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Comment On A Comment


It started with a post by Rogue Medic. One of the comments by an anonymous poster not only generated a reply post by RM, but then Ambulance Driver got into the act. After reading the posts and comments, I decided that I had to get in on this too. Originally, this was going to be a comment on AD’s post, but it became long enough that I decided to get some posting mileage out of it.

Anonymous is not only nasty, he’s wrong. Dead wrong. Only the dead are likely to be his patients or his systems patients.

As a soi disant profession working with and within another profession it’s our responsibility to put up or shut up. The studies from Los Angeles and other systems that demonstrated that paramedics (at least in their systems) were not competent at intubation were a challenge to EMS to prove them wrong. A few systems have taken up this challenge and proven that their system’s paramedics can intubate with a high degree of success and an extremely low degree of misadventure.

Other systems have taken the fingers in ears approach that AD outlines. They just know that their systems don’t have those problems. They don’t need no stinkin’ numbers, they have the certainty of faith to carry them through.

Even bad science will trump no science. Good EMS systems will need to respond with good science to refute the bad studies. It would also be beneficial if good systems could prove not only that their medics can intubate, but also identify the attributes that set the conditions for that success. It might turn out to be a low medic to ALS patient ratio, it might be something else. We won’t know until someone takes the time to find out.

Those who follow these things and participate in the various EMS forums have been hearing for several years now that it’s only a matter of time until most medics lose the ability to intubate. Most don’t believe it, but some do believe it and a few systems have even started to study the issue in a serious manner.

The problem is, that even in science it seems that hysteria and sensationalism often drive the debate.

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After a long career as a field EMS provider, I'm now doing all that back office stuff I used to laugh at. Life is full of ironies, isn't it? I still live in the Northeast corner of the United States, although I hope to change that to another part of the country more in tune with my values and beliefs. I still write about EMS, but I'm adding more and more non EMS subject matter. Thanks for visiting.


  1. I think that part of the comments by anonymous were presented from a Devil's Advocate position. If we can get some good science, maybe the emotional distortions can be ignored.

  2. Maybe, maybe not. But we've both played devil's advocate before and I don't recall either of us using insulting language to do it. We have to get good science soon, before it's too late.

  3. You need think about it. Despite the emails, the overwhelming evidence showing global warming is happening hasn't changed."The e-mails do nothing to undermine the very strong scientific consensus . . . that tells us the Earth is warming, that warming is largely a result of human activity," Jane Lubchenco, who heads the National Oceanic and Atmospheric Administration, told a House committee. She said that the e-mails don't cover data from NOAA and NASA, whose independent climate records show dramatic warming.

  4. I have thought about it. The evidence is non existent. The world is cooling, not warming. It's likely cyclic. If NOAA is so convinced, then they, like all scientists, should want to release their data. But, they won't because they know that the data is fudged at best.

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