The Ultimate EMS Protocol

I don’t handle the card much anymore. It stays inside a plastic sleeve in my planner. The edges are worn and the words are faded. It wasn’t printed on kind of paper that travels well in a wallet for twenty plus years. But it’s been worth carrying. It is, quite simply, the ultimate EMS protocol.

I don’t read it often. I’ve read it enough times over the past two decades to have it pretty well memorized. It’s my STAR CARE card.

I got it back when I was a paramedic student at Baystar Ambulance in San Mateo California. It was 1992. I always believed the original author was none-other-than EMS guru Mike Taigman. Mike had signed on to be the quality care guy at the fledgling service and I knew the cards had originated in his office.

The idea was simple. We can’t write a policy for eveything you may encounter in the field. Instead, use this guideline. If the decision you’re about to make passes these eight tests, we support you. NO matter what. Come hell or high water … we have your back.

It’s brilliant really. It’s the policy to end all policies. It’s the grand daddy algorithm. It’s the ultimate protocol.

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You Can’t Give Away What You Don’t Have

Imagine we were walking down the beach together on a sunny day and I suddenly looked at you and said, “Would you like an apple?”

If you were hungry, your initial reaction might be, “Yes, I’d love one.” But you might also be a bit perplexed. I mean, what if I clearly didn’t have an apple? Somewhere in your mind you’d wonder where the apple was. Did I have one stashed in a pocket? Do I know a good fruit stand near-by? Your next offering might be an awkward sounding question. “Uh … do you have an apple, Steve?” or perhaps, “Where is it?”

When it comes to physical objects the implication is clear. I can’t give you something that I don’t have. It’s not physically possible. Nothing could be more obvious. And that brings us to an interesting point about some of our more non-tangible assets like compassion, patience, kindness and good patient care.

You see, when writing about things like kindness, compassion and patient rapport I’m as guilty as the next guy of falling into “tips and tricks” mode. In the past I’ve written articles about how to speak and behave in ways that help build patient rapport. I’ve listed tips for making the patient feel welcome and comfortable and I’ve extolled the virtues of good listening, kind interactions and compassionate care. But I, like many other EMS authors, have overlooked one simple truth.

None of it  really works if you don’t feel it.

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Patients Don’t Buy Backboards

I have a Labrador named Eddie (pictured below). He eats only Eukanuba dog food. That’s because we buy it for him. If we bought him a different brand, I’m sure he would eat that as well. He might need to get a little hungry before he agreed to the switch, but my gut tells me that he would eventually concede.

Knowing my dog, probably sooner than later.

I want to quote from the Eukanuba web site:

Satisfy your dog’s taste buds with the succulent flavors of beef and rice. Your dog is sure to enjoy every bite with real beef as a key ingredient.

Reading this, one thing is clear. Dogs don’t by dog food. This product was clearly not formulated for dogs and it isn’t marketed to dogs. This product is designed to make people feel good about what they’re feeding their dogs. If dog food was made for dogs it would be cat flavored or rodent flavored or bird flavored … or maybe even other dogs butt flavored. My dog doesn’t care about succulent beef and rice. He cares about feeling full. Nobody is going to convince me that rice tastes succulent to a dog.

So what about backboards? Patients don’t buy the backboards they ride to the hospital on do they? Patients are the end users of the product, but EMS organizations make the decision which backboards to buy. It stands to reason that the backboards are probably designed more for the people who buy them than the people who use them.

You see where I’m going with this right?

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Connections

Sure you communicate with your patient, but do you make connections? The difference may sound like semantics … but it’s not. The difference is extraordinary.

Do you remember James Burke? He was the plucky, dry humored narrator of the 1970s BBC TV series “Connections”.  James would begin each episode with some historical event like the invention of the catapult and show how it was related to the way we make billiard balls or some other impossible sounding connection. His message was simple and profound. The big idea was that we are interconnected in ways that are complex and impossible to predict. Reality doesn’t flow forward in a perfect linear timeline.  An intricate web of human connections drive history and innovation forward.

Without one minor connection another crucial event becomes impossible. Alter one seemingly insignificant event and you change the course of history.

There is something vital in the way we are interconnected. When we connect, we change each other in ways that we can’t predict. If we simply communicate with our patients and coworkers but never reach out across that gap and connect with them, our work can become dull and routine. On the other side of the gap the patient / caregiver / human relationship is far more fulfilling.

If that sounds worthwhile, let me give you a few tips for making conscious connections with your patient.

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