This is a coordinated post by our friends Greg Friese and Steve Whitehead.
†- Gregís post on this topic can be found at: http://www.everydayemstips.com/?p=3628
†- Steveís post on this topic can be found at: http://theemtspot.com/2010/08/25/too-much-information/
ďThey Donít Know What They Donít KnowĒ
Itís an established fact that 60% of fatalities within confined spaces are would-be rescuers. They see someone down in a confined space, enter the space, and are overcome by the conditions that took down the initial victim. The process sometimes repeats itself, with multiple would-be rescuers entering the space and falling victim themselves. Itís tragic really, but the cold, hard fact is that these people are victims of their own ignorance. They donít know what they donít know. They donít know that there is a fatal set of conditions within the space, and they donít know that whatever it is that killed the first victim, or subsequent victims, will kill them as well. Itís a well documented phenomenon that plays on the compassion of the would-be rescuers and ends up getting them killed.
They simply donít know what they donít know.
So when I was approached by our friend Greg Friese from www.EveryDayEMStips.com the other day regarding a comment he received on one of his training articles, I was interested in doing a co-post with him. He also has contacted our friend Steve Whitehead from www.TheEMTspot.com and together weíre tri-posting on this issue. Their links will follow below and are just great as always.
The comment that followed this online training article was written presumably by a paramedic. It was a critique of the article that simply stated ďtoo much information for a paramedicĒ. I read that, and immediately thought of confined space incidents, where ignorance can get a person killed. Lots of situations fit that scenario and itís not always the rescuers who get killed. EMS providers who ďdonít know what they donít knowĒ can and do kill patients. More often, they donít provide the best possible care.
Thereís this thing that we have made it our business to know how to repair. Itís called the ďHuman BodyĒ and if youíre reading this article, the chances are good that you possess one. The human body is VASTLY complex. Itís the most complex machine we humans know about and we are still learning about it to this day. There are some amazingly smart people out there who have dedicated their lives to studying these meat machines that our brains pilot around and they still havenít figured everything out yet. We can help set it back on course to heal itself in a lot of cases but we canít construct a new one. We donít know about all the minutia, the microscopic works inside of it that make it do all of the amazing things that it does. The levels of systems within systems that function seamlessly within still other systems are numerous and fascinating. I learn something new about it all the time, and still there are people who know vast amounts more about the inner workings of it and about the huge number of things that can affect itís operating effectiveness than I do. The human body is remarkably complex yet elegant and perfect in its design.
And we who call ourselves ďmedical professionalsĒ are well advised to study every possible aspect of it. Consider it your ďlifeís workĒ. If your job is to fix and support the end users of the human body, you darn well better know everything you can about it.
ďButĒ, you say, ďThere are people out there who are supposed to know much more about the human body than we are. Theyíre called Physicians, and they get paid a whole lot more than we do. Weíre just paramedics. (or EMTs).Ē And youíd be right for saying that, of course. Physicians have the ultimate responsibility for knowing the human body. Itís their lifeís work as well. Their patients live and die based upon their knowledge, skills, and talents they have for examining the human body and being able to figure out whatís going on. Their whole practice is based upon their knowledge, skill, and talent. The more they know when theyíre working there, the better provider they are.
Itís that simple, and itís exactly the same for us EMS people. The more we know, the better we are. Nobody is better served by dumbing us down. Nothing is gained by denying yourself knowledge. Not a single patient is better served by you not knowing everything you can know about what is going wrong with them and itís your duty to learn as much as you can about what youíre supposed to know about.
What is the line for how much paramedics ďneed to know?Ē Is everything that we need to know covered by our initial training course? Is that everything we need to get out there in the world and start slinging IVs and Meds all willy nilly?
I look at the paramedic license as a ďlearnerís permitĒ. Itís the baseline knowledge level needed to function at that level under supervision. Itís a jumping off point from which the provider should immerse themselves in knowledge. I can certainly say that Iíve learned volumes past my initial certification and that the ďextraĒ knowledge has saved lives. Did you know that Fentanyl can cause chest muscle tetany when administered too rapidly? Or how about that lasix, when pushed too rapidly can cause hearing loss? †Do you know that ST depression in the high V leads can signify a posterior MI? What about differentiating an acetabulum fracture from a ďpulled groinĒ? Can you reliably predict the patients whose blood pressure is going to crash after Nitroglycerine administration by reading a 12-lead EKG? What about the clinical presentation of a non-ST elevation MI? Do you know the MEND stroke screen? What about the different neurological exams to find an intracranial bleed?
Etcetera, etceteraÖ The point is, there isnít a cut off. The final exam we take for our licensures prepares us with the baseline knowledge to get out there and learn what it takes to make us truly great EMS providers. The true professional will learn this, and constantly seek the knowledge he or she needs. The average to sub-average provider will comment that they ďdonít need to knowĒ something.
Get out there, get fascinated, and learn as much as you can. It will never be enough knowledgeÖ but your mind is a sponge for a reason.
Study Hard. Know Your Stuff. No Excuses.
This is a coordinated post by our friends Greg Friese and Steve Whitehead. Be sure to read their posts on this
Gregís post on this topic can be found at: http://www.everydayemstips.com/?p=3628
Steveís post on this topic can be found at: http://theemtspot.com/2010/08/25/too-much-information/