Have you ever.....

[Niftymedi911]

With the paradigm shift of EMS moving from a protocol/standardized assessment approach to pure evidence based medicine, have you encountered a lot of resistance from administrators to accepting these changes vs. what currently works? I work for a small rural service that prides itself on its good reputation to provide excellent medical care. But, with this in mind, would they not want to follow the paradigm shift to provide the best? I started this conversation with my current employers and they couldn't answer me. I'm looking to see what the attitude of the general population of EMS thinks. Action Jackson

[chbare]

Evidence is a funny thing prone to errors, misinterpretation and bias. If the evidence is strong, reproducible and generally accepted then I'm quite willing to change. Unfortunately, the strength of evidence is quite debatable and sometimes to the neglect of progress, we must reject alternatives that may be better until additional data is available.

The most productive thing to discuss is what are you proposing to change and what evidence are you using to base your conclusions on?

[Niftymedi911]

C-Collar/LSB removal, Induced Hypothermia, removal of Atropine, Removal of Morphine, adding Ketamine, adding chemical restraint. Yes, we still use atropine. :/ It really is sad when the state EMS Board is too lazy to make they're own protocols/Guidelines they just copy and paste the one state that has the most restrictive. This all started after I was QA'd for not putting a C/P on 15 lpm NRB with no evidence of SOA. When I heard them say the ole mantra of "Everyone gets high flow oxygen". I could do nothing but *facepalm* Action Jackson

[paramedicmike]

What is "Action Jackson"?

What is "SOA"? Please don't say shortness of air. There is no shortness of air.

As for your question, I agree with CHBARE. I'm wondering, too, what evidence you took with you to present when raising these questions.

Edited July 2, 2013 by paramedicmike

[Niftymedi911]

What is "Action Jackson"? What is "SOA"? Please don't say shortness of air. There is no shortness of air. As for your question, I agree with CHBARE. I'm wondering, too, what evidence you took with you to present when raising these questions. Action Jackson is my term of endearment everyone calls me by. It was derived after a shift I had where I was first due to a plane crash and MCI bus crash @ 55 mph all in the same shift. SOA is an accepted term here in lieu of SOB. I'm used to using the term dyspnea myself, however after working 3 years in Kentucky I was sick of getting called an arrogant A hole because I used big words. So, thus why SOA. As far as evidence, 2010 AHA ACLS guidelines is a start for some of the stuff. However, I didn't even get that far. I was cut off in mid sentence and told no. Which is why I took to the masses to see what kind of atmosphere there was about it. I mean well with my posts and I do have the capability of putting all the studies that pertain to it as evidence. However, I am tad bit under the weather today and don't feel like it.

Dammit tapatalk is merging all of them together. Sorry for the jumbled mess.