Tuesday, May 04, 2010

Community

Last week I had the privilege of attending a ceremony in which a town received a Heart Safe Community designation, which goes to towns who meet certain criteria in terms of their EMS systems and availability of training, education and public access defibrillators and other factors affecting the Chain of Survival.

At this particular ceremony there were three cardiac arrest survivors who all got up and told their stories -- of their lives on the day they went into arrest, of who saved them, and what they have done with their lives since. All three suffered their cardiac arrests in public places, recieved bystander CPR, were defibrillated within minutes, and had rapid response from EMS. All three returned to productive lives.

Watching them speak, for a moment, I pictured a dead version of them besides themselves. Cool, lifeless blue heads, bloated bellies, vomit strewn down their mouths, unending flat lines – a version that could easily have been a reality if the Chain of Survival had not held strong on their day.

Those grim images faded and were replaced again by the living, by the human warmth, smiles, and by their grateful tears as they recounted seeing a daughter graduate, being present for the birth of a grandchild, going on a trip to Paris with a wife of fifty years.

Every ambulance company president, every hospital CEO, fire chief, municipal elected official, EMS medical director, state and regional EMS representative, right on down to front line paramedic, EMT and first responder ought to attend one of these ceremonies every year.

Turf wars are too common in EMS. Over the years I have seen it in many forms. EMS versus fire, first responder versus ambulance, intercept medic versus transport medic, ground versus helicopter, commercial versus municipal, volunteer versus career. Field versus hospital. Big hospital versus small hospital. Town versus region, region versus state. While we all say we are for the patient, we all have our own agendas. And that can cause our eyes to drift from the prize. A badly put together conflicted system can kill.

It is so easy to forget what EMS is about. It is not about us. EMS is about our communitites. It is about those three living souls and their families who still have them.

EMS is about designing the best system possible, not necessarily for our service’s or hospital’s needs, but for the patient’s needs. We need to check personal and institutional egos at the door. We need science based protocols, system benchmarks, quality improvement/assurance programs, and out-of the box thinking that is never afraid to change the status quo if it is the right thing to do for the patient. And we need to each prepare personally, so we are always ready to do our best.

This is not frivolous work we do. Those three survivors are a testament to that.