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

- Rogue Medic

Treat the patient, not the machine

At EMT-Medical Student, Joe Paczkowski writes 4 Phrases That Should Never Be Said on an Ambulance. It is ironic that his title contradicts his second statement, and not too long after a sentence on contradiction. However, that is just something I find amusing – it does not affect his message.

We need to stop dumbing down EMS and using bad rules to make up for our lack of understanding.

1. Treat the patient, not the machine.

A Tom Bouthillet favorite, since the machine usually referenced is the heart monitor and Tom writes EMS 12 Lead. We always need to remember that our equipment helps us to assess our patients. If we do not understand the appropriate use of the equipment, we will probably not be using it in a way that is helpful to our patients. We always need to be considering the possible influence of something else.

Each part of our assessment needs to be put into perspective. It does not matter if we are assessing with our eyes, ears, fingers, manual sphygmomanometer (BP), non-invasive sphygmomanometer (NIBP), pulse oximeter (SpO2), 3/4/5/12 lead electrocardiogram (ECG), waveform capnography, or something else.

No part of our assessment is always right. By considering all of the relevant assessments that we can begin to figure out why an assessment result that does not seem to fit with the other assessment results. Is it a clue to something we are missing with our other assessments? Is it machine artifact? Is it a peculiarity that is normal for this patient? Is it a reflection of the environment that will change once we are out of that environment? Or is it something else?

We do not have absolutes in EMS. We need to be constantly aware of the possibility of something else.

When we stop looking for the something else, we will occasionally miss something very important.

Go read the whole thing.



  1. Thanks for the link! I actually didn’t even catch the entire “Never vs never say” irony.