If we are going to have standards, they should be based on some evidence that they work.
Is something better than nothing?
Something is only better than nothing if the something is something good.
Is a grade better than 80% good for bragging rights?
What does the grade mean? Does the exam demonstrate that the person understands good patient care? I do not see evidence that this initial exam does that.
The NR exam is just an initial exam, but some benighted people think that there should be higher pay for people who have passed this particular brand of entrance exam. Are they supposed to remain beginners forever?
Is a structured way of doing things a good way to evaluate people for the unstructured, or minimally structured, job of paramedic.
We also discuss what I wrote in Advanced Airway vs. BVM During CPR – Which is Worse?
There is no evidence that ventilations improve outcomes.
I was at Dr. Banerjee’s presentation on cardiac arrest and how their treatment protocol produces better outcomes than the rest of the country. One person in the audience kept complaining that he is wrong to not follow the ACLS guidelines because he will be sued. Dr. Banerjee’s response should be obvious – You need to show evidence of harm to win a law suit. I produce better outcomes than the rest of the country.
John Broyles brought up the way we educate badly with our focus on verbalizing Gloves on – Scene safe! and not thinking about what we are doing as far as using gloves and continually assessing scene safety.
Gloves are often inadequate BSI (Body Substance Isolation), but we act as if wearing gloves will protect against everything; as if wearing gloves somehow produces a force field around the body that protects parts of the body not covered by the gloves; as if gloves do not tear or break down and need to be replaced on the job; as if gloves make up for not cleaning our hands; as if touching clipboards and other equipment with gloves on is doing anything other than spreading germs all over the equipment that we will later pick up without gloves on; as if gloves need to be worn for every patient.
Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings
CDC (Centers for Disease Control and Prevention)
According to the CDC – Not every patient.
According to the CDC – Not every time.