Saturday, January 7, 2012

Did We Help?

One of the ways I like to evaluate calls is by whether or not we did something that actually helped the patient.

Here are some things I consider:

1. Did the patient feel better when we left than when we got there?
2. Was the patient better emotionally- less scared, etc- when we left than when we arrived?
3. Were we able to provide any treatment that improved the patient's condition? Was there measurable improvement?
4. Were we able to provide information to the medic that was helpful in some way?
5. Were we able to help the patient in some non-medical way?

Sometimes, we're lucky to be able to claim one of those.
On a really good day, we'll get them all.

It might be easy. If the problem is that the patient fell and couldn't get up without help, we're in luck. We can help them up, reassure them that it was fine to call us, let the medics return to service, and help the patient make changes to help prevent future falls.  All good.

Sometimes, it's easy in a different way. If the call is for a person who isn't breathing, and we open the airway and they start breathing again, that's pretty straightforward.

Some of the most difficult calls, though, it's hard for us to tell whether we did anything that actually helped, especially when we don't get to know the ultimate outcome. If it's a major trauma, and we extricate, package, and hand them off to a flight medic... did we do something that helped? Maybe. If they survive, probably. If not... none of that list really applies.

So there needs to be another list. The one that has to do with doing what we are trained to do, to the best of our abilities, and in the patient's best interest. Sometimes, that's all we get. Those times, I wish there was a better way for us to know if what we did was the "right" thing, to know that our protocols really are the best possible care. With various changes to protocols over the years, and new research coming out, sometimes it starts to look like not everything we do is as helpful as we'd like it to be. There are protocols that get held onto long after they should have changed, and other things that simply have no real scientific basis, and I'm not in a position to change any of that.

At least not at the moment.

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