First, I must start off with a big thank you to everyone who assisted me, and my colleagues on the protocol committee, with their submissions of their service’s or state’s protocols. While quite mountainous, that information was priceless, and combined, it helped us formulate our new protocols.
A big thank you to Rogue Medic as well, who was the direct impetus of many of those submissions, and whose work has made it into more than one discussion over a conference table.
It’s been a long 10 months, but it’s done.
Finally, our company’s protocols have been completed. But there are still a few hurdles, of course.
Now, instead of a medical director, we have a medical direction team.
Now there are five doctors running our medical direction.
That’s good and bad, I suppose.
Doctor A is an orthopedist who believes in the liberal administration of analgesics. Thanks to Dr. A, we will be able to choose from Fentanyl, Morphine, Toradol, and Nubain. I don’t think we will be using much Nubain, but we shall see.
Dr. B is a pulmonologist, and is working with management to procure BiPAP for each of our ambulances, instead of the disposable CPAP that we have been using. He is making available a myriad of respiratory drugs, without the need to request orders.
Dr. C is a cardiologist who recently moved to our fair city, and is a big fan of EMS 12-lead, Dr. Smith and Dr. Walsh. She insists on proper lead placement, with frequent 12-lead acquisition, and is a big proponent of intravenous nitroglycerin. When discussing nitro spray, I believe the line she used was something akin to “urinating into a hurricane.” She also has instructed supply to “order lots more Lifepak paper.” I like that.
Doctors D and E are both emergency physicians, one an MD, and one a DO. In discussions with them, I think they have only a minimal clue what EMS actually does. But that could be a good thing, too.
All of these delightful people are research-minded, and what to do what is best for their patients, as opposed to what everyone thinks they should be doing.
There’s no telling how long it is going to take for all of these protocols to be stamped and implemented. I imagine it will be another 6 months or so.
But Local Ambulance Service is about to do some great stuff. When things become more official, and actually roll of the presses with signatures, I will update my faithful readers with that information.
Thanks, y’all.


When done, please forward to @flobach!
Tj
@meditude
It’s sad, but sadly unsurprising, that the EM physicians are the ones with the least idea of what EMS does. I’m frequently simultaneously amused and appalled by the ignorance of people who are supposed to be our allies. ACEP should be ashamed of the lack of knowledge some of it’s members have.
That aside, it sounds like you did a really good job with this.