Psychological Trauma in EMS Patients | PTSD

Free EMS Seminar –

NY Paramedics and EMTs. 

Through the use of case-based lectures, highly interactive student activities, and realistic scenario stations, this course prepares providers to integrate specific interventions designed to mediate patient psychological trauma on all ambulance responses. The evidence based content reviews the physiological and psychological effects that occur when patients and family members experience an emergency situation requiring EMS involvement. For full details click the image below.

12-Lead ECG Interpretation for Advanced Life Support Providers a

Get full details via the download click here. 


Free Webinar | EMS Exam Success

Study5Join me for a free live webinar on March 16th at 1500 hrs, EST

Everyone has a different method of studying and preparing for exams.

You have probably developed this over the course of your life and it works for you.

The thing is, maybe you are working harder to study and pass exams. In EMS this is definitely when working harder is NOT smarter.

So, I am doing a quick EMS Exam Success workshop that you can come join me in.

In this webinar I am going to show you my method of studying and preparing for an exam and how I coach EMS students when they are struggling.

A method that has worked for them and me time and again.

It’s 100% free and I am giving away a special gift at the end of this event as my way of saying thank
you for joining me. (Hint: It’s a download of EMS study resources that usually sells for $20).

To get details and sign up for this event just click the link below.

Click Here To Sign Up 

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Member CVA Feedback

EMS1So my post the other day about my CVA call offered me one huge insight to my members…. they are great.

Not just because they have sent me numerous emails and messages about this call agreeing with my course of action but also because they offered me feedback about the call itself.

Three common points mentioned where;

  • That this patient could have had a UTI or other infection. I did actually consider that but the patient did not feel like she had a temperature and her heart wasn’t elevated. She also had no recent illness or injury complaints. But this was a great point by the members.
  • The other one was why I didn’t do a BGL test. I actually did do one but forgot to note it in my original email.
  • The third was why I gave oxygen when her SpO2 was above 94%. I do agree that there is research showing no need for supplemental oxygen in this case. But research doesn’t always follow along with protocols or what the ED docs expect. So sometimes we have to keep doing some things we may feel don’t need doing.

I also received many more thoughts on this and appreciate all the great feedback. It lets me know that my members are indeed true EMS professionals who think outside the box and look for things beyond what may seem to be the obvious.

If you didn’t have a chance to read the original post you can do that here.



If you struggle with clinical judgment or want to improve your skills in this area. I encourage you to check out Turbo Medic. Many of the members of the blog or email list are also Turbo Medic members or have been in the past. Build your knowledge base and join me inside this exclusive members only website today.



My patient has slurred speech but…. WWYD?

zebrahtI sent this email to my members the other day about a possible stroke call I had.

Most of us expect that one sided droop, weakness, slurred speech or no speech deal.

What I get is a 78 y/o female completely alert who says she feels like her speech is slurred.

I do note some slurring. But no facial droop, negative Cinninatti Scores etc.

She also complains of headache that has been worsening over past 3 hours and numbness to her right hand for the past 20 mins, which is about the time she noticed her sleech issues.

When doing my history taking she can’t seem to recall details like why she takes a medication.

She says she feels “dopey” like she can’t formulate her thoughts as she usually can.

Her BP was 176/100, HR 88, RR 18, Sp02 98% on room air.

Here is what I did.

I called this in as a Code Stroke. Started an IV, gave 02 via NC and perfromed a 12 lead.

To me although she wasn’t presenting like a classic stroke patient, there where enough signs and symptoms to suspect that one may be occuring.

It may even have been a TIA.

But I felt better to up triage and treat as a CVA than blow it off and have her suddenly get worse enroute to the ED.

Plus I always worry that if I don’t point out my suspicsions she would end up in a ED room or hallway and not be seen for 10-15 mins or longer and suddenly a nurse will think “hey this may be a stroke” and now precious time has past where the alert talking patient is now unable to communicate or move her entire right side.

So, what would  you do in this case? The same? Totally opposite?

I’d be interested to know if you think her complaints warranted a priority transport or not.

Leave your comments below with your thoughts and keep an eye out for a follow up on this in a few days.

EMS Study Help

If you want to be a better clinician and think about a bigger picture with your patients like the one above, Members of Turbo Medic do just that. Anyone can follow a protocol, real EMS professionals look at the whole patient presenation and treat/transport in the best interests of their patients. Join me at Turbo Medic and see what I mean –


A Cool Thing About EMS

wwpmainLike any job EMS has it’s negative aspects. Often we can get bogged down with them and forget why we became EMT’s or Paramedics and miss out on the cool stuff. The opportunities that can matter and leave us as individuals feeling like we have a pretty cool job after all.

Recently I had the opportunity to do a stand by for a Wounded Warrior Project Bike Ride.

If you know me you know that this is a foundation that I support and have in the past donated a percentage of sales to them. I never have had the chance though to be at an event in person and see first hand the amazing dedication of its members and the participation of the Wounded Warriors themselves.

