"Statistically speaking, it doesn't apply to me"...

[mycrofft]

Using a little white stove gas to goose a reluctant campfire. Skipping eye protection while using the chainsaw. Buying and loading handguns in the house and carrying them about. Driving without a seatbelt.

Going off protocol. Obtaining medical materials and equipment and using them while not on duty. Becoming the "go to gal or guy" for family and friends when they are hurt or sick, either or both to treat and recommend whether or not to go to their MD.

Statistics say these all end unintentionally badly thousands of times a year, yet at the moment, secure in our self-confidence, we all have done some of these things, or others (remember petting that alligator when you were a kid?).

The punchline to the old saw about the pregnant woman was "Hundreds of times before now, and nothing happened!".

How do we feel about our own talents and training versus statistics? Should we "play the averages" (as our protocol writers eventually must), or trust our instincts and ourselves and "go for it", counting on results to mitigate risk? Are we, medical workers, a nation of cowards, or accountants, or safety-minded individuals?

 

[mgr22]

Are we, medical workers, a nation of cowards, or accountants, or safety-minded individuals?

Are there no other choices?

 

[CFal]

Disagree about the carrying a loaded handgun, nothing inherently dangerous about it unlike seatbelt wearing.

 

[mycrofft]

Are there no other choices?

Make your own flavor!

 

[mycrofft]

Disagree about the carrying a loaded handgun, nothing inherently dangerous about it unlike seatbelt wearing.

Good comment, but not the way you intended.

Statistically, a private handgun is much more likely during its service life to be used in an improper fashion or in an accident than to do anything else except make the carrier feel more secure or to be used exclusively to punch holes in paper.

So we each take responsibility, train, and a act responsibly…but ask the folks things happen to and they say the same.

"I didn't stop cause nobody was coming".

"I never thought that would happen to me".

"I've shot Dextrose-50 into veins directly before a couple times and nothing went wrong".

"How was I to know that headache I handed my girlfriend's mom two Advils for was an intracranial bleed?".

Good point CFal, a better illustration than I thought to give.

PS: I have a few personal examples I'm too embarrassed to share.

PPS: Coincidence: very roughly, about thirty thousand deaths annually for guns of all sorts and for motor vehicle accidents

 

[Anonymous]

Everything I do in life has an element of risk to it. I know riding in an ambulance puts my life at risk, especially in the back, but it is a risk I choose to take. Life = Risk and I am not here to merely exist. I choose to let common sense prevail, all the while fully aware that I am not in control, and my life can end at any second.

Training an statistics are merely one more tool I have to assess the probability of an outcome.

Here is an article I found interesting:

Although the human brain is well adapted to respond to risk, it’s not so skilled at sorting out which modern risks to worry about. The current issue of Psychology Today explains why in its article “10 Ways We Get the Odds Wrong.”


“Our biases reflect the choices that kept our ancestors alive. But we have yet to evolve similarly effective responses to statistics, media coverage, and fear-mongering politicians….Though emotions are themselves critical to making rational decisions, they were designed for a world in which dangers took the form of predators, not pollutants.”

Part of the problem is that our emotions have evolved to help our brains make “lightning fast” assessments about risk before we have a chance to think. Things that have been around awhile — snakes and spiders, for instance, scare us. But bigger risks, such as fast driving, don’t trigger the same instinctive response. “Our emotions push us to make snap judgments that once were sensible — but may not be anymore,” the author, Maia Szalavitz, writes.

Fear also strengthens memory, the magazine reports. So catastrophes like plane crashes and terrorist attacks stay with us. “As a result, we overestimate the odds of dreadful but infrequent events and underestimate how risky ordinary events are,” the author writes.

The problem is, this leads to bad decisions. The magazine notes that after Sept. 11, 1.4 million people changed their travel plans to avoid flying, choosing to drive instead. Driving is far more dangerous. The decision caused roughly 1,000 additional auto fatalities, the magazine reports.

The magazine details several other fascinating examples of how we get risk wrong. We underestimate things that creep up on us, which helps explain why we fear cancer more than heart disease. Having control gives us a false sense of calm, which explains why we worry about pesticides on our foods, even as we use weed killer in our own yards.

And notably, we seem to need a constant level of risk in our lives, which leads to “risk compensation” and explains why people end up speeding once they put a seatbelt on.

Source: http://well.blogs.nytimes.com/2008/...-blame-your-brain/?_php=true&_type=blogs&_r=0

 

[Bullets]

Good comment, but not the way you intended.

Statistically, a private handgun is much more likely during its service life to be used in an improper fashion or in an accident than to do anything else except make the carrier feel more secure or to be used exclusively to punch holes in paper.



