dead or injured somewhere, or were uninjured enough to run.
No sign of anyone was ever found, though I'm sure that the police investigation eventually led to someone who was likely involved.

So, that brings to mind another 10-50 we responded to. A car left the highway on a dry, warm night, slid down an embankment and rolled several times. We found the driver, deceased, still in the vehicle. Looking at the skid marks and talking to the investigators leads me to believe to this day that a momentary lapse at the wheel, maybe reaching for a CD or seeing a deer at the side of the road, coupled with the steep embankment (and just plain old bad luck or whatever), caused the car to swerve just enough, and that was it. I still have a hard time getting my head around that.

Tim McGraw's song, Live Like You Were Dying talks about living every day like it might be your last. So hard to fully put into practice, but do any of us really know?

Stay safe out there.

Tuesday, June 12, 2007

I'm still here

Been way busy lately. EMS has been kickin my butt: Lots of calls and lots of late calls = sleep deprivation for this EMT. I'm getting recharged though, so I hope to be back to some more regular blogging soon.

Just an observation. In the past 10 days or so I have run probably 25 "E" calls. Of those 25 I would guess that we had PD (police) on scene for 15 of them. Is it the moon or something in the water? Who knows? One call had 3 County Sheriffs, 4 State Troopers, 2 Border Patrol Officers, and a couple of police dogs tossed in for good measure. You know what a scene looks like with 10 vehicles running their lights?

Stay safe, I'll be back soon, barring any crazy unforeseens!!

Sunday, June 3, 2007

Busy Weekend

Just wrapping up a pretty busy weekend. I worked the overnight shift at AmCare last night. We ended up with three calls after midnight, so we got little sleep. A couple calls were decent, not fantastic by any stretch, but we did get to use our skills.

On with Enosburgh today, doing a 24. This is Dairy Festival weekend, very similar to Maple Fest in St. Albans a while back I guess. We were on standby for the 10k road race, and ended up transporting a patient with heat exhaustion. It was nice to be able to really make a difference (like lowering his temperature about 5 degrees from on-scene to at the hospital, and getting some IV fluids into him). I wish I had my camera to take a pic of the back of the ambulance after the call: We had IV set-up bags, tape, 4x4s, cold packs, chux, open med bags, monitor leads, etc., etc. all over the place. Funny how you don't realize the mess you're making when you're really working the call until you get ready to get the rig cleaned up. :)

We went from that call to a seizure call. The transport time was a good half-hour, and it was just my partner and I. He struggled just about the entire way to maintain the airway with suction and positioning, while I drove like heck. No IV access due to the tonic-clonic activity. No benzos because we are not allowed and our medical director isn't convinced that paramedicine would be valuable in our district. Ok.

Just got back from a call that involved the State Police (seen those guys several times this weekend). Great to have the "Super-Troopers" go in and make sure the scene is safe for us, thanks guys!!

Thursday, May 31, 2007


I wrote briefly a few days ago about my trip to Arizona. I did get a chance to talk to some EMS providers and also got a tour of Southwest Ambulance's headquarters in Mesa, Arizona. The tour of Southwest was a real eye-opener for an EMT that runs in rural New England.

The crew pictured above were nice enough to talk to me about what they do. They are an RN and EMT-P and they run together as a Critical Care team. They had just finished their rig-check and were checking and signing for their drug box when I first met them. Their ALS box was a whole lot bigger than what I carry as an EMT-I here in VT! We talked about our respective scopes of practice; they were shocked that we have no paramedics in my VT district. Thank you to everyone I met at Southwest, especially Ms. Sandy Nygaard who took over an hour out of her busy day to show me around.

I also got to talk to a crew from another ambulance company, PMT. I saw their ambulance parked outside of one of their satellite headquarters, and just walked in. The crew was made up of a paramedic and an EMT-B. We talked about their service area and I was a little surprised to find that EMS in the definitely urban City of Scottsdale, AZ has a lot of similarities to what we do here in rural VT. They have multiple nursing homes in their area and are called to them frequently. One of them even made a comment about not having a highway in their service area (it is served by another service), and thus they got to go to relatively few 10-50s. Sounds familiar!

I tried to stay aware to what was happening around me as I spent several days touring the area. I did see several working scenes that I would have loved to be a part of. The opportunities for a career EMT are plentiful, and the and sunny everyday. Hmm......

Saturday, May 26, 2007

Saturday at EAS

Made it through Friday night without a "Memorial-Day-based" EMS call, though I was not on duty last nite. I left the house to take the kids fishing at 20:15 last evening and clipped the pager to my belt. My wife asked if I was on call and all I could say was, "no, but I just have an uneasy feeling about this weekend." She said I couldn't respond with the kids in tow anyway, but hey, don't we all want to stay connected? I mean if The Big One were to come up, I suppose I could drop them off at a friend's house between the fishing spot and quarters, right??

