Episode 112 - Field Training and Evaluation Program

Episode 112 - Field Training and Evaluation Program

Hosts:  Bradley Dean, Eric McCullough, David Blevins
Guests:  Skip Kirkwood

Leaving school doesn't mean the learning process stops. On this week's episode, Skip Kirkwood, a passionate advocate for EMS Training and developer of the Field Training and Evaluation Program, joins the gang to discuss the impact of field training and the impact it has on raising the standards for those just entering the field and those who've been in for a while.

Locally known and nationally recognized, Mr. Kirkwood, MS, JD. EMT-P, EFO, CEMSO,  has an extensive history in EMS having served as frontline paramedic to Chief of the Emergency Medical Services Division in Wake County, NC and past president of the National EMS Management Association. He currently serves as the director of Durham County (NC) EMS and on the editorial advisory board for EMS World.

Links and Resources

EMS- FTEP


Durham County Names Howard 'Skip' Kirkwood as New EMS Director

"Beyond the Classroom"

Episode 111 - EMS Administration and Medical Direction (pt1)

 Episode 111 - EMS Administration and Medical Direction (part 1)

For this week Bradley, Eric, and David would like to focus on some things that EVERY administrator and Medical Director should know about their EMS System.  This will give every day EMS providers an insight into what Administration looks at whenever something new comes out and a snapshot of what an administrator does…..  Next week we will look at the new hire and training…..

 

1.       Community
2.       Purpose/Goal
3.       The System
4.       Diversion vs. EMTALA
5.       Medical Community

 

Episode 110 - FD-CPR

 

  

It has been another great week, and we are delighted to have Michael Herbert and Christopher Watford joining us for the Tuesday EMS Tidbits Podcast to discuss ‘Firefighter Down: CPR’.

 

Why FD-CPR? (information below is in part/whole/paraphrased or just plain copied from www.fd-cpr.com)

When the unthinkable happens, and a firefighter collapses on an emergency scene, we need to be prepared to provide the highest level of care possible.  We know that good neurological outcomes can be had in out of hospital cardiac arrest provided high quality chest compressions are initiated early.  Unfortunately, the resuscitation of a downed firefighter presents a special concern: they’re in full turn out gear with an SCBA!

 

In essence we have an access issue.  Before we can initiate chest compressions we must extricate the fallen firefighter from their gear.  Undirected attempts at removal of turnout gear is time consuming and chaotic.  Therefore, we have developed a simple technique to doff the gear from an unresponsive firefighter which requires minimal training and no additional equipment.

 

Michael Herbert, BS, NRP

Michael is a Clinical Educator with Advanced Circulatory and a FireFighter/Paramedic with Leland Volunteer Fire/Rescue Department, Inc.  He has worked all sides of Fire and EMS, from a tailboard rookie up to a line officer.  He is a two-time State of North Carolina champion paramedic, an enthusiastic educator, a physiology nut, and a lifelong learner.

 

Christopher Watford, BS, NRP

Christopher is a Lead Software Engineer with Global Nuclear Fuels, a part-time paramedic with New Hanover Regional EMS, and a volunteer paramedic / EMS Lieutenant with Leland Volunteer Fire/Rescue Department, Inc.  He is a senior editor with the EMS 12-Lead Blog and Podcast, and also a two-time State of North Carolina champion paramedic.  Christopher is an ECG fanatic, a devourer of research, and enjoys mixing software with medicine.

 

As part of the podcast we will want to discuss their material, and how other people can access/download and use their material.  They have licensed their material in a manner which means that anyone can use this for your own training.  You can share it with other people, take what you need out, and put in your own material.  All they ask is that you provide attribution for the material used.  The material is licensed via Creative Commons Share Alike.

Firefighter Down: CPR

Episode 109 - Pain Management

Episode 109 - Pain Management

Pain Management and Prescription Drugs

Another ‘Hot Topics’ in EMS is Prehospital Pain Management.  I can not count the number of times that I have heard providers say “If it doesn’t hurt me, I am not giving them pain medicine”, or “if they don’t look like they hurt, I am not giving them pain medicine”.  There are many other things that should be debunked, or dismissed as part of our assessment.  Most medical conditions or injuries cause pain, and pain is often the marker that initiates the patient to seek care. 

