Inside EMS

‘Normalization of deviance’: Chief Gary Ludwig on the death of Tyre Nichols

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

This week, Inside EMS host Chris Cebollero is joined by Chief Gary Ludwig to discuss killing of Tyre Nichols, which led to the firing of five Memphis police officers and three members of the Memphis Fire Department. Ludwig previously served as the deputy chief of the department for 10 years, running their EMS program.

Chief Ludwig discusses professionalism, how a “normalization of deviance” may account for the lack of concern for bad behavior, and leadership’s role in keeping our workforce safe. The pair round out the episode by discussing whether it’s time for EMS to start wearing body cameras during patient care or at other times during a call.

Top takeaways

“The cameras are rolling and people know the cameras are rolling and this is still the behavior.” — Chris Cebollero

“We behave on these cameras inappropriately, and nothing happens to us. You go on the next call, there’s cameras there – body cams, security cameras, Ring doorbells – there’s cameras everywhere. We behave inappropriately and there’s no consequences, even though it was captured on camera, so it becomes normalized.” — Chief Ludwig

How to identify, manage provider apathy in EMS

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

As the industry waits for more details in the case involving two Illinois EMTs charged with murder in the death of a patient, cohosts Kelly Grayson and Chris Cebollero discuss the lack of compassion show by the providers and the scourge of apathy that plagues EMS. The conversation explores how EMS leaders can help keep industry personnel on a more professional path.

Top takeaways

"Members of the workforce will stay for low pay if they are treated well, or good pay if they are not treated well, but they won’t stay for both.” — Kelly Grayson

"We must define our own professionalism, and every call we go on now has the opportunity to become a national news event. It is not 'if' but 'when.'" — Chris Cebollero

Additional resources

• Malpractice or murder: When do EMS providers cross the line from negligence to a crime?
• Video: Is deeply disturbing patient care murder?
• Listen: 'How does this happen?' – Wolfberg and Wirth weigh in on EMT murder charges
• You've seen the video; now what? 14 action steps for EMS leaders to root out bad behavior
• You’ve seen the footage – Now what? Part 2: 15 steps for providers to compassionate care 
• Prone positioning: Therapy or apathy?

A blueprint to success in 2023

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, Host Chris Cebollero discusses goal setting for a successful 2023. Chris breaks down the top 5 golden rules for making your goals and resolutions a reality.

Chris notes, “success does not happen by chance, you have to create the opportunities that will create your success.”

Listen for more on:

1. Developing a motivating value statement
2. Using the SMART method of developing goals
3. The importance of developing an action plan
4. Ensuring you are sticking to the plan you developed

This is a great show to outline a blueprint for your success in 2023.

’How does this happen?’ Wolfberg and Wirth weigh in on EMT murder charges

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In the first episode of the 10^th year in EMS, Cohost Chris Cebollero is joined by the legal powerhouse of Page, Wolfberg & Wirth’s EMS Attorneys Doug Wolfberg, Esq.; and Steve Wirth, Esq. to discuss the case everyone is talking about.

An Illinois prosecutor has filed virtually unprecedented first-degree murder charges against two EMS providers over the death of a patient in their care. Wolfberg and Wirth broke down the points of the case and the lessons for EMS in an EMS1 article, "Malpractice or murder: When do EMS providers cross the line from negligence to a crime?"   

In this episode, Wolfberg and Wirth share their first impressions of the case and the body camera footage of the incident.

Wolfberg noted what hit him was the “callous, cold, very detached, aggressive demeanor of the providers.” “You get into EMS because you care for people – how do you get to the point to what we saw in the video – that’s really where I keep coming back to,”  Wolfberg said.

Wirth added, “it wasn’t until I looked at the video that I felt outraged – outraged is the word that comes to my mind – how could a human being deal with another human being in this fashion – basically treat another human being as an inanimate object.” He asked, “how does this happen … because we can’t allow this to happen; we can’t.”

Are first-degree murder charges warranted in this case? See how EMS1 listeners are weighing in.

2022 countdown: Top 5 most controversial news stories of the year

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Our co-hosts bid farewell to 2022 by counting down the most talked about and debated stories from this year's slate of Inside EMS episodes. Join Chris Cebollero and Kelly Grayson as they discuss EMS-police relations, patients' gender identity requests, legal conundrums and more. 

