Heart-burned multi-lead medic troubles

[Crasha172]

I'm a relatively new medic (about 1 year in) and am being constantly questioned about treatment by more experienced providers. being a new medic i was given more initial training in 12-leads initially and recently took Bob Page's "multi-lead" medic class independently of my service. now I'm having heart-burn from these more senior medics telling me my treatment is inappropriate because I'm, in their words "thinking outside the box" which they used as a negative quote. I'm sure that these medics have limited or no exposure to 12-leads and are very intimidated, but 15-leads and they look at me like I'm from mars. What do i do to get them to leave me alone to do my job?? please help.

Heart-burned in michigan

[mitllesmertz1]

Well, for what it's worth:
Some new medics, with a brain full of exciting EKG knowledge, get a little carried away when looking at a 12lead.
They talk about Axis, deviations, intervals, blah blah blah.
It's all very interesting to them, although rarely is it CLINICALLY RELEVANT.

The ability to diagnose AMI/Ischemia is really the ultimate goal.
Maybe the ability to recognize VT using a 12lead, as opposed to a 3lead.
But really, alot of the stuff you just spent hours and hours learning is really not very useful.

So keep it inside. Don't point out the extreme left axis deviation, or the bi-atrial enlargement.

Everyone will be happier :)

[LasVegasEMS]

I agree with mittle to an extent. The little in's and out's of 12 Leads can be interesting, but only to those who themselves find it interesting. However, you go trying to talk about it with people who dont care and you're gonna get a rash of Sh*t for it.

My advice is this: In a respectful way, ignore them. If your treatment skills were really that "out of the box" to the point of being dangerous, QA/QI would have gotten involved a long time ago. They may think your treatments are different and wierd to them, but in the end, you're not under their control and quite frankly don't owe them an explanation, the exception being if you're a junior medic on a dual ALS truck, but it sounds like people talking to you at the hospital or station.

If you really feel the need to share this information, find someone, preferably an experienced provide who also likes staying up-to-date, and kick things back and forth with him/her.

[medic18]

Keep using the multi-lead assessment and what you have learned. Remember the conduction problems you can find with the multi-lead monitoring -vs- limb leads and you will not give lidocaine to someone that has multible condution blocks that you can not find on the limb leads. Remember "if you are monitoring lead two you have no clue".

[Crasha172]

thank you for all the replies, i definitely appreciate a non-biased opinion. the bottom line is that my company trusts me on an ALS truck with an EMT-B i just don't understand why these other medics have to make it their business, leave me alone and i will leave you alone and we all go home at the end of the shift.

[AZCEP43]

You are the new guy, and they just might be trying to figure out how much stuff they can give you before you crack.

Not a way to endear them to you, but not uncommon either. Keep using the information to benefit your patients. It won't happen often, but it only has to happen once.

[jdy2kgt]

Just remember you are the new man in. Yes you probally are more knowledged on things then the guys doing this for several years, but don't try and show off to them about it. EMS is very sensative and some people get offended easily. And never forget "EMS IS A SMALL WORLD" burn your bridges in one place and it will stick with you no matter where in the country you go.

[Medic1027]

I have been a medic for over 25 years, and in my most humble opinion, the fact that you "think outside the box" is both refreshing AND intimidating to those peers that may not have had the education that you have. Years ago, the classroom wasn't as informative as it now, so keep in mind that you are learning more now as a medic BEFORE you hit the streets than someone who got their card in the late 80's or early 90's. BUT, in the same token, if you take the information you get from assessing a patient, and DO SOMETHING with that information, kudos to you. But if the information you recieve serves no purpose other than irritating your peers, then you may want to keep it to yourself and file it into the "golley gee wiz" file for later. Just my .02 worth.

Scott

[reaper1]

I agree. Alot of older medics don't like technology. They like the old school stuff and that is fine. Me, I like to keep up with the newest stuff. This keeps me educated and helps keep the best care for my pt's. Just find yourself a medic that does the same as you and talk to them. But, don't turn a deaf ear to the older ones, as they can teach you things you will never learn in school.

If they keep it up, then don't tell them what treatment you did. There is a thing called HIPPA and they have no rights to ask you!!

[leylandauto]

As another 'old school Medic' (1981). I struggle now to keep up with new Medics. Lets face it, the training now is in many cases much more comprehensive then when I was in school. Many of the people I work with now are younger than my own kids but they bring some real good tools to the table on a call. V4R's and V8/V9 leads definitly have a place in the street. Us old guys can bring things to the table as well and I like the mix of having a young, aggressive partner with me. I think it is a good mix. So, dont flaunt the knowledge in front of them because it can be intimidating and arrogance has to be earned :-) Keep quietly doing what you think is best and you will get slowly accepted. Just remember to know your place and respect your elders, you will become one some day :-)

[medic929]

Don't worry about them, they are lost is all. I am a vetran paramedic and an Instructor in MI, and I teach the same principles as I too have had Bob for class. The thing is, they do not like new school ideas. They have been treatiing people the same way for years and it has "worked" for them so why change. The fact is, medicine is not an exact science. Things change and we learn more every day. New ideas and technologies help us to treat people better. I teach old school medics all the time about 12 leads. They get frustrated because it is new and it is change and they hate it. The days of cokie cutter paramedicine are over. We can no longer do treatment A because of problem A. We have to THINK about what is going on, evaluate things and then pick the best treatment. I assure you that 12 leads are the gold standard for cardiac and the older people who are not taking classes on 12 leads are going to regret it in the future. On the flip side, being new, older medics do not like the new guy who knows everything. You will learn so much more on the road with real patients, than can ever be taught in a classroom. Try not to be the "JFK" and be modest and learn as you go. Be confident in yourself and your skills, but not cocky. Not that you have it, but avoid the "Paragod" complex and you will see that people will be more accepting of you and your new ideas when it comes to patient care.