Archive for August, 2013

On Humility and Confidence

I firmly believe that to be in EMS you have to develop confidence in yourself. Not only in your skills but also in your decision making. Some believe that our protocols take away our need to make extreme decisions-I firmly disagree. We need to understand what underlies not only our treatment but also the disease or injury process we are fighting. It is vital we know.

Sometimes we have to do things that are hard to do, RSI, IO placement, synchronized cardioversion, for all these things and many more we need confidence. We need to be able to tell ourselves we are doing what gives the patient the best opportunity for survival, even if it’s something scary like a cricothyrotomy.

At the same time I have seen many medics become too confident. Too much confidence breeds cockiness. Too much breeds contempt for the patients we should be treating. I have seen a post recently that says we are here to treat the patient, not judge them. I agree with that.  To combat this we must be humble. We must know that our job is to help, even if it is a mental or behavioral problem. We must help even if it is the patient’s fault.

This is my problem. I need confidence… Because when I need to do something for the patient I need to perform, I need to excel. I need to believe, I need to know I am the best person for the job.

I also need to be humble, lest my cockiness cause an error that hurts my patient.

Good and evil, ying and yang, something I try to work on everyday.


Best part of a cardiac arrest.

I assisted another crew with a cardiac arrest from a dialysis center. The call went as good as can be expected. After CPR, high quality I might add, intubation, even though he had severe kyphosis, I/O, defibrillation and start of hypothermia treatment we get ROSC.  Good blood pressures, good CO2 waveform. I thought maybe it was a Potassium problem since he was early into his dialysis treatment, but I was just told on follow up they’re thinking it was a pulmonary embolism.

Without a doubt early CPR turned this man’s fate, now to see if they can fix the embolism and hope the hypothermia treatment helps the patient’s outcome.

Best part of the cardiac arrest?
It wasn’t my report!


Recently my job has demanded a lot more of my energies than usual. I have neglected my main blog, here at WordPress. I also run the Tumblr blog and would like to invite you to follow me there as well. The thing with Tumblr is that it isn’t the same as other blogging platforms. First of all it is much simpler to reblog items on mobile systems so I am able to post from wherever I am.

Some people can post controversial pictures and ideas, I usually post only ems related items and interact with people in all aspects of ems and first responders.

Hope you are all doing well.