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Mike McEvoy's Blog (23)

Methyl Fentanyl Bad Stuff

It is dangerous out there, no doubt about it. We have a responsibility to protect ourselves, our brothers and sisters and our patients from harm. The latest danger seems to me not to be carfentanil but paranoia. That's right, I'll call it "fentanyl analog paranoia."  It's bad enough that widespread misinformation has made prehospital providers the poster children for misuse of nitrile gloves.  Now, we're helping to spread ridiculous warnings about…

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Added by Mike McEvoy on August 18, 2017 at 11:41pm — 2 Comments

EMS Wake-Up Call

The mother of a 13-year-old girl gave me a wake-up call several weeks ago.  After her daughter overdosed on heroin, her husband rushed home from work following a panic-stricken call.  On the way, he passed an ambulance idling on a roadway several blocks from their home.  That same ambulance later arrived to provide care but only after law enforcement appeared on scene.  I knew exactly what the ambulance was doing--staging until the scene was safe.  Trying to explain this protocol to the…

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Added by Mike McEvoy on August 31, 2016 at 1:00pm — No Comments

EVENT Reporting: Time To Pull the Plug?

E.V.E.N.T. or the EMS Voluntary Event Notification Tool is a reporting web site launched in 2012.  Backed by a long list of prestigious supporters, EVENT was designed to accept anonymous reports of EMS safety concerns in an effort to improve safety across the EMS spectrum.  The concept was similar to an airline safety system that accepted "near miss" reports from…

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Added by Mike McEvoy on April 28, 2016 at 7:57am — No Comments

FDNY*EMS: Time for Big Changes?

FDNY is the largest fire department in the United States and is a trendsetter.  A recent report by the Citizens Budget Commission, a New York City watchdog organization puts some very interesting handwriting on the FDNY wall.  The report, "Twenty Years Later: Integrating Services In The New York City Fire Department" reflects growing call volumes, steadily declining fires and ever…

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Added by Mike McEvoy on December 13, 2015 at 9:54am — 1 Comment

Conference Speaker Proposals: FDIC and More

Having just weeded through a very large queue of FDIC 2016 speaker proposals, I thought I might share some tips and pearls for prospective conference speakers and presenters.  Three times or more each year, I cull through speaker proposals, grading and selecting those I believe would best serve the needs of FDIC, EMS Today (our sister magazine "JEMS" annual conference) and Pulse Check (a small New York State EMS Conference).  Some conferences limit the number of submissions, others don't. …

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Added by Mike McEvoy on July 10, 2015 at 5:00pm — 2 Comments

Show Me The Money: EMS Billing Reform Coming

If you missed the announcement from HHS Secretary Sylvia Burwell (published in the March 5, 2015 issue of the prestigious New England Journal of Medicine) on new Medicare targets for value-based payments, it's past time to wake up and smell the coffee!  Bottom line (and the reason EMS services need to be concerned): Medicare (aka HHS or Health and Human Services) plans to substantially accelerate…

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Added by Mike McEvoy on May 3, 2015 at 5:00am — No Comments

Uber Faster Than EMS?

A recent Jimmy Kimmel episode poking fun at EMS response times in New York City where Uber response time averages beat out EMS may not be so funny.  In an era where consumers can locate the nearest taxi, private car or rideshare from their mobile phone, it would seem that 9-1-1 is a bit behind.  Nationally, very few of us can see the locations of our apparatus and virtually nowhere can 9-1-1 callers learn the ETA of their assigned…

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Added by Mike McEvoy on March 28, 2015 at 9:30am — No Comments

Soaring with EMS Eagles in Dallas

Which is better: letting pain and muscle spasm immobilize an injured spine or doing it with the same tools we’ve used for decades?  Should hypothermia begin DURING the arrest?  Do response times make any difference whatsoever in patient outcomes?  The answers to these and other hot EMS topics were intensely debated in Dallas last week at the 14th annual Gathering of Eagles, EMS State of the Science Conference.

The U.S. Metropolitan Municipalities EMS Medical Directors…

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Added by Mike McEvoy on February 29, 2012 at 2:00pm — No Comments

Free EMS Care: We Can Blame Ourselves

The recent news coverage of Chicago Fire Department losing big bucks to unreimbursed refusal of transport calls is not a problem unique to Chicago.  Sure, asthmatics will call for an albuterol treatment when caught without their own medications and some hypoglycemic patients…

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Added by Mike McEvoy on September 29, 2011 at 10:00am — 1 Comment

Contagion: Possible or Not?

The recently released Warner Bros. movie, Contagion details the fictional outbreak of a deadly and highly contagious novel respiratory virus.  While some aspects of the movie are improbable, a major outbreak of a deadly disease could really happen.  The Centers for Disease Control (CDC) was extensively involved in the production of Contagion which was partially filmed at their headquarters in Atlanta.  If anyone…

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Added by Mike McEvoy on September 16, 2011 at 9:23am — No Comments

CDC On Zombie Apocalypse: Are Ya Kiddin' Me?

