I assume that you are most likely in EMS or have a healthy interest in it.
I assume that you are pretty much committed to learning as much as possible about the care you give your patients.
I assume that you are well read and subscribe to the ethos of delivering evidence based practice.
I assume that you are clinically up to date, or at least striving to be.
I assume that you are still very much in the minority of EMS providers.
Thats not to say that everyone else is bad and well behind the times (although there are some out there like that), just that as a group of professionals, there are many who are happy to just potter on and do what is expected of them on a day to day level.
The publication earlier this week of the 2010 AHA and ERC Resuscitation guidelines was hotly anticipated by providers all over the world.We were looking forward to some potentially radical changes which could provide real and significant increases in the survivability of our patients from out of hospital cardiac arrest.
Many bloggers and podcasters have addressed the issues and changes that have come from the new guidelines. So much so, that I am going to side step doing just that in this instance.
What frustrates and annoys me is that as we are being asked to be more professional in our actions, more professional in our reading and studying; more professional in our application of knowledge into practice and more professional in our duties, that we still cannot command the respect from many others that we actually know what we are talking about and understand what we are reading.
I am aware that I cannot change my practice to the new Guidelines until they have gone through our clinical governing body, the Joint Royal College Liaison Committee, and then have been approved by our medical directors and then fed down to the operational staff. I accept that it would cause chaos to allow each paramedic, as an individual practitioner to implement the new guidelines when they have read and understood the rationale behind the changes and the impact that they may have. It was cause nothing but confusion and poor application of skills if you had a couple of medics at a cardiac arrest working off seperate guidelines and not knowing what they other is wanting.
I can see this taking quit some considerable time to filter through all the bureauocracy of the NHS before we can once again state that we are using the best and most up to date evidence based practice.
Tom Bouthillet asked a great question of Dr Kleinman on the recent edition of The Medic Cast podcast when he wondered what could be done to reduce the delay in time from the publication of the new guidelines to the implementation of them. That just goes to show that this is apparently a much bigger problem than just UK pre-hospital care.
Until I get the ok, I guess I will still be doing everything to the best of my ability but continuously hoping that someday soon, someone will say to go ahead and use the new guidelines. I know that it isnt a magic tablet to the disease of Cardiac Arrest, but personally, I just want to know that I am doing what is recognised as the best possible medicine for trying to return my patient to his or her family.
How is it for your service? Will you be implementing soon or will it take some time?