Transcript is automatically generated.

Erik: [00:00:00] The first video was the guy with, you know, fire behind him. Apparatus behind him. Yeah. Holding a baby in 

Matt: The ultimate... Midnight Christmas Eve. 

Erik: Oh no.

Matt: He calls us back.

Narrator: You are listening to EMS with your hosts, Erik Axene and Matt Ball. 

Erik: Well, we had an interesting conversation this morning, I think this is gonna be a, a cool topic. 

Matt: [00:00:30] Yeah. Yeah. It's a topic that's, well, it's always a hot topic when you talk about EMS and the fire service. 

Erik: Yeah. 

Matt: That is always a, a fun topic to discuss, 

Erik: but I think that most people don't realize some of the things you're about to say.

I mean, most people's perception of the fire service or a fire department, what they do 

Matt: right, 

Erik: is not really a reflection of reality. 

Matt: Yeah, I think both from the civilian standpoint, like I get asked all the time, you know, how are you a firefighter? Are you a paramedic? Like, what, which, what are you? And so explaining [00:01:00] that to the general population, but, uh, this, 

Erik: what do you say by the way? 

Matt: Well, I mean we're both, I'm both, yeah. Which is true. Both like, I'm dual, we're dual certified. Right. Uhhuh, I'm a firefighter and a paramedic in my department. Right. 

Erik: Uhhuh. 

Matt: Um, I ride, the way that we usually rotate it is you do two shifts on the ambulance and then one shift on the engine. Obviously that changes up a little bit, but we fight fire off the ambulance.

Most of the departments in this area, you know, if you're on an ambulance, I have all my gear on the ambulance, so if we get a call. A structure fire, you know? Yeah. [00:01:30] We have two ambulances in my city. Uh, two ambulances automatically are dispatched to that call. Um, but before we start, I think we need to remind everybody to like, share and subscribe to our podcast.

Mm-hmm. Follow our page and 

Erik: like, is the thumbs up thing? 

Matt: Yep. Like share sums, thumbs up, subscribe to the YouTube page. Uh, that helps us out. And then comment, like, if you have questions, you can put comments on there. But also now we're offering something new. We can actually issue CE credit Yes. For this podcast.

But there's a [00:02:00] caveat to that. 

Erik: That has to go through the website. That's right. Axe ce.com. That's right. And you sign in. You can, you can get credit for these podcasts. 

Matt: That's right. A lot of people have asked us, Hey, is there any way I can get CE credit? I love your podcast. Can I get credit for it? Yeah. I mean, and our lectures are pretty similar to our podcast.

The format. 

Erik: Yeah. Yeah. We just a little more. 

Matt: Yeah, a little bit more formal. Formal. 'cause it has to be formal. Yeah. Right. The rules and regulations where the podcast can be a little bit more casual. Correct. But if you need this to get the actual credit, you have to get the certificate and all those kind of things, the objectives, the [00:02:30] questions, those are all standard.

You have to do that. Yep. And so that's why you have to do it through our website. So go to axen ce.com. Yep. And uh, you can get actual credit there. We're bumping knees together. 

Erik: Yeah. 

Matt: But yeah, it's a very interesting, um, you know, fire, uh, EMS in the fire service. Yeah. Um. It's uh, you know, a lot of firefighters.

I think I was recently watched a video on social media where the National Registry was talking about how fire department advertising, when they're doing recruitment, [00:03:00] it's almost a bit of a bait and switch. Mm-hmm. Because you know, you see these posters and join that. You know, whatever fire department, and it's always got a dramatic fire photo of somebody on an aerial ladder or somebody going through a door filled with fire or whatever.

And so it's this mindset of you think. Oh, I'm gonna get into the fire service and I'm gonna be fighting fire. That's what I'm gonna be doing. You watch TV shows or movies and you think I'm gonna be doing dangling up buildings and, you know, doing all this kind of stuff. And that's not totally reality.