PPS: Coincidence: very roughly, about thirty thousand deaths annually for guns of all sorts and for motor vehicle accidents

Yeah, and if you own a pool youre statistically more likely to drown at home then those who dont, doesnt mean anything

And your talking about accidental discharge, which accounts for less than 1000 deaths a year, hardly comparable to motor vehicle deaths

 

[usalsfyre]

"How was I to know that headache I handed my girlfriend's mom two Advils for was an intracranial bleed?".

What the heck are you trying to prove/say here? This thread seems to be just incoherent rambling.

 

[mycrofft]

Thanks.

Yeah, and if you own a pool youre statistically more likely to drown at home then those who dont, doesnt mean anything

And your talking about accidental discharge, which accounts for less than 1000 deaths a year, hardly comparable to motor vehicle deaths

I am talking specifically about Center for Disease Control's figures citing these:

(Source: http://www.cdc.gov/nchs/fastats/injury.htm


Mortality, All injury deaths
Number of deaths: 180,811
Deaths per 100,000 population: 58.6

Motor vehicle traffic deaths
Number of deaths: 33,687
Deaths per 100,000 population: 10.9

All firearm deaths
Number of deaths: 31,672
Deaths per 100,000 population: 10.3

Source: Deaths: Final Data for 2010, table 18 Adobe PDF file [PDF - 3.1 MB]

This includes accidents/carelessness; mistakes; homicides; suicides; shootings in the line of duty (good shoots); everything else.

I am not going to debate firearms, we have already established that multiple times here.

Swimming pools at home: Especially without adequate fencing or gates left open, a good example, especially if you ratio it versus deaths by drowning in home pool versus outdoors, community pools, etc. (And versus how many hours a year the pool is actually used). Thanks, that's a good one.

"I swear I locked that gate"; "Little Jimmy can't climb like that!"; "Lassie was just chasing the ball and fell in". etc etc.

 

[mycrofft]

Everything I do in life has an element of risk to it. I know riding in an ambulance puts my life at risk, especially in the back, but it is a risk I choose to take. Life = Risk and I am not here to merely exist. I choose to let common sense prevail, all the while fully aware that I am not in control, and my life can end at any second.

Training an statistics are merely one more tool I have to assess the probability of an outcome.

Here is an article I found interesting:



Source: http://well.blogs.nytimes.com/2008/...-blame-your-brain/?_php=true&_type=blogs&_r=0

As much as I dislike Psych Today's "science" mixed with opinion (such as "studies" which turn out to be questionnaires for the author's 101 level students to fill out, sample of 60 or so, being generalized to the Third World), the concept that we are blind to certain dangers is very true.

We are hardwired to respond fast to fast danger. We seem to be unable to respond to slow dangers, like early cancer, HIV, STD's, global warming, termites in the house. We also discount danger we have not experienced personally if the possible reward is valuable enough to us (sex, money, chocolate, drugs, power).

So we have trouble thinking of ourselves as vulnerable or fallible until we've experienced it ourselves, or a close second-hand. (That's why teenaged kids are less risk abuse as a whole than aunts…and some adults stay that way. See definitions of "Sociopath" or "Psychopath").

Especially when OUR risk is actually a risk for others…like driving fast in an ambulance.

 

[mycrofft]

What the heck are you trying to prove/say here? This thread seems to be just incoherent rambling.

If you handed an NSAID to someone for a headache and they died consequently (not necessarily as a direct consequence of) your giving them a drug which affects coagulation, you took a risk (giving an oral drug on for own hook) and someone else may have paid. (The bleed may have been bad enough all by itself; then again, an exam might have revealed signs of increased ICP. Know how to use a opthalmoscope to check funk, or an otoscope to check for inner ear bleeds, or even do a quick history before handing over a med?

My wife says I'm incoherent then hands me Advils. Wonder why?

 

[usalsfyre]

If you handed an NSAID to someone for a headache and they died consequently (not necessarily as a direct consequence of) your giving them a drug which affects coagulation, you took a risk (giving an oral drug on for own hook) and someone else may have paid. (The bleed may have been bad enough all by itself; then again, an exam might have revealed signs of increased ICP. Know how to use a opthalmoscope to check funk, or an otoscope to check for inner ear bleeds, or even do a quick history before handing over a med?

My wife says I'm incoherent then hands me Advils. Wonder why?

You're saying as a pre-hospital provider who's not on duty and is asked by an acquaintance if they should take a readily available OTC med you'd incur some sort of liability be it criminal or civil? Right...

Tone the hyperbole down and you'd be a lot more effective.

 

[Tigger]

If you handed an NSAID to someone for a headache and they died consequently (not necessarily as a direct consequence of) your giving them a drug which affects coagulation, you took a risk (giving an oral drug on for own hook) and someone else may have paid. (The bleed may have been bad enough all by itself; then again, an exam might have revealed signs of increased ICP. Know how to use a opthalmoscope to check funk, or an otoscope to check for inner ear bleeds, or even do a quick history before handing over a med?

My wife says I'm incoherent then hands me Advils. Wonder why?

