EMS dogma

When I trained retrievers professionally, I used to get a steady stream of business from members of the By Gosh and By Gum Club, whose club motto went something like, “By gosh, it seemed like a good ideer, so by gum, that’s the way I done it.” They were the guys who thought the way to introduce their Lab pup ...

My writing partner Gene Gandy and I are planning a new series of monthly articles in EMS World Magazine. Each month, Gene and I are going to take on a particular piece of EMS dogma, myth or obsolete clinical practice, and subject it to the withering scrutiny of current research. We're still working on the series title, and we're compiling ...

An excellent explanation as to why bad ideas and outdated concepts persist in EMS organizational culture.

According to TOTWTYTR, that should have been the title to my latest article in EMS World Magazine. Unfortunately, I had already submitted it to my editor by the time my buddy weighed in. Pity, that. I cribbed many of my best lines from him, including the original title of my book. Go, read. Enjoy.

To hell with the 3 nitro rule, let's figure out a way to give nitro via in-line nebulizer attached to our CPAP masks.

Now, an 80+ minute trip strapped to a spine board isn't the cruelest thing I can think of doing to this man, but the other two possibilities involve nipple clamps and a live ferret. He weighs less than his age, and his chart already includes orders for a Fentanyl patch PRN and gel seat pads for his wheelchair. I don't like the idea of boarding him if I can help it. But we're not talking about what I would do. What would you do?

Caretic [noun; care-i-tik] Def: One who unapologetically defies dogma, conventional wisdom and poorly written protocols to provide quality patient care. Often confused with heretic, by the same people who unquestioningly propagate dogma, blindly accept conventional wisdom, and write stupid protocols.

Next time one of my co-workers makes a silly decision based solely on what the vehicle looked like, I'm going to ask him, "Are you an EMT, or an auto insurance adjuster?"

In comments to my last EMS Newbie post, reader 40Lizard commented on the discussion Ron Davis and I had on this episode of Confessions of an EMS Newbie: Funny you should mention starting an IV before giving NTG- we’ve been having that discussion in class this week- and the general consensus is that unless we are SuperMedic and can have ...

… and there’s a time for common freakin’ sense. I know paramedics who can tell you chapter and verse about their patients, and hand off a thoroughly assessed, neatly packaged, NEARLY DEAD patient. There’s a time and place for a thorough history and physical exam. That time and place is not when your patient is circling the drain. The ambulance ...

A great many ground EMS crews are infected with advanced rotoriasis, but the problem is not limited to the EMS profession. Quite a few rural ER docs are ate up with it, too.

Question: What do the above things all have in common? Answer: All of them are things in which some people desperately wish to believe, despite the utter lack of credible evidence of their existence. Now, before you roll your eyes and say, “There goes AD again, making unsupported blanket statements just to make his point,” I will cop to just ...