Erik: Well, it's funny you [00:03:30] mentioned that I was just at a conference in, at Myrtle Beach last week. Mm-hmm. Um, the Metro Fire Chief. Yep. And, uh, there was a promotional video, I can't remember which speaker did it, but it was a promotional video related to fire. And yeah, the first video was the guy with. You know, fire behind him, apparatus behind him.

Yeah. Holding a baby in the ultimate, yeah. Like it really is the ultimate, right? Yeah. That's the ultimate. But that was kind of the, what you're saying is that, that that's a rare occurrence. You 

Matt: know how many babies I've pulled outta buildings in [00:04:00] 20 years? 

Erik: In 20 years, I'm going to, 

Matt: sorry, you were gonna guess.

Yeah, no, no. I zero 

Erik: never happened. And in some areas that may happen more frequently for sure. But still, even you told me, I think in New York City there was a, a guy with. Decades of experience and only on Rescue One. Rescue one. Yes. 

Matt: Like these guys go to all the big stuff. 

Erik: Yeah. 

Matt: And he said that he, and I think he was the captain there for 20 years.

Mm-hmm. And he said he had four legit rescues, which means like any babies, he didn't [00:04:30] specify if it was a baby or not. But 

Erik: Uhhuh, 

Matt: uh, yeah. I mean obviously if you work in a large urban department, um, especially, you know, maybe a. Lower income area. Uh, you certainly see more fire if you work for Houston or LA or New York, Chicago, you know, these big cities and you know, you work in rougher areas, you're 100% for sure seeing fire.

Um, but even in those departments, you are still running EMS calls. 

Erik: And I think that there's something about a firefighter that. [00:05:00] And yourself included. I, I think, and, and there was a time in my life I was applying to become a firefighter. I, I wanted to put myself in, in the position to save somebody's life.

Sure. Absolutely. So I think there's that. Uh, but the reality is if, if your expectations are every day, you're fighting fire to go save people from a burning building, not reality. You're not Yeah. Not reality, but certainly being available to do it. It's like an ER doc, right. I've been trained for a bunch of procedures that I rarely do.

Right. And I'm excited for them. I train for them. Mm-hmm. [00:05:30] But most of the time it's. What do you call it? Poo pains. And poo 

Matt: pains and yeah, grandma, I believe you 

Erik: said lift assist. I think. Yeah. Lift assists and poo pains. It's like in the ER though. I mean, it's like sore throats and 

Matt: flu-like symptoms. Yeah, like tummy hurts, 

Erik: fever and a kid or something.

It's just, and again, and we've talked about this before, 50% of people in the ER don't need to be there. Right. And so I think that in the. The EMS service too. It is like we're transporting people that don't need to be transported 

Matt: constantly. Yeah. Yes. Yeah. And, and, and there's a, you know, there's some misunderstanding around, you know, what is [00:06:00] EMS there for, you know, a 9 1 1 EMS service and the general citizen?

I don't blame the average citizen. No. You know, for calling 9 1 1, because. You know, what is an emergency to you might not be an emergency to me or vice versa. Right, right. And so, so I don't, I certainly don't blame the general citizens now when we're talking about some facilities. 

Erik: True. Oh, I have to say something though.

If you're a 25-year-old man with a ladder. I'm not gonna just check the smoke detectors first. You didn't say it. I said it. I'm the ER doc. I'm the medical [00:06:30] director that's gone on the calls. Well, so story time. 

Matt: Well, I'll give you a little story time. I, I might have shared this story with you, but it was Christmas Eve.

Okay. We were on shift about eight o'clock that night. We got, I was on the engine that night, actually, I think I was driving and we got a call for a, uh, residential, uh, fire alarm, smoke detector. 

Erik: Yeah. 

Matt: Show up at the house. Okay, fine. And the guy's like, yeah, my smoke detector's chirp. We're like, okay, you know, people don't know.

We educate him. Right. No big deal. So we go in and this guy was a big, tall guy. He was probably 6 3, 6 4. Big [00:07:00] guy. Well, the smoke detector, literally my captain was a big guy too. He could literally just reach up, no ladder needed, just reached up, grabbed it with his hand, took it down, you know, he cleaned it out.

