How Does Increased Education Alter Treatments?

[AnthonyM83]

One of the most common questions I hear when discussing increased EMS education is how will that affect what providers do in the field?

What are some good ways of explaining this? This question isn't just coming from lazy providers, rather from intelligent people who always have their face in a medical or EMS book because they like knowing.

I'm looking for overall explanations as well as specific examples that could be helpful for those asking that question.

[JakeEMTP]

I truly believe that a higher educated provider can make a more thorough assessment of the patient and confidently treat the patient based on said assessment. Instead of following the "Cookbook" with the "patient presents like this, do this" or "Mother may I" mentality ( not saying protocol shouldn't be followed, more that one doesn't necessarily have to follow the complete algorithm, just because).

I also believe because of the more indepth study of the material ie: A & P, we tend to understand what is going on with our patients a little more. The classes that were in my programme, and I can only speak from my experience, were geared to make me a more well rounded provider. The English classes for example help me write better narratives and assist with grant writing ( which I was Army Volunteered for :wink:).

I really don't know how to answer your question. I cannot see why providers would not want to increase their education on their own merit or see the benefit of it. I had the option of going the certificate route or the degree route. The choice for me was simple, the latter. I realise not everyone has that option based on geographical region and it is a shame, and quite frankly a disgrace.

[aussiephil]

EMS is & always will be a thinking profession.

To that end, providers should always be looking at what their knowledge base is, & how it can be improved.

Having said that, it is how they personally apply the knowledge in the field with their patient that is relevant. It will affect some of their decisions, but ultimately, the protocol, or should they be more aptly named guideline, will be the driving force for treatment.

For example, in my service i have a protocol for vomiting, it says to give an anti emetic, it lists a choice of 2 anti emetics I can use. But should I give an anti emetic to every vomiting patient? No I shouldnt. Should I rush to my drug kit for it. No way.

However, I have a patient post MVA, presenting with neuro-motor defecits, is being treated for spinal injuries, but has no nausea, will I give them an anti emetic, just in case - I would certainly hope so.

Anthony, to answer your question, there is no answer, it is an individual thing, some people will take what they have learned & try to over treat, others, no matter what they learn will always undertreat.

Phil

[AZCEP]

The simple way to explain it is education allows for better decision making as to what treatment does/does not need to be performed.

Example: Patient complains of generalized pain. Do you need to use a medication to relieve it, or will positioning work just as well? How about what type of medication? A narcotic, or perhaps an anti-histamine? Does this patient come from an environment that frowns on medication use at all?

There are so many different angles to take on a given patient situation that an educated provider will be better equipped to look at.

[irme]

To me the magic of education amplifies your ability to use inclusive medicine treatments and examinations coupled with evidence based medicine to make better clinical judgements. One example I constantly see in relation to this is MI’s in females. The “textbook” chest pain patient was originally based on male patients ignoring female MI’s.

As a well educated paramedic you have clinical judgement that when you have a pt with epigastric chest pain and vomiting you wont immediately say “oh here is abdo pain”. Instead you have that realisation that pain around the body is often referred and that to assume it is abdo pain goes against every ounce of higher education training you have been given.

Lack of EMS education is negligence via ignorance – that doesn’t make it ok!

[AnthonyM83]

The answer I usually gives is that it allows you to do better decision making when you come upon a situation where there's no protocol for it or you're not sure which protocol it falls under because it's so similar to more than one.

I'm especially interested in why we have to know things so in-depth. For example, how does knowing the organelles of a cell alter our treatment in the field?

It seems to be in-depth biology education that people often question (even those who enjoy the education itself). How does it alter treatment/behavior in the field?

[craig]

EMS is & always will be a thinking profession.

To that end, providers should always be looking at what their knowledge base is, & how it can be improved.

Having said that, it is how they personally apply the knowledge in the field with their patient that is relevant. It will affect some of their decisions, but ultimately, the protocol, or should they be more aptly named guideline, will be the driving force for treatment.

For example, in my service i have a protocol for vomiting, it says to give an anti emetic, it lists a choice of 2 anti emetics I can use. But should I give an anti emetic to every vomiting patient? No I shouldnt. Should I rush to my drug kit for it. No way.

However, I have a patient post MVA, presenting with neuro-motor defecits, is being treated for spinal injuries, but has no nausea, will I give them an anti emetic, just in case - I would certainly hope so.

Anthony, to answer your question, there is no answer, it is an individual thing, some people will take what they have learned & try to over treat, others, no matter what they learn will always undertreat.

Phil

Just to set the record straight, they are PROTOCOLS not GUIDLINES. by the implacation that they are guidlines also takes away the security of the authorisation of the states medical advisory committee.

by having Protocols (even though we can alter them and report the changes in an variation to protocol form) keeps the STANDARD of treatment that the public expects and deserves.

using your analagy of the vomiting protocol, I remenber last week that we had a female that had an ovarian cyst. she was in pain and had morphine at the local coutry hospital prior to transport to the City base hospital.

Now this patient with the abdo pain from the ovarian cyst and the morphine felt a little nauseous (as one would expect) but had not and did not feel like she was to about to vomit.

however it was sugested by an officer on the car that he would give her some metaclopramide for the trip. when it was pointed out to him that it was not in the protocols scope or SOP, he said that it would be a benift for her (really said "but isnt she vomiting" :wink: )

It was even pointed out to him by the nursing sister on duty that even she could not administer the maxalon untill the patient had started to vomit.

yes Phil, education can and is a good thing, but people must also realise that although they may have a higher level of education than others (or even percieve that) that this does not always translate into the ability to make rational decisions and get that knowledge to the 'finger tips', we all know of people that carry out interventions an drug administration because they CAN, not becuase it is the best thing.

stay safe

Craig

PS

you are not 19

people know where you are from

and you have been in the industry for almost 4 years so you may need to update you bio

[craig]

Protocols are there for the C.A.R.E principal.

remember this and you will be alright

stay safe

craig

[jsadin]

Ummm...if we become more educated then maybe our protocols will change to guidelines.

I know in some systems this is already the case (although not in The Peoples Republic of Massachusetts).

[mshow00]

[quote="craig

Just to set the record straight, they are PROTOCOLS not GUIDLINES. by the implacation that they are guidlines also takes away the security of the authorisation of the states medical advisory committee.

by having Protocols (even though we can alter them and report the changes in an variation to protocol form) keeps the STANDARD of treatment that the public expects and deserves.