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A Two For One

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It’s not often that I get to write a combined post about both firearms and EMS. This one is actually a little bit about crime, a little bit about firearms, and a lot about EMS. Or, to be more accurate, the lack of EMS.

Man shot 16 times with automatic rifle during ambush in Cleveland, EMS refuses to respond, officials say

That’s a pretty convoluted headline. At first glance, I thought maybe it was a case where the paramedics refused to go to the scene because of danger. That wasn’t the case at all, but the real story is actually even worse.

First the hysteria in the lede,

CLEVELAND, Ohio — A gunman with an automatic rifle ambushed a 22-year-old man Sunday and shot him 16 times outside his Collinwood home, and Cleveland EMS refused to pick him up because he drove across the street into Euclid, according to police.

Actually a gunman (how do we know it wasn’t a gunlady?) with a SEMI automatic rifle shot the poor Yute 16 times. A fully automatic rifle technically be a machine gun, although the term “assault rifle” is even more scary and sexy.

Also, this run on sentence makes it seem that EMS responded, hit the Euclid city limit, and said “No, we can’t cross into Euclid.” Such was not the case, as the screw up, if indeed it was such, happened in dispatch. Or as I used to call it, “The Puzzle Palace”.

The victim suffered gunshot wounds in his the right side of his chest, his shoulder blade, his right knee, his right shoulder, his right hand, his left
knee and his left foot.

He drove his SUV east and crossed into Euclid, according to police reports. A Euclid police officer found him with gunshot wounds.

So, the victim drove east into the City of Euclid where a police officer found him. You’d think that the police officer from the City of Euclid would call his dispatcher ans day, “Hey, I got a guy here with a bunch of bullet holes in him, please send an ambulance.” Or something like that. You’d think that, but you’d be wrong.

Cleveland EMS refused to pick the man up because he left the Cleveland city limits, according to police reports. Euclid’s ambulance was in South Euclid
on a call. The Euclid police officer loaded the man into the back of a Cleveland officer’s cruiser.

Now, the story is a bit less clear. Euclid’s ambulance was on a call, so they weren’t available. Did the dispatcher in Euclid call Cleveland and say, “Hey, this guy was shot in your city, please come and get him?” Did the dispatcher in Cleveland say, “Nope, not going to drive over the line into Euclid.”, and maybe suggest that the victim get back in his SUV and drive back?

I doubt that. I rather think that this story, gives us a better idea of what might have happened.

Cleveland police advised Euclid officers the man was a victim from a shooting they were investigating. Despite being in need of first aid, Cleveland EMS would not transport him to the hospital, according to the police report.

So, Cleveland police ended up in Euclid and interacted with Euclid offices. My guess, and keep in mind I’m basing this on news from the Fake Stream Media, is that the Cleveland officers wanted the patient transported to a hospital in Cleveland (which might have been a good idea), and called their dispatcher who talked to EMS dispatch and said something like, “Hey, we got a guy that got shot in Cleveland and drove himself into Euclid, can you send an ambulance to pick him up?”

At which point the dispatcher would be inclined to say, “Uh, doesn’t Euclid have any ambulances available?”

I can see how this sort of thing would happen, although obviously the reporter doesn’t know much about EMS, so he just put together some factoids and wrote a story.

If I were charged with investigating this case, here is what I would want to do.

Interview the police officer(s) on scene.

Talk to the police dispatcher who handled the call.

Talk to the EMS dispatcher who took the call.

Listen to the police radio traffic from Euclid, the police radio traffic from Cleveland, and if there was any, the recording of the phone call from the Cleveland PD to Cleveland EMS dispatch. It’s also possible that the request for an ambulance came via the Computer Aided Dispatch (CAD) system if they share the same system. There’s a good chance that listening to all of the voice traffic and a review of CAD records will give the investigator a good of idea of what transpired.

My guess, and it’s really only that, is that there was miscommunication, not any negligence. The Cleveland police officer might have thought it made sense to bring the victim back to Cleveland and called for an ambulance. The police dispatcher thought that it made sense to send a Cleveland EMS unit into Euclid. The EMS dispatcher thought that Euclid would handle the call. And so on.

I would think that the Euclid officer initially called his dispatcher and asked for an ambulance, but maybe not. Maybe the Cleveland officer told the Euclid officer that he’d get the ambulance.

These are a few of the possibilities of what might have happened in this case.

It also won’t surprise me if someone, most likely someone from Cleveland EMS becomes the scapegoat for all of this. After all, when public agency management fails to have clear cut policies someone has to be blamed. Unsurprisingly, that someone is often a lower level employee.

Thing You Can’t Do In EMS

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People who have been in EMS for a while, so called dinosaurs, seem to always lament the passing of the old days. They recall days of yore when equipment, techniques, and even behaviors that are no longer viable were used. To them, all of those things were great and effective. It’s hard to let go and I share some nostalgia for the early days of EMS when there were not so many rules. In fact, there were hardly any.

