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

- Rogue Medic


Also posted as part of the Handover over at Life Under The Lights. Go check out the rest of what is there.

Over at A Day In The Life Of An Ambulance Driver, there is a post titled R-E-S-P-E-C-T. There is a lot to say about this, but I will try to keep it short.

Ambulance Driver highlights the problem with the EMS entitlement attitude. We have cards that reads EMT (A, or B, or D, or I, or P, or whatever). We feel this entitles us to some kind of respect.

Is respect an entitlement?

Is respect something that is earned?

Is respect something we should worry about?

Next they’ll be taking our blessed intubation away!

Without the ability to administer our Laying on of the PVC, how will any of our patients survive?

Why is it that so many of us crawl out from under our rocks when we feel that our image has been impugned?

Why is it that so many of us seem to put more effort into demanding respect than we do into earning respect?

Why is it that so many of us cannot intubate safely, but can’t stand the thought of having that skill taken away from us?

Where are we when there is an opportunity to practice intubation?

Why aren’t we demanding that we be allowed to practice intubation, even if it is on our own time?

Why aren’t we trying to protect our patients from the deterioration of our skills?

Why do we feel that adding RSI (Rapid Sequence Induction/Intubation) to the ways that we can mismanage an airway will make us more professional?

We have pathetically low standards, but we wish to punish medics who were canceled; medics who were out working non-stop in a disaster; medics who were expected to also do the job of the snow plows; medics who did transport many more patients than usual; all without any help and short staffed.


Because we are to believe the claims of these armchair critics, that they would have disobeyed dispatch, walked to the patient, and waited in the residence for over a day for some backup to arrive, or would have safely carried Mr. Mitchell out through a quarter of a mile in snow and ice without any help, because that is the respectable thing to do. In the mean time, the other crews are making up for this canceled crew being out of service.

And because some inappropriate language was used on a recorded phone line, because that is not the respectable thing to do.

As if Curtis Mitchell died from inappropriate comments. The autopsy results have not yet been released, but I think it is safe to say that will not be the official cause of death. If there were never any inappropriate comments, would Curtis Mitchell be alive?

Well, Ambulance Driver gets the same kind of grief, just toned down, because nobody seems to be claiming that his use of Ambulance Driver in the title of his blog has killed anyone – yet.

I have known Kelly since before he began writing A Day In The Life Of An Ambulance Driver. We may not always agree, but the only criticism I have of him is that there are not enough people like him in EMS.

There are too many whiners in EMS, not enough leaders.

There are too many people satisfied with our ridiculously low standards in EMS.

There are too many of us demanding respect for having a card that suggests that we met the ridiculously low standards in EMS.

There are too many people worried more about protecting our image, rather than worried about caring for our patients.

There are not enough people demanding higher standards in EMS.

Why are we worried more about phone calls than about our patients?

Why are we worried more about skills than about our patients?

Why are we worried more about tiles of nobility[1] than about our patients?

I am a paramedic.

I am an EMT.

I am an ambulance driver.

I occasionally make inappropriate comments.

I do not ask for respect from anyone.

At some point, I will write something that will anger every one of you.

Maybe I already have.

I’m OK with that.


^ 1 Title of Nobility Clause
Article I, Section 9, Clause 8
US Constitution
Full Text

No Title of Nobility shall be granted by the United States: And no Person holding any Office of Profit or Trust under them, shall, without the Consent of the Congress, accept of any present, Emolument, Office, or Title, of any kind whatever, from any King, Prince, or foreign State.