ADJUSTED

EMS Professional with James Holmes

October 03, 2022 Berkley Industrial Comp Season 4 Episode 44
ADJUSTED
EMS Professional with James Holmes
Show Notes Transcript

In this episode, ADJUSTED welcomes James Holmes Paramedic Communications Specialist with the University of Mississippi Medical Center. In this episode James talks about what it is like to work in EMS and discusses some things people should know about handling medical emergencies.

Season 4 is brought to you by Berkley Industrial Comp. This episode is hosted by Greg Hamlin and guest co-host Matt Yehling, Directory of Claims at Midwest Employers Casualty.

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Visit the Berkley Industrial Comp blog for more!
Got questions? Send them to marketing@berkindcomp.com
For music inquiries, contact Cameron Runyan at camrunyan9@gmail.com

Greg Hamlin:

Hello, everybody and welcome to adjusted. I'm your host, Greg Hanlon coming at you from beautiful Birmingham, Alabama where the skies are blue today. And with me as my co host for the day, Matt yelling, Matt,

Matthew Yehling:

you want introduce yourself. Hello, everyone. This is Matthew Yaling, along the banks of the mighty Mississippi joining you from St. Louis, Missouri. Thanks for having me back, Greg.

Greg Hamlin:

Glad to have you. We have a special guest today, James Holmes, a EMS professional. And we're excited to have you James with us for today. And James, where are you out of?

James Holmes:

I'm out of Jackson, Mississippi.

Greg Hamlin:

Awesome. Awesome. So the South was representing today with that Alabama and Mississippi, and Missouri. Absolutely. Excellent. Well, James, we wanted to have you on the podcast. You know, one of the things that we deal with all the time, and worker's compensation is obviously people getting hurt. And very rarely do we get a chance to hear or ask questions from the perspective of a EMS professional. So we're excited to have you with us today. And also wanted to let you know how much we appreciate working with your son who's an employee at Berkley industrial comm. He's fantastic. So you've done at least one thing, right.

James Holmes:

Great. Glad to hear that.

Greg Hamlin:

So the big question, I wanted to start with this. So how did you end up in the medical field,

James Holmes:

that's actually a pretty cliche story. When I was in high school, our Career Center had a battery of tests that they would give us from time to time to try to give us some kind of a guidance down a career path. And one of the tests that they gave us, I don't remember which year it was, but it kind of matched our personality, with our academic strengths. And then kind of gave us a list of some careers that we would be good at. And one of those was as a paramedic. And while I was familiar with what a paramedic was, I didn't really know what one did. And so when I started doing a little research to see what one did, would it that sounds like an absolute blast. And I wanted to do that. And I was all about it from that day forward. So luckily, my high school had access to an explorer Scout program, and explorer scouts help expose a young person to a career path. And they had an explorer program for EMS. So at the ripe young age of 1617 years old, I was able to do some ride alongs on an ambulance, and see what it is that paramedics and EMTs actually do. And once I did a few of those, I was hooked. And I was all about it from there forward.

Greg Hamlin:

That's fantastic.

Matthew Yehling:

That's really interesting. I know Greg always asked everybody and teases about, you know, you wanting to do this since grade school or whatever. But it sounds like you are the exception to answer there. Yeah. So you mentioned that what does an average day of an emt or paramedic look like? Why don't you walk us through that?

James Holmes:

Well, the best part about being a paramedic is that you never have the same day twice, because you're there really to respond to emergencies. And there's no pattern to the emergencies. They just kind of come when they come. The one consistent is that we start the day checking off our equipment, making sure that we have everything, make sure everything works. And just being prepared for whatever comes our way that day. And from there on calls take precedence over everything on the shift, take priority over eating, sleeping anything. And we just go and do what comes.

Matthew Yehling:

So you work for. And just to clarify, because I know EMTs and paramedics might be associated with a fire department or hospital or a private agency. Which one of those do you work for? And how do you get your calls.

