It's Ovah,..It's ALL Ovah,...

WHO Decides H1N1 Pandemic Is Over

GENEVA — The World Health Organization declared the swine flu pandemic officially over Tuesday, months after many national authorities started canceling vaccine orders and shutting down hot lines as the disease ebbed from the headlines.

WHO Director-General Margaret Chan said the organization's emergency committee of top flu experts advised her that the pandemic had "largely run its course" and the world is no longer in phase six — the highest influenza alert level.

"I fully agree with the committee's advice," Chan told reporters in a telephone briefing from her native Hong Kong.

The virus has now entered the "post-pandemic" phase, meaning disease activity around the world has returned to levels usually seen for seasonal influenza, she said.

But Chan cautioned against complacency, saying that even though hospitalizations and deaths have dropped sharply, countries should still keep a watchful eye for unusual patterns of infection and mutations that might render existing vaccines and antiviral drugs ineffective.

"It is likely that the virus will continue to cause serious disease in younger age groups," she said, urging high-risk groups such as pregnant women to continue seeking vaccination.

(snip)

WHO chief Chan insisted that declaring swine flu a pandemic had been the right decision, based on the internationally agreed rules that existed at the time.

"We have been aided by pure good luck," she said, adding that if the virus had mutated then the death rate could have been much higher.

As someone closely-involved at a county level, I'm going to strongly disagree with that last statement. While many may deride the government and media outlets for stirring mass-panic over the entire affair, I'm going to paraphrase one of my fellow county organizers: if nothing else, it was a good exercise in healthcare mobilization and deployment should we ever be attacked by a biologic agent!

Personally, over 50% of my company's paramedics received PA Dept of Health endorsements to administer the H1N1 vaccine and I'm looking at a freezer full of PA DoH-assigned H1N1 doses that will have to be destroyed because they're past their expiration dates.

Luck my ass!

Ain't Karma Just Like Pelosi??

Woman Makes Fake 911 Call, Then Calls Again as Garage Door Crushes Her in Fatal Mishap

CALDWELL, Idaho — Police say an Idaho woman who made a false 911 call to lure paramedics out of their station made a real emergency call minutes later when she got trapped under the station's garage door.

Melissa R. Farris died Oct. 2 of injuries suffered when she was crushed by the closing garage door at the Canyon County station.

Farris, a former paramedic at the station, had been trying to crawl under the door after the ambulance left to respond to a nonexistent traffic accident she'd called in a few minutes earlier.

Caldwell Police Chief Chris Allgood says it may never be known why Farris was trying to gain access to the station

But according to a police report obtained by KBCI-TV, her sister told investigators that Farris may have been going after prescription medication stored in the station.

Braying Jackass!

Louis Farrakhan: H1N1 Vaccine Developed to Kill People

Nation of Islam leader Louis Farrakhan said the H1N1 flu vaccine was developed to kill people, UPI reported.

"The Earth can't take 6.5 billion people. We just can't feed that many. So what are you going to do? Kill as many as you can," Farrakhan reportedly said during an event in Memphis, Tenn. "We have to develop a science that kills them and makes it look as though they died from some disease."

The 76-year-old added that many wise people won't take the vaccine, according to UPI.

His comments were made during an event to observe the group's Holy Day of Atonement, and also marked the 14th anniversary of the Million Man March in Washington.

Click here to read more on this story from UPI.

15 Years Ago This Week,...

The TrekPerson, having endured 15 months of class time, internship, externship, and a romance gone down the drain from a lack of personal time, opened a large manila envelope from the Pennsylvania Department of Health (large envelopes meant good news back then).

Out popped the letter from the state saying "congratulations, having passed all of the requirements, you are now a licensed paramedic" along with my test scores (don't ask,..just think about what they call the guy who finishes last in medical school - doctor!) and three neat little patches:



Wow! 9 extra ORANGE letters!

OK,..I've since gotten over touching myself about it.

I've worked for 7 private ambulance services and four 9-1-1 community-based services. I've lost count of the number of babies I've delivered, the number of "bad accidents" I've rolled on and the number of "why in God's name did you wake me up a 3 am for this??" calls.

I've been the newbie with shaving cream in his turnout gear. I've been the father confessor, and I've been in positions of responsibility.

Stuff that only highly-trained doctors were allowed to do is now commonplace in the back of my bus.

I'm 40--(cough! cough!) something. I have a partially torn rotator cuff and a bad lumbar disc or two. I'm getting arthritis in my knees and hands.

