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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5 Big Trauma Scene Mistakes You Can Avoid

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 six 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 six, “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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