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At The EMT Spot, there is an excellent discussion of phrases that are used, and abused, by those of us in EMS. Here are some of these begging to be banished phrases, a few of which I view a bit differently.
“We can do this the easy way or the hard way.”
There are two reasons I dislike this tough-guy approach to patient transport. While the statement is true, it rarely convinces people to go the easy way. Something in our human DNA makes us want to rise to a challenge and this phrase is often interpreted as a challenge.[1]
You are screwed, but since I have a bunch of people to back me up, I Double Dog Dare you. Come at my army, Bro.
This may produce a response, but not a cooperative response.
Are we looking for a cooperative response, or are we looking for an excuse to play rodeo?
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“Paramedics save lives. EMT’s save paramedics.”[1]
This is one of the reasons I listen to my partner, when a suggestion is made. Sometimes they see something I do not and sometimes, they will not be distracted by something that distracts me.
I know some medics who claim that everything is their responsibility, so they will not let a basic EMT interfere with their decisions, but this is silly. We still make the final decision, but artificially limiting the information we use to make that decision is not a good idea.
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“Based on the mechanism of injury…”
Mechanism of injury should raise our index of suspicion. It should alert us to the possibility of injury. It should not dictate our clinical care.[1]
The Mechanism Of Injury is not the injury.
The Mechanism Of Injury is only a clue to what might be injured.
Might be -
What if . . . ?
We are supposed to ignore assessment of patients -
we are trained to assess patients -
and treat based on our assessment of vehicular damage –
but we are not trained to estimate vehicular damage.
What kind of damage equals what amount of kinetic energy delivered to an occupant?
What if the occupant is restrained?
What if the occupant is restrained and an airbag deployed?
What if the occupant is not restrained and an airbag deployed?
What if the occupant is restrained and no airbag deployed?
These are things that we should consider, but they are rarely part of Mechanism Of Injury considerations.
What about crumple zones?
Crumple zones deform to sacrifice the vehicle to protect the occupants, so they are supposed to result in a totaled vehicle, but occupants who are not injured, or occupants who only have minor injuries.
Do we provide pain management based only on mechanism of injury?
Of course not. That would be bad patient care.
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“Pain never killed anyone.”
I hate the guts out of this phrase. And I’m embarrassed to say that it recently came out of the mouth of one of my EMS mentors. I get the truth in the statement and it’s worth considering when we talk about the prioritization of care.[1]
What truth?
For anyone who claims that pain never killed anyone, there is one obvious response -
Prove it.[2]
Why does anyone believe that pain cannot kill?
Wishful thinking?
Ignorance?
Willful self-deception?
We like to be able to justify the damage we do to patients.
It’s only pain.
For most of us, it is only pain when it is someone else’s pain.
We are using cognitive dissonance,[3] when we pretend that we are doing something good for patients when we are torturing them.
It is too dangerous to treat the pain.
Is it dangerous to treat pain if we are not competent at pain management.
If we are not competent at pain management, why should anyone trust us with any patient care?
We do cause harm in EMS, but we come up with excuses that allow us to feel that we are not really causing harm.
I only do good.
I was only following protocol.
Pain never killed anyone.
These are all deceptions.
Why can’t we tell ourselves the truth?
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Footnotes:
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[1] Six EMS Phrases That Should Be Banished
July 27, 2012
The EMT Spot
Steve Whitehead
Article
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[2] EMS Garage Rant – Prehospital Pain Management
Rogue Medic
Fri, 24 Sep 2010
Article
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[3] Cognitive dissonance
Wikipedia
Article
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