While Capt. Tom at EMS12Lead.com might not be trumpeting his success, I will do it for him, as well as for the rest of my colleagues at Hilton Head Island Fire & Rescue.  This week we received another honor, the IAFC's Annual Heart Safe Community Award.  With a lot of pushing and pulling from Capt. Tom Bouthillet, and a lot of support and cooperation from other notables, including Fire Chief Lavarn Lucas, Deputy Chiefs Brad Tadlock and Ed Boring, Capt. Eric Lainhart, our medical control docs, Bo Sherwood and Van Gaube, and of course, Kelly Arashin, we received the award in recognition of the system we have in place in our community.

Between our bystander CPR education efforts, placement of automated defibrillators in the community and our advanced life support response system, individuals experiencing a cardiac event have a significantly better chance of survival than in the past. If an arrest is in progress, we dispatch additional Fire/Rescue companies, where all the line personnel are trained in use of the "pit crew" concept, to maximize the efficiency of assigned resources and to deliver a very high standard of care.  

It doesn't end there: our Fire/Rescue personnel have a number of tools we can use, including 12-lead EKG monitoring with transmission capability and the ability to provide therapeutic hypothermia if indicated.  Our system is also capable of identifying possible STEMI patients in the field and setting off an additional chain of events.

Our delivery of the patient at the Hilton Head Hospital Emergency Department is just one more step.  There, they will have already been alerted by the teams in the field and depending on the situation, have either already brought in a cath lab team, or are prepared to continue therapeutic hypothermia through as needed.  We have a great relationship with our emergency department personnel and we all work together as a team to provide the best possible chances for a positive outcome.

What's more is that the pertinent information is documented and shared through the CARES Registry, where we will be able to extrapolate data needed to help us improve our service.  We have identified methods for communicating good performance as well as performance requiring remediation.  And above all, the system is delivered daily by nine Fire/Rescue companies with extremely professional, caring, and knowledgeable personnel, all of whom are aware of the importance of excellent public service.

When we factor this in with our recent CFAI accreditation, which we have maintained through three cycles, we are pretty proud.  But even more impressive is that our personnel have maintained their positive attitude and professionalism despite comments made about their integrity by certain individuals in our community, rather than those individuals stepping back and defending what they should have known to be true.  Our entire force maintained this very same quiet professionalism even when held to a 1% salary raise last year (and that was not across the board) and no increases in years before that, not because they were afraid to speak out, but because they heard the concern of the community, especially with the economic situation being what it was, and they were willing to accept that and soldier on, when they had every right to be vocal and upset about the situation.  These personnel have also maintained their quiet professionalism among other challenges as well, challenges that will remain unsaid by us, because that's the kind of people we have.

One of the primary things we say to guide our people is to always "do the right thing".  If that means stopping and helping someone change a tire, or picking you up off the floor for the seventh time that week, or loading up your kids in the rig to take them to the hospital when we are transporting you because you have no family available, we do what it takes to make our "customers" happy.  And we say customers because it isn't just the taxpayers; we serve the visitors, the workers, the homeless, anyone we deal with.  They may be patients today, or the may be the homeowner on another, or the occupant, but to us, they are people.

We have an extraordinary amount of pride in our department, but a lot of humility as well.  I talk about all of our personnel because I am proud of them, but they don't go around bragging about it, so I am happy to tell you all about them.  We have very high expectations of our people, but we have fun too.  And while there are plenty of bad moments, the good definitely outweigh the bad.  The difference is that we try to let everyone in on the decisions (to the extent possible), we listen, we try to get them the tools they need (but they aren't spoiled, our budget didn't budge but a single digit percentage from last year), and we do things safely, with a lot of common sense applied rather than emotion.

So while we will be celebrating this new award, we already realize, it is recognition for what we have done.  For us, what we have done so far is never good enough.  We will continue to push forward and improve from where we are today, to keep looking at ways we can tweak this or adjust that to make our organization that much better.  We do not rest on our laurels.