We arrived at the staging area and I did not know this but the Project provides all the bicycles and tricycles and helmets. They provide the water and organizational support to have these events succeed.  So as I watched the staff unload the bikes, lining them up I grew emotional knowing what this was all for. I began to realize this was more than the commercials I have seen on TV.

Not that I wasn’t aware of the depth of this organization and the importance of what they provide for our wounded veterans. I think it was more of seeing it first hand and perhaps knowing it was so much bigger than me and my simple donation.

As we began the riding route, a few bikes had issues. The WWP also had staff  to troubleshoot and fix any issues with the bikes along the way. This was a short 13 mile ride and included one short break midway. During this break I knew my role was to support them in a medical role. My partner would go around to see if the participants needed anything from us during the break and to let them we were there should they require us. There was one rider who fell early in the ride but got back on his bike and continued on.

In all there were about 35-40 participants and staff and the pace was set to the slowest rider, never leaving any one rider behind too far. It wasn’t a race. It was a ride to support the Wounded Warriors and the WWP.

The entire event lasted about 4 hours. Not long. But long enough to for me to realize that I get to do some pretty cool stuff in EMS.

I have been on Third Watch, meet actors, singers and athletes.

The honor I felt being a part of this Wounded Warrior Project Bike Ride was beyond anything I can think of in recent years. I suppose as a veteran myself I feel a connection to these warriors. While I can never compare what they have gone through or what they continue to struggle with. I still feel they are my brothers and sisters.

It is experiences like this that make me proud to be in EMS. That drive me forward to look beyond the negatives and focus on the positives.

Maybe we can’t all be a part of events like this. To sit back and say “What a cool job I have”.

Yet I have to disagree in that each day we have opportunities to say just that. The newborn we delivered, the STEMI we alerted, the CVA we recognized or even the hypoglycemic patients we treated. To me these are all pretty cool things we are a part of and do everyday.

I think by recognizing that we are professionals, that what we do for our patients and their families really can matter. We can say “What a cool job I have”.

We can feel honored in being in a position to help others when no one else can. It’s an honor that I think we all overlook sometimes. It’s an honor and privilege to be allowed into peoples homes everyday when they are at their worst. We must recognize this and treat it that way.

I hope you as my reader recognizes this. If not, my hope is that you get to do something cool like I have mentioned in this post. Something that makes you take a step back and realize that being offered these opportunities truly is a cool part about EMS.

I have posted some pictures below from the stand by and I hope you will go check out the Wounded Warrior Project by clicking here.


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EMS Employee Scheduling In Real Time

EMS scheduling doesn’t have to be difficult or confusing for EMS managers or employees. Check out this video that shows a first hand account of how using EMS employee scheduling and management software can benefit an organization and it’s employees.

Get a customized free trial of the software mentioned in the video by clicking here.



Control Your EMS Scheduling | More Than Just Words

250x300-web-kasondraYou may have seen several postings and heard commentary about EMS Manager. This innovative and easy to use software has been proven to save both time and money when it comes to managing your EMS workforce.

Check out this video that actually shows you how employees can submit availability using the software. I think that while commenting and giving links to their free trial is great. A video like this really shows the power of this software tool.


I know must be impressed by now. Go check out what EMS Manager users are saying here and if you or your agency is looking or even considering moving to an online EMS employee management and scheduling software, sign up for a free trial by clicking here.


Are Volunteer EMS Agencies Cheaper To Operate?

Training1You often hear the about the struggles of volunteer EMS agencies and raising funds to operate and provide the highest level of care to their communities. While the labor may be cheap, the costs to run the organization is the same as any of the paid agencies out there. Sure it may vary depending on location but no matter how you look at it, it isn’t free.

Even members of the volunteer agencies pay out in time. I’m sure you have heard the “Time is money” phrase and members and officers alike put plenty of time into their volunteer organization. Just think about how much a paid EMS professional gets and how that same pay is being done for free by volunteers. 

Now I don’t want to get into the whole paid vs. volunteer debate here in a short blog post, you can join us on the podcast for that discussion. But I thought it would be a good idea to highlight one way that volunteer EMS agencies and members can cut down on time spent and equate that into savings. 

Listen, saving your members time and ensuring that you have members scheduled for training and shifts etc. makes the whole organization run smoother and I think a stronger organization as well. Check out this story below on how one EMS volunteer agency was able to save time and energy by making one aspect of the operation run smoother:

Using spreadsheets to organize, schedule and accommodate payroll for 20 paid and volunteer staff members at Roanoke Municipal Ambulance became far too time consuming for Troy Schuler, Chief of Ambulance Operations. “We needed to make a change. I spent several months trying all the free demos I could get my hands on. What I like best about EMS Manager are all the options the system has and the fact that I can customize it to fit our department’s needs.” Schuler states. “I feel EMS Manager is more of an all around management tool; it’s not just scheduling software.”

