Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

EMS Mythology Starter Kit

We believe in all sorts of dangerous ideas about EMS:

OLMC (On Line Medical Command requirements) protect patients.

RLS (Red Lights and Sirens) saves a lot of time.

Replacing blood with NSS (Normal Saline Solution) or LR (Lactated Ringer’s solution) saves lives.

Long board immobilization protects patients from spinal injuries.

Basic EMTs cannot safely apply a spinal clearance protocol.

It is more important to stabilize the head and neck, than it is to assess and treat the patient.

High flow oxygen is good for everybody. If some is good, more is better.

Furosemide (Lasix) is a good treatment for ADHF (Acute Decompensated Heart Failure).

Naloxone (Narcan) is harmless and it helps to identify heroin overdoses.

Intubation is airway control.

Without an OPA (OroPhayngeal Airway) or NPA (NasoPharyngeal Airway), we cannot provide a good BLS (Basic Life Support) airway.

Helicopters are used appropriately in EMS.

Most patients transported by HEMS (Helicopter EMS) are seriously injured patients.

HEMS use does not delay arrival at the trauma center.

CISM (Critical Incident Stress Management) is a good way to deal with stress.

Steroids are good for spinal injuries.

Sedation and pain management are things that EMS cannot do safely and effectively on standing orders.

SSM (System Status Management) is wise use of resources.

Traction splints protect against femoral artery lacerations.

Real medics/nurses/doctors do not need Waveform Capnography to confirm tube placement.

NTG (NiTroGlycerin) is just for chest pain, not ADHF.

A protocol, that limits what a medic can do, is safe.

Beta natriuretic peptide (Natrecor) is the future if ADHF treatment.

CPAP (Continuous Positive Airway Pressure) is too heavy to bring in to the patient.

CPAP is just an ALS (Advanced Life Support) treatment.

MAST (Medical Anti-Shock Trousers) saves lives.

MAST acts just like a transfusion of blood.

ASA (Aspirin – Acetyl Salacylic Acid) is not an important treatment.

Amonia inhalants should be used in EMS.

Epinephrine improves cardiac arrest outcomes.

Amiodarone improves cardiac arrest outcomes.

Lidocaine improves cardiac arrest outcomes.

Atropine improves cardiac arrest outcomes.

Sodium Bicarbonate has been moved so far down in the ACLS (Advanced Cardiac Life Support) guidelines because it has no real uses.

Sodium Bicarbonate is the first drug for hyperkalemia.

Sodium Bicarbonate is the first drug for acidosis.

Prehospital treatments are effective at warming up hypothermic patients.

The Golden Hour is not just a marketing tool.

Eclampsia only happens during pregnancy.

Heat stroke is when the overheated patient can no longer sweat.

We carry naloxone for opioid overdose, so we should carry flumazenil (Romazicon) for benzodiazepine overdose.

Endotracheal drug administration is not harmful.

An experienced medic can tell right away, whenther someone is faking being sick.

Paramedic-initiated refusals are a good idea.

Morphine is dangerous for cardiac chest pain.

On an infant we should assess the brachial pulse.

Pulse oximetry is used properly by EMS.

If it wheezes it is asthma.

If it crackles it is ADHF.

ADHF will have pink frothy sputum.

Benzodiazepines need to be given slowly to actively seizing patients.

D50W (50% Dextrose in Water) is the right treatment for adult hypoglycemia.

We need to use a credit card, or razor, to remove a bee stinger.

CO (Carbon Monoxide) Poisoning will produce cherry red skin.

If you really want to restrain a patient, you have to hog tie them.

Medics can’t intubate well.

Medics can’t intubate children well.

Medics can’t use RSI (Rapid Sequence Induction/Intubation) well.

TASERs cause VF (Ventricular Fibrillation).

Diminished breath sounds mean a tension pneumothorax.

Cross-training is not dangerous.

More medics means better EMS.

Fire Department EMS is good for EMS.

We have to clear from this call quickly, so we can keep ambulances available for the next call.

HIPAA means the hospital cannot share information with you.

This won’t hurt.

That didn’t hurt.

We don’t do that.


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