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Inside EMS: Emphasizing patient advocacy in EMS education

Critical insights into the implications of recent court rulings on EMS practice and patient care

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In this episode of the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson delve into the complex and ever-evolving legal and ethical dimensions EMS. This episode comes in the wake of a significant court ruling in which two paramedics were found guilty of criminally negligent homicide in the Elijah McClain case. The hosts discuss this judgment’s far-reaching implications for EMS professionals, emphasizing the heightened legal scrutiny and accountability now present in the field.

Memorable quotes

“More and more, we are starting to see prosecutors making examples of paramedics, EMTs, who are not doing the right thing, or them thinking they’re not doing the right thing, and our peers are now starting to get connected with murder and manslaughter charges, and it’s something that we have to be very, very cognizant of.” — Chris Cebollero

“I think that where this case went off the rails is that both paramedics involved forgot that they were first and foremost patient advocates and were acting as law enforcement.” — Kelly Grayson

“We’re doing our job with ego and this isn’t about you. This is about the people that call for our help, and we’ve got to break that habit, because our poor interactions with people are leading to those national calls when these folks die.” — Chris Cebollero

“What could be the worst day of somebody’s life ... that’s powerful, right? People forget what a privilege that is. But we have to be able to remember that our ego is not good for medicine.” — Chris Cebollero

“You should train and educate yourself enough that you’re not in doubt very often, but you should be conservative and call someone for, for consultation. That’s what medical control is for.” — Kelly Grayson

Key takeaways

Cebollero and Grayson discussed the growing legal scrutiny faced by EMS professionals, with the following takeaways:

  • Importance of accurate medication dosage. The conversation emphasized the criticality of correctly estimating a patient’s weight for administering weight-based medications. Misjudgment in dosage, as seen in the McClain case, can lead to severe consequences.
  • EMS education and training needs. The podcast underscored the need for continuous education and situational awareness among EMS practitioners. The hosts debated how such high-profile cases could influence EMS practices and potentially lead to overly cautious behavior, which might not always be in the patient’s best interest. Cebollero and Grayson stress the necessity for precise patient assessment, a skill that goes beyond technical expertise to encompass a deep understanding of the patient’s condition and needs. Their discussion points to a growing need for EMS education and training to adapt and address these challenges, ensuring that EMS practitioners are equipped to make informed decisions in high-stakes situations.
  • Patient advocacy and interaction. Another key aspect of the conversation is the role of paramedics as patient advocates. The hosts argue that EMS professionals should prioritize their medical responsibilities over any perceived obligation to law enforcement. This episode critically examines the ethical considerations in EMS, particularly in scenarios involving mental health or police involvement. By sharing personal experiences and insights, Cebollero and Grayson highlight the delicate balance EMS providers must maintain between following protocol, ensuring patient safety and navigating complex legal landscapes.

Read for more: The EMS system failed McClain and the justice system failed the paramedics

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The Inside EMS podcast is a regular expert discussion of hot topics, clinical issues, operational and leadership lessons for EMTs, paramedics and chiefs