We pay a lot of lip service to “saving lives” in EMS don’t we? From our sarcastic replies to the polite greeting, “How’s your day going?” to our citizen “Life-saver” awards, the saving lives terminology and mentality pervade our industry. The media raves about life saving technology and we debate if our interventions were truly life saving. And the cold, hard truth of the matter is, none of us have ever really saved a life. Not one of us.
I’m sorry. As much as I hate to burst the life-saver bubble, I think it’s time. I think it’s time to rethink our life-saver mentality. The more I learn about emergency services and the complexity of modern medicine, the more I see the truth. This is the truth I see.
We are a small sliver in the pie that makes up a patients entire course of care. Our role is deeply significant and in many cases essential, but EMS does not exist in a vacuum. We are one person, in a team of thousands, who are all essential to proper patient care.
Let me put it to you this way.
Let’s go back and take a closer look at the last life you saved. Perhaps it’s a mid-sixties male who was found in cardiac arrest. All the stars aligned. He had good CPR. You were positioned close to the scene. You walked in, defibrillated a coarse v-fib and got a pulse back. A week later the dude walked out of the hospital with two new stents in his left anterior descending coronary artery and a full plan for rehabilitation and a return to health. Ta-da. Well done.
Now picture yourself standing in the middle of a football stadium. The stadium is empty. Make it a big stadium, because we’re going to start to fill it pretty quickly.
Let’s start with that guy who did good CPR. Surly he needs a seat in the stadium…front row, fifty yard line. But wait. He didn’t teach himself CPR. He didn’t invent the technique. Put his CPR instructor next to him. That gal did a great job teaching him. And while we’re at it, let’s put her instructor-trainer next to her. But none of them created the technique of CPR. Let’s put all the researcher who contributed to the body of knowledge that is our current understanding of effective CPR right along side of them. The stadium’s starting to look full and you haven’t even arrived on scene yet.
How about the 911 system. The call went through to a well trained dispatcher who sent the right unit and gave good instructions. The 911 system was well designed to place the resources in the proper area. So now let’s add them all to the bunch. This dispatcher, the dispatch trainer, the dude who designed the EMD system, the I.T. gal that keeps the computers running smooth, the radio technicians; all of them played a role. And while were at it, let’s not forget the ambulance mechanics. They need to get their job right every single time too.
Now that you’re on scene, lets talk about that fancy defibrillator. I’m sure the design team, the engineers and the technicians at Zoll would like a few seats in the stadium. Lets put them down in the lower deck. Add in all the folks who contributed to defibrillator design and development over the past twenty years. You didn’t create that fancy machine yourself did you? How about the researchers who figured out that defibrillating the patient right away was the right move? They’re going to need a whole section. Box seats go to the instructors who taught you ACLS. We might as well have a party-section for all of your instructors.
Holy guacamole. We haven’t even left the scene yet and our stadium is filling up far to fast. Where will we put the doctors, the nurses, the cath-lab technicians, the specialists, the physical therapists, the dozens of technicians and lab workers and all the folks who trained them. How about the cleaning staff that made sure the patient didn’t end up with an extended ICU stay for a MRSA infection or the dietitians that dutifully served low sodium foods each day. We’re going to need a big, big stadium.
Now let’s come back to you, standing proudly on that 50 yard line. Let’s give you a microphone and hook you in to the public address system. Let’s give you a chance to talk to all those people that played an essential role in this patient’s care. Think about it. If any one of them didn’t show up and do their job correctly, the patient’s course of care could have been much different. But they did show up. They showed up and did their jobs, just like you did.
What will you say to them?
I doubt you’d have the hubris to say, “I saved this guys life.” I imagine you might say something like, “Thank you for letting me be a part of such an amazing team.”
We fill a privileged role in EMS. We are the public face of an amazing team of people. We get to be there at the moment of truth. Sometimes we get to perform the intervention that keeps the whole ball moving forward. We get to perform our jobs right there in the public eye. Sometimes people who don’t understand how it all works get the misguided impression that we saved someones life. When they make that mistake we should correct them.
We owe it to the rest of the team.
What do you think?: Do you save lives? How do you see your role in the emergency medical process?
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