 

The role of providers is to help alleviate pain and provide comfort for the patient.  This can be done in a number of ways to alleviate pain, but many providers are afraid of administering the medication or do not want to do the extra paperwork.  While analgesic practices vary widely across the nation, I believe that it will be worth while to discuss the pathophysiology and physical need for pain management.  The 5 or 6 different opiate receptor sites, why people become addicted, how other medications are often prescribed to begin weaning patients off of harsher narcotics, etc.

 

As a provider it was not until a few years ago that I began to truly understand the need and different aspects of pain relieve, why some people become addicted to narcotics and some do not.  Analgesia is not equally provided to those in need, and this is a discussion that we need to put out there for the prehospital community to encourage them to examine their practice more closely.

 

http://www.naemsp.org/Pages/dialogPrehospitalPainManagement.aspx

 

http://www.naemsp.org/Documents/Topic004-NAEMSP-PosPaperOnPainMgmntanagement.pdf

 

http://www.summa-ems.org/file.php/1/PROTOCOLS/Pain%20Management.pdf

 

https://www.jsomonline.org/Publications/20081111McManus.pdf

 

http://www.amr.net/About-AMR/AMR-Medicine/Clinical-Quality-Initiatives/The-Things-that-Matter/pain-attitudes--2013.aspx

 

http://informahealthcare.com/doi/abs/10.3109/10903127.2013.844873

Episode 108 - Flipping the EMT...classroom!

Flipping the EMT...classroom!

Scott Snyder will be joining us to talk about some educational theory in the EMS Classroom.  One of the hot topics over the last few years has been “Flipping the Classroom”, which has become something of a buzzword that has been driven by high profile publications in The New York Times (http://www.nytimes.com/2012/06/25/us/25iht-educside25.html?_r=0); The Chronicle of Higher Education (http://chronicle.com/article/How-Flipping-the-Classroom/130857/); and other publications.  The material presentation occurs outside of class through reading or lecture videos, and then the class time is used to do the harder work of assimilating the knowledge, through problem-solving discussions, or debates.

Episode 107 - Aeromedical

Episode 107 Aeromedical

    There's nothing quite like the sight of an air medical helicopter touching down in the middle of a critical scene to scoop away a critically ill or injured patient. In fact, most of us, at some point, had dreams of being that medic in the aircraft providing life-saving care "in the air." 

    We are excited to spend some time talking to a civilian and military flight medic. Jerome Lovelady is the regional trainer and Flight Paramedic for Air-Evac having served both on the streets as a field medic and in the air for over a decade. Sergeant First Class Banta is a flight medic/ trainer for the Tennessee Army National Guard having served in Operation Iraqi Freedom and Enduring Freedom. If you've ever wanted an inside scoop to what it takes to be a flight medic, this is THE podcast you must watch. Do. Not. Miss. It. 

Resources and Links:

The DUSTOFF Association

United States Army School of Aviation

Air Evac Lifeteam

Vanderbilt LifeLight

Appropriate Utilization of Air Medical Transport in the Out-of-Hospital Setting

Guidelines for Air Medical Dispatch

Prehospital use of tranexamic acid for hemorrhagic shock in primary and secondary air medical evacuation

Identifying Obstacles to the Utilization of Helicopter Emergency Medical Transport in the Eugene-Springfield Ambulance Service Areas (NFA – EFO Paper)

Air versus ground transport of major trauma patients to a tertiary trauma center

Study: Transport of Trauma Patients by Helicopter Costly but Effective

Helicopter Transport Increases Survival for Seriously Injured Patients

Benefits of Air Medical Access

Episode 106 - Preceptor Development

Episode 106



Episode 106 Preceptor Development

    Are paramedic interns being assessed equally amongst all providers? Are we giving out students adequate training to make them competent and confident prehospital providers? Do we eat our own young?  Art Hsieh, author, presenter and paramedic extraordinaire, offers insight into how "boots on the ground" paramedics as well as educators alike can work together to provide a consistent and high standard for evaluating interns in the field. 