If you get a chance to come to our Island, make sure you stop by a station.  EVERY station and Headquarters is open to the public and we encourage visitors.  We will always take the time to show someone the trucks, or to take a blood pressure, or just to talk about what we do.  We are an all-hazards response agency who takes the job very seriously and we like sharing what we do. Thanks to all of you at HHIFR; you all make me proud to be affiliated with you. 

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A few weeks ago, there was a tragic sequence of events that occurred in a community in our county. While working a medical alarm, a City of Beaufort fire engine was stolen by a man, who in his flight, killed a pedestrian as well as struck a number of cars.  Talk about your "Swiss cheese modeling"; short of an astronomical syzygy, I'm pretty sure you can't find a better alignment of factors to recreate that event again. If you saw that in a movie, you'd think, "How stupid!  A man escapes from a military hospital, finds an idling fire engine, and escapes his pursuers. It isn't likely to happen."  But it did.

Things happen every day that defy logic.  Truth, as it is said, is often stranger than fiction.

Deep down inside, we might say to ourselves, "That could never happen here."  Or we feel it coming up and we suppress it, because we know, if we were ever to actually verbalize that, it WOULD happen.  But we are all guilty of seeing something happen and thinking that we are either too good, too well-trained, too attentive to the details, too big of a department, or even too remotely disconnected from "big city" problems for certain events to transpire. It just won't happen to us.

This is something that happens in families as well.  I know people who are perfect parents and their children defy any reasonable expectation of success.  I know parents who have no business reproducing who have amazing children.  I know fire or EMS agencies that I can't believe, due to their ineptness, that they haven't facilitated some major catastrophe. And I know the most professional organizations ever who have had arsonists surface among their ranks, or they lose firefighters, or they burn down an entire zip code. 

Unfortunately, right now public servants have a target drawn on their back.  Some of our brothers have actually drawn it on there for us.  We are in a profession (career and volunteer alike) that used to be considered trustworthy, honorable, valiant, and courageous.  We have a few mutts in our midst who have caused people to think otherwise.  The job hasn't changed, nor has the opinion MOST people have of public servants, but the fact is that when someone can paint "firefighters" or "EMTs" in a convenient picture and wrap it up in an emotional context, they gain attention.  And so long as we tolerate membership from those who give us a black eye, we continue to enable that perception.

Our business has enough danger, innuendo, drama, and everything else that we don't need to add to it by tolerating personnel with bad attitudes, carelessness, or poor morale.  We have to seek the causes of these problems and root them out.  We have to be positive and focused on the service we provide and how we improve that delivery daily.  We must reward people for doing things right and remediate those who do things wrong.  But even when we do all these things right, our team might have someone swimming below the surface, counter to our culture or our expectations, who is intentionally or unintentionally, just waiting to pop to the surface.

If you really want to change the minds of others, the first step in doing so is by exuding professionalism yourself.  Nobody is going to follow your advice if you aren't in front leading the charge. If everyone in emergency service had that mentality, it would be a lot easier to bring the rest of the world forward.  But remember, even in the best of situations, even with thorough planning and training and coaching, sometimes things go wrong with no real expectation.  Our job as leaders is to minimize the risk of those events occurring, be proactive and engaged, and to present alternatives that eliminate those bodies from lining up.

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I fell asleep at my computer last night.

I am working on a project that has pretty much occupied all of my time over the course of the last three shifts. I think, in retrospect, that the reason that I am having to embark on this dreaded project is simply that a great number of people failed to understand that their actions or inaction created a mess that someday would have to be unraveled.

The mess doesn't even go back a short while.  When I say a great number, I am talking about numbers probably nearing a hundred.  Anyone close to this project that knows that I am talking in circles and understands the scope of this project might disagree with me, but I see the failure in my own interface with the situation, and I see the failures in many others who permitted the condition to occur, knowingly or not.

In a microscope, closely examining one piece of the puzzle, you might not even notice the problem exists.  But when you step back and look at the larger picture, you can see it is definitely crooked.  There are warning signs printed all over this and frankly, they were ignored. But they are insignificant when you step back even farther and realize that any problems we face today could have been avoided had individuals assumed some responsibility and did the right thing early on.

