Change,.. for the better?

Think back when you first got in to EMS. What type of equipment did you have? What was the quality? Were they things you thought would be around forever? Were they techniques that were the "latest and greatest" only to be superseded in 5 years? What about personalities, traits, and qualities of our people? How about our patients?

Used to use a Datascope and LP5. Now we're up to a LP12 or LP15. 12 leads in the field, capnography, pulse oximetry, all that from one monitor. Used to be everything separate and HUGE.

Two man cots were the norm. What a pain! The amount of back injuries had to have been astounding during those days. Saw one a couple weeks ago and thought of how long ago it was when I used one. Then the one man cots came out with the Teflon runners. Still a pain to put in a bus. Now we have electric cots. Nicer to maneuver around but the added weight may be a concern for some. I think ours is about 27 lbs heavier than our old ones.

The old gumball lights on a truck's exterior used to be "it." Now a vehicle can be "Griswolded" up with LEDs. Man, what a difference! Sirens also have made neat changes. The old "Q" to the Rumbler, which I think is neat. I do like how a lot of departments have a Q on their vehicles in keeping with tradition or just because it's always been a reliable warning device.

AEDs have progressed mightily. They've been out since 1979. We got our first one in 1989 for $12,500 and it was the size of a large carry-on luggage bag. Had a nice screen to see the rhythm and it was damn heavy. Now ours are about the size of a big laptop and cost around $1400. The new ones can be "automatic" and do seemingly everything for you. Long battery shelf life, lighter, smaller, cheaper.

@IRLMedic mentioned BSI. Holy cow! Didn't it used to be a sign of a busy or "good" shift because of the amount of blood you had on your uniform? It was for me! Never brought another uniform to work if one got dirty. Nah, it just showed the other crews how busy I had been. Gloves? Safety glasses? CO detectors and monitors? I gripe at new EMTs and our rookies if I see them without gloves on, regardless of who the patient is. I'm not the best example but I also do a good job of keeping clean and not getting anything on me.

We are lucky enough to have received a grant for a Glidescope. It's a terrific tool that, in my eyes, is making intubation a lost art form. I love the fact that it helps keep our faces away from a patient's face in case of unexpected showers of vomit and other nasties and that it gives us a great color picture of what we're after. Expensive, yes. In a couple years the cost will probably be cut in half.

Our CPR changes have been rolled out this year. Seems like every couple years there's a change or two in store for us. This year they remove drugs and have even less emphasis on respirations. Used to be hyperventilation was good and airways were paramount. We could push drugs through an ET! Now if we can't get them tubed and no peripheral line we just put in an IO. With BIGs and EZ IOs IV problems are seemingly a thing of the past. IOs didn't used to be thought of in adults, just kids. Now they're becoming more and more standard first attempt on certain situations for time's sake.

We used to treat HTN in the field. We used to give a lot of bicarb, calcium and mag. Some of the other meds I used to carry were Brethine, Lanoxin, Mannitol, Decadron, nitro paste, among others. I think I'd be hard pressed to find those on a bus now with short transport times, if at all. MAST pants were the norm; Sager splints and build-a-boards; steel O2 cylinders. Just a year or so ago I got rid of an old bicycle pump suction unit I had in my supply closet. I remember when V-Vacs first came out and they were lauded because of the way they could suck up a can of Chunky soup in no time flat. Remember the old blue laptop case looking suction units that never seemed to have enough power to suck anything?

So, what's next? What else can be improved on? I'm trying to think of different ways things will be improved in the next year, 5, or 10 years. I'm amazed as I look back and see all the technological changes I've witnessed, how treatment modalities have changed, and how everything in EMS continues to evolve in to a new form of medicine, rife with technology and knowledge, fueled by exuberance, dedication, and longevity.

EMS will always be around and we will continue to change with it as it changes. How will you accept the changes we make?