James Holmes:

So currently, a very recently made a transition into a little bit different workspace as a paramedic where I work in a transfer center associated with a large metropolitan hospital, that when patients are trying to get transferred or they need specialized care that only my hospital can offer. I'm the one that makes that happen. Prior to this majority of my time in EMS has all been working for private ambulance we have in the EMS industry there a lot of fire based EMS and a lot of hospital based EMS and I just haven't been privileged enough to work for either one of those specific industries or subsets of the industry. and have predominantly worked for private ambulance companies over the course of the last 20 plus years.

Greg Hamlin:

So that's fantastic. One of the things I, you know, I was thinking about your career path and how you talked about taking those aptitude tests in high school. I remember when I took that I, it came back as a park ranger. And obviously, I did end up that I think I liked being outside more than than I do now. But I think it's great, though, that your school had an opportunity for people to gain exposure to the industry. And that's something I wish we saw more of in more industries, honestly, is, I'm not really sure how high schoolers are supposed to know what direction to take when they haven't been exposed to what might be out there. So just talking about your own journey, as you work as a paramedic, what's the hardest part most challenging part of what you do every day?

James Holmes:

When you ask that question of most paramedics, you're gonna get the same answer. Okay? And that is sick and hurt kids. Okay? It's something that human beings are designed emotionally, to respond very strongly to being protected with kids and to comfort kids when they're hurt. And the natural body response, pretty much leads the average person when a kid is involved in an accident, or hurt or is very sick, doesn't leave you thinking very clearly, I think anybody that's a parent that's had a very sick child knows that feeling of panic and not really knowing what to do. So we're specifically trained to be able to take those emotions and put them in the back seat for a minute. And just refer to the training that we have, and just starting at the top of the list and working our way down, to figure out what's going on, address it and stop either a disease or an injury process, and at least stabilize it. And then we deal with the emotions after. And so like I said, most EMS providers will will tell you that very sick and very hurt kids is the hardest things that that we do. Thankfully, it doesn't happen on a daily basis.

Matthew Yehling:

So you want to be the thermostat. And that that thermometer and that situation, right?

James Holmes:

Absolutely, absolutely. Kind of the analogy that works really well as we tell the new guys that are coming in to be like a duck on a pond above the water, it appears all calm and quiet and serene. But if you look under their their feet are going 1000 miles a minute. That's great. Yeah, your brain can go 1000 miles a minute. But if you maintain that calm, outward demeanor, then it helps to calm everybody else. Sometimes it's hard to not get sucked into the panic and the chaos, but just kind of centering yourself and going okay, what do I have to address right now? Let's do it top to bottom and go from there.

Matthew Yehling:

That probably leads into where I was gonna go. Next is, you know, when you're assessing that emergency, or kind of the unknown situation that you're coming upon, what are the first few things that go through your head,

James Holmes:

the first thing that you always worry about is you and your partner safety, we go to some very uncontrolled environments sometimes. And I've run calls where there have been sick people at crackcast. Yeah. So when you're in these environments that are uncontrolled, you always have to be alert for your safety, just because not only is it your safety, and your brain, your partner's safety, but your patient safety. And so sometimes you have to kind of prioritize things based from a safety point of view. Most of the time, safety is not something that really comes into play, it happens enough that we need to have it on the forefront of our mind. But most calls we run, you know, we don't have to worry about getting chased with an axe or anything crazy like that. So once you kind of get past that part, then it's a pretty simple approach of is the person awake or not? And if they are awake, and they tell me what's wrong with them, what's bothering them, what hurts, and then assessing how their breathing is and how their circulation is. It's the classic ABCs that you learn when you take a CPR class. But it's something that we do for every single person that we encounter, and it gives us a good baseline as to figuring out what is going on with them. And are they stable or are they unstable? Because if they're unstable, you have to kind of shift gears and things have to happen much more quickly and sometimes in a different order than when somebody is pretty stable if they just got a tummy ache because they've been throwing up for a couple of days. You know, there's not likely to be a lot of immediate risk of sudden death, you know, so So the way that plays out is different than walking in and seeing somebody breathing like three times a minute, then you have to shift your priorities and do what what you have to do to stabilize a patient and, and get things going.

