We all have our good calls and our bad calls. Don’t we? Sometimes things just flow. Sometimes the patient, the bystanders, the crew members, everyone just clicks. And it’s beautiful. It’s like that perfect drive off the tee box that keeps you coming back for another round. The three point jumper that makes you wonder if you should have tried to play college ball.
Unfortunately (perhaps) it is the rare scene that runs flawlessly. More often than not we look back on our calls and think about the things we could have, and should have done better. Of course, that’s how it should be. Without those moments we don’t grow or become better. Some EMT’s carry the philosophy that we should emerge from our field instruction with flawless medicine. Nothing could be further from the truth.
Here is my list of five common trauma scene mistakes I have encountered frequently in my career. I am guilty of doing all of these, some with painful frequency. In those moments of personal scene review, I rank these as my top five, “I wish we had done that differently.” items.
#1 Failing to manage the scene.
We learn a lot about patient care in school. Unfortunately our education regarding management of the scene may be limited to being taught to blindly recite the words, “Scene safe, BSI” as we enter our skills stations. Scene management can be hard. Especially management of big scenes with multiple priorities like calling for more resources, assessing hazards, protecting bystanders, interacting with family and friends of the injured and triaging multiple patients.
On these scenes, patient care suddenly becomes a warm comforting blanket. Caring for one patient seems so much more manageable. Patient care priorities like holding c-spine and doing an assessment call to us like a sirens song. Don’t do it! It seems obvious but, when it’s your job to manage the scene, manage the scene.
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What if I told you that you could adopt one simple, yet powerful belief that would improve your happiness at work immediately and forever? What if I could tell you one simple truth and, if you were willing to accept it, you would feel less stress and bring more joy and well being to your job starting right now? Would you be interested? Read on.
Carl Jung was the first psychologist to put fourth the theory of the collective unconscious. He recognized that an individuals behavior was driven, not only by their personality, but by the myths, ideas and beliefs held collectively by their culture.
It’s worth recognizing that when you came to emergency services you arrived with some of these beliefs.
You had an idea in your head of what an EMT, a paramedic or a fireman was. It’s probable that your beliefs were based more in the myths of the collective culture than reality, but the industry could take some blame as well.
We did nothing in your training to convince you that your job would be anything different than what you had seen on TV and in the movies. We may have even used some of these images in your recruitment process.
If you endured a fire academy you were taught each day about structures on fire and victims that needed to be dragged to safety and turned over to imaginary medical personnel. In EMT class you spent each day learning about the various medical emergencies that befall humans. From aneurysms to zygomatic fractures and everything in between, we drilled you on how to recognize those sick patients and how to intervene appropriately. And you learned. You diligently studied for the day when you would be the one responsible for caring for the sick and bringing calm to the chaos.
But the instructors didn’t say much about headaches. Blinding migraine headaches that make the patient so photophobic they can’t see to drive their car. They didn’t talk about stubbed toes either. They didn’t mention that many of the patients would be depressed, abused, addicted and homeless. Nothing was said to prepare you to kneel before drunks and criminals and people with mental imbalances, social dysfunctions and minor yet overwhelming needs that have nothing to do with your training.
In all your training nobody prepared you for emergency services. We may never have even mentioned that emergency services has much less to do with the real, life threatening emergencies than the collective myths told you. Instead, it has everything to do with caring for people and their problems. Welcome to EMS.
But here’s the kicker … none of this is a bad thing.
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