Resources and Links: 

Teaser Episode 106 - Preceptor Development

 

 

Teaser Episode 106 MP3 Here

The Tuesday EMS Tidbit podcast has reached the end of our first month of production.  While this topic has been in discussion and development for several months, this past month Bradley Eric and I have enjoyed the discussions we have had with each other, and the guest that we have had on the show. 

If you missed last week, the Tidbit hosts enjoyed the virtual company of Dr. Daniel Patterson.  Dr. Patterson discussed his research on the topic of fatigue in EMS.  During the conversation we spoke about various shifts that have been attempted, as well as recommendations they have discovered to help the EMS family be less fatigued by the job. 

This coming week we speak with Art Hsieh.  From his experience in EMS Education, Art talks with us about the role of the preceptor in EMS education. 

Check us out. 

http://podcast.tuesdayemstidbits.com/2015/04/episode-105-fatigue.html

Episode 105- Fatigue

Episode 105 Fatigue

    Blood shot eyes and caffeinated drives. Living the EMS life is exciting, boring, fun, mind-numbing, exhilarating, soul-wrenching, and most of all...exhausting. In this episode, we discuss fatigue and the impact it has on our lives both inside and outside the ambulance. Special guest Dr. Daniel Patterson brings his expertise and research on fatigue so that we can better understand the sleepy monster that drops our eyelids and dulls our minds.  So, grab a cup of Joe, sit back, and enjoy this latest installment of Tuesday EMS Tidbits. 

Resources and Links:

Association between poor sleep, fatigue, and safety outcomes in Emergency Medical Services providers

Why is EMS at risk for Type II diabetes?

The Shift Length, Fatigue, and Safety Conundrum in EMS

Effects of Sleep Deprivation on Firefighters and EMS Responders

Study measures effect of sleep deprivation on EMS providers

Nurse Fatigue

Recovery between work shifts among emergency medical services clinicians

Patient Safety: Fatigue, Sleep, and Work Schedule Effects

Fatigue in Emergency Medical Service [National EMS Advisory Council]

Sleep Quality and Fatigue among Prehospital Providers

If you're ever at this point, it's time to grab some caffeine. 

Teaser Episode 105- Fatigue

Episode 105 Teaser Edition

The Tuesday EMS Tidbits podcast has been a tremendous experience, and you the listeners have given us awesome feedback.  Thank you for helping us during this introduction period, and through some of the changes we have experienced.

In this week's teaser edition I discuss the prior week where Bradley, Eric and I had the opportunity to speak with Dr. Michael Murphy and Mr. Michael Keller from the Difficult Airway course.  While an hour was certainly no where near long enough to discuss all, we certainly discussed some of the basic behind airway management, and we are already scheduling to bring this group back together for another edition.

Coming up next week, we bring Dr. Daniel Patterson onto the show to discuss his research into Fatigue in EMS.  In this episode we discuss the effects of various shifts, additional jobs and various other aspects that cause fatigue and what we can do to limit its effects on our profession.

Join us this coming Tuesday when we release Episode 105 - Fatigue

Episode 104 - Difficult Airway Management

Episode 104 - Airway Management

Episode 104 - Airway Management

     Episode 104 MP3 Here

   Don't let your ego get in the way. The difficult airway, while frustrating, is manageable with the right amount of finesse and practice. Dr. Michael Murphy and Mr. Michael Keller  join the Tuesday EMS Tidbits gang to discuss the "difficult airway" and how you, as a practitioner, can overcome these challenging situations.

  Dr. Murphy is well known in EMS culture and brings more than a wealth of knowledge to both the practical and academic environment of challenging airways. Mr. Keller has extensive knowledge in all things airway and has earned this knowledge by serving more than 25 in both urban and rural EMS settings. 

  This episode will leave you wanting more so be sure and browse the resources below to satisfy your craving. 

Hosts:  Bradley Dean, David Blevins, Eric McCullough

Links and Resources

The Elaine Bromiley Case from Simpact on Vimeo.

