An Open Letter to JEMS

Dear JEMS Magazine,

I used to look forward to reading JEMS in print and on-line but lately you have been publishing some content, that there is no other way to put this, that is pure shit.

I’m not sure if the editorial board simply stopped caring or they are desperate for submissions, or both. You know the quote from Spiderman, the one about great power and responsibility? When you have a readership of 420,000 a month I think it applies here. [1]

jemsThis week you published a cautionary fan fiction-esque tale in which a paramedic gave narcan to an overdose patient and because of that her partner died, the paramedic went on to sustain a catastrophic brain injury and four law officers had to go get tested for bloodborne pathogens and the patient got tazed. [2]

It was like reading a bad Chose Your Own Adventure book; If you chose to administer narcan go to page 37.


In another article about pain management the author (the editor-in-chief) states the following, “Under the circumstances, the only way for me to gauge if they were pinching his injured foot and potentially causing further injury was to hear the change in pitch of his screams.” [3]

Clearly the author does not understand that 100-200 of fentanyl (or the equivalent) is not going to make someone numb. We aren’t doing nerve blocks in the field. If someone has broken bones and you crush them more, a one or two hundred micrograms of fentanyl are not going to render them unable to feel pain.

The author then goes on to reinforce the idea that we should not treat abdominal pain in patients because “pain medication can mask injury and inhibit patient assessment is in situations where we have to palpate a patient’s chest or abdomen after a traumatic injury to assess for internal bleeding or significant organ damage.” [3]

The author then concludes his piece with, “and never forget the power of a calm, professional demeanor, comforting communication, a splint and padding on their injured areas and a smooth ride to the hospital without anxiety-creating sirens in operation. It’s often as powerful as pain medications.” [3]

I’m not saying it doesn’t go a long way to do all those things, but when someone has significant pain there is no reason to not treat it.

Perhaps next week you can post an article about a patient that wasn’t put on a backboard and then he coughed and is now paralyzed.

You owe it to the EMS community and to the patients we serve to produce better content than this and to ensure that the content is congruent with current best practices.

In case this finds its way to anyone at JEMS, or anyone else needs reassurance that treating abdominal pain is safe and does not effect diagnosis or delay treatment, please read the following: Medscape article on abdominal pain





3 thoughts on “An Open Letter to JEMS

  1. This is why I no longer subscribe to #JEMS. “The Conscience of EMS” has been very forgetful that science is a part of “conSCIENCE”. I hope they step up their game quickly. And they aren’t doing anyone any good by continuing to sell ads for products that science has shown don’t improve or in fact worsen patient outcomes (cough… BACKBOARDS… cough).


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