One of the principals in this project called out everyone else on the team and with good reason.  I say that because he is absolutely right; the system failed us.  Or to be clear, we failed the system, because it wasn't all to be blamed on the way we manage these situations.  Instead, key stakeholders ignored critical information.  They felt like status quo was acceptable. Or perhaps they felt inadequate to address the most pressing challenges.  I told this individual that while the historical aspect of how we got to this place is important, just to put the picture in perspective, who to blame is irrelevant. The situation is what it is and you can't unring a bell.  We must look forward.

Those of you reading this might assume you know what I am referring to, but I am suggesting to you that you re-read it and ask yourself, "What am I doing that is creating this same situation today?"  Because if you are honest with yourself, there are any number of issues I have to deal with that follow this chain of events and I am sure I am not alone.

I have quoted my father on any number of occasions in this regard, probably the quote that will stick with me for the rest of my life: "Do it right the first time."  Had we addressed the issues when they were small, had we fixed the leak, had we prevented the spark, had we communicated the concerns, if we had done any of these things, would they have corrected the problem before we got to this disaster we now embrace?

Let go of your concerns for a moment and realize that a drop of water contributes to the flood that sweeps away your home.  Everything affects everything else and that ripple becomes a wave, given the right conditions to grow.  Don't be part of the problem; solve the issues before they become a nightmare to untangle. 

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I'm returning to my hometown November 4 through 6, 2011, for a few cheesesteaks (I'm a Pat's Steaks guy), to see some childhood friends, and mostly, to share some of my insights at the inaugural Liberty Regional Training Event presented by GoForward.

While Philly is a big place, the event is being held literally in my old backyard, within an easy walk from my old house.  And I should know, I used to have to do that all the time.  I actually used to sneak into the movie theatre that is in the hotel complex downstairs from the convention center during the summer and swim (unauthorized) in the hotel pool.  Back then it was a harmless day spent being a delinquent, nowadays, someone would have you hauled off to jail.

But all that being said, I'm excited to be involved in this event and from what we are seeing so far, the excitement isn't limited to me.  And further, if this and the others planned go off well, they could end up being regular stops packed with some of the most exciting names in today's (and tomorrow's) fire service. 

So while you have a chance, sign up, join me for a few cocktails on Friday night, and especially join me during my two scheduled presentations: Zen and the Chief Officer and You Can't Make This Stuff Up.  Hopefully I will be able to meet some of you who have only been able to interact with me here.  I'm looking forward to that weekend.

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The lack of real leadership surfaces in a number of the world’s problems. I don’t necessarily feel like people can’t handle the job, I just think that in a lot of cases, people are designated as leaders who have no business in that position. To me, they are like gases with asphyxiant properties.

Some of these gases or mixtures aren’t necessarily harmful in and of themselves, but to us, their harm is that just by occupying space with their presence, they ruin what could be a perfectly suitable atmosphere. So to make the atmosphere tenable again, one effective tactic would be to replace these noxious materials with the materials we find suitable. 

Similarly, poor leaders displace good leaders.  By just being present and nothing else, they contaminate the atmosphere. As a result, good leaders are simply forced elsewhere.  Hopefully those good leaders can find places to create a better condition, but the loss of those individuals is intolerable to those left behind and the organization suffers.

In reading and watching the news in recent days I am reminded just how damaging these “asphyxiants” can be to organizations and really, to society. I see my job as being one to facilitate good leadership. I try to encourage you to be better people, to use good judgment, to learn and understand, and to be “missionaries”, carrying the message of good leadership to others. I don’t consider myself to be a good leader – I see myself as a continual work in process and have plenty of faults – but I recognize good leadership and I have observed what it takes to promote good leadership in others.

As much as I’d like to suggest to poor leaders that they should move out of the way to permit good leaders to fill that space, I think it is more realistic to say that perhaps we should convince those individuals to be more open-minded to learning, to engaging their people, and to promoting good practices. So you can see, instead of removing the problem, there is another tactic we can use in mitigating an asphyxiant atmosphere: by mixing the material in with a good atmosphere and making it much smaller in proportion to the whole, we can “safe” the atmosphere. While we may not always have the answers, if we can permit ourselves to be exposed to good practices and to see how things should work, we can make things better, incrementally, but just the same, much improved.