Times change and EMS has changed, but there are some things you can’t do now. Or at least you can’t do without substantial risk of getting caught and facing some sort of penalties.

In no particular order,

You can’t cheat the federal government. Or the state government, for that matter.

DOJ Settles with Everett Fire Department over Improperly Inflated Fees for Medical Transport

The U.S. Department of Justice, the Washington State Attorney General’s Medicaid Fraud Control Unit, and the City of Everett Fire Department (EFD) today settled all claims that EFD had been overbilling government programs for medical transports, announced U.S. Attorney Annette L. Hayes. Under the terms of the settlement, Everett will pay the two federal programs $127,848, and will pay the Washington State Medicaid program $75,158.

What did Everett do wrong?

According to the settlement signed today, between January 1, 2010, and June 26, 2016, Everett Fire Department personnel submitted claims to federal and state health benefit programs indicating that a higher level of life support service was provided to patients covered by those programs. When the Everett Fire Department paramedics provided only basic life support (BLS), they still coded the claims as if they had provided advanced life support (ALS) which is entitled to a higher reimbursement. Analysts used a sample of claims to determine the damages appropriate in this case.

“Upcoding” as it’s called. Can’t do it. Dallas FD found that out back around 2009 when they were caught doing the same thing.

Here is something else Dallas FD and Everett FD had in common.

Records indicate that a whistleblower within the Everett Fire Department had expressed concern about the routine up-coding, but was ignored.

In the Dallas case, as I recall, the whistleblower tried to solve the problem internally and was fired for his troubles. Which is when he became a “disgruntled ex employee”. Which just about any law enforcement officer will tell you make for great sources of information. Gruntled ex employees are the best kind.

Everett will pay $117,581 to the Department of Health and Human Services, and $10,267 to the Department of Defense. An additional $75,158
will be paid to Medicaid Fraud Control Unit for the State of Washington.

Another article states that the billing company (get ready for that IRS audit) will pay part of this. Also, that the City of Everett paid out more in legal fees than they did in the settlement.

We all complain about it, but you still can’t do it.

SA paramedic bust using ambulance as commuter omnibus

JOHANNESBURG, (CAJ News) – SOUTH African authorities have suspended a paramedic who has been caught allegedly using his ambulance as a taxi.

It is alleged the 46-year-old medical worker in the central Free State Province was also drunk when he reportedly transported three passengers. He
allegedly picked up the hitchhikers and drove them to a local taxi rank.

This kind of a two fer as he was also drunk while on duty. Needless to say, that is right out.

This was his biggest crime,

The incident that occurred when he was on duty also incurred the wrath of taxi drivers plying the route the paramedic allegedly operated.

Said cab drivers were mad that he took money for this. So, it’s not like these folks were stranded out in the middle of nowhere.

The investigation continues.

Drug diversion is bad business.

Judicial Diversion denied to former EMS supervisor

It was like many other opioid-based cases that find their way to Criminal Court. A good person has a life-changing event – most often surgeries –
which results in pain medication being prescribed and the patient becoming hooked.

The addiction leads to criminal activity and lives are changed forever.

For Randy Davidson, the addiction-fed actions came with a steep price. Some might not think the price he is paying is high enough.

Davidson, 48, of Lake Tansi, appeared last month before Criminal Court Judge David Patterson for sentencing after he pleaded guilty in May to official
misconduct, forgery and two counts of theft of less than $1,000.

Lest you think otherwise, it was never okay to steal drugs from ambulances. I’m glad that Davidson was caught.

Here is the part that makes me mad.

Putman sought judicial diversion for her client in hopes that by successfully serving under supervised probation and completing all the
requirements related to diversion, he could not only be restored to the community in good standing but might be able to reapply for the license he
had already surrendered to the state.

Doctors, and for the most part nurses, who are caught diverting drugs (or self report) are not criminally charged. Many are put through rehabilitation programs, have supervised practice, restrictions on their use of drugs that can be abused, and eventually are restored to their previous status. EMS personnel who are caught (or self report) are fired, stripped of their license or certification, and criminally prosecuted. The system has far more sympathy for a drug dealer who is also a user (most of them) than for a person whose life went off the rails due to becoming addicted to pain medications.

For the people who still want to think of EMS as a “profession” keep this sort of thing in mind while you prattle on. While you may think of EMS as a profession, the courts and employers don’t, and won’t cut you any slack at all. Mr. Davidson is now pretty much unemployable at anything above the level of fast food counter help, maybe not even that.

Sadly, Davidson’s story is not at all rare or unusual. I know of several similar cases, including one at my former agency. That one almost cost several managers their jobs and made life miserable for all of the medics for a quite some time.

That’s all for today, because what I thought would start out as a somewhat light hearted post has suddenly made me sad and angry. Not in a phoney Corey Booker sort of way, but in reality.

I’m sure I’ll find more examples of Medics Behaving Badly in the not distant future.

