As a side note, I recently had the pleasure of having Greg Friese, the Editor of EMS1.com in a class. I would ask everyone to please check out this website for information, updates, news and innovations in EMS. EMS1.com
Many years ago, I noticed that when my mother brought bread home from the store, she took the heels and threw them away. When I asked her why, she said that’s what her mom always did. When I asked Grandma, she gave the same statement. I was lucky enough to know my great-grandmother and asked her. She said “Because my breadbox was too small.”
How many things do we do in EMS, or in life, because it was always done this way?
Red Lights & Sirens – How many times do we drive to scenes with out hair on fire to find out that minutes really do not count. As well trained responders, we can provide care to our patients immediately upon our arrival. In reality, how many of those illnesses or injuries would be adversely affected with a minute or two delay in response. Many times we find that they’ve been ill for hours, or not really an emergency. We drive to our scenes hot because of the anecdotal cases of something being far worse than described by the dispatcher. Racing to the “Help I’ve Fallen” cases puts us and everyone around us at risk as we rush to help. Our very first lesson in first aid was “Keep yourself safe.” Have we?
Stand them on their head – For many years, we placed shock patients with their feet elevated. When I’ve discussed Shock in detail a few months ago, I covered that our problem can be found in the lungs, pump, fluid and pipes. We have to fix the underlying problem to cure the shock, and many times this takes a surgeon. In reality, they are already compromised and placing them upside down will only make things more difficult. Simply laying them down will help alleviate the forces of gravity on their circulation without putting undue pressure on the head or central organs.
Realign the bones – For years we’ve been using traction splints to move fractured femurs back in alignment. We’ve been taught that the movement of bones can cause internal bleeding, and it is possible. Moving the jagged edges of one of the largest bones in the body, near one of the most important arteries can only lead to problems. Splinting the bone to prevent it from moving and rapidly transporting is our best option. If the alignment does cut the artery, the patient will exsanguinate before we can get further help.
KED immobilization – If we wish to immobilize our patient prior to extrication, the KED board only gives a false sense of security. We are further to save the time needed to properly attach the short immobilization device and use manual methods to ensure alignment as we move them to a full body stabilization method. When we use the KED, the hips can still rotate, and these rotational forces can be transmitted throughout the back to the point of suspected injury. If we avoid the KED, we will likely be more careful and thus can ensure that the rotation occurs as a whole unit.
There are many things that we have done because of the generations before. If you have practices that you know are outdated, please comment below.