Sunday, December 1, 2013

EMS, John Henry, and Providing Care

Another blogger has pointed out the useless ness of the Glascow Coma Scale outside of trauma and the under 8 intubate idea, and I hope you take time to read this,
But what about where it applies, trauma, RSI is known to improve a patient’s outcome in traumatic head injuries, unless it is performed by EMS. The cause of this is often EMS providers freaking and hyperventilating a patient. Folks, oxygen can hurt, and over oxygenation has a negative consequence involving morbidity and mortality.
So what am I getting at here. RSI is a very important tool that should be in every Paramedics tool bag, as long as they can ensure it is done properly. So what do we need to do this properly, two things, End Tidal CO2 Capnography and a ventilator. This is going to hurt some peoples feelings, but a ventilator does the job better than you because it doesn’t have adrenaline. You set the rate, tidal volume, and voila perfect controlled respirations.

This is something no one wants to admit, machines can do things better. I am an advocate of taking CPR out of people’s hands as well. These things involve a level of control that humans are not capable of. IV access is an art, but EZIO makes IO access better, easier, and safer so we can use it in the most critical of situations.

The idea here is to ensure that we are doing the best thing for our patients. We need to accept that our egos are not more important than our patients. As a Paramedic, we are expected to make proper decisions in high stress environments. So why not push to make our lives simpler. We all know that we need to ventilate the patient 8 times a minute after the intubating. We know a patient needs 100 compressions a minute with minimal interuptions. So why not seet it and forget it.

I know, I am probably giving up my title as a Paragod by saying this, but we need to perform better. We need to learn to cheat. From Video Laryngoscopes to Thumpers, there are tools out there that can help us perform better. Agencies need to determine which ones will cover their deficits and budget appropriately. Providers, you need to be honest. Admit your faults. This is how we get better, and remember that when John Henry said he was better than the machine, he died beating it.


                As always I value your input and comments,

                Lone Medic.