Last On: 2:14AM, 10 Nov 13
Daved van Stralen
  • Male
  • Redlands, CA
  • United States
  • Physician
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The First Five Minutes
4 Replies

Generally, you will identify which rule, policy, or protocol to use in the first five minutes on scene. Even if you find a senior officer on scene you must learn what you are to do, what is your…Continue

Started this discussion. Last reply by Bob Sullivan Jan 6, 2011.


Daved van Stralen's Page

Latest Activity

Daved van Stralen and Ryan Kelley are now friends
May 4, 2013
Daved van Stralen replied to Allison Moen's discussion The First Time You Heard the Term 'Paramedic'
"It was 1972 and I was on an ambulance response in a bar for a guy who bloodied his mouth eating a glass beer mug (parts of it are edible, it seems). The firefighters from the salvage unit were starting an IV so I asked my partner who they were. He…"
Aug 10, 2012
Daved van Stralen replied to Ed's discussion Cardiac arrest victim secondary to hanging. Treatment?
" I admitted four kids to the Pediatric Intensive Care Unit who attempted suicide by hanging. There was little, if any, published experience on managing survivors as almost all the articles came from the pathology literature and autopsies. Those…"
Oct 20, 2011
Daved van Stralen replied to Kevin's discussion Hospital Transporter job....
"Don’t waste your time. By that, I mean, don’t take any job and simply do what the job description says. Even RNs, paramedics, and doctors waste their time by doing the same task over and over, 20 years of the same year repeated year…"
Sep 12, 2011
Daved van Stralen replied to Skip Kirkwood's discussion Being The Best That We Can Be - a discussion at
"Skip, in response to your opening statement from the link posted: Paramedics commonly hold others responsible for their plight or believe others hold the keys. Whatever it is, paramedics don’t seem to hold anything Yet every profession that…"
Sep 12, 2011
Daved van Stralen and Joffry van Grondelle are now friends
Jun 10, 2011
Daved van Stralen left a comment for Joe Paczkowski
"Joe, I like your concern, and drive, to improve EMS and your medical background will help. Jim and I had a similar conversation discussing your concerns about JEMS and change in EMS. Jim had ideas but he approached it differently than I did at the…"
May 7, 2011
Daved van Stralen replied to Tony Ricci's discussion What was the sense of this JEMS article?
"Joe, the journals you describe are primary research journals which publish primary or original research while JEMS presents peer-reviewed secondary research (review) articles.  The primary research journals also publish secondary research that…"
May 5, 2011
Daved van Stralen replied to Tony Ricci's discussion What was the sense of this JEMS article?
"Point well taken. They once changed the title to one of my articles to less than professional wording and would not do an article on oxygen delivery as there was a doctor in San Diego who went to people's homes (house calls) and brought…"
May 4, 2011
Daved van Stralen replied to Tony Ricci's discussion What was the sense of this JEMS article?
"  It would certainly be nice to have a standard format for EMS cases like the case reports in the medical literature. I, too, have had problems with the scenarios used in EMS education and do not understand why the authors do not use real…"
May 4, 2011
Daved van Stralen replied to Jennifer Berry's discussion 5 anatomical features that affect ventilation
"The back. Scoliosis also contorts the airway, more difficulty mask ventilating and great difficulty visualizing the airway,   Laryngospasm in child. If you are mask ventilating a child and the airway is suddenly occluded it is likely…"
Apr 17, 2011
Daved van Stralen replied to Taegan's discussion EMS Personnel Carrying Weapons
"Thank you, Carl and Pascal. Outnumbered, no cops or firefighters, on foreign turf while threatened or being in fights (verbal and physical, hands, fists, knives, and guns), with weapons, working with colleagues who were shot at … was not a…"
Mar 2, 2011
Daved van Stralen replied to Allison Moen's discussion Prehospital Intubation & Cardiac Arrest Survival
"Rogue, you are correct, everything you listed is a system failure and should be evaluated as a failure of the system. This approach opens far more opportunities to improve and makes for richer lessons learned. Someone misusing a tool is a system…"
Feb 24, 2011
Daved van Stralen replied to Allison Moen's discussion Prehospital Intubation & Cardiac Arrest Survival
"If a critical mass of evidence shows that a particular procedure in a particular environment with a particular type of provider makes that number go down, then it cannot be the gold standard.   The concept of a single-point failure is commonly…"
Feb 24, 2011
Daved van Stralen replied to Allison Moen's discussion Prehospital Intubation & Cardiac Arrest Survival
"I think the evidence is that we are on the dollar standard. Anyone know how we can go onto a patient standard?"
Feb 24, 2011
Daved van Stralen replied to Allison Moen's discussion Prehospital Intubation & Cardiac Arrest Survival
"Rogue, We can check with Skip in this one but, from my discussions with lawyers in several states, I understand that Standard of Care or Standard of Practice is a legal definition to what a conventionally trained physician would do. It relates to…"
Feb 19, 2011

