A Challenge for the Industry

Tucked away in the back of the EMS Today Exhibit Hall was a board surrounded by a number of Post-Its bearing the question “What is the BIGGEST CHALLENGE in the EMS Industry?”  There were a number of responses on the board including head scratchers such as the one that stated standards should be lowered for volunteer providers, and no that was not my “trolling” submission.  Mine, unfortunately, did not make the final copy of the board, but I think that it needs to be delved into so what better place to do that than my little corner of the internet?

My response was a simple one but an important one for all of us to remember.  My Post-It read “Stop being afraid to fail.”  We are so dead set on our own success that we are content with staying in a safe area of development in our industry.  Why try something new?  What if it does not work?  What if I do it wrong?  What if I cannot do it well?  What if somebody dies?  The answer to all of these questions are simple.  Respectively they read like this: our industry will not progress; dust off and try something else; practice more you’ll get it; again, practice; and finally, people die.  We cannot prevent that.

When looking at some of the most successful people and industries one will find that many, many people have more misses than hits.  Take me, for example.  My first choice of where to spend my career, which I thought at one point that I would never leave, was not the right fit for me.  I’ve tried other blog ventures, and had two or three that never got off the ground before I even started writing on the pages that you are reading today.  I’ve invested time in countless projects that just did not work out.  All together though, the things that I put my heart into that have worked are in my eyes pretty successful.

Even great inventors such as Thomas Edison, who held over 1,000  patents for his inventions had more than his fair share of failures.  Throughout his lifetime, he tried to invent devices that could project motion pictures, an automatic vote recorder, and a way to effectively mine and separate ore were some of his most notable misses.  The bottom line is failure happens.

It seems to almost be a universal character flaw in our industry that we are petrified of failure or more specifically having our shortcomings pointed out to us.  I am no exception to this role.  I cant even count the number of times I walked away thinking to myself, “How dare they question my care?” or “they have no idea of the barriers that I deal with in the field.”

One prime example that comes to mind was a shooting that I helped a crew with a number of years ago that occurred at the end of the driveway for our trauma center.  The patient was shot multiple times with a large caliber firearm and was unresponsive but still breathing with a pulse.  Re rapidly extricated him, moved into the truck, and cut off as much clothing as we could in the 90 second transport time to the ER doors.  Instead of the usual radio report, they got a call from our dispatch center to relay our message of, “tell them we are coming, he’s shot multiple times, and I have nothing else for them.”

It was one of the messiest traumas that I delivered in my years in that system, and the trauma attending, when he arrived, was angry that there was not much done and more specifically, he was mad that EMS did not do more before arriving at the ER.  We explained to him as clearly as we could that we came from the end of the driveway.  It took a little convincing from the ER attending who we worked with far more often that we had done all that we could.  I think that he finally got the picture when they locked down the ER due to the proximity of the incident.

In all seriousness though, we, as an industry, need to find a way to break out of the safe zone that we currently find ourselves in.  Five years ago, I felt that we were challenging ourselves and trending in a positive direction but I cannot help but feel that we have plateaued on many levels.  Our conferences have become homogenous and repetitive, and we still have yet to fully embrace anything that resembles evidence based medicine, or more appropriately in a term that I heard last week at EMS Today, knowledge based medicine.  We are so much more apt to rely on anecdote than we are what studies and evidence shows us.

Until we can start looking at certain things that we do as an industry and admitting to ourselves that there are things that don’t work, and things that we must do better, we will continue in this vicious circle that leaves us operating in a vacuum while the rest of the medical industry looks down on us and passes us by, which brings me to my final point.

In order to figure out what we are not good at, we have to have some kind of idea of what we even do, and how we perform, and no I’m not talking about a diesel bolus evaluation of response times.  It comes down to patient treatment, and its impact on outcomes.  The only way that we can learn that is by taking a trip down the rabbit hole to take a hard look at what statistics and benchmarks can be valuable to our services as well as our industry.

Dare to question the quality of care that you provide, dare to be willing to fail, and dare to strive for something better.  That is really the best thing that we can do for the future of our industry.

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