In Greek tragedies, the hero typically displays some form of hamarita, also known as a “tragic flaw.” Hamlet was brooding, Othello was jealous, Macbeth was ambitious. For the most part, it is their tragic flaw that is usually the key to their undoing. When the hero ultimately falls, they tend to sow the seeds of their own demise with their respective tragic flaws.
People often use the word hero when they refer to EMS caregivers. EMT’s, paramedics, firefighters, we all get the hero moniker pinned on us from time to time. I cringe at the term. Most of us are uncomfortable with it to different degrees. And, if there is any truth to our hero title, it is certainly closer to the heroes of Greek tragedy that the comic book heroes we grew up with.
In other words, we all have our tragic flaws. Yes, all of us.
Here are eight of the most common tragic flaws of the EMS hero persona. I have, at one time or another in my career, embodied each and every one of these flaws to one degree or another. I’ve lived each one of them. I would guess that most of us do.
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Part two of a two part series on scene presence. Part one is here.
While we’re talking about scene presence, I think it’s important to bring this one up. I’ve hesitated to talk about the illusion of control on the blog even though it’s a learning point that I invariably discuss with new students on the rig in the first one or two shifts. The illusion of control is deeply
applicable to learning scene presence, but, quite frankly, it contradicts something I’ve preached here on The Spot for some time.
It contradicts my advice to always be authentic. When it comes to authenticity, the illusion of control is the exception to the rule. I suspect that some of my regular readers may have take issue with that. It’s OK, I’m a big boy. I can handle it.
In the world of scene management and scene control, the illusion of control is a metaphor for how we should respond when things don’t go the way we planned.
There is an awkward and embarrassing moment that we all have to deal with while running calls. It helps to think it over before it happens. If you’ve been in EMS for any length of time, it’s already happened to you. So let’s talk about it now. How do you react when you make a mistake during a call? What do you do when things don’t go as planned? How do you respond when you make an outright flub, guffaw or blatant error right there for everyone to see?
My answer, “The illusion of control.” Allow me to explain.
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C-spine immobilization is not a benign procedure.
It’s not something that’s always worth doing “just in case.” It’s not risk free, comfortable or even practical. And, now, recent research from the Washington University School of Medicine suggests that it may not even do such a good job of keeping the patient’s head still.
Does anyone else agree that we’ve seen enough bad news about c-spine now that we can stop the massive overuse that plagues our industry? Can we start evaluating people and deciding who does and doesn’t meet criteria for spinal immobilization. Please?
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Study shows venous blood tests artificially high on capillary glucometers.
Did you know that it matters where you get the blood sample from when you’re using a glucometer? If you did, congratulations. You understand more than I did about glucometers before I read this study that showed venous blood tests as much as 17.42 mg/Dl higher on capillary glucometers than capillary blood.
Why do you care? 
If your agency is using standard, over-the-counter capillary glucometers, these are specifically calibrated to give accurate readings on capillary blood. The kind of blood your finger oozes when you poke it with a lancet. Not the direct venous blood that you might get off your IV needle or directly from the end of the IV catheter.
Does this mean that you should stop using the IV site, or needle, or little drops of blood on your bench seat to test the patients glucose level? Not necessarily. Venous blood will still give you an accurate ballpark estimate of the patients glucose level. Just be aware that if you’re looking for a dead-on accurate blood glucose level on your diabetic or altered mentation patient, you need to do a finger stick. And know that a venous blood sample reading will most likely be an artificially high number.
Now you know.
One of the nice perks I’ve found to blogging is that every now and then I get to rant. This piece might fit into that rant category. Not necessarily the full blown, foot stompin’, leave the caps lock key on, kind of rant, but a rant none the less.
I’ve started a bunch of IVs. Some were really good. Some were, I can’t believe I got that, there must have been some divine intervention involved, good. Of course I never say anything like that at the time. I tape it down nonchalantly and act like I get the hard ones all the time.
I’ve had my share of bad ones as well. I’ve missed IVs in veins so big that I should have been able to throw the needle dart style and still hit the vein. I’ve chased veins across peoples arms and left them with bruises to remember me by for weeks to come. I’m not proud of it, but I’ll take ownership of it. IVs aren’t my favorite thing to do. I didn’t become a caregiver because I liked causing people discomfort with needles. (Though some of my patients have seemed convinced otherwise.)
Along the way I’ve picked up some pet peeves about starting IVs and I’d like to share them with you. This is a list of my top four, please don’t do this, IV pet peeves.
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