High Tech or Just a Gimmick

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An ambulance company in Massachusetts is using Amazon Echo in an attempt to improve the care it’s EMTs and paramedics give to patients.

Here is a YouTube video that outlines what they are doing.

The idea is that the crew can ask Alexa about protocols and medical information various medical problems.

The spokesman for Brewster points out that the protocols are about 300 pages long. This is true, but a look at the Massachusetts protocols shows that they are broken down into several fairly simple sections.

It’s nice to have a reference and I keep a copy of my state’s protocols on my laptop and Smart Phone for reference purposes when I’m reviewing a case with one of my clients.

Mostly, I use that to confirm what I already know. What I know is based not only on my 35 years of initial and continuing education, but also my experience as a field provider.

Memorizing protocols, medication information, signs and symptoms, is part of what makes a paramedic a clinician. It’s easy, or at least should be, although somewhat tedious to memorize all of that information. The harder part is synthesizing that plus what you see before you (the patient) into a diagnosis and treatment plan.

I don’t know if this application will help that process. The problem, at least from what I see in my day to day Quality Improvement efforts is that newer paramedics just don’t see enough patients to garner the necessary experience to make good judgements.

Ironically, I think that there are too many paramedics out there in the world. Because there are more paramedics than patients that are actually ill enough to need paramedics, there is a serious lack of valid experience.

I’ve seen paramedics who are adequate if the patient isn’t very will. They can (usually) start an IV and (usually) give basic medications. If the patient is very ill and really needs good care, these paramedics are often not up to the task.

It’s not that they are bad, but they are the victims of mediocre education and lack of experience.

Sadly, many paramedic programs and many EMT programs are diploma mills. They teach their students enough, just enough, to pass the certification examinations.

Said examinations are what I refer to as the “Bunny Slope” of EMS education. If you’re not familiar with downhill skiing, you might want to look that one up. Hint: It’s not the bar with the hot tub in the middle.

More formally, I often tell new EMTs or paramedics that their shiny new certification card is just their license to learn more.

If one is serious about working in EMS, one will find that EMS is just one long series of going to classes. Besides the continuing education and refresher classes, there are add on classes. Classes on Cardiology, classes on trauma care, classes on pediatrics, classes on airway management. Most of these are optional, so all too often minimally competent providers find these boring and would rather do something else on their days off.

When my kids were younger, they’d see me heading out the door on a day off. They’d ask where I was going and the answer was usually “To a class.” They’d then ask if I was teaching or taking? Teaching is a really good way to learn your material, because if you’ve ever taught a class you know how embarrassing it came be if the students know more than you.

While I’m still on my soap box, I’ll also say that the lack of desire to learn beyond just enough to become certified is one of the key factors in why EMS is not only not a profession, it’s not even a trade.

If I were to venture a guess, I’d have to say that Brewster might be trying to solve a problem of provider knowledge with artificial intelligence.

That’s most unfortunate, but sadly, I don’t think it’s the last time we’re going to see something like this.

Just remember, Artificial Intelligence is no match for natural stupidity.

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