We changed the battery, did all the things. And we put it back up and my captain tells him, he says, Hey, if this happens to go off again or starts chirping again, it's probably a bad detector. And so he shows him how to do it. He goes, just quarter, just twist it, unplug it. You'll have to get a new, you know, go to Home Depot, whatever.

Get a new detector. 

Erik: Yeah. 

Matt: Guy's like, okay, fine. Midnight. Oh, Christmas Eve, Uhhuh, [00:07:30] he calls us back. 

Erik: Uhhuh. 

Matt: We're like, bro, we were, you're a grown man. Like, again, if it's an elderly person, like Please don't get on a ladder. Don't, we don't want you falling, but like you're an able bodied six foot, four able bodied, 30 5-year-old guy, like.

Come on bro. 

Erik: Who's already called? Who's already called, been called. We've already 

Matt: taught you how to, this is not rocket science, right? Or the amount of people that don't know how to shut the water off to their house. That's a whole other issue. But these facilities, when it comes to EMS, these, you know, [00:08:00] burnout is a huge problem.

Erik: Uhhuh, 

Matt: and, you know, guys get sick and tired. Uh, first off, if you go into the fire service, I think we need to start there. If you go into the fire service in the modern day fire service in AmErika, the nationally, the majority of. EMS calls are run by fire departments, right? There's private ambulance companies mm-hmm.

Uh, all over the country, but the majority of EMS calls 9 1 1 EMS calls are gonna be run by a fire department 

Erik: and I, and last year I looked at the data, [00:08:30] uh, 70% of all 9 1 1 calls were EMS. There were only 2% that were fire suppression, 

Matt: and that's nationally. So you have to think within those numbers. Are those places we talked about Houston Dallas?

La Chicago, these, these big urban areas that are probably doing the bulk of the firefighting, right? Yeah. Um, you know, I mean, in my department, we certainly, we had a structure fire yesterday. You know, we certainly fight fires, but not to that level that everybody not on Chicago fire. That's not, that's not reality.

Um, [00:09:00] and so people get into it thinking that's what they're gonna be doing. And the reality is. Is that the bulk of what you're gonna be doing is EMS calls. Right. And to quote my chief EMS is what moves the needle in the modern day fire service. Mm-hmm. And the reality is whether you choose to like it or not like it, it is a reality.

Erik: Yep. 

Matt: Is that most citizens nowadays are not concerned with, you know. [00:09:30] Uh, dying in a house fire in the middle of the night like they were 30 years ago. We've talked about this before. Mm-hmm. What they're more concerned with is that they're gonna have some sort of a severe medical emergency. They're gonna have a heart attack or their mm-hmm.

Loved one's gonna go into cardiac arrest or something like that. Yeah. And they want to know that whoever is responding, whether it's a private company or the fire department, they want to feel confident that the people that are showing up are competent providers that know what to do. 

Erik: Correct. 

Matt: [00:10:00] Right. And so for the, all the people out there that are looking to get into the fire service, just know mm-hmm.

That. Yes. Firefighting, extrication, you know, all that kind of stuff is a part of the job. Yeah. It is not what you're gonna be doing on a daily basis. 

Erik: No, that's right. By far. Yeah. 

Matt: Um, and so, you know, training like we do is a huge part of that. Um, you have to be ready to go on these emergencies, and I think a lot of times too.

Uh, from a [00:10:30] leadership perspective, whether it's a medical director or a officer chief level, level perspective, EMS is changing. Right. And we are now considered really since 2020, we're considered part of the healthcare team. Mm-hmm. The overall healthcare team, you know, every paramedic hates it when they're called an ambulance driver.

Well then don't be an ambulance driver. Mm-hmm. Right. Don't just give 'em a dose of diesel. Like that's why they're calling you an ambulance driver is 'cause that's all you're doing. You're not starting IVs on patient that needs IVs. You're not [00:11:00] administering oxygen to patient that needs oxygen. Right. And so if you don't want to be called an ambulance driver, then treat your patients.

