It's quite possible you're reading this at work right now. In fact you might be on your smartphone, checking this out from a link posted on Facebook or Twitter that you found while staging in your ambulance, at least that could be the case according to the audience feedback at Greg Friese's 8 a.m. EMS Expo talk. In "Understanding and Using Social Networking for Personnel Communication & Education," Friese polled the audience on use of social media, which includes e-mail, Facebook, Twitter and blog sites.

More than 50% of people in the audience reported that a majority of their co-workers use smartphones, higher than the national average. He added that more than 60% of providers in his Thursday morning social media session, "Trends in Online Education for Emergency Responders," have WiFi in 60% of their ambulances.

Do you have WiFi in your ambulance? If so, are you allowed to use it for social media?

But the main discussion points this morning weren't on how many people use social media, rather how EMS providers use social media and how EMS agencies and administrators should tackle this use. Some managers in the audience favored a blanket policy restricting use on the clock, while others suggested that could actually make the situation worse.

"We can't stop this," Friese said, citing statistics that Facebook users upload 2.5 billion photos per month and YouTube users upload 20 hours of video per month. He suggested agency officials dust off their Internet use guidelines, decide what's best in their community and continually educate providers on what constitutes a good post.

"Social media might not be the biggest problem  your agency faces. Solve your biggest problems first and prioritize correctly," he says.

One type of social media site he suggested might be a higher priority than others are geolocating sites, such as foursquare and gowalla, where users show where they're located because it might compromise the security of the providers.

Do you think this could pose an operational risk by compromising security?

Friese added that social media sites can actually be positive for agencies, adding that providers can get valuable training lessons and tips from e-mail, video, podcasts and webcasts. He also stressed the importance of every agency having -- and frequently updating -- an online presence because people are out there on the Internet, looking for information. He said EMS agencies should communicate out with official pages on such sites as Facebook and Twitter, which allow for direct communication that's instant.

Also, he added, these sites are free and easy to use. You just have to figure out how much time you want to devote to them, or you might end up missing your next call because you were so engrossed in your most recent YouTube find. ... Lots of food for thought.

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Obviously there should be regulations. Don't use it on a call, don't post your location, no patient date, don't do while you're driving. You know, the common sense stuff. And I can even understand if the company does not want IT'S wifi used by employees, that is their discretion. But to tell me that my use of social media, on MY smart phone, during down, will somehow hurt the company. In a word, bullshit.

The problem is, behind the times management and HR departments got caught with their pants around their ankles when social media blew up. And I'm referring from everything from twitter to message boards to blogs. And instead of actually trying to understand it, they throw a blanket policy of "oh no, you can't do this or we'll freaking spank you". Hell, where I work, if I am to even mention my company in passing on any online social media site (including this one!), I have to add the legalese of "the thoughts and opinions do represent "suchsuch ems" in any way, shape or form". Seriously, they're so worried about something I might say that my posts require fine print? Don't get me wrong, I understand the company doesn't want you bad mouthing them, or giving out company information, but some of this stuff is over the top. For instance, on my company's network, I can't access page! That's right, JEMS Connect, a site where I discuss all different points of the field with other medical professionals, is restricted by the company I work for. That is just insane.

I think the proof of how strong social media can be was proven time and again at the EMS EXPO this week. Not only easily proved by the amount of EMS bloggers who were at booths, but how about the fact that EMS1 itself was Twittering and doing Facebook updates. Hell, EMS1 had the equivalent of a Twitter scavenger hunt.

Social media has helped my a huge leap in letting medical professionals from all over the world come together, share some war stories, laugh together, and learn from each other. I've learned about other systems, world wide, in the past 18 months, then I did in the first 7 years of my career.

Yes, there need to be rules. But really, it doesn't require much more then common sense. I really think the positives far outweigh the negatives on this one.

but only during major emergencies/disasters where the public needs to be notified. Obviously the information that John writes about (patient info) is off-limits. But if I want to notify the public that a major highway is shut down due to a multiple-vehicle accident, then I do so on Twitter. And other emergency managers who follow me retweet it out to their contacts as well and the information gets well dispersed within the emergency management and public safety communities. But there is a downside to Twitter, which I will discuss shorty.

Here in Silicon Valley (where I live), we have an "official" emergency notification system called "AlertSCC" ( that is used by both Santa Clara County & the cities within the County, including San Jose.

AlertSCC is the means of communication used by the Santa Clara County Emergency Management office to alert the public (those outside the reach of emergency dispatch) when information the EM office would like widely disseminated during major events such as earthquakes and fires. Only trained, credentialed officials have access to the notification system including city officials, county emergency managers, fire chiefs from different jurisdictions, certain EMS officials, and certain police officials. I do not have access to the AlertSCC notification system, but some people who follow my tweets do.