Profile Information

Primary Agency/Department Type
Private EMS
Primary Department/Agency Name
AMR, San Bernardino (CA) County
Years in EMS/Public Safety
Other Past or Current Departments
current - Adjunct Professor, Emergency Services, Crafton Hills College, Yucaipa, CA
past - Medical Director, San Bernardino County Fire Department, CA
Medical Director (Founding), Emergency Medical Care Degree, School of Allied Health Professions, Loma Linda University
Rescue Ambulance Driver (paramedic), Los Angeles Fire Department 1974-77
Ambulance Driver (First Aid Card, Later EMT), Adam's Ambulance Service, South Gate, CA (1972-74)
My Training:
Pediatric Critical Care Fellowship, 1987-89
Pediatric Residency, 1984-87
Medical School, 1980-84
Paramedic Training, 1975-76
EMT class, 1973
About Me
What I learned from firefighters, cops, and the old Central Receiving Ambulance men I now use in medical care.
Day Job
Assistant Professor, Pediatrics, Loma Linda University School of Medicine
Personal Site/Profile
I Love Being in EMS Because
The camaraderie from solving problems the public cannot or will not solve themselves.
Relationship Status

Comment Wall (7 comments)

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At 12:21pm on January 31, 2010, Daved van Stralen said…
Dave, you are on the right road. It seems odd because you have been here before but were probably told you were lost. As you learn the terrain you will no longer need directions or a road map. Rather than ask questions, articulate the problem. A US Marshall who trains Marshalls told me that he has people articulate the problem as that gives them half the answer. "Do you have probable cause to stop a rich white guy in an expensive car who is driving in an ethnic ghetto on a weekend at two in the morning? Yes, because he is either lost, looking for drugs, or looking for prostitutes." Dave, you are at the level where articulating the problem gets you more than half-way there and your options become more clear, where to look becomes more evident. I would sure like to have a cup of coffee sometime with you. See my answer to your question on the website.
At 10:47pm on January 28, 2010, Dave M said…
I was reading back thru the posts and one paragraph stood out for me. At least it was only one, I'm sure that others will later. You were talking about Professionalism and leadership and mentioned the article by James Goss (I enjoyed reading it by the way, lots more to think about). Bear with me as I'm still thinking through this question.

Your statement of accessing the individual thru the group is opposite of how I have always thought of it but after adding it to some some lesson material from a the previous mentioned leadership class it started to make more sense. Then I added our thoughts about the individual becoming more "embedded" (is that the right term?) in the company. So, my question. What affect does the "follower" have on the effectiveness of a leader? If those following you have decided that they don't want to follow your lead, are you still effective?
At 10:02pm on January 25, 2010, Dave M said…
If at any time I become annoying, just let me know, but to be very honest, I am learning a great deal from our "Conversations" as a Samurai once said. Sounds like you are saying to take the theory out of theoretical and make it practical. A lot of what I heard in the classes I took made sense and still does, the problem that I see comes back to the individual versus group. Most of it was focused on One to One leadership and not on the group dynamic. I'm realizing that the concepts you use for individual leadership are not effective when it comes to working with a group.
At 4:08pm on January 25, 2010, Daved van Stralen said…
You chew on it because what you know and what you experience is not congruent with what you read or what others say. The discomfort produced drives you to understand better by cutting away what does not fit, augmenting what works, and adding to fill in holes. You are self-correcting. Hmm... science is a self-correcting body of knowledge. You are scientific. Don't be afraid of abstract; it has bad press, that is all. Now, think of leadership but take yourself out of it when it comes to their performance. See where it takes you.
At 3:56pm on January 25, 2010, Dave M said…
I don't know if I've heard it put that way before. Sometimes it seems as if I have to "chew" on a thought for a while befor it becomes clear. This is especially true with this topic as it can become very abstract. Leadership as a goal is very abstract because the way to gauge success is to "lead" those you work to be able to do what you do as well or better than you do. At least that is what my thoughts to this point are.
At 3:29pm on January 25, 2010, Daved van Stralen said…
I like how you think. It seems thought to you is a process like breathing, it will never stop as it has no final goal. An associate of mine read a book at my suggestion and he liked what the author had to say. Which is good since he is a retired US Navy Admiral. It's your Ship by Captain D. Michael Abrashoff. Odd, isn't it, that it is subtitled "Management techniques from the best damn ship in the Navy."
At 1:28pm on January 25, 2010, Dave M said…
I put another post on "Crossing the Threshold" on the Levels of Leadership. If you would please read it and let me know what you think. Also, what authors/books would you recommend for me to read to learn more on this topic? Thanks, Dave.
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