2016: Can I get a do-over?
Although the Ambulance Driver had a year he wants to forget, there are five noteworthy events in EMS propelling us into 2017
Dear Santa, you know what I’d really like for Christmas?
A do-over. I’d like to start over at Jan. 1, 2016, and just take a mulligan on this entire freaking year.
Not only did we lose a bright light like EMS educator Rich Beebe, 2016 also saw the deaths of my childhood heroes like John Glenn, to talented artists who entertained us, like David Bowie, Harper Lee, Prince, Alan Rickman, Glenn Frey, Ron Glass and many others. Honestly, it’s enough to make a guy want to attend a midnight screening of Die Hard in Winslow, Ariz., while dressed like Ziggy Stardust, and mournfully sing Purple Rain as Hans Grüber plunges from Nakatomi Plaza.
Except, I’d probably go to the Special Hell that Shepherd Book warned us about, the one reserved for child molesters and people who talk at movies.
If you don’t get all those references, kiddies, just ask your parents.
But there were also notable EMS events aplenty in 2016. Here are five of the most important:
I’m talking about Point Of Care Ultra Sound, a technology that is becoming increasingly affordable and adopted by a growing number of EMS agencies across the country. With a little training, an EMS provider can use ultrasound to do everything from spot cardiac wall motion to help us distinguish true PEA and asystole from the impostors, to guiding our difficult IV sticks, to spotting subtle signs of obstetrical emergencies, to just increasing our diagnostic capability in general. Prehospital ultrasound has the potential to transform what we do, and we’re still discovering new and useful applications.
EMS Compass Initiative
For all too long, we’ve wrestled with the question, "What makes a good EMS system?" Is it cardiac arrest survival? Response times? Public opinion and goodwill? Level of service? System design?"
It’s a truism in our profession that if you’ve seen one EMS system … you’ve seen one EMS system. The advancement of our profession has long been hindered by the fact that there are no universally accepted benchmarks for system performance. Heck, most of us don’t know how well our own system functions, much less how we compare to the rubes in the next county.
With the EMS Compass Initiative, real progress has been made toward establishing a set of useful performance benchmarks based upon a consensus of EMS industry leaders. And now that we’ve got something to shoot for, we can set goals on how to get there.
And, hopefully, set even higher benchmarks once we’ve attained those goals.
Remember the good old days when really hardcore addicts used horse tranquilizers, and you could recognize you were in a meth lab by the smell?
Now, a horse tranquilizer like ketamine has proven to be an EMS sedative and analgesic agent with a much safer effect profile than our mainstay drugs like fentanyl and midazolam, and the hardcore addicts are using elephant tranquilizers. Heroin laced with carfentanil is cropping up in major cities across the U.S., and has transformed routine overdose calls into hazmat operations. Carfentanil can be easily absorbed through the skin or inhaled, and at 10,000 times the potency of morphine, poses a real safety risk to EMS providers.
And unlike the meth lab, often the first clue you’ve been exposed to carfentanil is the respiratory depression or arrest.
EMS agencies across the country have seen huge spikes in opiate overdoses, and have taken extraordinary measures to combat the epidemic. From EMT and layperson use of naloxone to legal shoot houses in heroin hotbeds, we now live in a country where it is easier to get naloxone for your addicted loved one than it is to get Sudafed for their cold. Some medical leaders are even laying part of the blame at the feet of the Joint Commission’s aggressive pain management standards, although the Joint Commission disputes this.
Whatever the reason or who is to blame, the opioid epidemic has the potential to shape our culture for years or generations to come. This begs the question, "Is it time we declared an armistice in the War On Drugs?"
Because if we aren’t outright losing the war, we’re at least at a stalemate and the definition of insanity is continuing to do the same thing over and over, expecting a different result.
Whether it be the growing number of people advocating for EMS provider mental health support, or EMS agencies providing body armor for crews, to more stringent ambulance design and construction standards, EMS provider health and safety remains a hot topic.
And all those advances still aren’t enough. We should be doing more. EMS needs a wholesale culture change where provider health and safety is concerned.
When I was 16, I made the mistake of wearing my cutoff jeans to the lake, and wore them commando style. After a visit to the Port-O-Let, I accidentally got my wedding tackle caught in my zipper, leaving me faced with the ultimate in unpleasant choices; face the agony of unzipping, or endure humiliation and ridicule by calling for help.
Until Nov. 8, 2016, that was the toughest choice of my life.
Whether you voted for Trump or Clinton, or took a principled but ultimately pointless stand to vote for neither, the Presidential campaign of 2016 left us all feeling like we had our genitalia stuck in a zipper. There were insults, blatant falsehoods, scurrilous lies and character assassination, cynical pandering and manipulation, shady backroom deals and enough loathsome behavior to last for years to come.
Four years, to be exact.
But hey, that’s every Presidential election. I expect politicians to behave like immoral, narcissistic sociopaths. Some are just better at hiding it than others.
What distressed me was to see my countrymen engaging in it, too. 2016 saw the near death of civility and manners in our national discourse. We demonized our opponents, and placed ad hominem attacks in higher regard than ideas and policy debate, and all on behalf of two people most of us would cross the street to avoid if we were about to pass them on the sidewalk.
Our noble experiment in liberty was reduced to a Jerry Springer episode.
Place value on everyday beauty
As I look ahead to 2017, I try to console myself that civility and manners are not dead, merely on life support. They can be revived. We’re a better people when we’re not acting in anger, and there is still time to heed the better angels of our nature. For my part, I remind myself that happiness is often simply a choice to place more value on the beauty in our lives.
And so in closing, I wish you more beauty in your lives, that it may fuel your happiness. Be you Christian, Muslim, Jewish, pagan, atheist, agnostic, Democrat, Republican, male, female, transgender or some flavor in between, the common sentiment voiced this time of year is one I think we can all agree on:
Peace on Earth, and good will toward men.