Chief Schuler states he and his staff utilize EMS Manager’s forum feature quite frequently.  He likes the way his squad can interact and discuss upcoming events, past meetings and training sessions.  He also uses the forum to allow members who could not attend a meeting to come up to speed on what they missed by reading the minutes online.  In addition, Chief Schuler indicates he uses EMS Manager to keep track of various training documents and staff certifications as well.

“The biggest difference I have seen in our department is the way people change their shift and sign up for shifts. It used to be done via email or text messages. EMS Manager has sped up the process dramatically. Now, personnel can change shifts and find coverage on their own through the system, without having to make a thousand phone calls back and forth with each other and with me,” adds Chief Schuler. “On average I save ten hours a week doing payroll and scheduling. Those 40 hours a month I save enables me to focus more on recruitment and community outreach.”

Like many SaaS (Software as a Service), or cloud based, software systems EMS Manager also provides a convenient mobile web app to subscribers.  This makes the system available from any smartphone or other web enabled device – such as an iPad or iPod.300x300-web-Jay

The majority of staff at Roanoke are volunteer, including Chief Schuler.  Since they have full-time jobs elsewhere, the ability to access and make changes to the schedule remotely is very important.  Chief Schuler states the mobility of EMS Manager allows him to manage the department much more easily and puts the schedule, employee data and staff communication at his fingertips.    

“One of the main reasons we chose EMS Manager is that it allows me to manage my team while I’m on the go. I can keep the schedule rolling smoothly from anywhere,” shares Chief Schuler. “All my staff are currently using the mobile app too.  It has made scheduling a thousand times easier and faster.”

I think that is some powerful feedback and is worth giving something like this a try. In fact EMS Manager has a full featured customized free trial of their software. So, if you think that saving time and expenses can help your agency, sign up for a free trial at EMS Manager. 


Paramedic License or EMTP Certification?

ems paramedic questionsThis content is from the Authorized Transmissions newsletter, but I thought it would be great to pull it out and highlight it all on it’s own.

When it comes to being a licensed paramedic or a certified EMTP, opinions vary and it will depend on who you talk to.

Certification: Agency or association grants recognition

Licensure: Governmental agency’s competency standards are met

Now when you think about it, for most states it is one and the same. Even states that require NREMT “certification” still mandate that you take a state exam or meet state standards to be considered competent to practice as a paramedic in that state.

From the NREMT website “…Licensure, .. is the state’s grant of legal authority, pursuant to the state’s police powers, to practice a profession within a designated scope of practice. Under the licensure system, states define, by statute, the tasks and function or scope of practice of a profession and provide that these tasks may be legally only by those who are licensed.

As such, licensure prohibits anyone from practicing the profession who is not licensed, regardless of whether or not the individual has been certified by a private organization.”

So, what’s in a name then? Especially if both descriptions are interchangeable and more importantly any state allowing you to work as a paramedic is giving “license” to do it.

Well that is just it. Some states like NY and NJ have been getting petitioned for years to change the identification from certification to license, but for some reason it just has not happened.

What’s the hold up?

Resistance due to education levels? Fears of infringing on other healthcare fields? Perhaps even those EMS insiders who like things just the way they are?

However you look at it. The bottom line in my opinion is that the paramedic profession should be licensed.

States cannot continue to dictate requirements and keep it noted as a certification in order to keep other professions happy.

Nationwide, paramedics should hold licensure and if need be, individual states can set specific requirements for that region in order for that paramedic to work and practice within a set scope or guidelines.

Government agencies need to remove all mention of certification from paramedic programs and gear all education and testing to a licensure format. If that means making exams more difficult, setting higher continuing education requirements and holding individuals to a higher standard overall, then so be it.

I think that this would be a move in the right direction for EMS as a whole and a step that is relatively easy to implement.

Listen, I don’t have the answers to this or know why with a certainty the word license is not the accepted rule.

Maybe we shouldn’t be putting too much energy into this to begin with since in the end it’s just a word.

The reality is that, no matter what the state calls it, a state issued “license” or “certificate” is functionally the same and is a “license”.

The difference to be aware of is that while the terms might be interchangeable for what a state calls it, non-government agencies like the NREMT, are certificates since licenses grant an official privilege (like the ability to drive or practice medicine) whereas a certification is simply a non-government agency saying that you have met their standards (like NREMT, AHA, PHTLS).

What do you think? Does it matter?

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EMS Employee Scheduling In Action

It’s one thing to mention how useful and financially beneficial the EMS Manager software is. It’s a whole another ballgame when you can see it working in action and actually envision how you can see yourself using this employee scheduling and management software.

The video below gives a behind the scenes look at how to sign up for open shifts in your workforce management & employee scheduling software using EMS Manager.

Click here to sign up for a free customized trial of EMS Manager.