National Concealed Carry Reciprocity

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There is a bill floating around in the U.S. House of Representatives called the Concealed Carry Reciprocity Act of 2017 . The Bill purports to defend the Second Amendment Rights of residents of one state when they travel to another state. As it stands now, there is a hodge podge of state laws regarding concealed (and open) carry of firearms. There are also varying laws regarding mere possession of firearms.

For the purposes of this blog post “firearms” means handguns, rifles and shotguns are a different topic and in general are much easier to move between states.

Even more confusing, there is an incredible range of reciprocity rules between the states. Some states, Virginia comes to mind, will recognize any other state’s permit. That’s pretty cool, although with the new Governor of the state, I expect that to change once again. Other states, Massachusetts and New Jersey come to mind, will not recognize any other state’s permit. Even worse, New Jersey flouts federal law and routinely arrests out of state residents who are transiting the state with their firearms legally stored. Some states will only recognize other state permits under limited circumstances, which I won’t bore you with.

It’s a mess, to say the least.

The Bill now in the House is supposed to fix that and maybe it will.

It doesn’t matter if it will or not, because I think it’s bad law. I’m against the federal government meddling in the affairs of individual states unless there is a clear Constitutional issue. Which is why I think that the Heller and McDonald cases were properly decided. In both cases, the local government was depriving it’s citizenry of any Second Amendment Rights under the guise of “public safety”. The Court saw through that charade and applied the Law of the Land correctly. If in some future case, the Court says that every state, District, and Territory must have some provision for residents to arm themselves, I’d be fine with that too.

This law seems to go beyond that and dictate how each state will deal with every other state. Which is beyond the scope of what the federal government should be doing.

Additionally, I don’t want the federal government sticking it’s nose into firearm licensing in any way. States are going to complain that they don’t want to recognize the license or permit of State X because State X doesn’t have the same training and testing requirements as State Y. The danger is that the Congress of the United States might just decide to legislate that State X must meet the more stringent requirements of State Y. At which point, State Y can up the ante and make their requirements even more stringent. Before we know it, we’re going to have a rigorous de facto nationwide training and testing standard that is not only difficult to meet, but expensive as well.

The net result is that there will be far fewer people with licenses or permits to carry firearms. Which is the opposite of what we really want.

Yes, I know that none of that is in the proposed legislation. Which doesn’t mean that it won’t be in the bill that is passed. The bill has to go to the Senate, where it is very likely to die. If it doesn’t expect Senators from highly restrictive states to insist that the federal government impose training and testing requirements.

I know some of the readers will think that I’m over reacting, but I’d guess that those folks have never watched how much legislation changes during the legislative process. What’s that old saying? “Those who enjoy the law or sausage should watch neither being made.”

Keep in mind that there would be significant person advantage for me if there was a national reciprocity law. At least on paper there would be an advantage. More than one of the states I visit frequently don’t recognize my home state license. In one or two of them, I have the option of applying for a non resident permit, but no guarantee that it will be approved. Having a “denial” on your record when you apply anywhere else is problematic, especially in states where a denial can be made for no reason.

As it is now, I have licenses from multiple states that allow me to carry to about 80% of the places to which I travel. For those who are going to comment about Utah, keep in mind that it does nothing in my particular case. Keep in mind also that it currently costs me almost $300.00 total to renew all of those licenses. One also requires a six hour drive one way for renewal as they require in person renewals. So, add about another $100.00 (at current prices) plus a couple of meals, to that cost.

Having a one size fits all license from my home state would  be very convenient, but I think the larger principles of keeping the federal government out of what should be a state license and not risking an impossibly high standard for licensing outweigh my personal convenience.

For anyone tempted to compare this to driver licensing, keep in mind that the traffic laws in most states are very similar. A red light is the same everywhere. A double yellow line means the same in every state. There are some variations in each state, but that’s more in definition than anything else. Speaking of licensing, a good example of what can happen when the federal government got involved is CDL licensing.

The NRA is behind this bill, but I don’t think that they are thinking it all the way through. There are people at the NRA who know the legislative process much better than do I, but in this case I think they are making a mistake.

That’s where I am on this, at least as of now. Maybe the bill will be passed as is and I’ll be happy, but I’m skeptical, to say the least.

Effect and Cause

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As opposed to Cause and Effect.

I came across this article about guns sold by police departments at auction that were later used by criminals or found at crime scenes.

AP Exclusive: Debate simmers over police selling seized guns

SEATTLE (AP) — Kyle Juhl made one last attempt to patch things up with his fiancée, then took back his ring, put a gun to his head and pulled the trigger as she and her mother ran from the apartment. The bullet went through a wall and narrowly missed a neighbor’s head as she bent to pick up her little boy.

The Smith & Wesson 9 mm that Juhl used to kill himself in Yakima in 2014 was familiar to law enforcement: The Washington State Patrol had seized it years earlier while investigating a crime and then arranged its sale back to the public. It eventually fell into Juhl’s hands, illegally.

It’s fears of tragedies like that, or worse, that have created a split among law enforcement officials over the reselling of confiscated guns by police departments, a longtime practice allowed in most states.

