I mentioned that I’m going to add a category “Journal of Iatrogenic Medicine”, and this is the introduction.
Iatrongenic is harm induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures. In other words, by accident. The provided, whether doctor, nurse, EMS provider, or anyone else didn’t mean to cause harm, but they did.
In EMS when we see it we find that very often it is done by a provider who failed to recognize what was wrong with the patient, or the cause, or the correct course of action to treat the problem. That can be either using the wrong medication, device, or diagnostic procedure. It can also be an incorrect dose of a medication, or placing a piece of equipment incorrectly.
No matter what the cause, the patient suffers some degree of harm. Examples are giving a patient a medication to which he or she is allergic, or one that is incompatible with a medication the patient already takes. Or placing an endotracheal tube in the esophagus instead of the trachea.
It can even be a simple error such as sitting a patient with low or no blood pressure into a “stair chair” to move them out to the ambulance. The risk there is that they will lose what little blood pressure they have and pass out or worse.
Or not interpreting patient breath sounds correctly and giving an incorrect or no treatment.
I could probably write another 1,000 words just listing common medical errors, but I think you get the point. Except for putting a patient in a stair chair, doctors and nurses have done all of what I listed also.
Part of my job is to read patient care reports to look for errors large and small. Small errors are corrected during periodic reviews. Larger errors are reported to the system medical director and he determines if he or she considers it a large error and what action is needed.
Every EMS system in the country has a set of protocols for providers to follow when examining, diagnosing, treating, and transporting patients. Some states impose one set of protocols on every EMS system, some do it by county, and a couple allow each EMS system medical director to determine their own protocols.
My job entails reading reports and determining if the provider understood what was going on with the patient, what the correct course of treatment is, providing that treatment correctly and safely transporting the patient to the most appropriate facility for further treatment.
Then they have to write a report that explains all of that.
The approach I take, because it’s the approach the owner of the company wants, is to treat all of this as educational.
Which is all I’ll say about that since I don’t want my readers to fall asleep.
Because I read a lot of reports I come across some real doozy’s from time to time. Those are the reports that I’ll feature in posts about Iatrogenic Medicine.
In case anyone is worried, I will carefully vet each report that I write about so that there is no Protected Health Information revealed. When I quote text, all identifiers will be removed.
I’ll dissect the reports, what was done wrong, what the correct course of action was, and anything else I think is valuable.
That’s it in a nutshell. I should get the first post up in a day or so.