I still get a rush going to hot calls, but hate the insulated Starbucks drinkers who think they're more important than me while screaming down the road at warp speed.

I hate the job and I love the job.

I am the TrekMedic.

I am.....a paramedic.

Joey Vento was Right!

Gentle readers, as you know, the TrekMedic actually holds down a wage-paying job when he's not blogging along to information highway.

He's a paramedic. (A cranky, tired, old and arthritic one at that, but that's another rant)

Over the last week, the ability to proficiently speak the English language, especially when dealing with the sick and injured, sorely tested the TrekMedic's patience.

First, the TrekMedic was dispatched to one of our regular nursing homes to assist one of our BLS crews on a "Bleeding" call. Arriving at the same time as the BLS guys, we found an elderly woman in bed, unconscious. No, wait - she's just asleep. No evidence in her bed of any bleeding. After several long minutes of waiting and assessing the patient, the nursing SUPERVISOR, a young Oriental woman, arrived and simply stated to us "she bleeding." Nothing more. After several attempts to get her to expand on that thought, she finally pointed to the patient's groin area and said "down there." She then left, not to be seen again.

Follow up: the patient showed no evidence of active bleeding. Her vital signs were OK. The transfer paperwork the nursing home is required to send with the patient stated some blood was found in her diaper during changing.

Next, yesterday, while at the office performing my supervisory duties, I was told to respond to another facility along with a nearby BLS crew for a possible stroke victim with "bloody vision." Now, folks, this is more serious. A stroke could be causing the patient's blood pressure to go so high that an optical vein could have burst. This is a life-threatening issue!

OK,...so here's what happened: again, non-local nurse calls it in. The patient is in rehab because he's had a stroke and was no complaining of "BLURRY VISION." There are more than a half-dozen differential diagnoses why his vision is blurry. Again, the patient was fine, vitals normal, released to the BLS crew after consulting with medical command.

The point to all this pro-English ranting? Its bad enough that only 40+% of 911 calls turn out to be what was dispatched. Do I really need to fly down the road and put my life, as well as the lives of other commuters, in jeopardy because someone can't speak this country's language???

More Philadelphia FD EMS Woes!

Claudia Gomez of Fox 29 News has a scathing report on the Philliness of the PFD EMS system.

You can view the video here!

More Philly FD Woes!

Firefighter In Hot Water After Heroic Actions
Reporting
Valerie Levesque

PHILADELPHIA (CBS 3) ― When no other emergency units were close enough for a medical rescue, a Philadelphia firefighter took matters into his own hands. He saved a woman's life, but now he is in trouble of his own.

"If this man did not react the way that he did and so quickly, I would not be standing here," Michelle Smith said.

The man Smith is referring to is a lieutenant with Engine #72 in North Philadelphia. The lieutenant is in trouble for actions he took when he responded to Smith's 911 call. Smith was at a friend's house in Logan when she had an asthma attack.

The lieutenant transported Smith to the hospital in a fire truck, which is against department policy.

According to sources, the squad that responded called dispatchers who told them the ambulance was 12-15 minutes away.

However, Smith said that she did not have that much time, saying, "I don't think I had five."

The lieutenant has been taken out of his fire house and transferred to another engine company.

"It's an outrage, I understand rules are rules, in some cases, you have to make exceptions," Smith said.

The captain at Engine #72 has placed the lieutenant's name in for an award for saving Smith's life.

Officials from the Philadelphia Fire Department declined comment. The firefighter's union said they are waiting to see if any disciplinary action will be taken before they comment on the incident.


The TrekMedic adds:

5 more medic units and we STILL have this issue?? Three things come to mind:
1 - Nearest unit was 12-15 minutes away? Was it another broken hangnail "emergency?"
2 - Mayor Nutter - you can put 100 more trucks on the street, but you 9-1-1 call-takers need to TRIAGE the calls - life-threats before hangnails!!!
3 - I thought the duty of the PFD was to save lives and prevent property destruction. The L/T was a paramedic; he did what was in the best interest of the patient. If they followed policy, we'd be looking at yet ANOTHER lawsuit for malpractice. THINK, Nutter, THINK!!!!

A Call for Help!

Passing along a story from the Ambulance Driver,...

On Monday, April 14 a Regional EMS ambulance

was invloved in a serious accident.

Two of our EMTs sustained multiple injuries,

are currently hospitalized,

and will have a long recovery ahead of them.

The Rockland Paramedic Services/

Regional EMS Benevolent Fund

is supporting them in their recovery efforts,

but we need your support!


