Patients, Protocols and Practice

As someone who always looks for changes in patient care and ways to improve EMS and the treatment we give. It becomes hard to always walk that line between following protocols set by medical control. Trying to look beyond the cookie cutter formulas and think about a clinical picture being presented by a patient.

Each patient is different and needs to be thought of as perhaps needing a slightly different approach to their care and transport. Now of course there are bigger brains than mine out there that sit and create the protocols I am operating under. I don’t advocate working outside your set protocols provided by your medical control, but I do promote approaching patients with a thought process that goes beyond what is printed in your field guide.

Being a good clinician and thinking about the causes of a patients condition, the effects of treatment you give and the outcome upon arrival to the ED and beyond, is what makes good EMS providers at any level.  We are that extension of the ED and the doctor whose license we are working under via the protocols. So, by looking at the big picture with each patient we can practice as true health care providers and not just a ride to a hospital.

Protocols are guidelines that we follow after we can make that determination as to what the patient may or may not need. Sometimes that determination is made with your partner or with a online medical control consult. Our goal as prehospital care providers should be to blend the patient presentation, the protocols provided to us and practice good clinical judgement.

When new treatment comes along we should be advocates to bring that to the field. When protocols we are using are less than desirable for operating in the field, we should be discussing this with our medical directors to have them adjusted for better patient care and outcomes.

We have to take an active role in our education as well as be more vocal for what we need. Knowledge is the key to better patient care, better utilization of protocols and being EMS practitioners.

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