Right. Right. Be part of the healthcare team. Yeah. But a lot of guys don't understand the why behind things. 

Erik: Mm-hmm. 

Matt: You know, like antibiotics and sepsis, which we've talked about. Yeah. You know, I had one of our guys go, we're doing all this new stuff. Why are we doing all this stuff? Why don't mm-hmm. I, I get this all the time.

It doesn't matter what department I'm at. I get it all the time. Why can't we go back to just doing, doing it like this? I just don't understand. Well, the reality is we're [00:11:30] not doing that because what we're doing now. Is shown to have dramatically improved patient outcomes. Right? That's right. That's why we're doing what we do there.

We're not just doing things, the medical director isn't just saying, oh, we're gonna throw antibiotics into a sepsis protocol just so I can say that we give antibiotics. 

Erik: Yeah. 

Matt: There, there's data behind that, right? Mm-hmm. 

Erik: No, there are. There's a lot of to back up. You know, the, it used to be, and it still is to a large extent, the only time a fire department would get reimbursed for their services would [00:12:00] be when they transported to the er, right?

And that's an archaic reimbursement system. 

Narrator: Right. 

Erik: And that's changing. 

Narrator: Yep. 

Erik: And it's, it's, um, there's more accountability. Now. People are starting to look at the data. We didn't always have data, but with our EPCR systems, now we're collecting data. We can see how long it took a patient to get an Eek g or if they got one.

Mm-hmm. Or how long it took to get the IV fluids on a septic patient. That's right. Or did you get, did you identify sepsis, 

Matt: stroke activation, STEM activations, all of that? Yes. 

Erik: So there's more accountability now on the quality [00:12:30] of care that we're delivering. Before the ambulance bay doors. Yeah. And that's what you're talking about.

And so there is data just came out I think just this last year. Um, when we treat sepsis patients properly mm-hmm. Um, we can decrease mortality rate for every hour you delay, um, treatment of sepsis. Mm-hmm. And that includes antibiotics. Mm-hmm. Um, IV fluids. Mm-hmm. Activating, you know, the sepsis or whatever.

Mm-hmm. Um, you decrease mortality rate. Or sorry, every [00:13:00] hour you delay, you increase mortality rate is 7%. Right. And it was interesting when they separated out the data on sick ones, septic shock patients, we'll talk about this at some other podcast, but mm-hmm. Um, the sickest of all the septic shock patients, if we miss it and delay their treatment, mortality rates is gonna be going up even if you don't get antibiotics early.

Right. So, and there's some other data out there that shows just came out just in the last few months, I think actually it was January. Of 25, um, it showed that [00:13:30] there was no benefit for early mm-hmm. Antibiotics. Mm-hmm. Which refuted a lot of the earlier studies that said there was a benefit. Right. And I would argue that there is a benefit.

That study that said there wasn't a benefit was only represent representing about 4% of septic shock patients. Right. So you had a, a less sick patient population. Right. So you're not gonna see a lot of benefit. Right. Right. But when you get the sickest patients. I think there really is a benefit and hours count.

Mm-hmm. And it's, the data shows it 7% for every hour we delay [00:14:00] treatment. 

Matt: It's to go back to what you said kind of at the beginning was about like life saving. Yeah. And, and I say this a lot of time and honestly this will probably piss off a lot of firemen, if I'm gonna be honest, that are in the fire service.

They're gonna get mad at me. I think 

Erik: it's fun to make people mad, get the tip of the spear, you know, it's like challenge the status quo. 

Matt: You need to challenge, right? And so my challenge to the mindset 

Erik: respectfully, 

Matt: absolutely. Like, so I am not negating. Being a capable firefighter in any way, shape or form.

I know [00:14:30] I am not saying I know your hard. I know you well. Yeah. This is exactly, I know you like, so here's my, here's my analogy. Okay. When I get a firefighter, a paramedic, whether I'm teaching a class or in my own department, right? And they ask me, you know, well, why are we doing this and why are we doing that?

