The "They Think We're Stupid" Files

Brandon Oto over at EMS Basics shares a story where monkey-see monkey-do medicine went wrong. Go read the whole thing, and then come back. If you learn nothing else in EMS, learn this: protocols are no substitute for common sense and clinical decision-making. In fact, they’re often the antithesis of critical thinking and clinical decision making. Protocols, with very few ...

Sometimes, I can’t activate that verbal filter no matter how hard I try: Patient: “I’m allergic to aspirin, Tramadol, Vistaril, ibuprofen, morphine, and all the ‘cillin’, ‘mycin’, and sulfa antibiotics.” AD: “Uh huh. And what does each of those things do to you when you take them?” Patient: “Aspirin makes it hard to breathe, plus my nose swells up and bleeds. Tramadol and ...

Sketchy Patient: “Wait, you can’t give me pain medication!” Ambulance Driver: “Sez who? Are you allergic to Fentanyl?” SP: “No, I’m allergic to morphine.” AD: “Not the same stuff, and I thought you said ‘my guts are tearing apart’ or something like that.” SP: “Yeah, but y’all never give me pain medication in the ambulance.” AD: “That was them, this ...

… fool me twice, shame on me. I’m a pretty liberal guy when it comes to pain relief. My philosophy is simple: if you’re hurting, I try to make it stop. Acute pain is not a character builder, and it is one of the few conditions most paramedics are well-equipped to manage. I don’t like to see someone hurting if ...

Want to start a fight in an EMS social media forum? Just ask if EMTs diagnose. Invariably, you'll get hordes of people shitting their pants over a simple word, and twisting the English language into something unrecognizable in an effort to avoid calling something what it really is. General impression. Field diagnosis. Presumptive diagnosis. Field impression. We have an entire ...

… but I told you so. On KevinMD, we find a story that Oregon Medicaid recipients are 40% more likely to go to the ED – far more expensive care -than their primary care physician: The Oregon Medicaid findings highlight a central flaw in the Affordable Care Act. Expanding insurance without expanding the primary care infrastructure drives more patients to ...

Fun Fact: A couple of forgotten loose rounds of pistol ammo in your carry-on bags will cause the TSA to lose. Their. Minds. I suppose a little backstory is in order, so, in the parlance of my assault patients, “See, whut had happen wuz…” I bought a tactical man purse at the NRA annual meeting to carry my camera, pistol, ...

A tale related by a colleague: If the police find you passed out drunk behind the wheel of your car, keys in the ignition and the switch on, but are willing to cut you a break because you at least had the presence of mind to pull over and sleep it off, and apparently toted an ass whoopin’ before their ...

I follow a few EMS forums on various social media sites, but lately I've been commenting less frequently because the signal-to-noise ratio leaves me in despair of the future of our profession. I have to wade through far too many comments from adrenaline junkies, protocol monkeys, booger-eating cretins and fervent disciples of EMS mythology to find the comments of the ...

In the recent mass stabbing at Lone Star College in Harris County, TX, fourteen people were transported to local hospitals by EMS. A blog reader pointed me to the CNN.com story on the event, and the associated photo gallery. There are a couple of video clips, as well. You EMS folks, go look at the photos and video, and come ...

From Pravda MSNBC: Senators: Deal Reached On Background Checks. Two key senators have reached a deal to expand background checks to firearms sales at gun shows and on the Internet, sources close to the negotiations said early Wednesday. Um, guys? You already can't buy guns on the Internet without a background check. Go to one of the Internet sellers, Gunbroker, ...

Patient: “I don’t want to go to no hospital. I ain’t got no ride home. I’ll just go stay in my neighbor’s trailer tonight.” Deputy: “The medics just told you one of those cuts might need a couple stitches. Ain’t there somebody you can call to give you a ride home from the hospital? Patient: “There would be, if I ...

Triage Nurse: “So what’s with your patient?” AD: “Spewing from both ends for three days.” TN: “… and? AD: “Don’t know shit about him, didn’t do shit for him.” TN: “Oh. One of those, huh?” AD: “Yeah, he’s a real sweetheart. You’ll love him.”

Hat tip to Jay G. for this one:   Utah school cancels Elvis musical after complaints that All Shook Up is sexually suggestive.   In other news, Jailhouse Rock caused a spike in crime, Teddy Bear encouraged bestiality, and In The Ghetto glamourized the inner city culture that led to rap music and drive-by shootings. If they really wanted to ...

Protocols are intended to be an organized framework for delivering care. Written well, they are a floor, ensuring that even the least competent medic in your system delivers the same basic care as your best medic. Written poorly, they are a ceiling, forcing the best medic in your system to render care on a par with the least competent one. ...