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Saturday

Violence and Duty

We've just learned of an EMT in Jefferson County, New York, who has been shot and killed in the line of duty. We're also getting early news reports about a City of Rochester police officer who has been seriously wounded on duty.

There is a trend of violence towards responders of all uniforms...and yet we don't seem to take it seriously. We've been reporting on what seems to be a continual stream of attacks throughout 2008 and now into 2009. Yet, I have not seen nor heard of any training sessions or in-services being taught on the topic of scene safety. Why is this not a priority? I know, it can't happen here. (Sarcasm intended)

The fire service is full of scene size-up memory aids, COAL WAS WEALTH, WALACE WAS HOT, and others; none of them addressing personal safety. EMS is notable for teaching new EMT candidates to recite "BSI, SCENE SAFE!" upon entering any testing situation. Again, no translation to the actual assessment of a situation and personal safety.

Once upon a time a uniform, any uniform, would grant you respect and a certain level of protection in the community. EMS providers were looked at somewhat differently and could often move in and out of situations with little concern.

Times are changing. If we don't change NOW and start teaching our people to look at every scene for threats and start to size-up the people rather than the building we will invite more assaults and fatalities.

I'm going to challenge every responder to change they way they look at situations and consider all people a threat until proven otherwise. I'm also challenging instructors to begin cross-training with law enforcement on the topic of recognition of dangerous situations and self protective measures.

My commentary on this weeks Mitigation Journal podcast will be about the futility of BSI/SCENE SAFE/COAL WAS WEALTH.

Here are a few related entries from the archives:
Ready or Not (not even EMS) http://www.mitigationjournal.libsyn.com/index.php?post_id=385325

Firefighter shot at fire scene http://www.mitigationjournal.libsyn.com/index.php?post_id=362809

Rochester EMT saves Cop
http://www.mitigationjournal.libsyn.com/index.php?post_id=335844

Line of Duty Planning Series with Dan McGuire http://www.mitigationjournal.libsyn.com/index.php?post_id=398987

Thursday

After the Fire

This is the fire building from the 4-alarm the other night.

After the fire

Duty to Act Policy

Duty to Act; do you have it? Should your service have a policy on the topic? This post on the USFA Blog got me thinking about several issues. How many of us would even think twice about stopping to render assistance to someone in need? Chances are that we all would...

What are your organizational policies, if any, on the topic. The liability and insurance coverage is another matter. Would you be covered...malpractice...injury...the list goes on.

The first part of duty to act should be to protect yourself at all times. Your first duty is to yourself and your family. We often consider the use of PPE for various activities...but how often do you consider protection from legal issues?

Great blog posting - check it out here: http://blog.usfa.dhs.gov/2009/01/duty-to-act.html

Saturday

Not Alone Against Free Antibiotics

Free Antibiotics Are Bad. We posted on MJ earlier this week about a local supermarket chain here in Rochester, NY, that was jumping on the free antibiotics bandwagon. At the time of the posting there were few voices of warning. There were even fewer who wanted to remind the public (and maybe the Big Box Stores) that antibiotics are not going to help against the flu...think difference between viral and bacterial infection...and antivirals versus antibiotics.

Here is another opinion from Medical News Today about how free antibiotics are not a good idea for public health.

Nice to know you're not alone.

Monday

Less Sleep, More Colds

A recent study has me thinking. One of my changes for 2009 (not resolution, mind you...just a change) is to add more sleep. That is more sleep each night and more each week. A number of studies have looked at the effects and the toll of lack of sleep. It seems that from cardiovascular to immunologic systems are among the two at most risk. See Sleep Habits and Susceptibility to the Common Cold as published in The Archives of Internal Medicine.

Here is a summary of findings...
  • The less a person slept, the more likely he or she was to develop a cold (there was a graded association between infection rate and average sleep duration).

  • Participants who slept fewer than 7 hours were 2.94 times more likely to develop a cold than those who had 8 hours or more sleep.

  • The more efficiently a person slept (more of the time in bed actually spent asleep), the less likely he or she was to develop a cold (i.e. there was also a graded association between sleep efficiency and rate of infection).

  • Participants whose sleep efficiency feel below 92 per cent were 5.50 times more likely to develop a cold than those whose efficiency was 98 per cent or more.

  • Feeling rested was not linked to rate of infection.

  • These relationships could not be explained by the potential counfounders such as levels of virus-specific antibodies beforehand, demographics, the season of the year, body mass index, socioeconomic status, health behaviours, and psychological variables.

Wednesday

Iron Safety a Hot Topic in Rochester

The University or Rochester and the Rochester Fire Department have teamed up to help prevent burn injuries. A recent article in the Rochester Democrat and Chronicle highlights the efforts between the two agencies to develop a safety campaign to prevent these burn injuries. They are working on two solutions; first an educational brochure to be given to new mothers at the U of R and, second, a physical device to hold the iron flat and protect the sides.

The need for this type of information and protective device are evident based on the stats given by the U of R:

"...Between 2003 and 2007, the Strong Memorial Hospital Regional Burn Center treated 212 children younger than 5 for contact burns. While wood-burning stoves were the most common source, hot clothing irons burned 29 patients."

"Toddlers suffer second- or third-degree burns when they touch a hot iron or knock it onto their hands or face. Some of those burns require skin grafts, a five-day hospital stay and a month of recovery."

Check it out here.

Monday

Thoughts on extreme cold weather

Random Thoughts on extreme cold weather...

"evaluate every trauma patient for hypothermia and every hypothermia patient for trauma"

"life safety, incident stabilization, property conservation"

"confine it to the Zip Code of origin and keep it off CNN"

Extreme low temps and brutal wind chill expected here in next 24 hours due to last through the weekend...high temps predicted to be between 2 and 5 above with sustained 25MPH winds. That means wind chills well below zero.

Even small events take more resources and protection of responders can be difficult.
Don't forget Emergency Scene Rehab for cold situations (as important as during hot weather) and often forgotten.

Pumps can freeze, lines freeze turn into iron pipes, and the fire scene can turn into an MCI of responders.

"if there is snow on the roof...it can't be too hot inside"

MVC's on highways can become impossible blizzards...think rapid extrication...minor injuries and illnesses will deteriorate quickly.

Thursday

Retail Health Clinics and Recession

We've talked quite a bit about the potentials of Retail Health Care Clinics on this blog and on the Mitigation Journal podcast. A retail health clinic is a clinic operated and located within a retail store such as Wal-Mart. These walk-in style clinics can be found in other areas like airports as well. Often, these privately operated clinics run within a profit margin and cater to those without health insurance.

Walk-in and retail health clinics are attractive because they are time and cost-effective. There have been questions of quality raised by medical associations in the last year, but no official complaints or awareness of errors have been noted. The trend throughout 2008 has been for these clinics to open and remain stable. That is stable until the shopping season tanked.

This article from Reuters talks about the possibilities of failure and impact on the economy when "big-box" stores decline due to economy and/or recession.

And Here We Are...2009

I've been anticipating this second, this day, this year for quite some time. There is a number of reasons, personal and professional for my focus on this year. If you don't know what I'm talking about; you will...as long as you continue to follow MJ podcast and blog.

Without any resolutions for the year; I've been deciding how to make a few changes in life and activity. How will I do business, how will I conduct myself, how will I simply do all that I do just a little different...all questions that I'll continue to review throughout the year.

I hope you'll similar steps in your life. That is, any steps you take in 2009, may they lead you to where you want to be!

Best wishes for a happy and safe 2009.
Rick