Juhl’s gun was among nearly 6,000 firearms that were used in crimes and then sold by Washington law enforcement agencies since 2010, an Associated Press review found . More than a dozen of those weapons later turned up in new crime investigations inside the state, according to a yearlong AP analysis that used hundreds of public records to match up serial numbers.

 

So, 12 or so guns out of 6,000 became evidence in criminal cases. Not that all  were used in crimes, but they were somehow involved in crimes.

While those dozen or so guns represent an extremely small percentage of the resold firearms, some police departments contend the law shouldn’t be doing anything to put weapons back on the street. The AP did not look at how many of the resold guns figured in crimes committed out of state, so the actual number of misused weapons could be higher.

Or the number might NOT be higher. Which is my guess, because if the number was higher, then we’d be reading about it.

The National Rifle Association opposes the plan. [To destroy, not sell, the guns]

“The police chiefs maybe could sleep better if they went out and apprehended the criminals behind the guns and didn’t worry about destroying perfectly legal firearms that are no more easy to purchase than a brand-new firearm at a firearms dealer,” NRA spokesman Tom Kwieciak said.

This is a good point, and even the article mentions it. The police departments can’t sell the guns directly, they either hire a dealer to auction them off, or they trade them in to a dealer for other equipment. In either case, all buyers must go through a background check before they can purchase a gun.

There is no master list of guns sold by police, so compiling one for Washington state involved dozens of public-records requests to individual agencies. The federal Bureau of Alcohol, Tobacco, Firearms and Explosives keeps track of crime guns but refused to release information from its database, so the AP collected databases from individual agencies and compared them with the sold guns.
This is partially true. As we learned during the Obama years, if a trace is done through the BATFE, then they have the information. They don’t track all guns that are used in crimes.
Police departments sell all kinds of used, found, stolen – recovered, and evidence related property. I wonder if any of the chiefs lose sleep worrying about a former police cruiser that they sold being driven by a drunk. Or if any children are hurt while riding bicycles that were bought from the police? How about a table saw that someone bought at a police auction ended up cutting off a couple of fingers?
My point, which I think is obvious, is that inanimate objects don’t commit or cause people to commit crimes or create accidents. The crime is in the mind of the criminal. As at least one police official points out in the article, someone who plans to commit a crime will find the means to do it. As will people who plan to kill themselves. If someone really wants to commit suicide, then they will commit suicide. No gun? Find a bridge. No bridge? Find some rope, or a belt, or even a neck tie? No tie? Pills.
This is just political feel good virtue signalling. If society wants to stop or reduce gun crime, put criminals who use guns in jail. For a long time at that.
Society, at least some parts of it, seem more intent on banning inanimate objects than in fixing serious problems in society.
So, for now at least the taxpayers will see their money going to waste because some politicians (in which I include police chiefs) feel that it’s more important to engage in meaningless symbolism than meaningful solutions.

2018 Is Upon Us

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A belated Happy New Year to everyone. The holidays ran over me like a train. This was the busiest holiday season I’ve had in several years. We had holiday engagements every weekend in December, right into the New Year.

Right after that I drove to Gettysburg,  PA for the memorial for my long time friend and mentor Lou Jordan. If you knew Lou, you knew what an influence on EMS he was for 40 years. If you didn’t know Lou and are in EMS, you owe him a debt even though you probably don’t realize it. One of the first EMTs in the country, firefighter for Baltimore City, one of the original EMT instructors, an EMS state training director, medic for the FBI HRT, book publisher, and friend of 1,000s of people in EMS.

I like to say that Lou knew everyone in EMS and everyone important in EMS knew Lou. Along with a lot of people who weren’t important in EMS, but knew and loved him for the person he was.

About 200 people made their way to the small town of Union Bridge, MD for the service. People came from all over the country and at least one came from Great Britain to pay their respects. Lou was a one of a kind and I miss him terribly.

Now of course, I have to get back into my “work” routine. I call it “work” because I get paid to do it, but it’s not difficult. There are no long shifts, working in snow storms and freezing cold, carrying heavy (and not heavy) sick people down stairs, up stairs, or through a couple of feet of snow. It’s really teaching and working with a younger generation of EMTs and paramedics. A big part of my job is bringing my experience and education in EMS to people who were not fortunate enough to have the excellent opportunities that I had over my career. As much as we groused about our training at Sort of Big City EMS, we had opportunities that most EMTs and paramedics don’t.

For the most part, once the providers get to know me and I get to know them, we have great conversations and we all learn something.

Oh, and I get paid for it.

To be a good provider, one must always be willing to learn. Unlearning the “facts” that turned out to be wrong is sometimes the hardest part of EMS education. As a physician I know once said, “Half of everything I learned in medical school is wrong. The difficult part is figuring out which half.”

