Credibility and Redundancy

I’m going to make an important point and I need you to pay attention. That sentence, the one I just wrote. The one about saying something important. That was a redundant statement. And it undermined your sense of my credibility as a blogger and an EMS educator. No really, it did.

Not in a huge way. Not like if I had said something that you knew to be completely false, or got all wishy-washy, namby-pamby about some critical issue regarding your patient care. But it made you doubt my sincerity just a little. Somewhere in your subconscious you thought, “If it’s important, why not just say it?” You questioned why I felt the need to preface my important thought with a statement declaring my own thought important.

It’s as if I doubted my own credibility.

So why shouldn’t you doubt it too.

Right?

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How To Get Them to Hang-Up The Cell Phone

I want to share with you a quick technique I’ve been experimenting with for the past few years. I first came up with this while working as a supervisor in the private ambulance service. At that point I did a lot more interacting with bystanders on scene and it was often a challenge to get them to hang-up their cell phones and talk to me.

It still happens. And it seems that it’s becoming a more and more frequent event. People wreak their cars or fall down the escalator and their first thought is, “Oh my gosh, who’s going to pick up the kids at day care? What will my husband say?” And by the time we arrive, three to eight minutes later, they have their cell phone planted in their ear and the conversation is just getting under way. Does this happen to you to? I imagine it does.

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Mastering The Head-To-Toe Assessment

You probably practiced your head-to-toe assessment a bunch in your EMT class. Maybe more than any other skill in the EMT curriculum. If your class was or is anything like mine (as a student or a teacher) you performed the head-to-toe assessment again and again.

As much as we practice this skill in EMT class, I often wonder why so many EMT’s have such bad head-to-toe skills out on the street. It seems that, once we get out on the street, the systematic, thorough head-to-toe assessment falls out of favor and quickly gets replaced with the faster, more direct focused assessment.

That works just fine most of the time. If it didn’t, I figure it probably wouldn’t be such a universal phenomenon. (For the record, have you ever worked somewhere where this wasn’t the case? Neither have I.) The downside is that when the patient arrives who really needs a, honest-to-goodness, rapid, complete head-to-toe, we’re not up to the task.

I happen to believe that patient assessment skills are one of the defining qualities of a talented EMT. Here are seven tips to keep your head-to-toe in top form.

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How To Set Up An IV Line – Firefighter Style

You’ve been there before. You’re getting ready to start an IV. You pull out the necessary supplies, you hand off the IV bag and drip set to a nearby firefighter and he (or she) looks back at you a bit sheepishly. “I’ve never really been any good at setting these things up right” they say.

Let me tell you the down and dirty truth, strait from a firefighter. No self-respecting firefighter should be unable to set up an IV line.  Say what you will about patient assessment, vital signs, or splinting a broken limb, but IV lines are hydrodynamics. We use IV’s to take a fluid and transport it from one place to another, delivering water from its source through a flexible hose to a destination. Does any of this sound familiar?

Moving water around is what firefighters do. The problem here is that someone, maybe even you, taught that firefighter how to strip out and set up that IV line and you made it sound like a medical procedure. You probably told Mr. or Mrs. firefighter that the parts to the IV set up were things like an IV bag a drip chamber and a roller clamp. You may have described the process something like this.

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Do You Know?

What two significant things happened behind the scenes at The EMT Spot this month?

What two updates are coming to the site?

What the big controversy over pre-hospital intubation is all about?

What happened in Detroit and Toronto to create such a stir over response times?

What happened to 30% of UK medics last year?

What program in New Mexico has cut drunks in the ER in half?

What’s wrong with the 6 year old little boy in the EMT scenario challenge? Continue Reading…

The January EMS Roundup

“Every man should be born again on the first day of January. Start with a fresh page. Take up one hole more in the buckle if necessary, or let down one, according to circumstances; but on the first of January let every man gird himself once more, with his face to the front, and take no interest in the things that were and are past.”