You know, I don't just give 'em a dose of diesel, just take 'em to the hospital, let the doctors do that kind of stuff, right? My, um, response to that is. If you have a dying patient, but it doesn't matter what they're dying from, [00:15:00] trauma, stemi, whatever, you have a dying patient in the back of your ambulance, and your choice is to just say whether it's out of fear, because it's a complicated skill.

A crike or something like that that you've never done before. You've been trained on how to do it, but you're scared to cut somebody's throat open or whatever the case may be. You don't want to take their airway, you don't want to administer the antibiotics, whatever it is. And you choose instead to, let's just go to the hospital.

Let's just go. Right. To me, [00:15:30] that is no different than we pull up on a structure fire. I pull a line to the front door. 

Erik: Mm-hmm. And 

Matt: we open the door. You know, we look in and fire is just rolling in that house. Right. Or it's full of smoke. It's, it looks scary and dangerous in there, and we're being told there's somebody in that building, right?

Mm-hmm. What if I were to put the hose down, put my tools down and say, I'm not going in there. Let, let the next guy do it. Let let engine, let the next [00:16:00] engine or the next truck and let them do that. 

Erik: Right. 

Matt: I would be crucified. Yeah. By the entire fire service if I did that as I should be. 

Erik: Yeah. 

Matt: Right. Like you, that's who you, can you be 

Erik: fired for cowardice?

Matt: I would think so. Conduct unbecoming. Yeah, for sure. I would think so. Like you're failing to do your job, right? 

Erik: That's an oath you took. 

Matt: Absolutely. You risk a lot to save a lot. You risk a little to save a little. Right. And you know, I mean, again, we've talked about this before where, you know, some firefighters aren't gonna.

Whatever, [00:16:30] you know, hopefully everybody understands that that is part of the gig, right? Mm-hmm. If you're a cop and there's a school shooting, you're not backing out. And we've seen examples of cops that have done that, or departments that have done that, and it doesn't end well for them, right? Yeah. And so I would hope that most people understand nobody wants to do that.

Nobody wants to die in the line of duty, 

Erik: right? No, 

Matt: but you should know that that is a possibility if you go into this line of work. But back to the point. Is that if I back at it, to me, what is the difference [00:17:00] is if I'm saying I'm not gonna risk my life, there's Uhhuh to save this patient in a fire. Well, what's the difference?

If I back out and I'm a coward and I don't wanna do those skills in the back of the ambulance? Mm-hmm. That patient could very well die because I don't control that airway in the trauma patient. We know that hypoxia is part of the trauma triad of death. Yeah. Right? Yeah. And those patients, that oxygen decreases, the longer they go suffer.

Yeah. Yeah. They're gonna die. Right. So to me that's the same thing. And, and [00:17:30] what does it matter if you're in the lifesaving business? What is it, what's the difference between pulling somebody out of a burning building mm-hmm. Right? Or doing some cool technical rescue, swift water or hot, whatever it is.

Right? Yeah. And being capable of managing a complicated medical patient. Right. 

Erik: Right. Mm-hmm. 

Matt: At the end of the day, you're still sa potentially saving someone's life by being knowledgeable and capable to do your job. 

Erik: Correct. And, and it, I think in [00:18:00] defense of the, in the past. Well, it's, it's tempting to just want to get.

The patient outta your hands into somebody who can fix 'em. Right. I can see that. And at times there's 

Matt: things, trauma, patients trauma, sometimes you need to do that, 

Erik: you've gotta load and go. Absolutely. But you know, for pediatric, you know, patient a pd, cardiac arrest, yes. You gotta stay and get the patient stabilized.

Do those things right away. Yes. Delaying those things. Kill the patient. Absolutely. So I think there's a knowledge part of it and where I think maybe a po like a, almost like this false sort [00:18:30] of a culture of, of the best thing we can do is to get 'em to the people who can fix 'em. Yeah. And that's old, that's archaic.

That's not true anymore. Same thing, I think can be true. And even in the ER where, you know, you want to get that patient outta the ER so you can start moving people. Well, sometimes it's not really good to do that. Yeah. Sometimes you want to keep a patient in the ER 'cause you know, at night they're gonna get lost.