The year has started out on a positive note. The economy is roaring along, the stock market is setting new records on an almost daily basis. North Korea is suddenly interested in “talking” with South Korea. Employment is up, companies are bringing money (and thus jobs) back into the country, and in general things are improving. ISIS is a shadow of itself. A dangerous shadow, but it seems to be curtailed. On a related note, Saudi Arabia seems to be coming into the 20th Century. Not a bad listaccomplishments for a man who never ran for office before deciding to become President. Sure, some of his Tweets are cringe worthy, but those are just diversion devices for the not to bright. And don’t kid yourself into thinking that he had nothing to do with any of this.

For those of you who are “into” guns, in most places this is a good time to buy things. Gun prices are low because there are a lot of them out there, the same with ammunition. It’s not cheap, but it’s available and there are some good deals if you look around. Supply has caught up with demand. I have some acquisitions and dispositions planned for this year. I’ll be posting some pictures of recent purchases here and there.

Speaking of guns, don’t hold your breath waiting for national reciprocity to be enacted into law and signed by the President. It has been passed by the the House of Representatives, but I full expect it to die in the Senate. Even though it would personally benefit me, I’m not a big fan of the concept. Letting the federal government stick its nose into the licensing tent may be tempting, but as we know in an election cycle or two we could decidedly anti gun people in charge and things could go sideways quickly.

2017 will not go down as my favorite year ever. My daughter had a rough year in some regards and that makes me unhappy. One of her cats died quite suddenly, her long term relationship with a guy we thought was nice died not so suddenly, but quite painfully. The state she lives in is taking an incredibly long time to approve the paperwork for her to take her final licensing exam. On the other hand, she has been promoted at work twice this year, although with minimal increases in pay. I think it will all work out, but no matter how old they are, one does worry about his kids.

In addition, a long time co worker died one month after he retired. He had health issues, but had been improving. Another person I miss even though I didn’t see him often. A friend’s wife died, also suddenly. There was too much of that last year and a reminder that there will be more to come over the coming years.

Enough rambling for now. More posts will come as I have time. I’ve been thinking of the future of EMS, but to be truthful, I don’t know where EMS is going. A lot of what is or isn’t happening in EMS is related to funding. Which is uncertain, to say the least.

2018 will be interesting.

What I Hate About Winter

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Everything.

I suppose I could leave it at that, but that would make this a very short post. So, I’ll expand and elucidate.

Snow. I hate snow. I don’t ski nor snow shoe. What I do is shovel it. More accurately, I use my very nice Ariens snow blower to clear the driveway, heater cables to prevent ice build up in the gutters, cement eating salt make the walk useable. I also drive in it when I have to. Which is why I have a four wheel drive truck.

I also hate that snow storms mean that sometimes I have to postpone or cancel plans.

Cold. I hate the cold. The older I get, the more I hate it. Once again, cold stops me from doing things I like. Bicycling. Shooting at the outside range. Sitting outside enjoying a cigar and a single malt Scotch.

Because of the combination of snow and cold, I have to use my exercise bike 6-7 months of the year instead of riding outside on roads and paths.

Dark. It gets dark early in the winter. 8:00PM feels like midnight. It stays lighter long in the south, but I’m not in the south. By 4:00PM, it’s night time. And cold.

Here is the thing I hate about winter the most. I get used to it. Every year once the leaves have dropped off the trees, and the temperatures start to drop, I start to hate the upcoming winter. I dig out my winter clothes, my snow boots, make sure that the snow blower is ready to go. Then, as the winter wears on, my body adjusts, the cold isn’t so cold, I get used to clearing snow, and as the days start to get longer, I  start to think that the winter isn’t so bad.

The solution of course is to move somewhere that there is no winter. That’s my plan, but a couple of things have to happen before I (and Mrs. EMS Artifact) can move. None of which I have the least bit of control over and won’t bore you with.

Suffice it to say, I want to move to a place where, if I walk into the local big box store and ask where the snow blower parts are, I get a blank look.

I also want to move to a place where I can do outdoor activities 8-9 months of the year.

Which is to say, I want to move somewhere in the south. Which will have the added benefit to living closer to where my kids and grand kids live.

If nothing else, I got that off my chest. Thanks for reading.

Random Thoughts

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Pearl Harbor and today’s military

I’m trying to up my blogging volume, but my results have been less than stellar. I don’t think I’ll have time to blog every day, so I’m aiming for once a week. As a result, I’ll probably cover more than one subject a day. Here goes.

Pearl Harbor. Today marks the 76th anniversary of the Japanese attack on Naval and Army assets stationed at Pearl Harbor, Territory of Hawaii. This was one of the worst, in terms of moral, defeats in US history. It was also the worst single defeat suffered by the United States Navy. Ultimately, it lead to a humiliating defeat for the Empire of Japan. The military was moving towards, but not completely on, a war footing when the attack happened. After the declaration of war by Congress on Dec. 8, 1941 that pace became determined and in some ways frantic. The result was the largest military in the world, fighting wars on multiple fronts and winning on all of them.

A strong defense is necessary to deter nations that would wage war from doing so. Unfortunately, America as a nation needs to re learn that very expensive lesson every generation or so. Isolationism didn’t work in 1917, or 1939, or for that matter June of 1950. America is not a warlike nation, so our political leadership tends to neglect the military until there is a war that needs to be fought.