Greg Hamlin:

That's great. So you mentioned the ABCs. Cuz we might have some people who don't know what those are, what are they?

James Holmes:

The ABCs? Are airway, breathing, and circulation.

Greg Hamlin:

Okay, so start there.

James Holmes:

Yeah, start there.

Greg Hamlin:

That's great. As long as

James Holmes:

somebody can talk to you, their airway is open. That makes it, why the first thing we do is we asked him, Hey, how you doing? What's going on today. And if they can tell you that, then you already got a lot of information just based off a few seconds of interaction with somebody. And then you can, like I said, and just kind of move on from there.

Matthew Yehling:

So what's the kind of information you wish people had readily available for you when you did arise? In that situation?

James Holmes:

I'll tell you, the thing that I have seen people do that has helped me the most is, in situations where people have either a lot of medical problems, or take a lot of medicines, or have a lot of medical allergies. Anytime that you have a list already ready to go for me when I get there is hugely helpful. It makes my paramedic heart happy. When I asked somebody what medicines they take, and they go, hold on a minute, I got that list in my wallet, and they're able to just pull it out. And then I can look and see exactly what it is that they take. And if they don't have their medical problems listed on there, I can usually infer based on what medicines they're on, what kind of medical problems they do have. But that is hugely helpful, hugely helpful.

Greg Hamlin:

That makes a lot of sense. I think with a lot of employers, that might be a good information for them as if they've got people out on the job to make sure they have that information on hand. Because I don't know, if people always think about that. I know, I wouldn't have been having mentioned it. From your perspective, I could see why you want to make sure you're giving them the right treatment. And if they're on certain medications, you don't know, you don't want to accidentally be responsible for something getting worse,

James Holmes:

I imagine. Right? Right. And a lot of times, just that information right there provides clues to what's actually happening with the person and why they called you. For example, there was a place in one of my service areas that built big transistors, like the kind of stuff that they put on light poles, like these big, huge electronic devices. And we had a guy that had high blood pressure, and he would have these high blood pressure attacks where he would start getting dizzy, his chest would start hurting. And he would call us and you know, we would go over there. And once we knew that he already had high blood pressure. And then we took his blood pressure and saw that his blood pressure was really high, then that just kind of made all of the puzzle pieces fit. And then we can come up with a treatment plan, figure out where to take him where he gets his treatment at, and just get him the proper care that he needs for that day.

Greg Hamlin:

Great, great points. In my career doing worker's compensation, one of the things I've seen in that and they've noticed this too, is a lot of the injuries we see are preventable on the job. A lot of times it comes from carelessness or shortcuts or not following safety precautions. And I'm sure in your field, you've seen many different kinds of accidents. What's one thing you wish people would do more often that could have eliminated injury or reduced the impact of the injury?

James Holmes:

This answer is probably going to surprise you. Okay, but alcohol pretty much plays into more than 50% of what we do on a daily basis. So less alcohol consumption by the populace would make everybody happier, healthier, with less injuries.

Greg Hamlin:

That's a great point. You know, we had one the other day that involved methamphetamines where the injured worker fell from a height. And, you know, I guess there's some question whether he was using the head drugs on him on his person and in his vehicle, and didn't have his safety harness on and we've seen a number of those, even in the workplace, where no drugs or alcohol do are involved sometimes in cars, really serious injuries.

Matthew Yehling:

Yeah. I think that's an excellent point. And, you know, from a work perspective, obviously, you know, the majority of our injuries, hopefully don't involve alcohol, I can speak from my perspective that, you know, most of them don't, I can definitely see it from your perspective as an EMT treating everybody in the general population where it would Yeah, I do think you know, it's a good point to you raise up you know, the a lot of that what Greg and I are talking about on your work related injuries, if it's, you know, another co worker or somebody calling 911 and saying, hey, you know, we've had this accident and kind of providing information to 911? What are some of those key elements and key pieces of information that you need the person that's calling 911, to provide to the dispatcher so that, you know, they can ultimately get to you that you makes it a better outcome for everybody?

