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Tuesday

Paramedic Future

What role will technology play in the future delivery of out-of-hospital care? I once believed that an increased use of technology would increase the scope and duties of paramedics. Today I'm not so sure.

I'm now starting to believe that implementing technology may actually decrease the need for paramedic treatment and, dare I say, speed critical patients treatment.

I learned to read 12-lead EKG's over twenty years ago. It was not common for EMS to "do" a 12-lead and the technology wasn't there to support us doing so. Years later the technology became readily available and is in wide use today. Many seasoned paramedics looked down on the computer interpretation and some, including me, would not read the interpretation until after reading all the leads and making a diagnosis.

Luckily, the technology has grown and become far more trusted. That is trusted to a point where we can question if the middle-man is needed. That middle-man, of course, being the paramedic. I don't know how I feel about this; on one side, any EMT could attach the leads and obtain and transmit the readings to the hospital making 12-lead EKG readily available, sooner. But on the other hand, technology can't consider the patient as a whole and put all the assessment pieces together like a skilled paramedic can.

Like any other technology, once we become accustomed to it, we become dependent on it...try going a without your email or word editor and hand-write a few letters...get the point. In the case of EKG's I'm afraid we'll eventually decide we don't need to teach reading them any longer...what will we do when technology fails?

Anyway - here is a cool article on the use of Blackberrys and EKGs
http://www.theglobeandmail.com/news/technology/heart-attack-help-the-blackberry-solution/article665450/

1 comment:

  1. Anonymous6:03 AM

    Rick,

    Thank you for your post. Examining your argument that technology will eventually replace the need for the paramedic I find some flaws. I feel like your argument is similar to saying why teach long division now that we have calculators. However, the computer diagnosis on the 12-lead is horribly unreliable. I don't know how many 911 calls I've made for "ST wave abnormality" on perfectly good 12-leads. As providers and educators we need to push for solid physical assessment skills and diagnostic skills. The ability to read and interpret a 12-lead is still a paramount paramedic skill. I currently work one of my jobs at a teaching hospital and while moving a trauma patient a physician shouted, "the patient is in v-tach!" the physician reached for the defibrillator without question as one of the medics explained that the alarm on the monitor was merely artifact from movement. If we've learned anything it is that common sense isn't common at all. We need to continue to educate and trust the interpretation of skilled providers over technology.

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