Yep. And they're at risk for fill blank. Right. Um, so there's, there's a, I there's a temptation too. Sure. To, to offload. [00:19:00] Even in the er. Yep. Uh, and to get people out of the ER fastest, you know, I'm just gonna prescribe the antibiotics. Mm-hmm. Just make mom happy. Yeah. Well that's not good, right? Not good to over-prescribe antibiotics.

Yeah. Um, it's probably virus. Yep. You know, and antibiotics could even make 'em worse. Right. But mom is happy and she's outta my er, so we're good. There's a temptation to do that, so. 

Matt: Yep. Its like transporting patients to the wrong facilities, like especially with pediatric patients. Yeah, you, you get that pediatric patient pre-hospital, and I've got two [00:19:30] hospitals that don't deal in pediatrics in my city, so I gotta go outta my city to go to a, you know, a, a better facility for that pediatric patient.

But wow, this place is five minutes away and that's 15 minutes away and I wanna get back and eat dinner or, you know, and, and I get it. It's tempting, you know, maybe you're tired, whatever the case may be. Mm-hmm. I get it. But. Like don't get jaded, I guess is my overall point. Like if you're getting into the fire service, understand that this is gonna be the bulk of your role.

Erik: Yeah. 

Matt: And as you said, yeah, they're [00:20:00] starting to collect more and more data and paramedics are being held more and more accountable to the days of, oh, just give 'em a dose of diesel and run 'em to the hospital's. Not gonna really be good anymore. 

Erik: And I think if people are trying to do the right thing and stay up to date with literature and, and understand what is best for the patient.

Mm-hmm. It might be best for the patient to not just get up and load and go, and there's things I should do right now. Mm-hmm. Um, or at least in route. Yeah. Um, but there's, there's, it's not just in the pre-hospital environment, there's a [00:20:30] lot of literature coming out. Everywhere. Mm-hmm. Medicine's changing fast.

Yeah. And with AI, it's changing even faster because we're able to look at data differently than we've ever seen it. So we're gonna see a lot of change, I think, in the next, just in the next few years. Yep. Things are, I mean, we thought things were changing exponentially fast before, but with the advent of ai.

And Oh my gosh. I mean, things are really changing even faster than we ever imagined they could. 

Matt: Yeah. 

Erik: In fact, I don't even think we can keep up with the technology. Yeah. It's 

Matt: gonna move faster than we are. [00:21:00]

Erik: Right. Right. Things are changing so fast. It's like month to month we're getting new information.

Right. So I think there's a responsibility that we have if we really wanna do the right thing and save the mm-hmm. Person from the burning building. Right. Figuratively. I mean that whether you're an ER, doc. Treating a cardiac patient or you're, um, you know, you're in a nursing home looking to identify sepsis or whatever it might be.

Mm-hmm. That's you're saving lives. Mm-hmm. And if you stay up to date and optimize your care, right. Uh, you're decreasing [00:21:30] mortality rate, and I think that's saving lives. Right? Mm-hmm. Is if you have an opportunity to decrease the risk in a patient dying, right. That's, that's, that should be just as praised as saving a yes.

Baby out of a burning building. Absolutely. Well, maybe not as sexy, but you know, by decreasing mortality rate. 

Matt: Yeah. I'm laughing because that's the difference. Yeah. In my mind, that's the difference. And this is, to me, this is a cultural thing, is that it's more sexy. Right? You're gonna be, if I pull a baby out of a burning building, I'm gonna be on the news.

[00:22:00] Oh, hero firefighter. Say I have had, I don't know how many patients. You know, cardiac arrest patients are really sick. Right. I've never had the news call me and be like, Hey, I heard you had this really sick septic patient and you gave the appropriate, you know, that doesn't happen. Yeah. And so a lot of it, again, this is probably gonna piss off some people, but a lot of it is really based on our ego as firefighters.

Erik: Yeah. Is 

Matt: we want a little bit of that hero complex. Sure. You know, and to a degree, I get it right. We all look 

Erik: that. Yeah. 

