By Shannon Eliot
EMS1 Editor
SAN FRANCISCO — Months after crossing virtual paths with a fellow blogger on the other side of the Atlantic, paramedic Mark Glencorse found himself spending a week answering medical calls and learning the American EMS system with the San Francisco Fire Department.
Glencorse, the author of the blog Medic999, traveled more than 5,000 miles from Newcastle Upon Tyne, England, last Sunday to meet and work alongside paramedic Justin Schorr, who writes the blog Happy Medic.
The idea of an international exchange occurred after Glencorse experienced real-time communication benefits from a blog. Responding to a patient with a rare cardiac condition, Glencorse used information on the blog in the analysis of suspicious 12-lead EKG readings. As a result, he made an alternative diagnosis and instead of making a potentially unnecessary trip to the emergency department, Glencorse transported his patient directly to the CRC and later found that decision likely saved the patient’s life.
For eight days, Glencorse experienced what it was like to be a responder in the United States, by shadowing Schorr on his EMS calls. While not directly treating any patients himself, Glencorse readily observed treatment protocols, patient types, and how EMS resources were deployed. While they have been regularly updating their followers with their daily activities on their blogs, the visit has also captured the attention of Director and Producer Ted Setla.
Inspired by the first documented ‘blog save,’ Setla decided to film Glencorse’s trip as the pilot episode of a new EMS reality series. Developed in conjunction with paramedic Chris Montera, Chronicles of EMS is a show that will follow the lives of real responders, with the pilot episode promoted in a grassroots method of social media.
The pilot will be distributed in an online format in mid-to-late January. Although the production crew sought to film Justin’s reciprocal visit to the UK this week, it was unable to secure filming and logistical permission from Glencorse’s agency in time.
In spite of a flurry of emergency calls, tweets, and Facebook updates, I was lucky enough to catch up with the paramedics and crew members during filming to get their thoughts on the exchange and the power of social media in the industry.
EMS1: What surprised you most about the first response system in America?
Mark Glencorse: We arrived to treat an old gentleman and he asked, “How much is this going to cost me?” No one should ever have to choose between a doctor and food. In England, health care cost is taken out of your pay in a proportionate manner, so more is taken if you are wealthier and less if you are poorer, but if you have nothing, doctors and nurses would never turn you away from an ER.
I was also surprised that we had 11 people respond to a single heroin overdose, where in the UK it would have been two. I was amazed with all those people! Back home, we generally have one person driving and the other trying to do compressions, give medications, and grab supplies in the back of the ambulance, which can be quite challenging.
EMS1: What are some similarities and differences working in the US compared to the UK?
MG: Sometimes I feel you can’t compare the two because the systems are so different. As for similarities, we both have the same type of patients, including those with typical chest pain, system abusers, attention-seekers, and those who simply need a ride to the hospital.
In England, we rarely take heroin overdose patients to the hospital, but it seems to be mandated in America. In England, we don’t have to take a patient to the hospital if there’s no clinical need, and as a result we have a roughly 30 percent non-transport rate. Some inquiries may not even get past the call-taking stage.
Another big difference is in the medications we are allowed to deliver. I’ve noticed that we are allowed to give more analgesics in the UK, and U.S. medics are allowed to give more cardiac medications.
EMS1: Which ideas or practices would you take back to the UK system?
MG: Even though I was surprised that so many folks respond to a single call in San Francisco, it certainly is nice to have extra hands. I suppose the ideal would be some sort of balance or middle ground. I think there’s potential for the fire brigade to help us back in England, even if just one person is trained as a first responder. If we can’t get any other backup or response, I think it would be great to have them help us. You really can’t underestimate the impact of an extra set of hands.
EMS1: What’s your opinion of American responders?
MG: These are really dedicated guys. Everyone wants to do their very best and they all hold themselves to very high standards in dealing with their patients. No matter what system or configuration is thrown at them, they do their best with what they’ve got.
EMS1: What has your impression been so far about the exchange and this experience?
Justin Schorr: It’s been great. It’s been fascinating to work with Mark and learn about our professional differences, such as conflicting legal issues and the requirement here to follow instructions. I’m certainly looking forward to my time shadowing him in the UK in the coming days.
It has also shown that online grassroots efforts really can make a difference in spreading a message. Whether it’s through Facebook updates, Flickr, Twitter, or something as niche as EMS Garage, there is an online community out there following your activity. The support for our project and what we’ve been doing continues to increase every hour.
EMS1: How do you see the exchange of educational material via social media influencing responder decisions in treatment?
Ted Setla: The idea isn’t that we’re going cowboy and ignoring what we’ve been taught in favor of using someone else’s clinical information; after all, we’re still using our own protocols. But like in Mark’s case, sharing experiences can provide a new perspective or interpretation of data. For instance, consider a right-lead EKG interpretation. You may have been trained to examine and process that data in a certain way. Exchanging information is a way to think outside the box. As an example, if Lidocaine is removed from a county protocol, we may ask ourselves what we can use as an alternative. Paramedics in one part of the country or world can learn from one another’s experiences and influence their local county protocols if they find a potentially better way to do something.