… Gene Gandy and I have a new article in EMS World Magazine.
Gotta give props to Gene, who did most of the heavy lifting in this one.
Gene Gandy and Ambulance Driver, deconstructing EMS one myth at a time…
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When I trained retrievers professionally, I used to get a steady stream of business from members of the By Gosh and By Gum Club, whose club motto went something like, “By gosh, it seemed like a good ideer, so by gum, that’s the way I done it.”
They were the guys who thought the way to introduce their Lab pup to gunfire was to take him out to the gun range and tie him to the truck bumper while everyone shot, or throw their pups in the lake to teach them to swim.
God bless those guys, because I made a fair bit of money teaching their traumatized pups not to fear gunfire or water.
It was pretty rough on the poor dogs, though. And sometimes, the damage was too great to repair.
In those cases, a few of the club members dropped their memberships and looked for better ways to do things, but many just blamed the failure on their dogs or the trainer they hired to clean up their mess, and went on to traumatize other dogs and plague other pro trainers.
It occurs to me that the By Gosh and By Gum Club has chapters in every EMS system in the country.
By gosh, that’s what was in the textbook, so by gum it must be right.”
What they never realize is that a whole bunch of that textbook was written by an earlier generation of the By Gosh and By Gum Club.
“By gosh, it stands to figger that a feller with a broke neck ought not to move it, so by gum we’ll strap ‘em to a board to make shore that don’t happen.”
Some of them learn better and drop their club membership, but others will continue to do things the same way the rest of their careers, ignoring every piece of evidence that shows theirs was the wrong way.
Still just as rough on the patients as it was on the dogs, though.
My writing partner Gene Gandy and I are planning a new series of monthly articles in EMS World Magazine.
Each month, Gene and I are going to take on a particular piece of EMS dogma, myth or obsolete clinical practice, and subject it to the withering scrutiny of current research.
We're still working on the series title, and we're compiling a list of topics now.
That's where you guys come in.
What EMS practices do you think belong in the dustbin of history, next to the discarded Chokesavers, rotating tourniquets and PASG? What is the prophylactic lidocaine, sublingual Procardia or coma cocktail of today? What dogma do you see perpetuated even now, despite all evidence to the contrary?
WHAT PRECIOUSLY HELD SUPERSTITION, MYTH, CLINCIAL OR ADMINISTRATIVE PRACTICE, OR EMS URBAN LEGEND SHALL WE SLAUGHTER FOR YOU, DISMEMBER, AND FESTOON OUR BEDCHAMBERS WITH ITS BLOODY ENTRAILS?
All you have to do is, um, you know, chime in with your comments.
We'll get right on it.
Here on the blog and in various other EMS forums, I frequently challenge conventional wisdom on the care we provide. Other bloggers, like Rogue Medic, do it better, and more extensively.
And in the responses to most of those missives, invariably there are a few who indignantly splutter, "B-b-but, that's not the way we learned it!"
I'ver said it before and I will say it again: The only constant in the practice of medical care is that it will change. We are continually evolving.
In her book, Declarations of a Dinosaur: 10 Things I've Learned As a Family Doctor, Dr. Lucy Hornstein writes, "Half of what is taught in medical school is wrong, but no one knows which half."
The same statement applies to paramedic education. Half of what we are taught is wrong, but you won't know which half until you've been in the field a few years.
And in that vein, everything we were taught about treating sickle cell crisis was wrong, too.
If your continuing education only consists of the crap regurgitated in refreshers every couple of years, you're doomed to repeating the treatment mistakes of the past.
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