News, Training

Recruits, Restructuring, and a Really Great STEMI Test

Issue 9 and Volume 39.

  Recruits to the Rescue
With one week left in their training, Boston EMT recruits Peter Janeliunas and Michael Mendes were running drills with field training officer James McCabe, EMT-B, near the Charles River. What promised to be a training day turned into a call when a man standing on the bank of the river fell into the water and began fighting to stay afloat. While Mendes remained with the fallen man’s compatriot on the riverbank, McCabe and Janeliunas dove into the water to save the floundering man.

“That was a first-time experience for me actually,” Janeliunas told CBS Boston. “I grew up on the water. So, I was comfortable going in there. I knew the risks … ahead of time.”

McCabe and Janeliunas pulled the fallen man to the shore, and he was taken to a trauma center in critical condition.

The recruits were two among a group of 20 who successfully completed six months of training and were promoted to EMT the week after the rescue.

We give a thumbs up to these men for snapping into action in the Charles River and acting like EMTs, even before being given their titles.

  Troubling Restructuring
A recent contentious 3-to-1 decision by the selectmen of the Belchertown, Mass., Fire Department requires that all paramedics also be trained as firefighters. As a result, four of their paramedics were laid off because they didn’t have the requisite training. Fire Chief Edward Bock proposed the change, which he labeled a “restructuring” of the department. As support, Bock sited a 2006 study that “recommended the combining of departments and staff to provide a fire-based EMS,” according to masslive.com.

The decision had casualties: Paramedics Jack Kennedy, Emily Chandler, Kate Sullivan and April Fernandez all lost their jobs. Fernandez told masslive.com she had approached Bock about fire training three years ago but was told such training wasn’t necessary. When she requested to attend the fire academy, Bock allegedly refused her request.

The majority of selectmen supported Selectman Ron Aponte’s position that such a motion would be in the best interest of the residents of Belchertown. However, Selectmen William Barnett, the only dissenting vote, showed considerable concern with the motion. During the proceedings, he asked whether Bock had extended training to the four paramedics who didn’t have fire training. Bock said he hadn’t. When asked if the paramedics knew they would be laid off, Bock again said no. Barnett said he had only learned of the layoffs hours before the vote. “That is not how somebody should be treated,” Barnett said, according to masslive.com. “That is not the way I was brought up and not how Belchertown should operate.”

We chide the Belchertown Fire Department for adopting a motion that forced four of its paramedics—a past union president and all full-time females—without their knowledge or input, and for not extending any option to keep their jobs. We hope the department finds some way to consider Barnett’s and the paramedics’ dissenting opinions.

  Stellar STEMI Test
Paramedic, blogger and computer programmer Christopher Watford has developed what some are calling “the most awesome STEMI test on the Internet,” which he has named, simply, “ECG Assessment.” Using 36 sample ECGs from “Physician Accuracy in Interpreting Potential ST-Segment Elevation Myocardial Infarction Electrocardiograms”—a study authored by McCabe JM, et al. in Journal of the American Heart Association—the quiz tests the user’s ability to identify whether a given ECG indicates a blocked coronary artery, causing a STEMI.

This simple quiz provides a great challenge to anyone interested in putting their ECG-interpreting skills to the test. The assessment provides metrics at its conclusion, including negative and positive predictive value, sensitivity and specificity. It also compares the user’s results to those of other healthcare providers including cardiologists and emergency physicians.

We give two thumbs up to Christopher for putting his ingenuity to work in crafting a quiz that can help EMS providers sharpen their interpretive skills.

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