Administration and Leadership

JEMS Readers on Impaired Providers, Leadership & Other Topics

Issue 3 and Volume 39.

This month, a reader takes issue with the November Last Word column, where we gave thumbs down to two different instances where providers were accused of stealing injectable pain medications and switching them with saline.

Readers also give feedback on December’s Leadership Sector column by Gary Ludwig, MS, EMT-P; January’s Street Science column by Keith Wesley, MD, FACEP, and Karen Wesley, NREMT-P; and Novem- ber’s Tricks of the Trade column by Thom Dick, EMT-P.

JEMS November 2013

I just finished reading your November issue. While I thank you for the great topics, I am appalled by your “Last Word” column about two medics accused and fired for diverting medications.

I agree wholeheartedly that impaired providers need to be removed from service until they obtain the appropriate help for their personal addictions. I don’t, however, agree that public shaming of individuals with the disease of addiction is ever appropriate or beneficial to anyone in the EMS community.

The statistics on addiction in America are staggering and we in the EMS community aren’t immune to the disease. It’s our responsibility to help our fellow providers by asking the hard questions, reporting our concerns and supporting our colleagues through these issues.

One resource available to any and all first responders nationwide is Safe Call Now (206-459-3020), a 24-hour crisis line set up for the EMS, fire and law enforcement community.

Let’s begin to help ourselves and move past the shaming of addiction.

Deanna R. 
— Via email 

Editor-in-Chief A.J. Heightman, MPA, EMT-P, responds: 

Thank you for the email, Deanna. Although we understand your concern, the big picture here is that this is a problem EMS administrators need to be made aware of, and providers need to know they’ll be caught and punished if they don’t come forward and admit their addiction. We can be forgiving of an addiction, but not of actions that could result in the improper care of a patient—or even the death of a patient—due to a substituted, ineffective substance.


I wanted to take a moment to thank Gary Ludwig, MS, EMT-P, for his December Leadership Sector column, “Bridge to Nowhere.”

As a new paramedic (a huge career shift for me) I’m absolutely fascinated with where EMS has come and where we, as a profession, may be heading. The idea of “community paramedicine” is something I very much support and am eagerly watching to see how this may manifest in the years to come, particularly in the Southeast.

Thanks for writing this piece. It’s definite “food for thought.” Keep up the good work!

Donna C. 
— Via email 


I just read the November Tricks of the Trade column, “Magicaboola,” by Thom Dick, EMT-P, and I have a few things to add to it. I have several Brother MFC printers and am using them for the exact same reason as Thom. CISinks ( has ink for a good price for the Brother MFC. The tanks continuously fill and it only cost about $20 for more than a year of use.

Ken K. 
— Via email 


Thank you for January’s Street Science column, “Give Them the Epinephrine,” by Keith Wesley, MD, FACEP, and Karen Wesley, NREMT-P. My solution to the EMS problem of not giving epinephrine to children who potentially have anaphylaxis is to remove the temptations to procrastinate. EMS does not need to carry diphenhydramine. Don’t carry it and you’ve removed a major pathway to procrastination. Anaphylaxis protocol should make it very clear that nebulized albuterol is a second line treatment. It should be considered only after first-line treatment of epinephrine has been given. I think having the above in your protocols would lead to a study where EMS shines.

Tony D. 
— Via email


Drunk guy who said “hold my beer and watch this.” —Linda K. 

Fibromyalgia Exacerbation! —Alexander J. 

A busload of hemophiliac nuns hitting a glass truck… —Steve R. 
I dropped a piano on my left foot yesterday moving … Now my right hand hurts. —Jannie Scott R. 

Backflip-off-the-bar-top fail. —Adam B. 

Chicken wing incident. —Christine Ann B.