The RPS/Regional EMS Benevolent Fund is happy

to announce that we can now accept credit card donations

through the secure site PayPal!!

Professional Tribute

The TrekMedic will be away watching the Super Bowl commercials today and serving jury duty tomorrow.

To fill in the gap, he's cross-posting this EMS tribute from MaddMedic:





Enjoy!

Hello, 9-1-1? Our EMS is Dying!!

Gentle readers, it isn't the murder rate in Philadelphia that will pre-occupy the thoughts of newly-elected mayor, Michael Nutter. It is the city's ability (or lack thereof) to provide a vital service to the community that needs fixing, first and foremost.

Captain America, quoting the "paper that shall not be named here," started the blogging earlier this week:

Once again Philly Fire is in the news and the EMS situation is on the front page. As usual the news isn't good. Today's article in the XXXXX XXXX is about the city's failure to use private ambulances. As usual the Main Stream Media is way off base and their ignorance of the subject invalidates their coverage.

Lets start of with an overview: In Philadelphia, the Fire Department is the Marine Corps of the city's operating departments. Whenever something goes wrong, you can call 911 and you will get a firetruck to help resolve the situation. We respond to an estimated 280,000 calls a year and that number keeps going up.

Many years ago the Fire Department began operating the city's ambulances kind of by default. What began as an after thought evolved over time into a landslide. Today between 220,000 & 240,000 of our calls are for emergency medical service. Over the years 911 has degenerated from an emergency lifeline to the first choice of any citizen who needs a ride to the local emergency room. This was never the intent of 911. Remember the slogan "To stop a crime or save a life" call 911? Those days are long gone. Now the system is completely overloaded and unable to function properly under the crushing workload of everyday operations.

(snip)

Now the chickens have come to roost. People are dying because the system is melting down. Too many calls and not nearly enough ambulances. There are some tough decisions that will have to be made and soon. The talk in this article about private companies is a red herring. The Fire Department can't depend on outside resources to accomplish it's primary mission. That's why private companies aren't used. Also private companies are only far too willing to work in areas where there are plenty of paying customers with lots of insurance. They don't want to venture into the badlands to pick up the shootings and stabbings. The PFD makes no distinction as to where a call comes from we respond to everything, all the time.


The most recent death made national news (yet another black eye for the City):

Deadly Delays Plague Ambulance Services
Not Nearly Enough Ambulances to Go Around, Officials Say


By ANNE-MARIE DORNING
Jan. 18, 2008

Deborah Payne, Rotan Lee, Ricky Badway and Danny Rumph all have something in common. They're dead. And they died after waiting anywhere from 19 minutes to more than an hour for an ambulance in Philadelphia.

The latest incident occurred just a few weeks ago, in the early morning hours on New Year's Day. According to a Philadelphia Fire Department timeline, Payne dialed 911 at 2:30 a.m.

And so Payne and the firefighters waited. And waited. According to the fire department timeline, an emergency vehicle finally reached Payne about an hour after her first call, only to break down. Payne died while waiting for a second EMS vehicle to arrive.

It's a story Candy Owens said sounded sickeningly familiar. On Mother's Day in 2005, Rumph, Owens' 21-year-old son, was playing a game of pickup basketball at the Mallery Recreation Center in Philadelphia when he collapsed at 10:30 p.m. His friends dialed 911. They also called Owens.

"It was horrible. I watched my son die. It was the worst experience of my life," Owens said. According to Owens, it took an EMS crew 41 minutes to arrive, traveling halfway across the city.

The national standard for response time by emergency vehicles is eight minutes and 59 seconds or less. But according to a city controller's report released last month, one-third of Philadelphia's ambulances took 10 minutes or longer to respond in 2006. And there are just 28 ambulances in full-time service for a city with a population of 1.5 million.

Demand Up, but Supply Scarce

Philadelphia City Controller Alan Butkovitz said he ordered the study of the EMS system because of some troubling information.

"We know that since 1999, demand for ambulance services has almost doubled," he said. "We had been hearing about problems from paramedics for years now."

Butkovitz said his report showed that although the recommended average number of runs for an emergency unit is 2,500 to 3,500 a year, several vehicles in Philadelphia have handled more than 8,000 runs a year. And those vehicles are subject to break down more often because they are in use almost constantly. The report also found that "poor morale among many paramedics is fueling discontent and increasing turnover." In fact, the paramedic turnover ratio is now more than 50 percent.