Friday, May 25, 2007

22:45 Friday Night

My prediction for th weekend is trauma. Freakin-A, warm weather, end of the school year, maybe just a bit of "bored-EMT who knows what-the F is gonna happen this weekend" premonition. But for God's sake, hand the keys off, OK?

Today was a real opportunity for us to explore the retail opportunities, (as well as take care of a few personal financial obligations) in our service area, as well as being fully aware of the first best weather weekend, combined with the traditional party weekend of the year. Bottom line, Jeezum-Crow if the planets ever lined up better for bad-mojo, I cannot remember when. Good luck to all crews out there this weekend!!!!!

Memorial Day Weekend

Besides the obvious connection that EMS has to Memorial Day, the vastly increased number of PD cruisers on the roads today remind me that this is a big trauma weekend.

As a matter of fact, for some reason things are getting off to a hot start a little early, though they really haven't been trauma calls. I ran a possible broken hip call followed to a suicide attempt yesterday, and the other squads in the area have been running staight out as well. This AM shift is only a couple hours old and we've run 4 or 5 calls with AmCare already. As the weekend unfolds, who knows what else is in store.

Goes without saying, but lets be careful out there. Memorial Day means alcohol in increased quantities for those members of the public that wish to go there, and with that comes the potential for violence. Don't get caught between a drunk and the police that are there to secure the scene before you start to render aid.

As well, let's take a few extra seconds to stay aware on the highways if responding to an MVA. Keep an eye out for rubberneckers, and stay safe so you and your partner can do your jobs!

Tuesday, May 22, 2007

The Artist in the Ambulance

One of my favorite movies of all time is "Saving Private Ryan". Near the end of the movie, after Capt. Miller and his squad have finished the battle by the bridge, Miller (Tom Hanks) lies dieing and tells Ryan (Matt Damon) "Earn This." It appears that Ryan doesn't quite understand at first what is meant (neither did I at first as a viewer), but comes to realize that the sacrifice of others has allowed him to have a full and free life, and he ought to always strive to really earn the gift he's been given, to live a good and worthy life. As the scene in the war fast forwards to Ryan as an old man at the foot of Miller's grave in Normandy, he asks his wife (with tears in his eyes) if he's been a good man, because he had obviously tried hard to live up to Miller's dieing advice. What a powerful scene.

I came upon a song recently by a band called Thrice. I interpret the lyrics as carrying the same theme as above: The gift of life ought to be repaid by living out the rest of your life with respect and caring, to never forget the gift you've received.

Anyway, here's the lyrics, the song is great too. I'm sure its available for download at many of the music sites, I can't link to it without permission of course. I'm gonna try to get permission to link to it because I think the song is good enough to be the EMS theme song. Meanwhile here's a link where a sample of the song is available for listen, and the song can be downloaded for a fee:

"The Artist In The Ambulance"

Late night, brakes lock, hear the tires squeal
Red light, can't stop so I spin the wheel
My world goes black before I feel an angel lift me up
And I open bloodshot eyes into fluorescent white
They flip the siren, hit the lights, close the doors and I am gone

Now I lay here owing my life to a stranger
And I realize that empty words are not enough
I'm left here with the question of just
What have I to show except the promises I never kept?
I lie here shaking on this bed, under the weight of my regrets

I hope that I will never let you down
I know that this can be more than just flashing lights and sound

Look around and you'll see that at times it feels like no one really cares.
It gets me down but I'm still gonna try to do what's right, I know that there's
A difference between slight of hand, and giving everything you have
There's a line drawn in the sand, I'm working up the will to cross it and

I hope that I will never let you down
I know that this can be more than just flashing lights and sound

Rhetoric can't raise the dead
I'm sick of always talking when there's no change
Rhetoric can't raise the dead
I'm sick of empty words, let's lead and not follow

Late night, brakes lock, hear the tires squeal
Red light, can't stop so I spin the wheel
My world goes black before I feel an angel steal me from the
Greedy jaws of death and chance, and pull me in with steady hands
They've given me a second chance, the artist in the ambulance

I hope that I will never let you down
I know that this can be more than just flashing lights and sound

Can we pick you off the ground, more than flashing lights and sound

Friday, May 11, 2007

Urban EMS from a Rural Provider's Viewpoint: My upcoming trip to Phoenix, Arizona

A few years ago, before I was involved in EMS, my parents sold their home in northern Vermont and retired to Arizona. They live in the greater Phoenix area, and from all reports, they love it there. Considering they come from families that have generations of roots here in Vermont, it was quite a change for them. While leaving family and grandkids back here must have been incredibly difficult, they were able to admit that the long, cold, messy winters, inflated cost of living, and sameness of it all here was enough to spend their retirement years where the could actually live a little, not just struggle to get through another winter.