Textbook Manual of Emergency Airway Management.  Fourth Edition (ISBN13: 978-1-4511-4491-8)

EMS Airway Management Training

EMS Airway Clinic

Intubation 101

The Airway Site

Episode 103 - Reduction of Medical Errors

Episode 103 - Reduction of Medical Errors

   On this episode, we discuss the impact of medical errors in the prehospital environment. Guest host Gary Wingrove, President of the Center for Leadership, Innovation, and Research in EMS, joins us to help unravel the complex conditions behind cognitive bias and erroneous decision making. Gary has worked with colleagues to establish a system for identifying medical errors in hopes to use the information to better inform prehospital colleagues and avoid these dangerous situations. 

Hosts:  Bradley Dean, David Blevins, Eric McCullough

Links and Resources

• Swiss Cheese Patient Safety Theory

• No More Blame & Shame

• Clinical Human Factors Group

• Human Error: Models and Management (Study)

• National Coordinating Council for Medication Error Reporting and Prevention

• Institute for Safe Medication Practices

• EMS Voluntary Event Notification Tool – An EMS Culture of Safety Initiative

• Emergency Medical Error Reduction Group (EMERG)

• Medication Errors in Prehospital Management of Pediatric Anaphylaxis (Study)

• Paramedic Self-Reported Medication Errors (Study)

Teaser 103 - Reducation of Medical Errors

...

Bradley, Eric and I have enjoyed setting up the Tuesday EMS Tidbits podcast and speaking with our guest hosts. Next Tuesday, we talk with Gary Wingrove, President of the Center for Leadership, Innovation and Research in EMS. Gary has worked with colleagues to establish a system to help identify medical errors and use the information to inform others in how to avoid those situations. Join us on Tuesday for our next episode.

Mentioned Episodes:
Episode 102 - Breakdown: The physical and Emotional tolls of Emergency Services

Upcoming Episodes:
Episode 103 - Reduction of Medical Errors

Episode 102 - Breakdown: The Physical and Emotional Tolls of Emergency Services

 

Bradley, David, and Eric join with Nyi Myint with the Alcohol/Drug Council of North Carolina and Mark Lamplugh with the American Addiction Centers take time in this episode to discuss the physical and emotional tolls that emergency services take on an individual.  From the loss of sleep, multiple shifts, to the negative stressors of the profession, emergency service employees are placed in situations that cause significant consequences.

David Blevins
facebook.com/dsblev
twitter.com/dsblev
david@tuesdayemstidbits.com

Bradley Dean
tuesdayemstidbits@gmail.com

Eric McCullough
twitter.com/teachermedic84

Nyi Myint
Alcohol Drug Council of North Carolina
myint.nyi@gmail.com

Mark Lamplugh
www.marklamplugh.com/blogs

Additional Links

American Addiction Centers -

http://americanaddictioncenters.org/fire-services/

Share The Load Program -

http://www.nvfc.org/hot-topics/share-the-load-support-program-for-fire-and-ems

Are you Under Stress in EMS?

http://www.emsworld.com/article/10776875/post-traumatic-stress-disorder-in-prehospital-providers

International Critical Incident Stress Foundation

http://www.icisf.org

Understanding and Managing Stress

http://www.ccaa.net.au/aust/documents/Stress_Booklet.pdf

Paramedic and Burnout

http://www.giftfromwithin.org/pdf/burnout.pdf

An article to show it is not isolated to the US - one from Iran

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129899/pdf/WJEM-4-26.pdf

one from the UK
http://emj.bmj.com/content/21/2/235.full.pdf+html

We would not do justice to not recognize the stress and difficulty that PTSD puts on relationships.  Here is a 'spouses story of PTSD'.

Paramedic PTSD | A Spouse's Story PTSD
 

Episode 101 - Customer Service: Swallow an Elephant, Choke on a Gnat

Hosts: David Blevins, Bradley Dean. Eric McCullough

Podcast: Tonight's episode discusses the delivery of prehospital emergency care with a customer service based approach.  David, Eric, and Brad come together on this initial episode to discuss the various viewpoints of providing care and ensuring the patient satisfaction.