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Thankful and Hopeful This New Year

This time of year we all find ourselves taking stock. In reviewing the past year and looking forward to the next, we find things to be thankful for and make wishes for the future. I d like share some things that I m thankful for and dreaming about as a stimulus to those of you taking stock of your own experiences.


First, I must thank the readers of this column. I can t tell you how humbling it has been to come off the podium at conferences and have you approach me to talk about the columns you ve read. It s a pleasure to get your calls and e-mails, which either give me a chance to help you with something or provide fuel for upcoming columns. All of you who read my articles or books honor me with your trust and give me a chance to continue to grow and work in new aspects of our field.

I m thankful for quite a lot, personally and professionally. On a personal level, I must give thanks to my family for their patience in a career that, at its best, involves tolerating long shifts and weird hours, and, at its worst, often takes me away from home. In sharing my passion for my work, my family has empowered me to do my best, and if I ve done any good, they are responsible.

Professionally, the list is long. I am certainly grateful to for giving me a place to speak and share my thoughts with all of you. I have to acknowledge the American College of Surgeons Committee on Trauma, not only for trusting me to do the job they hired me to do, but for embracing my other trauma activities as compatible with their mission. I could not continue the depth and breadth of my work without their enthusiasm and support for trauma education at every level of care. The PHTLS family continues to be my volunteer passion, and the Executive Council team I ve worked with for 11 years is among the most dedicated and prolific group with which I have ever collaborated. The pleasure of working with them to carry the message to prehospital care providers all over the world has been a gift of immeasurable import to me.

I have had the pleasure of serving on the boards of three organizations that have a huge impact on the future of prehospital and trauma care. Working on the National Association of EMTs, the National Association of EMS Educators and Society of Trauma Nurses boards has been a learning experience. It s been a pleasure to work and share with these dedicated professionals to benefit the providers we represent. Although my role with these groups will likely change, I will continue to support them in their important work.

Less personal but of great importance, I m grateful for the work done in evaluating the effect of our practice on patient outcomes. It s clear as I write these columns and work on chapters in texts that the science is changing our practice, and the effects of education, training and evidence-based protocols proves measurable.

Wishes for the Coming Year(s)

So, in looking at what we ve done, what can we hope for in the future? Much. We ve seen great strides on several levels. First among those is the growing presence of career EMS professionals on boards, committees and hearings in state and federal government. Throughout our careers, we ve often been frustrated in the sense that we didn t have a voice in the development of our profession with regard to curricula, practice and protocol. In my work, I ve seen an increase in participation by prehospital care professionals, and it s having an impact. Practical, appropriate changes are being made out of our collective. In this new future, I m optimistic the final pieces of the EMS agenda will come together and result in curricula and protocols based on the science and history of our practice.

What Might Be Coming?

Well, like it or not, we ve rounded the corner of research in regard to invasive treatment. While many of us clamored for more aggressive treatment, the science is indicating that less is more. This is not specific to prehospital care but applies to all areas of medicine. We need to embrace what the science tells us, and act on the results of the studies. We should be disappointed with studies that show poor outcomes, but we should channel those emotions into training, working to improve outcomes and further study. We all win. We don t have to defend past practice, but we must be accountable to it and use it to become better.

A Word of Caution

One thing that still concerns me is our failure to use resources to the best of our abilities. Certainly this applies to the delivery of EMS services in general, and we need to continue to work on that. Specifically, I m talking about national initiatives that get caught in silos, with their efforts moving up rather than out. We still see proposals, protocols, legislation and funding requests pursuing the same issue and, in effect, diluting the mission s potential. This occurs in spite of the fact that many of these initiatives have representation in common with the same national organizations. Maybe a clearing house of sorts could be of use (virtual if not actual) in melding similar activities to enhance the chance for success and limit the possibility of diluting resources or confusing conflicting actions.

All in all, I am quite optimistic about our future. Challenges lie ahead, but as the world grows smaller and we share our successes and failures, we will find new, imaginative ways to solve problems and build for the future.

Thanks again to all of you, and best wishes for achievable dreams.