mailmantech82 Posted October 5, 2007 Share Posted October 5, 2007 Hey, I'm writing a term paper for paramedic school on how medical treatments and protocols have changed in the last 30 years or so. If anybody has any information or old protocol books, I would appreciate it! Thanks, Link to comment Share on other sites More sharing options...
dahlio Posted October 5, 2007 Share Posted October 5, 2007 Watch the old TV Show Emergency! Link to comment Share on other sites More sharing options...
Dustdevil Posted October 5, 2007 Share Posted October 5, 2007 Watch the old TV Show Emergency! Then go visit LA County and realise that nothing has really changed. At home, I know I have some old protocol books, textbooks, and ACLS sheets from the 70s and 80s. Unfortunately, I am nowhere near home. I think what you will find though, is that protocols are about all that has changed in EMS over the last thirty years. Bretylium and MAST pants have been laughed out the door. We're not killing as many people with calcium and bicarb anymore. We're not frying the myocardium with 500w/s defibrillation anymore. By the same token, few people have ever heard of a "precordial thump" anymore either. But it would be naive to think that, in ten years we won't have thrown out a few medicines and techniques we use today too. That's not really an EMS change. That's just medical progress across the board. Something more EMS specific would be EKGs. It was all about Lead II in 1972. In fact, it stayed that way until only about ten years ago. I learned 12 leads before I ever went to medic school, and I spent two decades wishing we had them in the field. Now they are pretty much the standard of care, although that standard isn't taken very seriously in far too many systems. Their medics are very poor at interpreting 12 leads, that is if they do it at all, instead of just letting the machine do it. This is one change that I am watching with a lot of interest, and I honestly can't guess which way it will go. I have a sick feeling that we may regress on this one, with all the urban firemonkeys and rural retards fighting anything that requires more than minimal training. Burn care seems to change every five to ten years. Dry. Wet. Dry again. Ointments. Shaving cream (NON menthol, please!) and Betadine foam in the late 70's. Burn Gel now. Who knows what will be next. Medical control-wise, many areas of the country have begun seriously moving their medics away from the old "eyes and ears of the doctor" theory of paramedicine towards a more or less autonomous practitioner. That's a great theory, but unfortunately not everybody is taking it as seriously as others. In most systems, when medics brag about how autonomous they are, it just means they can cook by the book without having to call anybody on the radio. But, in others, it means they can initiate medical interventions based upon independent, intelligent clinical judgment, not a cookbook and bag of "skills." Moving away from the "mother may I" school of practice is probably the most significant change in EMS in the last thirty years. But, as already noted, there are certainly plenty of places where that is still the standard too, and probably always will be. Another system-wide change of medical implications is the way we handle trauma. I have seen that come full circle. When I first got in the business, we didn't know dick. Red Cross first aid was all most of us had. Consequently, all a trauma victim got was load-and-go. Fast forward three years, and things had completely changed with EMTs now in the picture. Now you didn't dare leave a trauma scene without first making sure all your wounds were bandaged NR style, with tails tucked in, and all suspected fractures neatly splinted, despite the fact that they were unconscious with a BP of 60. Then it got even worse when we got paramedics. Now if your trauma patient arrested on you, you shifted gears from trauma to medical and started working them as a cardiac arrest, almost completely losing sight of the traumatic injuries. Today, we're back to where we were when all we had was Red Cross first aid. That is probably the biggest, and most dramatic change I have seen, and seeing it come full circle leaves you wondering what else will do so! Other medical treatment changes I can think of off the top of my head would include the use of sandbags to stabilise the head on a backboard. This was before CIDs, head beds, and those disposable foam blocks. It took us quite a few years to figure out that, if we had to roll that patient, the weight of the sandbag on the side of their head ended up on TOP of their head, which was a bad thing, lol. Along those same lines, it wasn't until the mid 1980s that everybody started using rigid c-collars, instead of the old foam "whiplash" collars. Also up until the mid 1980s, federal specs said we needed blue overhead "shock" lights inside the ambulance patient compartment, so we could soothe our frightened patients without having bright lights in their eyes. Some of us figured out many years earlier that this would make it really hard to tell when your patient was becoming cyanotic, lol. Yeah... this wonderful idea brought to you from the same federal government that so many people think ought to be running EMS and healthcare in general! Okay, now I'm having 70s flashbacks. Better go. :? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 5, 2007 Share Posted October 5, 2007 Dust, to get rid of those flashbacks, go put the 1973 Midnight Special in, then grab a coke and sit back. Link to comment Share on other sites More sharing options...
Scaramedic Posted October 5, 2007 Share Posted October 5, 2007 Some of the things I have seen. Ambulances at first (for me) were just vans with no raised roof. You had to hunch over your patient, and space was at a premium. Sirens were in the light bar on the roof, probably costing me some of my hearing. Backboards were made out of pine, that creaked when you picked up patients. Now they are usually some kind of plastic/polymer/fiberglass? Hell I don't know but it looks cooler. Gloves, not a big concern at one time. I remember doing my first monthly inspection on the rescue. When I came to the gloves check box the EMT was like "there's a box under the bench somewhere." I received my MAST pants training in 1987, they were the primary treatment for shock back then. I even got a snazzy little patch that said M.A.S.T. Certified. I wish I would of kept that. Radios have gotten a lot snazzier. We used to contact the hospital with a rotary dial radio. Peace, Marty Link to comment Share on other sites More sharing options...
mailmantech82 Posted October 5, 2007 Author Share Posted October 5, 2007 Hey! Thank you so much for all of the information that is coming in Marty and Dust...I appreciate it so much and it's very helpful! Link to comment Share on other sites More sharing options...
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