We once again learned that lesson on September 11, 2001. The Clinton administration had used the excuse of the “peace dividend” that came about after the fall of the Soviet Union to undo the rebuilding done by the Reagan and Bush administrations after four years of neglect by the Carter administration. After September 11, the US spent a lot of time, money, and lives fighting yet another war not of our choosing. We can debate all day whether we needed to go to war (we did), or rather if we needed to go to war with whom we did when we did, but we went and made substantial progress during the eight years of Bush 43.

Only to have most of that thrown away by eight years of Obama, a President who apparently didn’t think we needed to sustain a war that we had won and one that we could win. Again, we can debate the strategy, but as General Patton once observed, it’s foolish to pay for the same real estate twice.

Now, just about a year into the Trump administration we see the results of eight years of purposeful neglect of the US military. First, much of the military hardware we own is in need of repair, updating, or replacement. Sequestration meant that much of what was needed was not done because money needed to be shunted to operations and thus maintenance and training were shorted. We see that now in things like ships colliding at sea, a higher rate of plane crashes, shortages of personnel in critical fields (pilots), and officers resigning their commissions far short of when they would be expected to retire. Just this week a B1B Lancer bomber couldn’t participate in an exercise over South Korea due to a mechanical problem. Something meant as a show of force to North Korea turned to be an embarrassment.

Once more, we’re going to have to spend money and likely lives to rebuild our military.

A quick side note. The last surviving member of the US Army Air Force who participated in the Doolittle Raid on Tokyo, Lt. Col. Richard Cole, turned 102 last September. Cole was the co pilot for then Colonel Doolittle. Every day we lose another person who put his or her life on hold to save the world from despots.

President Trump

Still pretty happy that he won. Actually, more happy than I was on election day last year. I voted for him somewhat reluctantly, but there was no real alternative. He’s disrupted the norm in Washington, D.C. by actually doing what he promised. Shocking for a politician. The economy is up, standing of the nation is up, we’re likely to get tax reform, and maybe even national reciprocity for concealed carry. Maybe. Add to that changes in the administrative state, federal judgeships, and foreign relations, and we  have a pretty successful first year.

Yes, his Tweets still sometimes set my teeth on edge, but they do even worse things to the opposition.

Yesterday, he announced that the US would fulfill a 25 year old promise and move the embassy in Israel to Jerusalem. Just as with every other nation we have relations with, the embassy will be in that nations capitol. The reaction from the Left was as expected. Faux outrage.

My son surprised me with a text yesterday after the announcement, “Finest day of the Trump Presidency”. I was surprised because I never thought that as politically astute as my son is, I didn’t think this was an issue that he would pay attention to. I’m not sure if there are wider implications to that, but I think most Trump voters will feel as he does.

Sadly, the Democrats and some in the GOP, have decided that maintaining the phony baloney jobs is more important than doing what is in the interest of the American people and the nation. Hopefully, that will change, but it will be a battle.

EMS

Why does nothing in EMS ever seem to change? Sure equipment changes, vehicles change, but EMS itself doesn’t change. In most ways it’s a skill set in search of a trade or a profession. “Community paramedicine” seems to be a buzzword more than an evolution, let alone a revolution.

Pay for full time, non firefighter, EMS providers is dismal. Working conditions and benefits are worse. Do any fire based EMS systems have their crews drive around in pointless, computer generated circles waiting for calls that might never come? I doubt it. Yet, private systems and some municipal, non fire based systems do just that. As I’ve observed before, System Status Mismanagement is the equivalent of cutting 6 inches off the bottom of your blanket, sewing it on the top end, and then announcing that you’ve made the blanket 6 inches longer. Add to that the need to ask for permission to drive 100 feet to a building with a bathroom, no place to eat a meal that isn’t inside your vehicle, and calls that never seem to end. No wonder people flee EMS to go to other fields after short tenures. The constant churn of staff might be good for the companies, because it keeps salaries at the lower end of the scale, but it’s bad for the “profession”, not to mention for the patients. There is more than a little value to experience in EMS as in medicine in general. Would you rather have a physician that has completed a residency and has some years of experience, or a physician that is still in his residency?

Vehicle safety is a big issue in EMS, with lots of ideas and new  gadgets to make ambulances “safer”. Here’s my simple idea. Slow the f*** down. If we are to believe the various “card” triage systems, we can accurately determine over the phone who is sick and who isn’t. Sure.

Still in most of the country, an ambulance and a fire truck are sent lights and siren to calls even if it’s a relatively minor “emergency”. Depending on system structure, it  could be an ambulance, an intercept vehicle, a fire truck, and a fire supervisor. Once someone arrives, in theory they should be able to tell the other units to slow down. Nice theory. I used to tell people that most of the time, once we arrive the emergency (if there was one) is over. Not always, but in many responses our job was as much to sort out and calm the chaos as to provide actual medical care.