Be an agent of positive change. Promote best practices. And let’s all go home in the morning.

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Ryokan was a Japanese Zen master who lived alone in a hut at the foot of a mountain. He lived in abject poverty and his hut was empty.  The Master slept on the ground and spent his days meditating on a rock.  One evening a thief crawled through the window of his hut, but discovered that there was absolutely nothing to steal.

Awakening, Ryokan startled the robber by greeting him and welcoming him into his home.  When the thief wanted to leave, Ryokan said, "You have come so far to visit me and I would be dishonored if you left enpty-handed".  Having no belongings, Ryokan gave the robber his own tattered robe. 

The thief was completely at a loss for words, and he took the robe and crept away into the night. Later, when meditating on the situation under the full moon, the Master thought, "How unfortunate. The only thing I could offer that man was my tattered robe. I wish I could have given him this beautiful moon."

The story also has another meaning as well; that we should always consider that while things might be bad for us, perhaps there are others who are suffering worse.  I said the other day that we should increase our capacity for compassion, and on the fire service front, I guess it could be much worse.  You could be faced with a scenario like this one in Kenya.

When you are challenged with a problem, it always helps to maintain perspective.

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Given some of my posts, some of you, I think believe I'm a safety nazi.  That's pretty far from the truth actually.  I'm a true believer; when I got into the business, I did so because I wanted to be involved in it and because my family tradition led me there.  But I'm the kind of guy that if I didn't believe in it, I wouldn't have stuck around.  And the danger and the thrill, personally, did it for me.  What's more, it wasn't enough.

Over the years, however, I matured.  I grew up, which unfortunately (or fortunately, depending on who you speak to) changes things. I had the good fortune to meet movers and shakers in the emergency service world and each of them had a story to tell.  Mostly their story was that while it was fun being at the edge of sanity with some of the heroics we pulled off and the chest full of medals we earned, we never really appreciated the impact that one stupid move could make that would change the world forever.

The events of September 11 really put my priorities into focus.  On that beautiful September day and on into the night, I stood in front of the TV in my living room, oftentimes holding my then-baby daughter, with tears in my eyes when I realized that 343 of my brothers perished in the line of duty.  The effect that this loss has had on our nation is questionable, as today it seems like the public has forgotten that day.  But the scar it left on our job, on our family, is impenetrable.  There are children growing up whose fathers will never hold them or see them graduate or walk them down the aisle.  Or even look on with pride as they too choose to join our brotherhood.  Who won't be there to pin on Lieutenant's bugles at that first promotion.  Each of these 343 individuals had a profound impact on a number of others, and that ripple effect continues outward and outward until millions, even billions in this case, are impacted.

But the tragedy that happened that day is an anomaly, a blip in the statistics of firefighter mortality.  In fact, we can't ever factor in the loss of 343 individuals on that one day in any of the data we analyze because it throws wild swings into the results.  That certainly doesn't decrease their contribution any more.  In fact, it immortalizes it.  Forever that will be a group of people who stand alone.  But the 100 or so firefighters who die in the line of duty each year are considered, in a figure that has decreased over time, but not nearly in proportion to the fires we now fight. Looking at the situation after that day and understanding the effect the loss of those 343 people had on so many, it is obvious that any casual approach to safety results not just in a loss to the immediate individuals involved, but to many others.  Any poor decision causes a ripple that can become a tsunami.  

So on a grand scale, the loss of even ONE firefighter is an unacceptable one and extrapolated out into an average loss of 100 brothers a year affects not just you or your crew, but families and community, and everything else, multiplied 100 times.  And when a significant number of these injuries and deaths occur not from heroic deeds, but from failing to use common sense, I struggle with the argument that our "safety culture is ruining the fire service".  Let's just take the injuries and deaths that HAVE occurred from people putting themselves in harm's way out of the equation, and in looking at casualties that are related to cardiac events and failure to wear seatbelts, we could make a significant impact on sending more brothers home every day than ever before.  

