March 2005 Letters

We Want to Hear From You!

Send Letters to the Editor to:
Mail: EMS, 7626 Densmore Ave., Van Nuys, CA 91406-2042
E-mail: emseditor@aol.com
Letters may be edited for clarity and to conform to space requirements.

Peer Power

I agree with Mike Smith (The Power of Peers, May 2004) on utilizing peers to review calls and personnel performance and discover areas of excellence and concern. We have found them useful and have noted that the peers are harder on their coworkers than the management team.

I would recommend, though, when referring to a call critique, that “peer review” not be the term utilized. In the nursing and medical professions, a “peer review” is when an individual is evaluated by his/her peers to determine whether an action or series of actions should result in a disciplinary action, a revocation of a certification/license and/or notification to the respective state examiners’ board.

We had a flight program that was staffed by flight paramedics from a municipal EMS service and flight nurses from a city hospital. There was a particular mission wherein the assessment and subsequent care of a patient was in question. To determine what had occurred, a “peer review” was conducted. While not everything on the call went perfectly, it was determined that some simple re-education was all that was needed to be provided to the caregivers involved. However, when the director of nursing over the manager of the flight nurses was made aware of the “peer review” and the outcome, she promptly contacted the state Board of Nurse Examiners to inform them of the flight nurse’s “peer review,” as required by state law. This created quite a problem for the flight nurse involved, and left a bad taste in everyone’s mouth. While we had thought the issue was over, instead, it now had to be investigated by the state agency.

So, a word of caution about using the term “peer review” to describe a meeting of peers who are reviewing a team’s performance on a call. Now, the outcome of the call review may warrant such a “peer review,” but that would then be a separate meeting.

Jim Allday, RN, BSN, CEN, CCRN, CFRN
Star Flight Clinical Manager
Special Operations/STAR Flight
Austin-Travis County EMS

Mike Smith responds: What an interesting take on the use of the word peer. I must say, however, I’ve been using the term peer review for years in instruction and, more specifically, when working with groups relative to setting up peer review teams, and I’ve never once heard of such a situation as you describe. For what it’s worth, it would appear to me that the director of nursing kind of overreacted, but that’s just my opinion.

Heart Rate Redux

In Syed Ahmed Mustafa’s article titled EMS at 35,000 Feet, Part 1, in the November 2004 issue of EMS, he tells of a passenger whose pulse was 180 bpm that corrected after the patient coughed. Many years ago, when my wife frequently experienced episodes of tachycardia, her cardiologist taught her to bear down in order to slow her pulse down to normal. It is a trick that served not only my wife, but also several of my patients in a similar situation over the years who have called for an ambulance.

Leland Sorensen, EMT-B
Aberdeen Fire Department
Aberdeen, ID

Rules to Live By

My name is Becca Peterson, and I’m a career firefighter/paramedic for the Arcadia Fire Department in Arcadia, FL. On August 6, 2004, I was working my part-time job as a paramedic for a nonemergency transport company. I was tending to an infant patient, with her mother also on board. My partner lost control on the interstate at approximately 70 mph, causing our ambulance to roll over nearly three times.

I admit I never wore my seat belt on the bench seat, but minutes before, something told me to put it on. Before we knew it, we began to rock back and forth, and all I could do was pray to live through it. I was then knocked unconscious.

When we awoke, we were all ripped out of our seat belts and freon was spurting everywhere, airbags released. My first thought was the baby! I dug her out from underneath me. I then had to hurry the mother and get us out; I was so scared we were going to blow up. My partner was trapped in the passenger side. I was able to get us out and to call 9-1-1. But I felt so helpless not being able to do the job I was trained for. I could only shout orders, unable to stand because I’d crushed my distal tibia and had a head injury. I wanted to help, but couldn’t. I didn’t like being the patient.

It’s been nearly four months and I’ve had reconstructive surgery on my ankle, but have not been able to return to the career I love so much. I attend therapy six hours a week to gain mobility back in my leg. I have medics come to me now and tell me they think of me when they are in back, and buckle up. That was the best thing that could come out of this accident. Please remember, we are rescuers, and are not invincible. Please buckle up; it saved my life, my partner’s and patients’ lives.

Becca Peterson, EMT-P/FF via e-mail

Correction

The e-mail address listed in advertisements for Cindy Elbert Insurance Services in previous issues of EMS Magazine is incorrect. The correct address is cindyelber@aol.com. We apologize for any inconvenience this may have caused.