Since I did the last booklist on texts concerning faith, I
am going to turn the keyboard toward emergency medical services this time
(since I am in one of those rare moods where I am willing to speak about EMS
when not at work). I will probably do two more… one on good read for Scouters
and another on books I have thoroughly enjoyed reading for pleasure.
That said, this one will be a bit long as I want to be
fairly global in my approach in case someone out there is trying to create a
reading list that will help them further their career in EMS. It will be a list
that is clinical, managerial and also work a bit for educators. Ask any EMS
educator and they will tell you their opinion on text books. So will I, and
mine will appear below somewhere in this large minefield of titles. There will
also be several that you may need to find at used bookstores because they are
out of print.
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| Me, circa 1984 taking blood pressures at a mall. Photo by John F. Maier |
When it comes to EMS there is a lot to read. The problem
comes in when trying to differentiate the good stuff from the bad. Here is the
reality… what we need to read is directly related to EBM (evidence-based
medicine) or how to get enough data to perform EBM. Unfortunately, we are just
now exiting the dark ages of EMS where opinion and anecdote reigned supreme.
Many in EMS still hold to outmoded and unproven perceptions of a reality based
on isolated experiences and not aggregate or peer reviewed data.
Hence a quote from last year’s EMS State of the Sciences
conference in Dallas: “We have to stop defining EMS by the things we do and
start defining ourselves by the outcomes we produce.” I cannot remember who
said it, but it is so very true.
Then you step into an ambulance station or an EMS discussion
and you hear the focus. The talk is of this skill and that skill… of old
medicine versus new medicine (accompanied by lamentation as to why we have to
change… again). Try taking a skill, piece of equipment or a medication away
from a group of paramedics. You will be met by gnashing of teeth and you might
even get bit. Try adding something and you may be met with distrust as to why
you have crossed the threshold carrying “change” (“change” might as well be
Ebola to many EMS folks).
This list is going to center around EBM. If not directly
related to EBM, indirectly through how to look at data or treat people.
I will start with the clinical/education list. So let’s
crack the knuckles’ and get started:
- Emergency Care in the Streets – Nancy Caroline: To me this is the essential EMS textbook. It is a core read for the paramedic program and in my opinion, by far the best, most explanatory text out there for teaching paramedics. The accompanying resources are good as well. You will also find throughout this list that I really like the EMS publications published by Jones and Bartlett. I think they do a great job in the area of EMS.
- Critical Care Transport – also published by Jones and Bartlett: This is a core text for reference in starting any critical care program. You can get deeper with other books and resources, but this one is very global in its approach. Again, the resources are good too.
- The 12-Lead ECG in the Acute Coronary Syndromes – by Phalen and Aehlert: I still believe that the Phalen teaching model produces the best outcomes in prehospital STEMI identification and management.
- Prehospital Trauma Life Support: Given two major training programs in trauma care, I tend to like this one best for the timeliest adoption of new information.
- Cardiology Essentials – by Theresa Holler: I was delivering content that was hard to find in writing anywhere concerning cardiac care for years. Then along came this little book with its tips in the margins that covered everything I had been teaching. Good book.
- Wilderness First Aid (both the text and field guide)- published again by Jones and Bartlett: This one is great for those situations where care is not living right around the corner. We use it in Scouting so this one will probably come up again.
- Principles of Emergency Medical Dispatch – by Clawson, Dernocoeur and Rose: I am not a 100% sold fan of EMD, especially on the methodology of prioritization. I have seen a lot of cases where local data flies right in the face of that portion. That said, I do believe that it provides a decent framework for medical 911 dispatching and when the chips are down, every caller deserves CPR instructions. Read this one and at least you will have a working knowledge of the topic.
It would not be right to discuss EBM and not mention the
focus on periodicals. There are really only three that are worth reading from
an EBM perspective. I will however discuss a fourth more common one.
- Prehospital Emergency Care: This is the journal of the National Association of Emergency Medical Services Physicians. It contains peer reviewed, published science on the field of EMS. This is a must read if you want data driven future views of EMS as well as the debunking of age old non-EMB practices. They have even started producing model EBM care guidelines.