But we CONTINUE to resist changes in our industry that would make that difference.  Why?  Because you safety nazis are sucking the fun out of our job.  Because you are unreasonable in expecting me to maintain appropriate cardiac health to do the job.  Because we resist the notion that there should be a standard for doing the job.  Because it is inconvenient for me to wear my seatbelt.

There is absolutely no argument you can make to me that can reasonably suggest that increasing our safety is a bad idea.  I am a chief officer now.  I joke that my white helmet will likely remain white until I die, because my job is to send you guys in and to make sure that all I sent in comes back out in the same condition.  It's not the fun part of the job, but at some point, I had to grow up and accept my role.  I am no longer the "go to" guy on the scene for a really hairy rescue and even though I understand that, it's never going to escape me.  

A few years ago, I jumped into the water with Capt. Tom from the EMS12Lead blog and we made a rescue.  While he was a Lieutenant at the time, I was a chief.  My chief, when handing me the Meritorious Service Medal (I missed the actual ceremony, Capt. Tom got one too), reminded me that my job was no longer in the water, but on the shore.  He also indicated it would probably be my last medal.  I indicated that if I got another medal it would probably be my last medal because I'd be looking for another job.  He laughed at that.  But it was an awakening.  I realized how right he was.  My job is to keep you guys safe.  You job is to be safe about doing it and to only take risk when the risk is worth it.  Not only will I keep from throwing your body into an unwinnable battle, I ask that you keep from making decisions that require the same.

We lost 343 brother firefighters in one day in New York City.  They, as well as many more firefighters and other public safety professionals who survived, considered their duty to save others from that infernal hell and did so for thousands and thousands of others, and to their credit, we should be thanking them all for their courageous actions.  But this tradition was an act that isn't replicated in all of these line of duty deaths, because in the majority of line of duty deaths, preventable actions or shall I say, more mature and considerate actions, could have saved firefighter lives.  

To put it plainly, the lives we lost were not traded for a single save.  Our "duty above personal risk", while meant to signify that willingness to sacrifice, can also be read that we are devoted to "duty" above "personal risk".  We have a duty, not only to save the lives of endangered victims, but to be there to lead our families, to be there to teach our rookie firefighters, to be there to be a Cub Scout leader or to work in the PTA.  We have a duty to live our lives to the fullest, not to casually throw our lives away without a sane reason.

If the time comes, God forgive me, to throw my life in front of another so that someone may live a full and productive life, I know in my heart what my action will be.  But until then, I refuse to commit my body, or yours, to a decision based on a misguided view of heroism, or because it is what we always believed to be the duty of our calling.

Be safe and if anything, in the name of those who have gone before us, honor their memory by being there for everyone who remains.  And I ask that God bless the civilian departed and their families on this 10th anniversary of their death.  And most of all, God bless and keep our 343 brothers, their families, and the other firefighters who still suffer the effects of the horrible day, both mentally and physically.  We love you and miss you all terribly. 

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In this case the researchers are using the Green June Beetle, but given the size of the cockroaches (or Palmetto Bugs, as we like to call them in South Carolina) I have seen, we could probably equip them with a hammer drill and let them tunnel the victims back out of the rubble once they find one.

Cyborg insects are low maintenance, can get into very restricted and virtually inaccessible areas, and with these new developments, can be adapted for a number of different tasks.  Some of these cyborg applications could also be used for monitoring hazmats or terrorist attacks, doing pre-entry search and recon for SWAT teams, or spy work.  As far as our use of these creatures, the sky (or the basement) is the limit.

Never lose sight of this constant: Change is inevitable.  It''s how we deal with it that makes the difference. What we know today as the way we do business may be radically different tomorrow.

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It may take extra time that you don't think you have. That time may seem very valuable. The shortcut you take may seem like it saves those precious seconds. But I have seen in my life, many times when those shortcuts have proven catastrophic, and in most of those situations, I look at them and wonder, had someone taken a few extra moments to do it right, what the outcome might have been.

While the historical issue between response to rescues in New York City is frustrating and sad, since it seems to me to be the confluence of a power struggle and turf battle, instead of celebrating a terrific save the other day, instead we have this tragedy to contend with, as shared with us by Dave Statter on his blog.