Anyway, I am here in Arizona on a brief visit. The weather is warm and sunny and just about what I would design if I could have a "build-your-own-ideal-weather" genie. I hope to do a little research while here into the EMS scene. I've seen a few ambulances running around, but haven't gotten a chance to talk to anybody yet. I hope to get out an talk to a few medics today about what EMS is like here where the population of the metro area is over 4 million people!

Thursday, May 10, 2007

Prom-Week Mock Crash Exercise

I mentioned in the last post that I had the opportunity to take part in a mock-crash exercise for the local high school. This was a fun project and from our perspective was another opportunity to work with others within the community. Involved besides AmCare EMS was St. Albans City PD, St. Albans City FD, and St. Albans Town Heavy Rescue. Many other individuals and organizations donated time and materials. Did we make a positive impact on our target audience? It's hard to know for sure, but the reaction seemed positive.

This was the first time I have participated in something like this. I have been involved in a couple very large scale MCI drills/trainings, but their focus was more on learning to work with multiple agencies at a large scale event. The mock-crash we did on Tuesday was not really training-based at all. The goal was to accurately simulate the look and feel of a bad car wreck involving kids, alcohol, and fatality. Knowing this going in I was unprepared to find out that it felt almost exactly like working a real call. A lot was going on and we had only choreographed this thing to a very general point. Kinda cool to see that with very little guidance, all these 1st Responders managed to work together to make it seem like the real thing.

We are up close and personal at bad wrecks as a part of our jobs. We have seen the consequences up close and personally, whereas the general public may only pass a scene on the road or read about it in the paper. I hope this event helped at least some of these young adults realize that their actions can and often do have a large impact on others.

Special thanks to Ronnie Robtoy for the photos. Ron also shot video of the event, and I hope to have time soon to create a short movie that interested readers of WayOutEMS can access from this site.

Tuesday, May 8, 2007

Back at Long Last

It has been way too long since I've written anything here. I guess the reason is that I've been pretty busy at work but have really had nothing worth writing about call-wise. Today is really no exception, though we were extremely busy. This is the first time I've had to sit down for more than a minute or two since my shift started at 08:00. I'm on a "24" today at AmCare, though I signed up for an extra shift tomorrow, and by the time I get off at 17:00 I will have worked a "33".

I am in another slump as far as "good" calls go, having run my ass off today, driving for all the e-calls and riding all the BLS transports. I suppose it's not that bad, though it gets frustrating when just about every crew and squad in the area ran some good ones today. Last time I griped about this I ended up running an extremely messy code. I guess I should have learned the "be careful what you ask for" lesson. Besides, just because I'm driving a call doesn't mean I am not taking part: The way my partners and I generally work, we share the assessment duties, each of us asking questions and trying to form a diagnosis, playing off of each other to better nail down a treatment plan that makes the best sense.

We did have some fun today, and perhaps made a difference. We took part in a "mock-crash" for prom week at the local high school. I'll follow up this post with more about this, along with some pics as soon as I can get a hold of them. I also have some stuff to write about an upcoming trip to Phoenix, Arizona.


Tuesday, May 1, 2007

Maple Fest 2007 - Part 2

The Maple Fest turned out good despite typical Maple Fest weekend weather: a steady drizzly rain and mid 50s. I have been on this "promote EMS" kick recently and was disappointed to find out that our staged ambulance was parked quite a ways from the main center of the event. My hope was that we could get a chance to talk to some people about what we do.

As it turned out on Sunday, the final day of the festival, we got to do some promotional things. There was a giant parade and we had an (off-duty)ambulance, preceded by a lot of AmCare's EMTs kids walking with an AmCare balloon-laden wagon, throwing candy to the crowd. My daughter April, who is six, had the time of her life, even though later she told me that the bad part of being in a parade is that you don't get candy!

While the crowd was waiting for the parade to start, we got an e-call and had to disrupt things temporarily to zing through town running code-3. The call turned out to be nothing (false medical alarm), but nobody there knew that, so it looked as though we were doing something other than just sitting there.

