Technology in EMS and the future of final destinations
Disclaimer: This is my opinion and does not reflect the view of any entity that I trade time for cash with. Everything is meant for educational food for thought and you should always “follow your protocols.”
With the addition of apps, machines, and bilingual phone-a-friends; new toys are being brought into the fold at an increasing pace. We need to enlighten ourselves and learn to integrate this new equipment for the betterment of our patients. This also allows us to ease the cognitive load on calls or expedite operations. In addition, I want to expound on the shiny new directives involving choices of destination. These baby steps are welcomed, but I want to go into why we also need to be careful when proceeding.
“There’s an app for that.” is our new normal when searching for an answer to a specific problem. Today, we live in a technology-infused world, and such tech is being developed by the nanosecond. With products like metal murder pups and diet robocops on the market, we need to mesh this new technology, or it will leave us behind. Maybe not those specific things, but you get the drift. Cue all the Terminator quotes about Skynet.
These lexicons of medical information such as protocols have been historically printed to have an apocalypse-proof fail-safe way, at any hour, to search its spine for the spell needed to play paramagician in the field. The problem with this printed tomb of choices is that it needs constant care and feeding. Changes to protocols, dosing, concentration, or operations can require an entire army of ditch doctors to update their books and thus require a small garden of baby trees to print those pages.
Some people say, what’s not to like when you have an app at your fingertips that you can command to rummage around its memory banks to recall a particular guideline or chart at a moment’s notice? Well, for starters, to access its wealth of knowledge, a learning curve must be triumphed, then locate a phone with charged batteries, and have that phone on your person in your time of need to access its wealth of knowledge. Seems silly, but an app you don’t have the time to explore is akin to a rifle you only shoot once a year. As far as we know, the initial roll-out will be placed on company devices, but I have heard that eventually everyone will be given the golden ticket. Looks like I will be getting more use of the reading glasses I am supposed to be wearing these days when trying to read the small text. I might invest in a larger thingamajig in the future if it becomes an issue.
Hopefully, this app will not only include protocols but also other items like calculators and other references to add additional value. The only real limit is the budget of those involved, which unfortunately is held tighter than a BVM adapter on an AirQ. So, I won’t hold my breath.
When the live date is reached, I welcome the transition to the NASEMSO protocols as they have been vetted by various people who would in theory be on the leading edge of medicine. Cautiously optimistic in the sense that all things can suffer from death by committee but should be better than what we have now. Using cookie-cutter guidelines can be a double-edged sword, so whether they are adopted in part or whole is uncertain. Since we like the dark ages of active medical direction, I think we all can call this a win. Well, maybe more of a participation trophy than a win, but still progress.
Next on the agenda are the machines of convenience. While I do not hate the fact they exist, it does ruffle one’s feathers that they would choose this item over other things great that would benefit patients directly. I am sure various factors came into play like grant stipulations or other random “red tape,” so I don’t give full blame, but some people must wonder about their priorities. Other items of the “desert variety” that magically appeared previously did solve a problem but seemed more like a poorly implemented knee-jerk reaction to an event than a pressing need in my opinion.
These new sorting boxes will allow us to acquire things that would normally require a pilgrimage to the motherland so that the desk troll can ask us three riddles before obtaining our packages of life. Annoying? Yes. Especially those for the far-out lands in the west that much pass through the junctional labyrinth to reach green pastures. The spice can now flow more freely between the tribes cutting out the middleman/women/they/them and allowing us to keep fighting the good fight. Be sure to heed the witching hours of these boxes and don’t get greedy or you will have to feed the beast and face the wrath of your middle manager.
While on this topic, I have this soapbox over here that I need to stand for a minute and say a couple of words. This soapbox, unlike the sorting box, is not that tall so don’t fret. When the sorting box was put into place, the overseers removed some items from the catalog, because they would now be obtained from the box. No problem there, can’t have people ordering things when the princess is in another castle. The issue though is the fact that they didn’t tell anyone. Most of the troops on the ground only received word when someone from an outpost with a box noticed and subsequently conveyed those items were in there.
I understand the sad fact that most people are just lemmings of the system. I wish it weren’t so, but day laborers working on the boo-boo bus just don’t care about such structure and form. This is blatantly displayed by the lack of care and feeding of all the different species of meat wagon that is within our pervue. Conversely, some of us who strive to be “keepers of the craft” take notice of such things, and become disheartened when we have to find afterward. The lack of communication when the catalog changes, non-existent roll-outs, or simple operational changes. It’s disappointing and I hope in the future “we” become more forthcoming and use some decentralized leadership to allow officers to get buy-in and be officers.
“There are no bad teams, only bad leaders.” - Jocko Willink
Over the past couple of years, we just spent in the paramagician dark ages, we have been reduced to hundreds of small silos of knowledge, all different in both scope and intensity. Previously, people would say we have Western and Eastern medicine within the boroughs, but I say it is much more divided than that. Teams are like boxes of chocolate as Forest would say.
Moving on before my BP goes up, I would like to give an honorable mention to the babble fish that was given to us recently. Put it in your phone (Personal and Company) and please use it while at work. (I say personal because some of the company phones’ audio is worse than teachers in those Charlie Brown cartoons.) I have used the fish a couple of times with great success. There should be no reason to not have patient info.
“DO IT NOW” - Arnold Schwarzenegger
The last checkpoint on this party bus is the whack-a-mole game we play with hospitals. This dichotomy of the customers having the right to make bad decisions and the need to keep units available for the next bat phone call is the eternal struggle. We have been blessed with the authority from the overseer to say nay or to allow passage to only the most adjacent healer in the land. Aside from the fine print that exists in all good legal contracts, this is a step in the right direction. While I don’t like the process of gently pushing the needle, I understand the reasoning. Villagers with pitchforks would be crossing the countryside and we can’t have that.
When fighting the good fight, please be careful in making these decrees and becoming the final mediator. Ultimately, be a patient advocate and don’t just read into the letter of the law. As any good lawyer would say on xyz decision, it depends, and so does the right answer to any of these choices as well. I am all for giving the M.A.S.H. huts these companies have decided to place around the city a run for their money, but we must do so in good conscience.
Wrapping up this word vomit with a few parting phlegm notes. Integrate with the time and let technology be your friend, not your enemy. Communicate more. Whether it be training, operations, or scene management; we can all improve on letting people know what’s going on or what we want done. That’s me included. I am a megaton better than when I first started, but this marathon isn’t over yet.
Sorry for the long break. Lots of good and bad excuses, but I take extreme ownership and vow to do better. I am doing this for my self-improvement, but if some of you like this content as well, that’s cool too. I will sign off with a favorite quote from a really smart cookie.
“Don’t study to pass the test……. Study to not fail your patient in the exam of real life.” - Sean Smith
