Pre-Hospital Blog

There’s a great post up at HarvardBusiness.org on the culture at some of the “Top Places to Work” and how they differ from the norm and the worst.

In particular, the authors mention that “many organizations are bastions of dysfunction, where overwork and stress fuel negative and aggressive behaviors.” This rang true to me as the norm at least half the places I have worked in EMS.

We all talk about the need to show people respect and keep people motivated but I think many of us are at a loss as to how to do this day to day. There are some good pointers in the post, check it out.

Rogue Medic has a great post up on trauma triage criteria, leading into some harsh criticism of mechanism of injury as a treatment criteria.

Treatment based on mechanism needs to go the way of bloodletting and alchemy. I recall being trained to assess a patient based on signs and symptoms, not the vague possibility that they might at some point have sustained some hypothetical injury.

A good example of this is vehicle crashes. It is not uncommon to arrive on scene of a rough looking crash at highway speeds and see a patient who appears lucid and uninjured being encouraged to get down on a backboard, despite his protests that “I feel fine. No, my neck doesn’t hurt. Stop that.” Modern vehicles are designed to be destroyed in a crash. The vehicle will be subjected to far greater forces than the occupants. So when you see a car that’s crunched up like a pop can and a guy sitting on the curb, there’s not necessarily a need to toss him on a back board and run him emergent to the ED while you place bilateral 14′s and cut off all of his clothes. He needs assessed and treated based on his signs and symptoms, not those of the vehicle.

I am prepared to make the bold, unsupported claim that treatment based on mechanism is lazy medicine that creates unnecessary ambulance rides for a lot of “patients.”

Pop on over and check out Rogue Medic’s post. It’s worth your time.

Yes, it’s that simple.

via

Annals of Medicine: The Cost Conundrum: Reporting & Essays: The New Yorker

A great New Yorker article on skyrocketing healthcare costs.

Rogue Medic has a good post on EMS Mythology that will get your brain going.

We ought to go forward each day realizing that EMS as a profession has only been around for 30 years or so. Where do you suppose Doctors or Lawyers were 30 years into “Doctoring” and Lawyering”?

There’s a lot of work to be done, most of it we haven’t even identified yet. Some places are way ahead of the US.

“AEMS’ mission is to promote EMS, educate elected and appointed officials and the public on issues of importance to EMS, monitor and influence EMS legislation and regulatory activity, and raise awareness among decision-makers on issues of importance to EMS.”

Among issues they bat for are increased NHTSA funding for EMS, increased funding for the NEMSIS database, along with other EMS related funding from the Dept. of Homeland Security, Department of Health and Human Services, FEMA, and others.

They also offer, with NAEMT, an excellent website called the “AES & NAEMT Legislative Action Center” detailing current issues in EMS, and highlighting how your state representatives have voted on them. Information is available to write your representatives and urge them to vote yes in support of EMS, along with their past voting record in these areas.

To my knowledge, there is no other group in Washington dedicated specifically to advocate for the EMS industry. I suggest becoming a member if you are able.

Thanks to Chris and Episode 6 of the EMSGarage for drawing me to this excellent organization.

I am at the Colorado Advanced Life Suport Conference.  Mike Taigman was speaking yesterday, and he mentioned TED!  I was so excited that someone else had heard about it I laughed out loud.  Then I realized I should share this gem here.

TED stands for Technolgy, Entertainment, Design.  It is an annual conference held in Monerey, CA that “brings together the world’s most fascinating thinkers and doers, who are challenged to give the talk of their lives (in 18 minutes).”  The best part is that they make the best talks available online for free.

I’ve watched several of these through the years, and I have never been dissapointed.  The talks range from serious to hilarious.

I relate this here because I believe very strongly that ideas from anywhere can be incorporated into your practice.  The example used yesterday was this TED talk from author Malcom Gladwell about the history of Spaghetti Sauce.  The point of the video was that the food industry discovered about 25 years ago that there is no one perfect Spaghetti Sauce, there are hundreds; everyone has slightly different preferences and tases.  The point for our purposes: no one learns the same, and no group of people are is looking for exactly the same information.  By injecting variety into your teaching practice, you can reach more people more effectively.

Browse through the available videos and watch one that piques your interest.  I don’t think you’ll be dissapointed.

I’ll be checking these guys out from time to time. They seem to have a very well-structred and varied website with some gret news items and articles.

Check it out!