                         Henry Ward Beecher, US Congregational Minister

Certainly January is a month to face the future. If Minister Beecher would allow us just one transgression, I’d like to look back, for one brief moment, at the month that was.

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Medicine Between The Frames

One of my favorite bloggers, Seth Godin, recently introduced me to the work of Scott McCloud, an author who’s written several classic books on understanding comic books. Scott dissects the comic medium and explains the ongoing allure of the comic book to the uninitiated.

One of Scott’s observations is that comic books require imagination on the part of the reader because, in all great comic books, the action occurs between the frames. The artist only shows you snapshots of action and dialogue. Most of the story takes place in our heads. The real story is the stuff that we invent that happened in-between the frames.

Medicine works in much the same way. We assess, we ask our questions, we do our head-to-toe and we make a guess (educated) about what’s going on. Then we make a change, and the medicine begins, after we make the change, not before.

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The Art of Using Trauma Shears

I got a request recently from a maker of trauma shears to give their product a test drive and see what I think. I’m more than happy to give their shears a few turns around the block and kick the tires a bit. Who knows, maybe they’ll be really good. Maybe they’ll be my new favorite set.

All the shears I’ve ever owned have come and gone. I don’t have a particular set that I’m really attached to right now. I’ve had some great sets of shears over the years. I think my longest running favorite pair lasted around five years. I don’t remember the brand now, but they were good. Black handle with a bit of cloth tape for grip. (I know it isn’t a bio-friendly practice.) Nice tight feel to the action.

Like all shears I eventually lost them. Some scene was moving along and I handed them off to someone in the rush of delegation to strip a patient down and they never returned. Equipment comes and goes. It’s the way of things.

The truth of the matter is, it doesn’t much matter how good or bad the shears work. The guy (or gal) wielding the shears is the deciding factor in how fast a patient gets stripped. I can strip a human in seconds with a wobbly pair of $2.00 knock-offs. The shears just don’t make that much of a difference. It really comes down to technique. Here’s the skinny on how to take a patient from their winter-best to fully naked in seconds.

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Brotherhood

The Good Lord saw fit to grant me but one sibling, a brother. His name is Brian. He’s a good brother. He calls, he Skypes, he visits me half way across the country for road trips and family outings.

He’s in nursing school right now so I get to listen to him yammer on about how nurses are the greatest thing in all of medicine. Yeah, I know what you’re thinking, he’s not even out of school yet and he’s learning how to be patronizing to us EMS folk.

He’s going to make a really good nurse.

Sometimes I wonder if my brother wouldn’t be irked if he knew how many people I refer to as brother. Honestly, he’s the only one with clear rights to the title. He was the one defending me at the school lockers in junior high. He was the one that had to sacrifice the video game paddle so I could have my turn for all those years.

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The Non-Conformists’ Guide is Here!

I’ve gone live with the book and newsletter sign up and it appears that everything is running smoothly. I’ve already had a half dozen sign-ups and the link has only been posted for a few minutes.

Thanks for your patience. This writing project took me nearly six months to finish. I had an idea of what I wanted this book to be and I wasn’t willing to stop until I’d succeeded.

The result is The Non-Conformists’ Guide to EMS Success. This is no pamphlet or power point slide show. This is 48 pages, almost 16,000 words, and chapter after chapter of compelling ideas designed to challenge the way you think about your job, your leadership, your life, and your role in EMS. And it’s all free.

If you’re ready to stop listening to me talking about it and get the book for yourself, just click the newsletter sign-up at left. The EMT Spot practices a strict, double opt-in, anti-spam policy. We’ll never reveal your e-mail to anyone, ever.

You’ll receive an e-mail confirming that you really did sign up for Splatter and the e-book. Once you click the confirmation link you’ll received your welcome edition of Splatter and the .pdf version of the e-book will be attached. It’s as simple as that.

The newsletter will also have an opt-out link at the bottom if you’d rather not be on the newsletter mailing list. (But I hope you’ll decide to stay)

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