Administration and Leadership, Cardiac & Resuscitation, Patient Care

What Do You Want from Santa this Year?

Issue 12 and Volume 35.

Dear Santa,

Thanks for your Facebook update and recommendation that I download the “2010 Santa List” iPad application to expedite preparation of my gift list this year. It’s much easier doing an electronic PCR (present creation request) form to the North Pole instead of the old paper and mail way.

The update on your recent training efforts was also very encouraging. You’re the perfect candidate for the advanced-practice paramedic level because you have access to so many households and know who’s been naughty and neglecting to take their medications on schedule. I’m also impressed by your preventive medicine program, which alerts the older folks to tack down loose throw rugs, so you (and they) don’t fall and break a hip from sliding on their linoleum floor.

Having Mrs. Claus and all your elves re-trained on the new American Heart Association (AHA) CPR and ECC Guidelines within a month of their release was also an incredible accomplishment. I love how you taught your reindeer to line up in order and do continuous-compressions CPR in two-minute intervals and achieve a depth of at least 2 inches on every hoof compression.

I always thought the name thing was corny, but on second thought, the way you give out compression assignments is actually a coordinated way to let them know who’s up next and minimize interruptions:
“Now Dasher! Now, Dancer!
Then, Prancer and Vixen!
On the chest, Comet! Then, Cupid!
Then, Donner and Blitzen!”

Integrating AEDs, CPR depth sensors and feedback capabilities into each toy sack, re-adjusting Rudolph’s nose to flash 100 times a minute to keep the team in synch and using the snow that accumulates on the skids of your sleigh to cool IV fluids for therapeutic hypothermia (TH) were also ingenious ideas.

In addition, I want to commend you on your decision to fly over facilities not prepared to continue TH cooling and deliver your patients to designated TH centers. That’s right in line with what we’re already doing for critical trauma, ST-elevation myocardial infarction (STEMI), stroke and pediatric patients.

And, I’m glad to hear you’ve taken care of your “little weight problem.” I know Mrs. Claus was on your case after learning that your morbid obesity would shorten your lifespan by 12 years. We need you around, Big Guy, because we EMSers are gadget freaks, and you’re the only person who helps us sneak new gear, gadgets and toys into the house this time of year.

The “HO! HO! HO! DON’T GROW” notes you’re leaving behind this year for over-indulging emergency responders is also a great reminder to folks to eat healthier. Some are having a hard enough time carrying around their own weight, let alone a 300-lb. patient.    

You asked me to tell you what I wanted from you this year. Well, what I really want most is the gift of enlightenment for a few groups. Seriously, I’d like medical directors, EMS bureaucrats, receiving hospitals and lawmakers to realize how illogical it is to delay implementation of easy-to-adopt changes that could save lives and not make EMS providers have to wait years to do what’s best for their patients.

Outdated laws, the re-writing of EMS rules and regulations and slow review processes are needlessly contributing to the morbidity and mortality of countless patients who could benefit from proven equipment, medications and procedures.

Do you know that in some states, EMT-Bs still can’t administer aspirin to a patient having chest pain? A next door neighbor can come over and give the patient one, or a police officer transporting a patient to the hospital in their police vehicle could stop at a pharmacy along the way to buy and give them aspirin, but many EMTs still can’t administer it.

And, EMTs in many areas who, despite being trained and tested on their ability to recognize the signs and symptoms of anaphylactic shock, can’t carry an auto-injector pen and physically reverse obvious anaphylaxis.

The sad truth is that an 18-year old in a rural area can inject his allergy-prone mother when she has an attack, but if he’s not home, a responding BLS crew may have to watch his mother die while attempting to rendezvous with a paramedic unit that has the magical power to give the patient a shot.

It’s absurd. Enlighten our EMS leaders to streamline implementation processes for proven therapies and allow EMS responders to render critical care to obvious emergencies via protocol or with online physician oversight. The life an EMT saves could be one of their family members.

Best wishes for a safe and happy holiday season. Your lactose-free milk and gluten-free cookies await you. JEMS

This article originally appeared in December 2010 JEMS as “Dear Santa: The Gift of Enlightenment.”