Not sure how I missed this last week, but our illustrious Centers for Disease Control (CDC) posted a May 16, 2011 set of instructions to help citizens prepare for a potential Zombie Apocalypse.  Now, I'm not sure about you, but this tongue-in-cheek instructional set seems a bit out of line for our national health information web source.  The CDC has long maintained high quality, authoritative, and well…

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Added by Mike McEvoy on May 24, 2011 at 12:30pm — 2 Comments

A Pen Can Kill You

Just ask Lazar Greenfield, MD, a world renowned surgeon from the University of Michigan.  Dr. Greenfield's recent Valentines Day editorial in the American College of Surgeons (ACS) newsletter cost him the Presidency of the 77,000 member group he was poised to assume in October.  In the surgery news editorial, which some found demeaning to women, Greenfield described semen as a female mood enhancer and suggested that, "there's a deeper bond…

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Added by Mike McEvoy on April 28, 2011 at 2:37pm — No Comments

NFPA 1917: The Ambulance Is Enroute

The NFPA 1917 Standard for Automotive Ambulances draft closed for comment in December 2010 and the Committee met in Dallas during February 2011 to review the 1,785 comments received. Many comments and proposals for change were duplicative: 133 received on Vehicle Data Recorders (VDRs), 136 on maximum top speed of 72 MPH, 131 on estimated in-service vehicle weight, 132 on visual indicators of tire…

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Added by Mike McEvoy on February 26, 2011 at 1:49pm — 1 Comment

FDA Smack Down on Defibrillators

At the January 26, 2011 meeting of the FDA (Food and Drug Administration) Medical Device Advisory Committee, Circulatory Systems Devices Panel, a recommendation emerged to tighten regulation of AEDs (Automatic External Defibrillators).  Currently, AEDs are listed as Class III (high risk) medical devices being…

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Added by Mike McEvoy on January 29, 2011 at 12:30pm — 2 Comments

Are Bed Bugs Biting Your Wallet?

Bed Bug media hype has spurned considerable action in the travel industry, hospitals, prisons, homes and (of course) fire stations. These pesky little critters have developed resistance to many pesticides (which may account for the recent increase in infestations), are particularly good a hiding, but remain visible to the naked eye. That's right; you can see them! What you might not see so clearly are the unscrupulous profiteers hoping to drain your wallet with ridiculously expensive equipment… Continue

Added by Mike McEvoy on November 21, 2010 at 10:00am — 7 Comments

Hold CPR: Get an Ambulance and Helicopter

Time is ticking away. You might want to put down those few hundred pages of Emergency Cardiac Care Guidelines 2010 and pick up a copy of the draft NFPA 1917 Standard for Automotive Ambulances. "Doesn't affect me," you say? I'd bet otherwise; if you ride a bus, aid car, rescue, box, ambulance, or whatever else you call that patient care and transport vehicle on wheels, this standard affects you.… Continue

Added by Mike McEvoy on November 4, 2010 at 8:01am — No Comments

Don't Forget EMS!

Last week's announcement by the US Transportation Secretary that traffic fatalities have reached the lowest levels in 60 years overlooked an important contributor: EMS. NHTSA Administrator David Strickland cited increased seat belt use and tougher drunk driving enforcement as key contributors to the decline in traffic deaths. There was no mention of EMS. This is a grim reminder that we need better methods of documenting the… Continue

Added by Mike McEvoy on September 13, 2010 at 2:03pm — No Comments

EMS LODD and a Lesson

Champion EMS EMT-trainee Casey Steenland, aged 33 died on Friday, August 13th in Texas, an apparent victim of Carbon Monoxide poisoning. Three other Champion EMS members were treated, two required HBO (hyperbaric oxygen) according to local news sources. All four were apparently exposed to CO from an ambulance… Continue

Added by Mike McEvoy on August 14, 2010 at 12:13pm — No Comments

Ambulance Delayed: NFPA 1917

National Fire Protection Association (NFPA) Technical Committee on Ambulances balloting this week failed by one vote to move a draft “NFPA 1917, Standard for Automotive Ambulances” forward into the review and public comment process that would have rolled an ambulance design standard out the door during mid-2012.



At issue was inclusion of several AMD (Automobile Manufacturers Division of the National Truck Equipment Association) testing standards incorporated into the draft document… Continue

Added by Mike McEvoy on August 5, 2010 at 9:43pm — 1 Comment

EMT Fraud: Bad People or Flawed System?

Recent news from Massachusetts reporting suspension of 207 EMTs and revocation of 4 Instructors for bogus refresher training smacks of poor oversight. But it may also highlight continued frustration with recertification requirements placed on EMS providers across the United States that fail miserably at providing any real education. That's… Continue

Added by Mike McEvoy on June 20, 2010 at 10:01pm — 5 Comments

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