2009: A Year Leading Change

By Bob Waddell

Among many noteworthy developments in EMS this year, health care reform saw its initial steps in 2009. It will be many months and possibly years before we understand the impact this activity has on our lives, positive or negative. What we in EMS know is that health care will change. Will the changes improve the ways and means by which we care for patients? The effects are a great unknown, but our collective creativity will once again be put to the test to provide the highest standards of care with the resources available. EMS is the national "safety net." Let us stay strong, be professional in our clinical care and customer service, and demonstrate our commitment to caring for people.

This year also shocked our reality that helicopters and prehospital emergencies not only save lives, but sometimes also destroy them. With more than two dozen providers and patients killed in the process of transport, the helicopter EMS (HEMS) industry has been forced to ask the question, "When is it appropriate to use rotor craft in the prehospital arena?" Dr. Bledsoe has begged the questions for years and is now facilitating an open, frank discussion to save lives within the profession.

The "EMS Agenda for the Future" was intended to be implemented early this year. Instead, we are moving mountains of tradition for the benefit of advancement. The latest "Baby Agenda" — the National EMS Educational Standards — has been birthed. Yes, it will take a few years for this baby to walk on its own, but the joy of this new life in our home is amazing! Will this child be the perfect one without challenges? Not a chance! The Education Standards will be the same and you — the parents — are responsible for the outcome. Nurture and mentor the Education Standards because they will influence the future EMS professionals caring for many of us. We must educate them correctly.

2009 has brought a renewed awareness that all this talk about "evidence-based medicine" needs factual grounding. Rattling off facts and figures calculated in our heads during times of intoxication can no longer be the basis for protocols and standards. Just because something worked in the laboratory on 11 dogs does not mean it is intended to be used on the ill or injured. Just because a for-profit corporation is involved in the development of a product or process does not make the corporation a miracle or a curse. The same rules apply to non-profit corporations as well. An organization's IRS status is NOT a determining factor in the benefit or detriment to us or our patients. We have to start looking objectively at patient outcomes and how our care improves those outcomes. 2009 has been a wakeup call; don’t hit the snooze button.

Finally, my good friend Steve Berry reminded me that one of the many topics on which we agree and one that MUST be advocated to our profession is the reverence for our fallen. Over the past year, we have seen tremendous growth in the profession of EMS towards those who have given everything for others. Whether colleagues died on duty or off, their memories should always be an example for the rest of us.

For over 2000 years in the Christian world and more than 4000 in other cultures, the concept of how we care for our most vulnerable is the primary indicator of our compassion for humanity. EMS professionals — paid or volunteer, metropolitan or frontier, ground or air or water, simple first aid or advanced practice paramedic — are the best gauge for society's compassion. Look at and to your EMS comrades and you will know that we have a safety net worth protecting.