James Holmes:

I would say that probably the most important thing is specific location of where the injured person is. Yeah, it's, it's not something, you know, when you call 911, from your house, that address comes up on the 911, dispatchers computer screen, you know, and so that's really easy to identify where somebody's calling from. But when you have a 3000 acre industrial plant, and somebody has fallen, got their hand stuck in the machine, or something has happened, you got to know what gate you got to go in? Where are they expecting to see you? And either have somebody bring you directly to the patient, have them bring the patient to you? Or just give us really good instructions on how to get to where the patient is?

Matthew Yehling:

That's, that's wonderful advice. I mean, you know, not thinking about that, and then just kind of changing the approach and thinking about it. It's like, yeah, obviously, that makes sense. Like, you know, most homes are under 2500 square feet, you know, versus Yeah, an employer that works in, you know, buildings that are multiple storeys tall, or, you know, you know, like you said, hundreds or 1000s of acres of areas.

James Holmes:

Yeah, industrial plants tend to do this very well, actually, in my experience, because they'll there's usually either one way to go in, or they'll tell you which gate to go in. And then there's usually either security or somebody waiting for you, and they tell you where to go. And then there's usually somebody part of the safety team that meets you and says, All right, I'm going to take you where we're going. And so like I said, industrial plants typically do this very, very well. And that good, good experiences with

Greg Hamlin:

that. So what are some of the common mistakes that you see people make before you arrive, they're like, oh, wish you hadn't done that.

James Holmes:

There's not really too many mistakes that you can really make, you know, typically, when you're, when you're looking at it from the point of view of something has occurred. And this is a this is an emergency, when they think call the paramedics usually it's because they don't know how to handle it, they don't know what to do, or they just need more help than the help that's available. And so I always advocate for people to be trained in CPR and First Aid, because then you'll at least have some kind of basis of where to start helping, even if the help isn't that effective, you know, a little help is better than no help until I get there. And so any training that you can get will be beneficial on on your part, the only hard rule, as far as EMS goes is that there's no hard rule. And I say that because you can never make a rule that is universally applicable. Sure, you can make a rule that's pretty applicable. For example, you can say, you know, in the event of a car accident, somebody is majorly injured, stay where you are, or stay with the patient in the vehicle, don't try to you know, get out unless you know you're not injured. But if the car is on fire, that changes it, it doesn't apply if the if the car is you know, starting to get submerged in water, you know, you obviously don't just don't want to sit there and wait to drown. So you can't really have a one rule that fixes everything. So just kind of using your best judgment. And I always will tell bystanders that tell me, you know, hey, I did this because of this. And I don't know if it was the right thing to do. I always try to tell them, you helped. Thank you for helping you did great. And give them a little encouragement because no one ever wants somebody to think well, I messed it up last time. Next time somebody needs help. I'm not going to help. Sure. You know, the world needs to tell verse.

Matthew Yehling:

It's great information. And obviously, this is not a legal podcast. We can't give any legal advice, but most states have a right to I'm blanking here, give me help me out here. But Samaritan Good Good Samaritan. There we go.

James Holmes:

I got good samaritan. Yeah, yep.

Matthew Yehling:

So along the lines and you've touched on it a little bit like I'm a claims investigator. I want to know as much information about the accident reconstruction of the accident. What happened one event, you know, when the EMS was called, what information do you guys retain and log following each call? You know, if I'm, if I'm going back and I'm like, hey, I want to learn more about Greg Hamlins injury when he was in that burning flooding car in 30 Miles done You know, down the river, but, you know, all kidding aside, like what information what, you know, what's the kind of report look like that you guys submit and fill out after each accident after each call, I guess?