"Here's the deal. People wait a long time every day. Pretty much every day somebody is having a delayed response. Somebody is waiting a long time. And somebody is getting a fire truck and going without an ambulance every day," said Dave Kearney, a 20-year EMS veteran who is now a firefighter and secretary of the Philadelphia Fire Fighters Union.

Kearney said the members of a typical Philadelphia EMS crew get their first call as they walk through the door at 7:30 a.m. and they might get back to the station "once that day."

Private Services Out of the Loop

Unlike fire departments in many other major cities, the Philadelphia Fire Department has no agreement to call on private ambulance companies when its ambulances are already tied up and delayed answering new calls.

The fact that a system the size of Philadelphia's doesn't have such a back-up program — known as mutual aid — surprises Jim McPartlon, president of the American Ambulance Association.

"In any progressive and quality EMS system, response times should be adhered to and if that can't be adhered to they should have mutual aid." he said.

In Payne's situation, a private ambulance company was just blocks away.

"What if a 9/11 happened here? Would they seriously not put out a call to private companies and just try to do it all themselves?" said Butkovitz, the city controller.

In the 1990s, a growing number of large ambulance companies, such as American Medical Response, started competing with fire departments for the often lucrative emergency response and patient transport market. Fire departments had traditionally handled all 911 calls, and after treating and stabilizing a patient, they left the transport up to an ambulance service.

The "ambulance wars" heated up when fire departments in some communities started fighting back, taking over the entire paramedic business from private companies.

Fire officials insist they are best situated to provide the most effective and professional response.

"If somebody is breaking into your house, do you want the security guard from Wal-Mart showing up to help or the police? Do you see what I'm saying? Do you want to take your chances with some fly-by-night ambulance company?" Kearney said. (TM - That's a cheap shot, Kearney! More on that below!)

But that's not the way Owens sees it. She said she would have taken the chance on anybody if they could have saved her son.

As for a mutual aid system, Ayers said that "nothing is off the table" but added that there are "legal issues and union issues" that have to be worked out.

The TrekMedic (a 28-year veteran of the EMS) continues (and seethes):

OK,..first, you'll notice that Captain America makes the statement about the chickens coming home to roost.

With all deference to C/A and the PFD, here's why that is happening:

In 1991, the Commonwealth of Pennsylvania enacted ACT 45, the ambulance service licensing law. The Commonwealth was divided into more than a dozen administrative regions, acting under the authority of the PA Department of Health.

Philadelphia became its own region, due to its overwhelming size and population. Who became the agency authorized to carry out ACT 45? That's right, the Philadelphia Fire Department. The PFD only recognizes itself as the sole provider of 9-1-1 based pre-hospital care in the City. It treated private ambulance services, and the 12 or so community volunteer ambulances that existed in Philadelphia, some pre-dating the PFD's EMS program. I should know; I got my start at the now-defunct Wynne-Brook Community Ambulance, which served Overbrook and Wynnefield for 3 decades!

What transpired over the next 17 years? Private ambulance services operated in Philadelphia much like any business. The Philadelphia Regional Office of Emergency Medical Services became another government-run boondoggle, not unlike the recently-scandalous Licenses & Inspections Office.

Private ambulances learned the byzantine workings of PROEMS and found ways to circumnavigate the Commonwealth's rules and regulations in favor of higher profits.

In that respect, Mr. Kearney is justified in his remarks.

The solution to the problem? Its been brushed off by that "union issue" remark. Of course! Philadelphia is a union-dominated city and the IAFF Local 22 isn't going to allow non-union labor to operate in their playground, no matter how many dead bodies they push out of there way to make their point!

Here's the TrekMedic solution:

1. Get PROEMS out of the hands of the PFD and into the hands of the City's Department of Health! Pre-hospital care is a HEALTH issue, not a fire prevention issue. Let those brave men and women do their jobs - putting out and preventing fires and saving lives!
2. Get EMS out of the hands of the PFD, which has treated the service like a bastard step-child from Day 1 and also bring it over to the Department of Health. See #1 for the rationale.
3. Make private ambulance services adhere to the same rules as the City's EMS service and reward those who do with mutual aid contracts. Those who don't should be blacklisted by the City. And keep a close scrutiny over who owns the private services (trust me when I say the Russian mob has a great deal to do with this in NE Philly!)

Relations like this work in places like New York City (where my parent company's operations cover approximately 25-33% of the FDNY-EMS calls) and Phoenix (a comparable-sized city) where the largest private service, Southwest Ambulance, is held under the same exacting standards as the Phoenix FD's units.

Stop the madness and start saving lives!!!