Matt: But. Like you said, I, to me, I get just as [00:22:30] much self satisfaction of knowing I had a difficult. A medical patient, trauma patient, whatever the case may be, that I was able to manage that patient.

I activated that statement, I recognized it. I activated that statement. Mm-hmm. Whatever the case may be, and that patient had a better outcome because of what I did. Right. To me, that's just as satisfying as a feeling. Right? Yeah. 

Erik: So, and I think that if you can find the satisfaction in that, the fulfillment in that, yes, you're not gonna get on the news, you're not going to have the, the family [00:23:00] honestly isn't even gonna know to thank you.

Correct. You know who they're gonna thank 

Matt: the 

Erik: doctors, the ICU doc that's discharging them. Yeah. It's like, wow, I was that sick. I didn't know. Yeah. Wow, doc, you're amazing. And they come back to the ICU to bring that guy cookies. Yeah. Right. Well, 

Matt: I mean, I will say this though. Yeah. I mean, I have had patients come back.

And bring, that's bring us stuff to the stations. Same in the 

Erik: er. We've had that too. 

Matt: Yes. Yeah. As a matter of fact, the first guy, so in the fire service, at least in my department, a true CPR save is not when you just get [00:23:30] a pulse back, it's when the patient comes back and shakes your hand. That's what we consider a CPR save.

Right? 

Erik: Discharge home. That's the outcome measure. Well, we said, but 

Matt: we don't always get that. Like we don't know when they, and now we do, we get outcomes. But I remember, this is way back before any of that happened. Now I'm talking 18, 19 years ago. We went on a cart, is probably one of my first cprs we ever went on.

Went on this guy, older gentleman. Uh, we worked the code, we get Ross on him Uhhuh, uh, we get him into the er and about a week later. We are sitting in the [00:24:00] fire station. It was a Friday night, about nine o'clock. We're sitting in the fire station and there's a knock on our door and we go, and here's this guy.

Well, I didn't recognize him at first. Yeah. You know, because totally different context, right? 

Erik: Mm-hmm. 

Matt: And, uh. He ends, he extends his hand out, Hey, my name is blank. And he says, my friends call me Lazarus, thanks to you. And I'm like, what? And he's like, that's awesome. Don't you remember us? And then, you know, his wife's kind of emotional and uh, he tells us, yeah, I was the guy that you guys ran on and I've had that only a handful of times.

Erik: Yeah, 

Matt: [00:24:30] right. And they bring, brought, you know, whatever ice cream. It's 

Erik: amazing when that happens. 

Matt: Oh, it's so, I mean, literally when you can see that impact, and I, and that's what I want to encourage the future firefighters, uh, on, is that. That is a very fulfilling when you have a wife Yeah. 

Erik: Who 

Matt: is crying, or the mom of a child that is crying emotional because they're overwhelmed with emotion because mm-hmm.

You, whether it was a lifesaving thing or you made the right call, whatever the case may be, that is a very satisfying feeling. 

Erik: Yeah. No, it is. 

Matt: You know, I'm sure you've had that [00:25:00] as a doctor. I would hope so, isn't it? Yeah, 

Erik: yeah, definitely. People come back and thank you for. For whatever. I, um, tons of cases come to my mind where you, you unfortunately, the patient comes to me unresponsive.

Yeah. Right. Patient never gets to meet me or see me. And then they, they end up going to some other doctor who, when they wake up. Thanks, 

Matt: Adam. 

Erik: Yeah. Right. It's like, it's okay. Yeah. Because we know that what we do matters. Mm-hmm. And we, we. We save lives today. Yeah. We 

Matt: shouldn't be doing this for a bunch of priest.

No. I [00:25:30] mean, we all enjoy, we like to be praised. Everybody likes to be praised and thanked. 

Erik: You need it from time to time. Actually, I think we should be doing that to one another. I, 

Matt: exactly. That should be coming more from the departments because we see it more. We're doing, we're looking at the cases. But I mean, you know, if you're doing it to be on the six o'clock news because you're a hero, 

Erik: you're gonna be discouraged because it's probably not gonna happen.