In my last few years I bucked the trend, and in some cases the orders, in my agency where it was assumed that all transports were to be lights and siren. That’s not what the SOP said, as was pointed out to me by the chief when I complained about being ordered to transport a completely stable patient lights and siren. True, but that’s what was enforced by supervisors. I finally had enough and just ignored everyone who told me that we “had to” transport lights and siren.

The real reason that management tacitly approved of lights and siren transports was unit availability. Traffic in Sorta Big City was always a problem, a legacy of street laid out by cows wandering through the then countryside. Sorta Big City became a thriving big city during my tenure and that has accelerated since my retirement nigh on five years ago. Lots of new buildings, no new streets. A street that was barely adequate in 1990 is overwhelmed with traffic in 2017.

Sorta Big City has become a victim of the success of it’s service, the growth of the city, some city policies revolving around residency requirements, and incredible traffic congestion. A two mile transport through the city could take up to 30 minutes without lights and sirens. The best solution would be to double the number of units on the street, but that’s a practical impossibility. Cost aside, retention is an issue even for a service that has excellent (for EMS) pay and benefits. The work load for an agency that has 8 hour shifts as the norm is incredible. 12-16 calls per shift for a BLS crew.

As a result, staff leaves rather quickly. Paramedics who have gone through the rigorous promotional process successfully are highly sought after by suburban fire chiefs looking for experience medics who they can turn into firefighters. Pay for a 48 hour week is about what they would make for a 40 hour week at SBC EMS, benefits are the same, and the work schedule is far less hectic. Do the math as they say.

So, I understand the realities, but a lights and siren transport might be necessary for logistic reasons, but that doesn’t mean that the crews should drive like maniacs to get to the hospital.

It’s even worse if this sort of driving is done by EMS providers doing routine interfacility transports. The vast majority of those are pretty stable patients, but some providers just can’t resist flicking that switch and exceeding the laws of physics with their often top heavy, slow to stop, and not the most nimble steering vehicles. And that’s if the vehicle is kept in tip top condition.

Again, the solution is know the condition of your patient, and not to drive like a maniac. There is no excuse to get halfway to a call or halfway to the hospital because you got into an accident.

Trust the old, retired paramedic on this one.

Blogging

I’m not the only person who has slowed down on my blogging. Even the prodigious Ambulance Drive posts far less frequently. Of course he now writing a lot over at EMS 1 and of course he’s also doing a lot more podcasting. I saw him a few weeks ago at the Texas EMS Conference and meant to discuss podcasting with him. I’ll see him again next month at the memorial service for EMS icon Lou Jordan and will bring it up then. Who knows, maybe I’ll start doing podcasts.

My point is that blogging might be a dying art form, to be replaced by podcasts, Facebook (yech), and even Twitter (yech). Which accounts for part of my drop off in blogging. We’ll see how that progresses.

Enough rambling for today. I’ll try to keep to my goal of posting at least once a week. Maybe even more often if the mood suits me.

September 11, 2001

1

I have nothing to add, because it would be meaningless blah.

 

Harvey

2

Often, hurricane forecasts over state the danger of an approaching storm. It’s easy to be cynical, since meteorology is not an exact science. In the case of Harvey, the forecast was pretty close to spot on. Unfortunately.

In the case of Harvey neither wind nor storm surge were the major problems. Rain, over four feet of it, was the problem. Much of the rain came after Harvey was no longer a hurricane, but was “only” a Tropical Storm.

The flooding is something we have rarely, if ever, seen in the United States. At least not on such a large scale.

Maps show what Harvey’s impact would look like in other U.S. states

The maps at the link show how much area Harvey would cover if it hit in other areas of the U.S. A Texas sized storm indeed.

Texans being the fiercely independent, yet willing to help others in times of need, people that they are, Houston will recover. It won’t be a fast recovery, but it will be a recovery.

Government entities at all levels were prepared ahead of time and had assets well positioned to help. Unlike Katrina 12 years ago, the state and local governments didn’t ignore the threat, didn’t turn away help from outside the state, and most importantly didn’t blame the President when help didn’t come. In the latter case, there was no blame, unless you count the media who desperate to find something to complain about obsessed over the First Lady’s shoes. As if that’s a major issue when a couple of people have died (so far), thousands have lost everything they own and their home as well.

As always, the military and public safety personnel have done everything possible, and likely more than thought possible, to help. Much as they did 12 years ago, but received scant credit for that. Not that they do it for the credit or publicity, but the public should know what their tax dollars are paying for.

The media, is as always, the media. Two media outlets deserve extra opprobrium for their treatment of the victims. Charlie Hebdo, the magazine that had much of it’s staff murdered by Islamofascists a few  years ago, decided that it would be a pithy political statement to portray the dead of Houston as Nazis. Very funny, har, har. Politico, a US based left leaning “news” website had a cartoon lampooning the victims as white supremacists. Because we know that no Black, Asian, Hispanic, or any other group live in Texas. It’s fat white guys, from Texarkana to El Paso, yes sir.

