I am in the middle of transitioning from one position to another.
It’s crazy times: new organization, new responsibilities, and new location. It’s also a good time to sort through a bunch of books, papers and other “historical” items (read: junk) to determine what stays and what can go to the circular file.
In this pile are a stack of three paramedic textbooks that I used in 1985. The main text is 583 pages long. I remembered how hard it was to master all of that information over the course of the training!
Sitting next to these “historical items” is a pile of textbooks that the program I will be teaching is using this fall. There are seven textbooks; the main one is nearly 1500 pages.
The length of the course is only an additional eight months. The volume of information really is incredible, resulting in an entry paramedic that is much more sophisticated than in years past. The increased quantity of information also creates a situation where the responsibility level also rises.
Along with the changes in primary education, there have been efforts to reduce medical errors in healthcare. The Institute of Medicine report “To Err is Human” points out the frequency of death and injury sustained by patients while in someone’s care. Of the many reasons cited by the report, the volume of data and the inability to recall certain facts and concepts stand out as two areas where we could improve reliability and reduce error.
What I am referring to is the need to have system protocols nearby when working with patients. Where I currently work ambulance shifts, we have three-ring binders in the units that we can refer to when necessary.
For me, that’s fairly often. Drug regiments, dosages, transport destinations, disaster management — it’s much more difficult for me to retain this volume of info these days. And really, do I need to? I’d rather have a backup in place than have to totally depend upon my memory to perform my job.
Of course, books can get fairly ratty and cumbersome to use in the back of a moving rig; it’s also inconvenient inside the patient scene. Now, there is an app for this: Paramedic Protocol Provider by Acid Remap.
Designed for an iPhone or iPad, this nifty little program downloads clinical protocols from all over the country. I currently have three California Counties loaded in my app, and it updates automatically when new protocols are uploaded.
I can add my own notes and there are quick links to national data centers such as CHEMTREC or the poison control center. It’s simple, elegant and intuitive to use, which is perfect in one of those hair-raising situations when it’s tough to remember some arcane drug dosage or policy.
As EMS continues to evolve in complexity and sophistication, the ability to recall vast amounts of data becomes a greater challenge. It becomes paramount that we as providers are comfortable using a variety of tools to help us perform our job better.