After the parade, we moved our duty ambulance much closer to the event's center, next to St. Albans City Fire Department's main truck (311). The two vehicles and crew parked together generated a lot of interest, especially from the kids. The fire truck was a big hit with parents, who took snapshots of their little-ones sitting up in the cab. Meanwhile, I gave several tours of the ambulance, and I was happy to explain to people that we are a mobile treatment center, not just a ride to the hospital. A lot of people didn't know that, and seemed pleasantly surprised to learn a little more about what we do. I also got to walk around with the crowd and talk to a lot of the local people. All in all, the 2007 Vt. Maple Festival was a good time and a success. I hope to be posting some pics here soon.

Friday, April 27, 2007

If You See Seven Moons, You'd Better Finish Your Broccoli Pizza and Get Out of Town!

A patient actually told my partner and I this very thing tonight. Funny, yeah actually hilarious, but sad too, as this person was in serious psychiatric trouble. I've seen a lot of drunks and a lot of fakers, but this person was 100% out there. I hope they can find someway to help this person. All we could do was try to keep this person from hurting them self, even going so far as discussing restraints with medical control (CYA baby!).

Really got me thinking (actually ironically I was thinking of this very thing earlier today and this call reinforces it). What training do we as EMTs get for patients with behavioral or psychiatric problems? I don't remember getting much if anything in my B class, a bit in one chapter of the book, and my Intermediate class touched on it, but not really. How about a training or a class or something that we can get a foothold on better managing these types of calls. I mean, if its not some fancy new ALS thing are we not interested? Holding a hand and listening is sometimes all we can do, and really the best care for the patient. I mean a lot of us are pretty good at this sort of thing naturally, I think it contributed to our initial interest in becoming EMTs in the first place. But I'd like to learn more. I know I do my share of calls that have a "behavioral issue" component.

Overworked and understaffed - Revisited

I received an e-mail recently from a close acquaintance describing a situation they experienced regarding nursing home care. The problem seems to lie in under staffing; perhaps its about making money for the facility, perhaps there's just not enough qualified help available. Either way, the result is not good. I have changed the names of locations (in italics) in the original e-mail to protect the anonymity of the author and the location of the facility.

I heartily agree with your assessment of the nursing homes. I work at a retirement home here in Somewhereville sometimes and had a job this winter with a 300 apartment facility in SomeUrbanplace, Somestate. About half were in the assisted living part, but attendance of qualified personnel was limited there and in the rest of the facility - nonexistent.At the end of my employment there, I agreed to fill in at the reception desk in the independent living section for two weekends - all night 12 hour shifts. To my surprise, I was it - the only employee on duty - solely responsible for hundreds of people - most infirm, with walkers or wheelchairs - on three floors, in two buildings with several entrances to the various sections. It was so huge that I constantly got lost in the labyrinth of floors and corridors.The nurse on duty in the assisted living section was not allowed to attend to any residents in the other sections, so it was up to me to decide what to do when residents called for help. While I did assist several, I never called 911, though I think I probably should have is some cases. The poor residences were terrified that they would be reassessed and be required to move if it was determined that they did not have the capacity to care for themselves. One night, a lower level hall filled with the smell of smoke that smelled like someone burned from food. The chef (who's job topped mine) hadn't left by then, and decided it was not necsesary to call the fire dept, but I worried about it for hours, until the smell disipated, and still think I should have called 911.I could go on and on about the deficiencies in that place.

This seems like an extreme case, but it is happening everywhere that I've seen.

Thursday, April 26, 2007

Maple Fest 2007 - Part 1

Well, it's that time of year again. St. Alban's biggest public to-do is the Vermont Maple Festival, celebrating Franklin County's and Vermont's strong maple syrup-making heritage. As far as EMS goes, it mean three days of available overtime, an ambulance ride in the parade, and at least one crew on stand-by at the site during the daytime events.

It all starts tomorrow. Last year was my first and it was pretty cool. I'm told that it was a completely uncharacteristic day, as the weather was sunny and mild. Traditionally it is cool and rainy for the entire three-day weekend. Forecast for the weekend this year: Showers with highs in the 50's all weekend. Let's hope we can squeak out a bit of sunshine here and there.

Of course our job is to be on site to assist with medical emergencies. It is also a great opportunity to familiarize the public with what we do, and I hope to take the initiative tomorrow if I end up there. I likely will. I am working on the primary crew on Sunday, so I know I'll be there that day.

More info on the Maple-Fest can be found at: Check it out, maybe I'll see you there!