Everyone seems to be donating money to relief efforts. Which doesn’t mean that more won’t be needed. The Hurricane Harvey Relief Fund has been set up by the Mayor of Houston and a county judge. It seems like a worthy enterprise. Houston Texans play J.J. Watt has set up a Flood Relief Fund that has raised more than $14 Million so far. The list goes on and on of individuals, including the President, who have donated their own money. If you care to donate, my suggestion is to donate to a local, Harvey specific charity. I’m not a fan of the American Red Cross at all, so I don’t advocate for donating anything to them. They will tell you, in the small print, that there is no guarantee that any of the money that you give to them will go to any specific disaster. Other big charities may well be the same.

As if we needed more proof that there is no greater country on the planet than America, there is this. Pet rescue. In most other countries, there wouldn’t be enough in the way of resources to save a lot of people, let alone pets. In the United States, we have people who are setting up evacuation shelters for pets, people risking their lives to find and rescue pets, people donating food and other goods to pets. Rescued animals are not only being sheltered in other parts of Texas, some are going to other states as far away as Iowa and Washington. Pets. Pets. Again, no other country would, or could, do that sort of thing in the face of this kind of disaster. Austin Pets Alive! is accepting donations. I’m sure there are others as well, but as with donations to help people, check carefully to be sure that the charity is legitimate.

Speaking of other countries, where are they?  That sound you hear is crickets.

Looters. Might be the worst state to try this in. Texas has very broad self defense protections. A few minutes ago, I heard a police chief from Long Island, New York say on Fox News that it’s only property and not worth risking your life over. He also said that the best response was to call 9-1-1. I’m sure that people in Texas (if they have electricity and a working TV) are laughing at that. Fox also had a young black woman from the area who said that she doesn’t usually carry her gun with her, but due to danger from looters and other criminals, she is now. That’s a Texan, not a New York, response to criminals. A sheriff just warned looters that they should think carefully before they go out to loot buildings. The risk is that they might end up in a body bag. Again, not something you’d hear a police official in New York say.

Texas will recover from this disaster. It won’t be quick, and it certainly won’t be cheap, but it will happen. Because that’s what America does.

Charlottesville

2

I finished reading an editorial in the Wall Street Journal (unfortunately behind a paywall)  a few minutes ago and while overall excellent, a couple of things struck me as incorrect. One is a current talking point of the left. “The KKK may have been founded by Democrats, but it’s embraced by the Republicans these days” is what a very liberal friend of mine said a few weeks ago when we were discussing racism.

He was, however, unable to cite a single instance where a Republican had embraced anything of the sort. He also was unable to say anything except “That’s old news.” when I pointed out the racist enabling language by the former President/Vacationer in Chief.

Second, I think that the President’s Saturday statement decrying violence by all sides in the current political upheaval (it’s not a debate any longer) was not “too weak”, but was a call for calm on all sides. This latest case is correctly being investigated as domestic terrorism, but the problem is that prior acts such as the riots in Berkeley and other places haven’t been looked at as such.

That the police and National Guard were told to “stand down” is a national disgrace, but one that isn’t confined to Charlottesville. It’s not the first time in over two decades that this has happened. In Baltimore just last year the Mayor ordered the police to stand down so that the rioters had space to destroy property. Giving in to thuggery by anyone is bad for civilization.

I hate that this comment is probably right, but I’m afraid that it is.

We don’t like the new rules – I’d sure prefer a society where no one was getting attacked, having walked through the ruins of a country that took that path – but we normals didn’t choose the new rules. The left did. It gave us Ferguson, Middlebury College, Berkeley, and “Punch a Nazi” – which, conveniently for the left, translates as “punch normals.” And many of us have had personal experiences with this New Hate – jobs lost, hassles, and worse. Some scumbags at an anti-Trump rally attacked my friend and horribly injured his dog. His freaking dog.

Will the country dissolve into another Civil War, only this time divided not by North and South, but Left and Right? I hope not because the extremes of either side are not places where I want to live. Political violence of the type we’ve been increasingly seeing over the past several years is not only not the way things are done America, they are anathema to the democratic republic which we are meant to be.

I hope that the Department of Justice will investigate all cases of political extremism that exhorts or results in violence, no matter who is involved.

The driver that allegedly committed the murder is in custody, but that should be the beginning, not the end of the investigation. Violent attacks by anyone at what is supposed to be a peaceful political rally should not be tolerated and should be aggressively prosecuted by state and federal law enforcement agencies.

THAT is what I want the President to tell us is going to be his policy. Debate, yell, hold up stupid signs, sing silly slogans, wear idiotic costumes all you want, but any sort of violence should be stopped by the police immediately and the perpetrators prosecuted.

The only way that this political violence will be stopped is if it’s not tolerated no matter who is doing it.

All About Me

After a long career as a field EMS provider, I'm now doing all that back office stuff I used to laugh at. Life is full of ironies, isn't it?

I still live in the Northeast corner of the United States, although I hope to change that to another part of the country more in tune with my values and beliefs.

I still write about EMS, but I'm adding more and more non-EMS subject matter.

Thanks for visiting.

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