Matt: Probably not gonna happen. 

Erik: That's right. You know, I remember the story, uh, of our friend Brenda. 

Matt: Mm-hmm. 

Erik: You know, this is good day to talk about this actually. 

Matt: Yep, yep. 

Erik: And, uh, [00:26:00]

Matt: and we've said her name with permission just so everybody's 

Erik: clear. Yeah, of course. Yeah. And, uh, so her son, um, because of people recognizing patterns that we were teaching Yeah.

Um, saved her son's life. That's right. That's a neat story. And to, to talk to her and to hear the story and share it with other students, that, that's, um, that's a little bit of what we can do. Mm-hmm. It doesn't happen every lecture. 

Matt: No. 

Erik: Right. But, but I believe though, if we can teach in an evidence-based way mm-hmm.

Where we can learn those little tricks to decrease mortality, we may [00:26:30] not hear the thank yous, but they add up. Mm-hmm. What we learn really matters. Right. And we can, we can save lives little bits at a time. 

Matt: How, how appreciative do you think her son is that she was able to identify 

Erik: or his son 

Matt: that, huh? 

Erik: His son now has a dad.

Matt: Yeah, there you go. Yeah, exactly. 

Erik: Yeah. I mean, it's really scary. 

Matt: Yeah. When you think of it, does it, does it matter that it was not in a fire and it wasn't this sexy, dramatic situation to him? It doesn't No. That's right. Like to him, it was the [00:27:00] worst day of his life. Yeah. And you know, it, things happened that way.

And so 

Erik: diagnosis missed in the urgent care made in the ER because of a persistent mama. 

Matt: Yeah. 

Erik: And a doc who is willing to listen. 

Matt: That's right. And you can do that as a paramedic, you know, or an EMT, right? Yeah. You notice something because you're paying attention to things and you're listening to podcasts and staying on top of stuff.

You could educate doctors on things, you know? And that's a pretty, that's what happened in Idaho. Yeah. Do you remember that story? Well, you, the guy told you the 

Erik: story. Well, he called, yeah, he called, went through our website, wanted to talk. I [00:27:30] talked to him on the phone and he shared with me how. Um, he, uh, recognized a sign his partner got because he said, listen 

Matt: to you speak.

That's right. Yeah. 

Erik: Yeah. The stuff we've been teaching on our stuff matters in the virtual environment. You can learn a lot. Yep. And it sharpened skills. Well, he taught the er doctor a new sign on any case. And the cardiologist. And the cardiologist, they took the patient to the cath lab, uh, required two stents.

Yep. That saved that 80-year-old woman's life. Somebody's grandmother was rescued. Yep. 

Matt: Well, and, and at the end, end of the day, that's amazing. [00:28:00] You did your job. Yeah. Like you did your job. You were, you were forward thinking, you were staying on top of things. You did your job. Yeah. Right. That should be enough satisfaction that, hey, the end result isn't up to me, in my opinion.

But I did my best. I did my job. I. That should be satisfaction. 

Erik: We're all links in this chain. 

Matt: Right? 

Erik: Right. And, and if we can, if we can all do our job, that's how people say, you know? That's right. Get the best care. Now for some people it's just their time to go. 

Matt: Exactly. That's what, yeah, exactly. You can do [00:28:30] everything right and you, this patient still dies, right?

Yeah. That's not up to us. I think we all agree with 

Erik: that. That's right. But if we all do our job, decrease risk to patients, that's what save lives, and that's why we do what we do. 

Matt: That's right. That's right. And then we we're breaking down these difficult concepts. Yeah. And that's so you guys don't have to read all the crazy research papers.

We'll, we'll do that. We'll that for you. Break it down into little nuggets and you can ingest those nuggets as you like. 

Erik: I think you've given us a real clear picture of what it actually looks like. 

Matt: That's what the real fire service looks like. See you on the next one. 

Erik: See it out [00:29:00] there

Narrator: Thank you for listening to EMS, the Erik and Matt Show.