Do you have anything to back up these claims? So long as I didn't force feed the person, I don't think I'm on the hook for anything.

 

[mycrofft]

NSAIDS as a class are commonly known to prolong bleeding.

Relying upon "being held responsible" as the standard of care speaks for itself.

The salient quote from my OP is this:

" Going off protocol. Obtaining medical materials and equipment and using them while not on duty. Becoming the "go to gal or guy" for family and friends when they are hurt or sick, either or both to treat and recommend whether or not to go to their MD".

This could be "letting them use my asthma inhaler", or "Giving a neighbor a laxative because they haven't had a BM in four days and have lower right abdominal pain now" or other things.

If people start approaching me to help them determine if they need a doctor or not, or treating them (and offering a NSAID to someone approaching me as a trained practitioner is treatment) I'm moving off my role and into Ego Land, taking a risk based upon my history of infallibility. And if I take a risk like that, the other person takes it as well, with more to lose.

Summing up the Good Samaritan defense, "Do what you know and know what you're doing", we should also add "And do what we are supposed to".

The fact that something is commonly available is not a defense. You wouldn't give an alcoholic a shot of "medicinal whiskey", or a heamophiliac a piece of broken glass, or a two year old a Legos Luke Skywalker. (Once, the things you could common get included radium salts, opium, and Browning automatic rifles. Go figure).

 

[usalsfyre]

NSAIDS as a class are commonly known to prolong bleeding.

Relying upon "being held responsible" as the standard of care speaks for itself.

The salient quote from my OP is this:

" Going off protocol. Obtaining medical materials and equipment and using them while not on duty. Becoming the "go to gal or guy" for family and friends when they are hurt or sick, either or both to treat and recommend whether or not to go to their MD".

This could be "letting them use my asthma inhaler", or "Giving a neighbor a laxative because they haven't had a BM in four days and have lower right abdominal pain now" or other things.

If people start approaching me to help them determine if they need a doctor or not, or treating them (and offering a NSAID to someone approaching me as a trained practitioner is treatment) I'm moving off my role and into Ego Land, taking a risk based upon my history of infallibility. And if I take a risk like that, the other person takes it as well, with more to lose.

Summing up the Good Samaritan defense, "Do what you know and know what you're doing", we should also add "And do what we are supposed to".

The fact that something is commonly available is not a defense. You wouldn't give an alcoholic a shot of "medicinal whiskey", or a heamophiliac a piece of broken glass, or a two year old a Legos Luke Skywalker. (Once, the things you could common get included radium salts, opium, and Browning automatic rifles. Go figure).

So am I supposed to hide what I do? Or tell everyone I know "go to the doctor, I can't tell you anything because I MIGHT GET SSSUUUUEEEEDDDDD!!!"

Be realistic. No EMS provider should be out there selling themselves as alternative to primary care provider, but saying I can never give someone an Advil because they have a headache simply by holding a medic certification is horse caca.

I know you advocate staying inside the neat little orders box, most likely due to educational differences. However posting non-sense like this just makes it look like you're out of touch with the real world. There ARE real concerns about free-lancing ALS and how you justify it, but stories like this just make it seem like you're reaching at a non-existent problem.

 

[Medic Tim]

I would counter that technicians blindly following protocols is more dangerous than a properly educated clinician using guidelines ( deviating on your own). This just reinforces why our educational standards need to raise. If you can't trust an emt with a Tylenol or advil there is a very big issue.

 

[Handsome Robb]

Disagree about the carrying a loaded handgun, nothing inherently dangerous about it unlike seatbelt wearing.

I agree but I do also see mycrofft's point.

You've now introduced a loaded firearm into every situation you run into.

 

[Ridryder911]

I would counter that technicians blindly following protocols is more dangerous than a properly educated clinician using guidelines ( deviating on your own). This just reinforces why our educational standards need to raise. If you can't trust an emt with a Tylenol or advil there is a very big issue.

AMEN!

Also... just two NSAID causing a headbleed?..Don't think so. May not be the best choice but really doubt it be the cause . Now can one testify that headbleed was not there prior?

Again, part of the area one has to prove. As well, as one would do in similar circumstance with equal training and education.

R/r 911

 

[Handsome Robb]

AMEN!



Also... just two NSAID causing a headbleed?..Don't think so. May not be the best choice but really doubt it be the cause . Now can one testify that headbleed was not there prior?



Again, part of the area one has to prove. As well, as one would do in similar circumstance with equal training and education.



R/r 911

Yep!

 

[Ridryder911]

Ironic part of history I was told by a Law Professor .. .The Good Samaritan Law was introduced in the U.S. after an Readers Digest article in the late fifties about physicians not wanting to stop at accidents in fear of beign sued. Ironically, until at that time there had been no law suits filed against physician and healthcare providers rendering aid and very few medical lawsuits....

R/r 911