I have always learned and always taught that when lifting, we "crib to the lift". And while the spreaders are not the desired lifting tool, I have used them before and they have worked just fine. I preface that, however by explaining that I am also passionate about physics and when I have used spreaders, I also understood that the force applied must go somewhere, and if the load isn't stabilized, the force is going to create motion we don't want. In this case, the force displaced the object alright: lateral to the support (the spreader) and with nothing to support the load (cribbing) the load went to ground (and victim).

I don't care if you are FDNY, ESU, or anyone else. I have seen this very same shortcut taken before in departments that have had identically catastrophic results. I also recall other times when the load has shifted on the column, in one case, three stacked air bags.  In this case, the firefighter, who happened to also be the salesman of the lift bags and should have a little expertise in their use, himself was killed.

There's a lesson to be learned in every tragedy. Aside from the physical principles that apply to all of us here on this planet, there's another very important one. Driving recklessly, failing to wear your seatbelt, not wearing proper PPE, not paying attention to overhead power lines, and in this case, not providing an alternate column to support the load via cribbing, all might seem like they are saving precious seconds, but failing to do the right thing the first time, ended instead in tragedy.

Take a moment to ditch the emotion and be the professionals you are. Do the right thing the first time.

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"Despite the lives at stake, the recommendation to improve radio interoperability for first responders has stalled because of a political fight over whether to allocate 10 MHz of radio spectrum … directly to public safety for a nationwide network, or auction it off to a commercial wireless bidder who would then be required to provide priority access on its network dedicated to public safety during emergencies," says the report, whose authors include 9/11 Commission chairmen Lee Hamilton and Thomas Kean.

I distinctly recall the shouts of support from the American public for firefighters everywhere after the Towers fell, and how shocked people were when we let them know that one of our biggest problems is communications interoperability.  Then, in 2005, when Katrina blew through, the politicians were adamant that we needed the tools to combat this problem of communications interoperability.  And here we are, in 2011 and the politicians still will tell us one thing and do another.

Congress seems to find the time and support to help out their fat cat buddies when times are tough. Banks and corporations get bailed out and corporate big-wigs continue to get record bonuses.  In the meanwhile, public servants I work with get lacerated over getting a miniscule pay raises over the last three years, like these firefighters, cops, EMTs, teachers, and city administrators are sitting at home, counting the dough in their offshore accounts and laughing maniacally.  Really? And many other people, not just our brothers, are losing benefits, taking furloughs, or worse, losing their jobs altogether.  

It makes me sick when I see our politicians sucking up to the ones who shout the loudest on the right or the left while forgetting there are many more of us out here in the middle who are just trying to get by.  These are the same individuals with the nerve to take government pensions, government health care, and government paychecks, the whole while saying "government is bloated".

This proposal was meant to make our job safer, to improve our ability to save lives, and to combat disaster in our communities, but instead, our politicians want to continue to discuss the possibility of awarding the block to a commercial wireless company who, of course, stands to make billions off our first responders and probably still give us communications that suck.

If you really want to get mad about something, find a battle worth fighting over.  I'm throwing you the ball now, you are supposed to swing at it.  Here's one: Call your representatives today and tell them what you think of their continued stalling and their greedy tactics.  We need support.  This would be the support the politiicans continually promise us when the news cameras are on them and they're hawking their platform on the graves of firefighters, cops and EMTs.  It's the same support, of course, that is quickly forgotten when the lobbyists show up and when the big money is up for grabs.  

If you don't know who represents you, try this link: ContactingtheCongress.org.  It makes it easy for you; there are phone numbers and comment links.  Put your money where your mouth is.  Or better yet, get some balls and tell your representatives what you think.  Your representatives are supposed to be representing you.  Instead of taking a few minutes away from your valuable Facebook time posting an anonymous rant against a brother who had a lapse in judgement caught on video, try venting against the real enemies: the political hacks who tell you they support you but can't work together to fund necessary things like fire departments, fire education, and firefighters.  Here's a message you can send them: If they want that photo op with dirt on their face, shovel in hand, and helmet on their head, tell 'em they have to earn it first.  Support the brotherhood.  FTM.

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