It doesn’t take long in an EMT career before the excitement of “rushing to an emergency” turns in to “just another transport call.” The philosophy of “you call, we haul” in nearly every service can break the community servant’s spirit by turning a skilled paramedic into just an ambulance driver. But our system “just is what it is,” right?
Well, far from being a service based strictly on tradition, EMS is constantly challenging previous assumptions and struggling to reinvent itself. How we administer CPR has changed (again), we question the effectiveness of C-spine immobilization that we do standard on nearly every trauma patient, or argue the very validity of the “Golden Hour” around which many services have been designed. Almost all assumptions are open to be questioned. I say “almost” because I have found that there still are some boundaries to the willingness of many EMS practitioners to consider change. Some limitations are easily admitted, like the aversion to legal liability that means we transport anyone who asks us to do so regardless of their suspected need or ability to pay, but there are also less easily acknowledged sacred beliefs.
One of those that comes quickly to my mind is response time. To many, a quick response indicates excessively fast driving and is contraindicated by safety concerns. Besides that, we can justify ourselves since very few of our daily calls actually “require” a code response. While that point may be strictly valid medically, I would argue that our performance is often measured by the public in the agonizing minutes between the 9-1-1 call and the ambulance arriving at the curb. A patient does not need to be in some form of arrest in order for them, or their family members, to be distressed. Part of our job is being a calming and supportive influence. At the same time, I admit that it does not justify putting the driving public or ourselves at risk with an ambulance speeding to every call. But is it really a given that one means the other?
