The Tapes Don’t Lie, But People Do

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Over at JEMS Connect there is a discussion going on about the Pittsburgh EMS incident.

Frankly, most of the comments are as I’d expect, pretentious. I’ll get to that in a minute.

JEMS perpetuates the myth that Paramedic Josie Dimon was fire for swearing on the radio. First, she wasn’t on the radio, she was on a cell phone with communications. Second swearing on the radio is not a termination offense in any system I’m familiar with. Certainly people have been disciplined for it, but termination is excessive unless the person has a long disciplinary history.

The comments don’t dwell on that aspect, so it’s not that huge a deal. Nor do the commenters seem to have a really good grasp of the what the problem with PEMS.

One commenter, Ben Waller, misrepresents what I and Rogue Medic have said on this subject. When I say that this is a systemic problem, I mean that this is a management problem. It’s pretty clear, at least to me, that management failed to plan for extreme weather. This was not a question of medics being too lazy to do their job. From every report I’ve read, they were doing back to back calls all shift long. In fact, after digging out from the Curtis Mitchell call, they were immediately dispatched to another call. Nor was this a problem with third service systems, since we see far more of this sort of thing with fire based systems. Whether or not it’s a problem with all ALS systems, I’m not prepared to comment on.

What this clearly is however, is a failure of city management to prepare for a extreme weather event. Yes, I know I’m repeating myself, but this fact bears repeating.

Despite all the blather over at JEMS Connect, no one seems to really express this. This is not a matter of just walking ten minutes and saying hello to the patient, several other factors have to be considered.

What equipment are PEMS medics required to bring to the patient? Monitor? Medication kit? Primary bag? Conveyance device? Oxygen?

How is that equipment organized on PEMS rigs?

How would they get the patient back to the ambulance if he couldn’t walk?

Remember also that there was more than one call back to the Mitchell residence, at least one of them by a doctor. The crew didn’t give up, they were canceled by dispatch after the phone consultation.

Would sending the fire department have helped? Maybe having more hands would have been beneficial, but maybe not.

Sadly, most people will be content with the city terminating one person and disciplining three more. No one will want to look under the hood and fix the underlying management problems in Pittsburgh. My guess is that this sort of mismanagement goes far beyond just the EMS system.

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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.

11 COMMENTS

  1. I had not been following this on JEMS Connect. One important point about JEMS Connect, if Ben Waller agrees with you, be afraid, reconsider your position. Ben Waller is a logical fallacy generator. He makes ridiculous claims with absolutely no basis, apparently only because the ridiculous claims support his opinion. I left some comments for him. He will probably change the subject, claim I am being unfair, and trot out his favorite accusation – straw man. I suspect that the only reason he knows this term is that he has been criticized for using this logical fallacy on a regular basis.On the plus side, he may help to direct intelligent readers to us. They may understand that if Ben is criticizing us, we are worth reading. 🙂

  2. Thanks Capt. Schmoe. Rogue, I seem to remember reading Waller's incoherent rants somewhere in the past. I'm not sure whether or not if I should dignify his comments with a reply.

  3. I've had a few run ins over at JEMS Connect with Mr. Waller as well. Unfortunately his modus operandi is to hijack the conversation to pontificate how Fire based EMS is better than everything else… hence why I don't really bother with JEMS Connect anymore because it stops being a conversation when that happens.Interestingly enough, it doesn't sound like he has changed much.

  4. In most emergency operations plans, the mayor/city council is ultimately responsible for planning for these types of issues. As in "if you knew it was possible and you didn't have a plan for it, it's your ass we're coming after." Trust me, I've worked on a few, and that tidbit of info is nestled in there somewhere. I'd love to take a peek at the Pittsburg EOP.You brough up a good point on what would happen with the theoretical "well, we walked to him, now how do we get him back?" Could you imagine carrying/pushing Curtis Mitchell through a foot of snow? With equipment? What if someone slips? What if the cot gets stuck? Do they have enough blankets to guard him against probable hypothermia?

  5. I think it's organic to large bureaucracies to save themselves even if it means sacrificing individual members. Of course the people who make those decisions are at the top of the organization and they aren't likely to sacrifice themselves, are they?

  6. Minimedic, I've done that, it's not fun. Of course we had eight people on the call, not two. Then again the patient was in the 300+ pound range.

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