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Home > Topics > Social Media for EMS
July 06, 2010
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The Ambulance Driver's Perspective
by Kelly Grayson

Think before you post

Hasty online reader comments prove two points: Everyone is an expert about somone else's call and EMTs eat their own kind

By Kelly Grayson

If you ever doubt the decline of human civilization, all you need do is read the viewer comments on any YouTube video.

Read at your own peril, however. The poor grammar, atrocious spelling, questionable punctuation, and general lack of manners displayed there makes me want to curl into a fetal position and weep for the future of our species.

When posts go awry

Examples of hasty member comments

When Curtis Mitchell died because Pittsburgh EMS crews couldn't reach him in thirty hours, during the worst blizzard to hit the area in half a century, the first commenters on the EMS1 story were critical of the actions of EMTs they never met, on a call in which they didn't participate, under conditions they didn't experience, based on news stories by reporters with more interest in a salacious story than accurate reporting of EMS and rescue operations. News stories, in fact, that did little more than parrot the public statements by the mayor and public safety director, both of whom bear at least some responsibility for the debacle.

When MEMS paramedics mistakenly declared a woman dead, not just once, but twice, the reaction on EMS forums was universally critical. "How hard is it those for those idiots to check a pulse?" was the most common sentiment. Same story with two Prince George's County paramedics who had a similar call a couple of weeks later.

When AMR medics staged too close to a shooting scene in Jackson, Miss., they ignited a firestorm of negative public opinion, wondering why they remained parked less than a block away, and opining that Michael Olowo-ake would have survived had they entered sooner. Shamefully, some of those critical comments came from fellow EMTs. Some were even rash enough to criticize them because they didn't care for their employer.

Whenever the JEMS Facebook page posts a link to my blog or this column, it invariably incites a number of readers to react angrily to the term "ambulance driver."

All of this demonstrates two ugly facts about EMS that I suspect have been true since Jesus Christ performed the first successful resuscitation: everyone is an expert about someone else's call, and EMTs eat their own kind.

I'm not sure if that's testament to the IQ of the average YouTube user, or if there's something about posting on the Internet that inhibits politeness and common sense, but judging from what I've seen on various Internet EMS forums, I'd say it's the latter.

One of the advantages of living in the electronic age is the speed of interpersonal communication. A medical helicopter goes down in a remote location, and Twitter will be alive with the news long before the major media outlets. An EMT gets stabbed by a violent patient, and you'll read about it on an EMS discussion list the day before it appears in the local paper. An ambulance service owner gets indicted for Medicare fraud, and we'll be trying the case in various Internet forums long before the Eyewitness News gets wind of it, and without the due process afforded the accused by our justice system. News travels at the speed of thought these days.

Unfortunately, so does stupidity and rash statements. The price of having near-limitless information at our fingertips is tolerating people who run out of functioning neurons before they run out of characters in a Twitter post.

Most EMTs will attest to the value of a thorough and accurate patient assessment. Why then, do so many of us fire off ill-considered opinions before we have an accurate and thorough assessment of the facts? Is it our collective professional ADHD that renders us incapable of reading all the way through a story before burning up our keyboards?

And if you think there aren't a lot of ADHD sufferers in EMS, think again. This profession is tailor made for ADHD symptoms. Think about it. Are you restless? Do you crave constant and varied sensory input? Do you find it difficult to focus on tasks for any appreciable — hey, let's go ride our bikes! Oooh, a squirrel!

Sorry, got distracted for a minute. Where was I?

Oh yeah, incivility in EMS discussion forums. Whether due to poor impulse control from ADHD, or just a general lack of manners, shooting off your metaphorical mouth on an Internet EMS forum ultimately lessens us all. Don't be so quick to judge your peers when you weren't there.

Who among us has not read a news report of a call they ran, and wondered if the reporter was actually on a different scene? Controversy sells more ad copy than a simple, unbiased reporting of the facts.

Medics thrown under the bus
The death of Curtis Mitchell put a human face on the Great Blizzard of 2010. Ultimately, four Pittsburgh paramedics were thrown under the bus to salvage the reputations of a mayor and a public safety director who failed egregiously in their duty to prepare the city for the coming storm.

Did one the medics use inappropriate langue over the radio? Sure. Was it a firing offense? Maybe. Was the fact that Curtis Mitchell died their fault? No way.

Until you've worked in the worst snowstorm in 50 years, running three times your normal call load, and have been sent to a patient you can't reach without wading through several hundred yards through four-foot snowdrifts, with reports of downed power lines in that snow with just you and your partner available to handle all your equipment, don't say what you would have done. If you don't know that the patient has called 10 times for help in the past thirty hours, just as the individual EMS crews didn't, don't say that you would have ignored dispatch when they canceled the call and sent you on one of the dozens that are still holding.

Judging EMTs who supposedly can't tell if a patient is dead or not is especially easy over an Internet connection. I personally witnessed a patient regain a pulse and breathing a full ten minutes after the code was called, and that's after a doctor, and nurse and a paramedic (me) ran a 10-second asystole strip in three leads, checked pulses, and even checked heart sounds with a Doppler.

The medics in Prince George's County encountered a patient with extensive necrotizing fasciitis. Have you ever smelled it? It smells like decaying flesh, because that's what it is. It looks like obvious signs of decomposition.

It just so happens that, in that particular patient, it was present before he died. Likely, the infection would have killed him anyway. Sure, the medics should have checked a pulse, but one can see how they'd make that mistake. If you weren't there, don't judge.

The AMR medics in Jackson made the rookie mistake of staging within sight of a shooting scene. If you can see the scene, the people at the scene can see you, and naturally wonder why you aren't blazing in with your lights flashing.

But when a hysterical man covered in blood is beating on the window of your ambulance, how many of you are brave or foolhardy enough to step outside to see what he wants?

An increasing number of EMS administrators check an applicant's online presence before making a hiring decision. If you're posting inappropriate material in a public forum, or flaming people with ill-considered opinions, what does that tell a potential employer about your judgment and maturity?
Before commenting on a public forum, ask yourself if what you're going to say would earn you a shot in the teeth if your target were standing in front of you, or if your mother would wash your mouth out with soap for what you're about to type.

If the answer to either is yes, then remain silent and move on to the next thread.

About the author


Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (www.facebook.com/theambulancedriverfiles), or email him at kelly.grayson@ems1.com.

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