I hate being ambushed.
The other day, I was having what I thought was a private IM conversation with a kid who’s interested in EMS. He’s not a bad kid; he’s excited about EMS and can’t wait to start his EMT-B class. However, he wants to change the world of EMS.
Good for him, we all have to have some lofty goals to shoot for, right?
Oh, did I mention he wants to change the world of EMS RIGHT NOW? With no absolutely EMS experience? He’s not an EMT. He’s never ridden on an Ambulance. Never touched a patient. Never been puked on or shit on or called an asshole by a patient he was trying to help. No experience.
Now, this kid is also enamored with the King County Medic One system. I know that some people think it’s the bee’s knees. I, having worked BLS in King County, am most decidedly NOT enamored with KCM1. Frankly, I think it sucks. That’s MY opinion. And, it’s valid because I’ve been part of both BLS and ALS level patient care there. I’m just not a fan. That’s a post for another day. Maybe.
This kid is also a fan of the “EMS 2.0” movement. Great. I’m all for making EMS a “real profession”. Should every prehospital care provider be degreed? Yep. Should we raise the standards for paramedic education? Yep. Agree and agree.
Here’s where we disagree. It’s my opinion that sick and injured people deserve prehospital paramedic level medicine, even if they’re not circling the drain. Sorry y’all. That’s how I feel. As an example, I think pain management is a huge issue that medics in King County will not touch. C’mon guys, It’s simple, fractures and other ortho injuries should have their pain managed by ALS providers. That’s what I believe. I think it’s what a caring, competent medic should do.
The kid replied, “In my opinion prehospital pain management is unnecessary because in ten, twenty, or thirty minutes the patient will be in the emergency department.”
Seriously? When your grandma is lying on the cold kitchen floor with a hip fracture following a fall, I hope you are there to explain why she’s not going to get any pain meds prior to being seen in the ED. Oh yeah, it’s because you believe that pain management isn’t important and we shouldn’t “waste” an ALS unit on something so insignificant. Seriously.
Timothy, I called you an idiot in my IM conversation, and that stands. I also stand by the statement that you need to gain some experience in the field, even as an EMT, before you start to judge what is right and wrong with EMS today. You need to see sick and injured people before you can make blanket statements about treatment modalities.
Earlier today, I was pretty pissed when I saw that this kid took a private conversation we had and turned it into blogfodder, than I remembered he’s just a goofy kid sitting at a PC in his mom’s basement typing away… and I realized I don’t give two shits about what he thinks.
Medic 22, thank you for taking the time to write your side of the story.
I was very very wrong about the amount of time it takes to get pain meds in the ED. One study showed it takes an average of 75 minutes after triage in the ED to get pain meds.
“As an example, I think pain management is a huge issue that medics in King County will not touch.”
KCM1 paramedic Michael Damm at King County Medic One has been trying to bring pain management to South King County for 11 years to no avail.
“Sorry Kevkei, I forgot to address your last paragraph “DAMMEDIC, Although your MD may be correct that nobody has ever died from pain, I must say they are not a patient advocate and I am curious if they would say the same thing if they or their family were picked up and didn’t receive adequate analgesia. It’s always okay for them as long as they aren’t the one affected.”
I can’t agree more with you! I have been battling this topic for 7 years to no avail. At one point we had our agency MD on board yet the other program MDs in the county voted against it! Again, “nobody ever died of pain” was just one reason. Another was/is the potential abuse issue, especially with fentanyl compounded by the fear ketamine could be stolen off the trucks by youngsters for their Rave parties. Subsequently, our patients receive a proper induction via etomidate but very infrequently the administration of diazepam and morphine post intubation (only a few of us religiously use the agents). What you end up with is a patient who doesn’t remember undergoing paralysis and intubation but wakes up being paralyzed and intubated on a bumpy ride to the hospital.”
“He’s never ridden on an Ambulance. Never touched a patient.” Since when is doing CPR during a Medic One ride along not considered touching a patient and not riding on an ambulance?
Tim, unfortunately what you have proven is that KCM1 is an agency that is afraid to let their medics treat, not that they are the best in the country.
Doing CPR one time and having a few ride alongs is not the same as working the streets. I’m sorry.
I added to the discussion, medicthree.com
Thanks for chiming in M3. I’ll admit, I did get a little hot over this topic, but I find it frankly insulting that Timothy can criticize ALS patient care without any experience. The Zofran for nausea or Morphine for pain are two simple ALS procedures that we can and should use to care for our patients. Thom Dick said, “they don’t remember your medicine, they remember how you made them feel.” If we treat all of our patients with compassion, treat them as if they were family, then we are always doing the right thing.
“Tim, unfortunately what you have proven is that KCM1 is an agency that is afraid to let their medics treat, not that they are the best in the country.”
I now understand that KCM1 isn’t all it’s cracked up to be.
“they don’t remember your medicine, they remember how you made them feel.”
Great quote. Remember to say that the next time a kid in his mom’s base basement says prehospital pain management is waste of time.
Tim, unfortunately what you have proven is that KCM1 is an agency that is afraid to let their medics treat, not that they are the best in the country.
Doing CPR one time and having a few ride alongs is not the same as working the streets. I’m sorry.
“Tim, unfortunately what you have proven is that KCM1 is an agency that is afraid to let their medics treat, not that they are the best in the country.”
I now understand that KCM1 isn’t all it’s cracked up to be.
“they don’t remember your medicine, they remember how you made them feel.”
Great quote. Remember to say that the next time a kid in his mom’s base basement says prehospital pain management is waste of time.