Book Excerpt: ‘Life and Death Matters’

In this book, two veteran paramedics explore the characteristics needed to succeed in time critical emergencies in prehospital medicine


Clinical knowledge is crucial to responding to life-threatening, time-critical illnesses and injuries. But just as important are the character attributes, interpersonal skills and drive that allow emergency responders to act decisively in the chaos of prehospital medicine.

In “Life and Death Matters” NREMT Paramedics Samuel Adams and Christian Adams delve into the skills needed for success in the field, where seconds matter and judgment means everything.

By Samuel Adams and Christian Adams

There is no gray

Everything you encounter in EMS as a paramedic is black and white. There is no gray, only indecision. Indecision causes you to think that unfolding events are muddled or convoluted. Indecision causes you to think there are more difficult choices than there really are. Looking at situations and believing that things are gray is really just an expression of indecision. You just lack the decisiveness to act.

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Your interpretation of what is a perceived gray situation is really an inability to interpret information properly and then make an informed decision. What it really boils down to is a lack of accountability. You don’t want to make a decision that might be wrong, so you put off making a decision and chalk it up to a gray situation. You become paralyzed with fear of consequences. Your fear manifests with indecision. Your indecision compromises patient care. Again, there is no gray, only indecision.

Either you care for your patients’ best interests or not. This indecision clearly demonstrates a lack of working knowledge of the job. Do you understand your scope of practice? Your decision-making process should not include a foundation of fear; it should be founded upon confidence. If you lack confidence, you must ask yourself if you are a person who embodies these important principles as set forth in this book. Your confidence is built upon work. Work on your work ethic. Your integrity. Your self-reflection and growth. Work on these and you will become more decisive. You will see there is no gray, only indecision.

What kind of provider are you? One who lacks the willingness to make a decision for your patients’ best interests? Or one who is always concerned with your own self-serving ambitions or needs? Here, too, there is no gray. Your indecision is demonstrative of where your priorities lie. Let’s be clear. If you do not make someone a patient who should be, your tell is up. Your indecision and self-serving interests are on display. This is a reflection of lack of professionalism.

Your lack of decisiveness creates more problems for you, and the lack of decisiveness is contagious. When you are indecisive, it silently gives other providers on scene the liberty to make excuses for their own indecision. This problem then perpetuates itself, and patient care in the entire system declines.

When you become enamored with the idea that things are gray and muddled, and it’s difficult to navigate what to do on specific calls, what you’re really concerned with is the judgment of your peers. You’re concerned with what your peers will say about what you chose to do in a given situation. You’re concerned with what your medical director might say, or that you might get in trouble. Your concern is with whether or not your medical division is going to question what you’ve done. Here’s a newsflash: They should question what you’re doing because that’s how you grow.

If you’re not challenging yourself, you’re not in a state of self-growth. Being a paramedic is a constant state of growth in a constant state of change. You must learn to embrace change and welcome change. Everything you do in your career is going to change, from the medicine to the way we treat people.

If you are acting decisively within your guidelines and within your protocols, it’s going to make work much easier for you. You have to be able to interpret the information that you are given appropriately and then decide what to do. Much of your indecisiveness is due to a lack of proper understanding of what your job is. Your job is not necessarily to specifically diagnose people with an ailment. You have to understand that your job is to find life threats and then treat them accordingly. You are working in emergency situations.

About the authors

Samuel Adams and Christian Adams, authors of “Life and Death Matters,” are both NREMT paramedics and Colorado state certified paramedics. They have spent the majority of their paramedic careers precepting and developing new paramedics. This led to the development of Field-Medics with the focus on developing an integrated approach to prehospital emergency medicine. Field-Medics integrates Personal and Professional character attributes, decision making principles, and medical knowledge to create an extremely confident and successful first responder.

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Published Dec. 18, 2018

Self-published through Twin Peak Publishing, LLC

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