Monday, April 23, 2007

Vermont Bill Addresses Assault on EMS Personnel

H.142, introduced by Reps. Masland of Thetford, Botzow of Pownel, McCullough of Williston, and Shand of Weathersfield, seeks to enhance the penalties for acts related to assaults on PD, PD, or EMS members. I include the bill as introduced below:
Subject: Crimes; assault on emergency medical personnel
Statement of purpose: This bill proposes to provide enhanced criminal penalties for assaulting emergency medical personnel.
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1.
13 V.S.A. § 1028 is amended to read:
A person convicted of a simple or aggravated assault against a law enforcement officer or, firefighter, or member of emergency services personnel as defined in subdivision 2651(6) of Title 24 while the officer or, firefighter, or emergency medical personnel member is performing a lawful duty, in addition to any other penalties imposed under sections 1023 and 1024 of this title, shall:
(1) For the first offense, be imprisoned not more than one year;
(2) For the second offense and subsequent offenses, be imprisoned not more than ten years.

How do I feel about this? Obviously I am against getting assaulted, but I'm not sure that increasing the penalty will make much of a difference. It can't hurt. I think that those that are going to fight police and or firefighters are likely to take a swing at me or my colleagues even as we attempt to render aid. I will be writing my legislatures in support of this, anyone else feel like writing theirs?

Friday, April 20, 2007

Overworked and understaffed

Recent calls to local nursing homes have brought to light an issue that concerns me, and should be of concern to anyone with even the basic level of compassion for those in need. It is not uncommon for our crew to arrive at a facility and not be met at the main nurses station with information as to where the patient is located. Additionally, once we are pointed in the right direction, it is not uncommon to have the patient attended by (if attended at all) by an inexperienced LNA that has no knowledge whatsoever of the patient's baseline condition, emergent condition, or past medical history. It is at times like pulling teeth to get a clear picture of what is going on. We are given a copy of the patient's face sheet and a list of meds and ongoing medical issues, usually 3-4 pages long. By the time we have done our rapid assessment and loaded the patient, we barely have time to review the patient's [written] history before we are out at the ED.

The problem, as I see it, is that many of the nursing facilities have a tough time attracting and keeping good staff, and are constantly understaffed. Especially at night. It is a special person who not only commits to working with the elderly (and often times demented), but does so at a pay scale far below what they are worth. I'm not talking about RN's, cause I imagine they get paid a decent salary. They do have to have the commitment though, as they could pretty much have their choice as to where they want to work. LNAs and LPNs have it rough though. I imagine that the rewards of the job are similar to what they are in EMS: Just knowing that we've made a difference in some one's life is a pretty valuable fringe benefit.

So how do we as EMS providers work through the situation at these nursing homes? I've found that it is invaluable to get to know the providers there, and let them know (without sounding critical or condescending) how they can be most helpful to the EMTs (and ultimately the patients) when we arrive for an E-call. In addition, one of the things I found as a resource for the upcoming EMS Week is a pdf file that deals with how to better work together with nursing homes to increase the quality of the care we as EMS providers are able to give the patient's when we are called to the facility. I'll try to follow up with this in a future post.

Thursday, April 19, 2007

A Visit With Angels - Revisited

In my Tuesday, April 3rd post to this blog, I quoted from a private ad placed in our local paper by a grateful patient who was the recipient of a successful cardiac resuscitation in the ambulance. The newspaper followed up recently with a full article, and I include the link below.

Pretty cool.

Wednesday, April 18, 2007

Short transport distances/times

I was reading a thread on an EMS forum the other day that had to do with the amount of time spent with the patient on calls. A forum member said something to the effect that we are aware that one of the challenges of rural EMS is that transport times are often comparatively long, but wondered about the challenge of the very short transport time in an urban EMS system. Even though I consider just about everything about Vermont to be rural, I feel I have the two extremes with the two services I run with. In Enosburgh, we often have 30 minutes in the back of the truck with the patient. That's plenty of time to run through every assessment and intervention available and/or appropriate. Obviously the flip side of the coin is that definitive care is also 30 minutes away. In St. Albans, the opposite is often true, with drive-time to NMC frequently in the under-five minute range.

I ran with AmCare in St. Albans for nearly a year before starting to do some shifts at Enosburgh, and I think I understand the meaning of the phrase "trial by fire". Depending on the priority of the patient's illness or injury, we often have to move from a very focused assessment to a treatment plan, and right into treatment within minutes. With very few standing orders, communicating with OLMC can also tie up a minute or two. Don't misunderstand: We learn to do it efficiently, but never at the cost of good patient care.

I find it easier on Enosburgh calls to do IVs, simply because I learned to get them done in a minute or two. I sometimes think that the hardest part about an in-ambulance IV isn't finding the vein, but making sure everything is ready beforehand (flush, lock, catheter, tape, etc.) because there is not an extra set of hands back there to hand you stuff.