- Annals of Emergency Medicine: This is essentially the peer reviewed scientific journal for emergency physicians. At least one article in every issue will have some kind of impact on EMS.
- Circulation: Although I sometimes feel that the AHA is a day late and a dollar short on implementing change, Circulation is another resource for our endless goal of affecting those patients that are less than 0.5% of our total call volume… cardiac arrest.
JEMS (Journal of Emergency Medical Services): When I started in EMS, this magazine was the bomb. It migrated to a collection of EMS news (or behind the scenes after the news) and documentary of what those in EMS do. Now it is moving back toward science. The annual exception to this is what happens once a year (today in fact) when they release the EMS State of the Sciences supplement. This supplement is complemented by what I consider to be the best conference of the year the EMS State of the Sciences Conference in Dallas (otherwise known as “A Gathering of Eagles”). I will put a link to this supplement and another to the conference at the bottom of this blog entry… but act quick… if you intend to go to Eagle’s the positions sell out quick and they are already taking registrations for February 2015. It is a very cost effective conference as well.
The other conference that is great is the NAEMSP Annual
Meeting. It covers fewer topics than the State of the Sciences conference, but
it also has very solid, peer reviewed science where the State of the Sciences
is sometimes the raw data (but that is good when presented rapid fire in over
40 common sessions… you don’t have to pick!).
Now for books that help you achieve EBM and outcomes. This
is the art and the science (as Dr. Ed Racht would say):
- The NAEMSP 4-volume set (Clinical Aspects of Prehospital Medicine, Medical Oversight of EMS, Evaluating and Improving Quality in EMS, and Special Operations Medical Support): These are not only great reads by experts about what is important (THE MEDICINE), but a great desk reference set.
- The Six Sigma Handbook – by Pyzdek and Keller: It does not have to be Six Sigma, but it sure helps to grab a tool kit of QI tools.
- Six Sigma Simplified – by Jay Arthur: This book and its smaller stapled companion quick reference of what analysis you should use for what data are great desk references. If you do not know what to do with your data, this book will give you a start.
- Future Edge – by Joel Barker: This is an old read from the 1990’s but the message is clear. You must anticipate, innovate and be excellent. If you suffer from paradigm paralysis or if you do not know what that is READ THIS BOOK. It is by far my favorite management book of all time. It explains why innovation always comes from the fringe.
- Professional Presence – by Susan Bixler: I like this book. It convinced me to stop wearing EMS uniforms to meetings. Dress for the role you are in. If you are speaking with hospital administrators, dress like them, talk like them, learn their issues and seek win-win solutions. It is an old book, but I think it a good one.
- Legal Aspects of Emergency Medical Services – by Cohn and Azzara: This is just a simple, basic legal reference for EMS.
- The Magic of 3am – by James O. Page: I have been through three copies of this book. It is priceless. I still read sections of this to my medic classes. If you like ethics and answering the questions as to why you continue to be in EMS, this is a great book. If you have never read it, treat yourself.
- Thriving on Chaos – by Tom Peters: Want to really figure out what is going on in an organization? MBWA (management by wandering around). This is an eye opener about getting out of the office and engaging the people in your organization.
- A Passion for Excellence – by Tom Peters: Same author as the last one. Peters on organizational excellence.
- Thinking Critically – by John Chaffee: This book is really old, but it gives good background on the most important field skill in EMS, critical thinking. Critical thinking cannot be trained, but it can be honed to a fine edge.
- Raving Fans – by Ken Blanchard: Yes… it’s about customer service, excellence and the patient experience. It is also about listening to the people closest to the patient/customer.
- Leadership Secrets of Attila the Hun - by Wes Roberts: This oldbook from 1985 is fascinating. It talks about and dives into leadership traits and tactics. The book connects these historically and shows the skills you must hone to get people to want to follow you and at the same time not make tactical blunders so that your people see the winning scenario of their efforts. This is another must read book. At only 110 large print pages, you can read it in a night.
Well… that’s my EMS career book list. Hope it helps. I am
sure there will be some disagreements with my choices, but a blog is about
personal experience and expression so take it for what it is worth.
There are some useful links below (including one to the AMR
Ebola page which NAEMSP has stated is the place to go for EMS and Ebola
information):
2014 State of the Sciences supplement from JEMS:
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