EMS: Save the Red Lights and Sirens! A primer on anti-intellectualism.

People are always mentioning about EMS having a seat at the table in health care. If you are like me, you don’t want EMS to have a seat at the table in some boring meeting with other health care professionals. But that is exactly  what some people want. They want us to be college educated and to never use our lights and sirens again. They  want us to do less for our patients in the name of science. When discussing issues about EMS  on social media here are some pointers to ensure that EMS never becomes seen as health care professionals and we continue get to do the things we all love like drive fast and use backboards.

Ignore Science and Substitute Personal Anecdotal Data
When a meta-analysis comes out and shows your beliefs to be incorrect the obvious move is to attempt to discredit the scientists who did the study, or just discrediting scientists in general. Pointing out the fact that they are desk-jockeys in some lab and do not face the reality that you see on a daily basis on the streets is always a good strategy. If you have seen things work in your life then who are these scientists to say that they do not? A common tactic used by the researchers is to say the plural of anecdote is not data. Tell them that data is nothing more than anecdote aggregated and watch their heads explode. Then just tell them that your one example of data is more powerful than their thousands because you have seen it first-hand, as opposed to simply reading about thousands of cases.

Employ a False Cause fallacy
Can you believe that people still ask for proof of things such as red lights and sirens (RLS) being a good idea or asking for the evidence that backboards work? How many people have you transported on a backboard that had a spinal injury and did NOT become paralyzed because of the backboard? Lots, right? This clear evidence can be shown by the following equation:
[spinal injury + backboard ≠ paralysis] therefore,
[spinal injury (-) backboard = paralysis.]

For even more proof we can look at RLS transports,
Injured patient+RLS transport = none of my patients died. Clearly this is demonstrating the efficacy of RLS transport.

Always argue that correlation does equal causation, especially if you have seen it first-hand.

Appeal to Authority, Clearly State the Number of Years You Have Working in EMS
When faced with an overwhelming amount of data that is contrary to your beliefs you must fall back on your years of experience as a trump card. Who are you going to believe, some guy who only has 5 years on an ambulance or the grizzled veteran who has seen it all over a 28 year career?

Another strategy is to mention your certifications. No one would dare challenge your opinions when they realize you hold a AHA CPR or ACLS instructor card. The fact that you have these certifications should speak for itself as it is well known that AHA has a thorough vetting process. With an ACLS instructor card you are the expert and if people will not listen to you, they are refusing to listen to a subject matter expert.

Call any Attempts at Discussing an Incident as Arm-Chair Quarterbacking
Sprinkle liberally with “you weren’t there.” People who were not there should not talk about things. There is no need to examine our current beliefs or practices in EMS and fire. What we have been doing is just fine. Any attempts to look at outcomes or accepted practices that could in fact be dangerous should be considered an act of war against our collective reputation and must not be tolerated.

Employ Circular Reasoning: Use Your Protocols as Evidence
Protocols are irrefutable evidence that you are correct. How do you know this? Because it says it in the protocols..

Use an Outcome Bias with a Small Data Set
If you have been driving RLS for the past 6 years and never gotten in an accident then it must be safe. If you have never witnessed a pressure ulcer form from placing a patient on a backboard it is safe to say that backboards do not cause pressure ulcers. If you have never gotten in an accident while driving drunk, clearly MADD is just out to be the fun police and drunk driving is safe.

Personal Incredulity
You have your beliefs and you feel very strong about them. If you can’t imagine any way your beliefs are wrong, then they probably aren’t. Beliefs are based on something much deeper than logic and therefore are likely to be correct.

Go Ad Hominem
No true paramedic would advocate for doing less for a patient. Clearly those who want to do less for a patient, (less oxygen, less backboarding) are motivated by their laziness. Pointing out that using the guise of science to cover for being lazy is nothing more than a rouse is a excellent way to get your point across. Never forget the nuclear option exists. When someone insists your anecdotal data is not going to convince them, you may have to call them a paragod.

I have given you the tools you need to continue the EMS anti-intellectual movement on social media.

I guess another option is we could stop the anti-intellectualism and dumbing-down trend that is so deeply entrenched in EMS.  We could be open to exploring if the beliefs we hold are in fact correct and if our practices really are safe and effective. EMS and fire could embrace science and data and use them to produce better patient outcomes and increased provider safety.