I do my best to stay on top of trends and innovation in EMS; it is part of my job after all. The 2014 wave of Narcan for everyone and increasing inclusion of TXA in treatment protocols for severe hemorrhage did not sneak up on me. Following the news, inside EMS and in the broader world of healthcare, had me ready for the rapid expansion of public access epinephrine for anaphylactic reactions and the search for EpiPen alternatives.
All to say this news, prehospital administration of P2Y12 inhibitor by a N.J. MICU, caught me off guard. I immediately went to Google to research the what, how, and why of the P2Y12 inhibitor (unfortunately it is not a droid for moisture farmers) and reached out to members of the EMS1 editorial advisory board for their insights.
Credit goes to the Hunterdon Medical Center’s Mobile Intensive Care Unit for identifying an opportunity to improve STEMI patient care, presenting their case to the N.J. Department of Health Mobile Intensive Care Unit Medical Advisory Council (MAC), and standing up the protocol revision. We will watch for news of improved patient outcomes, as well as the adoption of this drug by other prehospital care agencies.
Medicine is dynamic
I am regularly reminded that medicine is dynamic. The things we used to do for patients - like oxygen for everyone - we no longer do. The 2018 National EMS Scope of Practice model will shape the next generation of EMTs and paramedics, while refining the protocols of already practicing EMS professionals.
This is what I do to stay up-to-date as a paramedic.
1. Keep an open mind
Some of what I learned in my initial training, like spinal immobilization based on the patient’s mechanism of injury, is no longer the standard of care. Though the evidence of what we should be doing might not be any stronger than what we have been doing, I strive open-mindedminded to new treatment practices, like ketamine for prehospital analgesia.
2. Read, listen, and view everyday
While I was in graduate school at the University of Idaho the associate dean told me, “If you read the literature of your field 30 minutes per day you will be in the top five percent of your field.”
We have unprecedented access to emergency medicine information. Take advantage of it in all of its forms - instructional videos, peer-reviewed journal articles, tips and resources, first-person accounts, podcasts, other media and participate in the FOAMed movement.
3. Learn continuously
I believe the recertification guidelines and licensure guidelines give us the latitude to pick continuous learning over education refreshing. The hours required are not maximums. They are the minimum or foundation for continuous learning. Build off of any service or state required learning activities with your own reading, listening, and viewing.
4. Get involved in the future of ems
I didn’t meet Jim Page, but I have heard many people say one of his favorite sayings was, “The decisions get made by the people that show up.”
Committees, task forces, councils and other opportunities for participation and input are forming all the time. The EMS Compass Initiative asked for our input on performance measures. The AHA asked for comments on the upcoming CPR guidelines. My state EMS advisory board regularly solicits for members. NAEMT has regular opportunities for state advocacy coordinators and committee positions.
Find an opportunity, outside your agency or department, to get involved in EMS. You will expand your professional network, find new opportunities, and understand EMS in a larger context.
5. Go deep into an EMS niche
As you read, view, listen, and participate, what aspect of EMS is of most interest to you? Pick an area of EMS where you want to go deep. Look to our EMS1 columnists to see where others have become the experts in our field. Bryan Fass has put in the work to become the expert in EMS fitness. Patrick Lickiss leverages his interest in quality care and education to write informative and useful patient assessment and treatment scenarios. Steve Whitehead is focused on all of us delivering artful and compassionate care for our patients. And we can’t forget the number of paramedics that defend, protect, and regulate as attorneys.
I am sure there will be another trend or innovation that will sneak up on me. When it does I will be ready to learn about it, reach out to experts for help, and share that information with others. Because that is how I have gone deep as a paramedic.
This article, originally published June 12, 2015, has been updated.