James Holmes:

Yeah, that's actually pretty detailed usually, because the mechanism of the injury is something that gives us an insight to where their injuries possibly why. Okay? So, for example, if you gotta if you have a guy that trips and falls down a hill, let's say, and that happens to be strewn with rocks, you know, if they fall down this hill, and it's five feet, that is a completely different animal than somebody that falls down a hill, that's 150 feet. And so we collect all the information that's that's pertinent mechanism of injury stuff, how fast was the accident, the direction that car was traveling, any other cars that they might have hit, that they hit trees that they flipped over, or they were in their seat Bill, did airbag deploy any of these things where they were in any safety gear? You know, I had a guy, one time that in San Francisco Bay Area was driving across a bridge, and somebody stopped really fast on him. And when he locked up his brakes, he went over the handlebars and also went off the bridge about 15 feet down into the water. Wow. So you got a lot of mechanism of injury stuff that you're looking at the fact that, you know, he was riding a motorcycle, what speed he was going on the fact that he fell 15 feet down to water? And then did he get knocked out? Did he land on his head? Was he wearing a helmet? Was he wearing any other safety gear? How long was he in the water, that 60 degrees, a lot of things, and, and all of that information is stuff that we're going to ask, we're going to try to get the answer to you. And it makes up what we like to refer to as a clinical picture as a whole clinical picture. And all of that information is supposed to go in our patient care report. And depending on the severity of the accident, or the incident will depend on what information actually gets transmitted immediately to the state for the state to gather information for their databases as far as accident, injury, and those kinds of things, but also to the hospital that they go to. And then the agencies that we work for, they're required by law to keep those documents for a certain number of years before they can possibly be destroyed. And I don't remember exactly what the length of time is, but it's a considerable amount of time.

Matthew Yehling:

Yeah, thanks for that. And I think you know, that as a claims person, I think that's good information to know, you're speaking our language, when you say mechanism of injury, right, when we are investigating, you know, was this, you know, related, and what caused this injury and things like that, I would just like to personally thank you for your service. I know, you know, what you do is a difficult job, and you see a lot of different crazy things. And, you know, it's it's, it is critical that we have people like you that are willing to run towards the emergency versus a lot of times everyone else is running away from these things. So thank you, James, for your service. I know Greg has some final questions and thoughts for you.

James Holmes:

Well, thank you. I appreciate that.

Greg Hamlin:

Yeah, I would, I would echo what Matt says, we certainly appreciate everything you do for keeping us safe. One of the things I wanted to do this season. Last season, we wanted to end every episode talking about a moment when someone was happy and who were they wet? And what were they doing and this season, what I wanted to focus more on was what keeps people going every day like what's the favorite part of what you do each day? Is there something in your job that at the end of the day, I mean, we all have parts of our jobs that are tedious or that are difficult, but is there some part of your day where you say, you know, that's why I do what I do, or that's when I'm really happy when I'm really at my best is in this type of situation. So for you, what would you say is your favorite part of what you do each day?

James Holmes:

My absolute favorite part is the fact that I get to connect with other human beings, and usually an unusual situation. And it is usually a very, it's hard to describe but it's a close almost defies words, when you connect with another human being, and on a level where they know that you are there for them. And you are absolutely there for them, no matter what it is they need and that you are the one that sometimes stands between life and death. Other times stands between their discomfort and their comfort and provides them with hope and a little bit of relief from whatever injury or illness that they're suffering from. So that connection with a human being is something that if you haven't experienced it, it's it's difficult to describe But it's very real. It's very palpable. And it's the thing that keeps humans connected together is that feeling of hope, appreciation, and just willingness to do things for other people without expecting anything in return. And that's the thing that gets me out of bed in the morning. Now, wow, that's

Matthew Yehling:

outstanding. I appreciate you know what you do even more now? Yeah,

Greg Hamlin:

absolutely. Well, James, I want to just thank you, again, for you spending some time with us today to talk about your profession and what you do every day. And I know you said it already. But you're definitely haven't have a noble job and serving others and helping people who are really in need and a lot of our injured workers that go through this. This is where it starts, it starts with an EMS call. So thank you for what you do. We appreciate you.

James Holmes:

Thank you so much. Appreciate that.

Greg Hamlin:

Just want to remind our audience that we are in our season four, which is releasing every other week on Mondays and encourage you to follow along, we have been sending out a survey. So if you want to provide feedback on what you like, what you wish was different, what you hope to see in the future. We're open to hearing from you and want to remind our audience to do right think differently, and don't forget to care. And we'll see you again in two weeks. Thanks, everybody.