Here's the rub:

Since AlertSCC is the "official" notification system, it is required to use verified information, or in other words, verify that the information going out to the public & first responders is accurate. Verifying information during an emergency or disaster takes time. Twitter does not require this verification, so it is almost always the first method of communication that takes place during the initial moments of an emergency. So Twitter is faster, but not always as accurate. AlertSCC is slower but verifies the information before notification... and yes, sometimes AlertSCC relies on "tweets" from reputable sources such as fire chiefs, EMS managers, police captains, and other mid-to-high level emergency managers.

A good example of this dichotomy took place a month ago during the San Bruno pipeline explosion. One of the first tweets on the explosion came from an off-duty EMS provider that was near the scene shortly after the fireball rose up in the air. Within the first 5 minutes of the explosion incident, several dozen tweets went out, including the EMS provider's retweets, which many public safety officials found useful as a way to understand what was going on in a neighborhood in San Bruno, CA.

But for the first hour (about 55 minutes, to be exact), almost all of the tweets (my guess is around 90%), stated that a commercial airliner had crashed into that neighborhood (San Bruno is just west of the San Francisco Int'l airport, and the explosion was less than a mile west of the airport) which had caused a huge fireball visible for miles, and set fire to over two dozen structures.

This information wasn't completely accurate as the fire was caused by a natural gas explosion. In fact even the on-scene firefighters didn't understand that they were dealing with a pipeline explosion rather than a natural gas explosion for the first few moments (around 15-20 minutes by my estimation) of the event.

In this case, the misinformation or incorrect information was inconsequential... and it served to notify public safety personnel (off-duty firefighters, police, ems, public health officials, emergency mgmt officials... CALFIRE...etc) that a large event had occurred and those who were off-duty were likely to be called in to work.

After receiving confirmation from SFO that no plane was missing, and after communicating with the Incident Commander on-scene, it was determined that a natural gas pipeline had broke and an explosion had set fire to several dozen structures. THEN the official alert went out... but only after verifying that the information was correct.


So you can see why it is difficult for EMS policy-makers (as well as Fire, Police, & other first responders) to set a policy on tweets... Twitter, which is open to anyone & everyone, is quick but not always accurate, and the "official" system may be accurate but not always quick. Add to that the fact that many jurisdictions DON'T EVEN HAVE an "official" notification system and you can see why Twitter can be effective during a MCI or other large emergency event.

I think most of us who have studied the problem understand this dynamic and work to use twitter as a useful adjunct in our emergency communications. But since we can't control who tweets what about any given event, it is doubly important to have the "official" notification system be as accurate as possible.

For the average EMS worker on the street, I would give this advice: Don't always believe what you see on Twitter, but instead rely on the official communication system if your agency has one. And if you DO decide to tweet (provided it doesn't conflict with your agency's policies), then be VERY careful what you say and who you say it to. Remember the old adage that if you line up a group of people and whisper something in the first person's ear, and that person whispers it into the second person's ear, and so on...... that last person in line is going to wind up hearing a completely different story. Like anything else in EMS, if you aren't trained or qualified in a particular skill, in this case Emergency Communications, then it is better left to the professionals.

Believe it or not there has been entire conferences on this topic. Emergency communications isn't an easy topic to manage. In fact, I would go as far as saying that emergency communications, particularly during an emergency or disaster, is the MOST difficult aspect to manage. If you know and understand this, and THINK about what you are tweeting before you hit "send", then you'll most likely be a credible source of information and steer clear of any disciplinary action. But most agencies are adopting a "no twitter or facebook" policy... something that may (or may not) infringe on an employee's freedom of speech.

also one last point -- -

Social Networking is nothing new. Twitter has been in existence for more than four years now, and Facebook was started way back in 2004. I've used Facebook as a way to communicate information (whether emergency or not) since April of 2005. And I've used Twitter as an emergency communications tool for over 2 years now.

So if your agency hasn't created a set of policies to deal with "this new-fangled social media thing", then chances are your agency just doesn't know how to manage it.

But whatever you do, don't call it "new" as if it were a passing fad. Twitter, Facebook, Foursquare and whatever else is out there is here to stay. We were warned REPEATEDLY during the 80's & 90's that the Digital Age will soon be upon us, and I can safely declare it is here now, and will be here for a long time.

So it's not "new" by any means.

I more concerned now that Facebook Mobile uses geolocating services to publicly display your location--my biggest concern is my own address before a patients.

If you are going to have a public face beyond an avatar, then you must be careful to what you subscribe and allow.

Mobile sites in particular have a habit of making opting out of sites and apps and options than opting in. Much like facebook hides it's privacy settings beneath layers of clicks and then provide ambiguous descriptions.

Our Agency has the double standard of banning Facebook access from work devices at stations (none of our mobile services are used beyond 3G data and voice) but has it's own Facebook page and Twitter account!

Photos from non issue devices is banned as is publishing identifiable images eg staff if relevant) and especially patients.

What you post should be placed in the same vein as talking in the truck you never know when your foot falls onto the press to talk switch. You never know who is watching........
As far as FB goes, if you're really worried about who sees what, but you still want to update, I've got a simple idea. This is what I did, because I don't need people I don't know getting that personal with me. In account settings, set everything to be viewable by friends only. Then just be vigilant of who is on your list.

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