Related resources

Check out the stories referenced in our episode: 

• Video: N.Y. officer on desk duty after handcuffing EMT in hospital
• 2 medics' credentials suspended after Texas patient dies in transport
• Mother's lawsuit: 23-year-old dies in ED area after Conn. hospital ignores him for 7 hours
• 2 Mich. firefighters suspended over delayed response to EMS call
• Air ambulance pilot refused to fly in dangerous conditions; feds say company retaliated

 

What makes an EMS book great?

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

This week, Cohost Kelly Grayson is joined by guest Host Greg Friese, MS, NRP, editorial director for Lexipol, and the pair discuss the traits of a great EMS book. Grayson and Friese, both fans of the genre of EMS literature, discuss the importance of clinical accuracy, a narrative arc that connects the patient responses, and author point of view. They also dive into whether the EMT or paramedic author needs to both experience and convey personal transformation through the narrative. Listen closely as Grayson and Friese shout out some of their favorite EMS authors and books. 

What's your favorite book by an EMT or paramedic? How did that book influence your education and career in EMS?  Listen to the full conversation and add your comments on the topic below.

Kelly Grayson is the author of "Perspectives, Volume I: An Emergency Medicine and Public Safety Anthology", and the follow-up, Perspectives, Volume 2.

Dissecting the lack of diversity of CPR manikins on social media

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

This week cohost Kelly Grayson is joined by guest host Greg Friese, editorial director for Lexipol, and the pair discuss a Canadian research study on the diversity of CPR manikins used in instructive social media posts within North and South America.

During a two year period, researchers found that fewer than 10% of the more than 200 manikin images used in social media instructional posts represented Black or Asian patients, while fewer than 2% represented overweight individuals.

“I kind of rolled my eyes at the study itself, but it does speak to a larger issue,” Grayson said. “No CPR manikin looks like me; none of them have legs and they all have at least one less chin than I do, but [this research] does speak to a larger issue in EMS, and society as a whole, about diversity and inclusivity in our profession.”

What do you think about the study? Listen to the full conversation and add your comments on the topic below.

Additional resources for EMS education

• The 'hidden curriculum' in EMS education: Teaching the good, the bad and the ugly
• Teaching differential diagnosis
• How to recognize lazy students, bad instructors

How best to manage the airways of patients with traumatic injuries

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Our Inside EMS cohosts Chris Cebollero and Kelly Grayson are joined by guest Major Chris Lokits from Louisville Metro EMS (LMEMS) to discuss paramedic intubations in the field. LMEMS is part of the Prehospital Airway Control Trial (PACT), a four-year Department of Defense research study aimed at "improving survival among people who have difficulty breathing after a trauma," through the University of Louisville. A significant number, up to 15%, of people with traumatic injuries die due to a lack of airway management. 

Dr. Raymond Orthober, LMEMS medical director and assistant professor of emergency medicine at UofL, is helping lead the university's participation in the clinical trial. 

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Additional EMS1 resources for intubation

• 5 tips to provide safe and effective ventilation
• Airway management: Improving first-pass intubation success (eBook)
• 5 tips for securing a patient's airway
• Improve endotracheal intubation with First and TEN approach
• 5 things to know about endotracheal intubation

The role of emergency management within the community

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Our cohosts are joined this week by Jeff Hensley, emergency manager for MedTrust Medical Transport in Charleston, South Carolina, who discusses the requirements for the position and the characteristics of a successful emergency manager.

The discussion also touches on the role of emergency management in the community during public health crises, such as the COVID-19 pandemic and the opioid epidemic. 

Why introducing waveform capnography can help EMTs grow

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visitlexipol.com.

Inside EMS cohosts Chris Cebollero and Kelly Grayson respond to the social media discussion on a recent EMS1 article: "Should waveform capnography be in the EMT scope of practice?"

The comments on the topic were divided:

• "If you can bag or insert an airway, you should be able to use ETCO2. As others have said, it’s a fantastic tool for all levels of clinical practice."
• "They need to be good at what is already in their scope of practice and most of the aren’t. They’re just medic dependent."
• "... Why is this even a question? Absolutely yes."

Our cohosts discuss how to train EMTs for this skill and how to make it a reality in the educational process. Chris offers his take on the topic and suggests that nothing needs to be added to the EMT curriculum; instead, he believes it's the responsibility of the agency to teach this skill.