To predict or determine the future, it is in self-interest that prehospital professionals do both

I’ve made it a goal to be a participant in determining the destiny of our profession.

To predict is passive; to determine is affirmative and conveys a sense of control. In the context of our profession, my opinion is prehospital personnel generally do neither. I am not speaking of issues within an organization or local jurisdiction. Rather, I am speaking of larger issues like federal legislation or professional self-determination. Note how there is no such thing as “self-prediction.”

Too much cynicism facilitates easy predictions. Dare I say negative suppositions at that. And it is ingrained in public safety folks to expect the worse, but hope for the best. As the retort goes, hope is not a strategy. Strategy is something like Community Paramedicine. Innovative EMS leaders did not just hope populations become less reliant on EMS, they created a model of proaction.

Positive or negative, predictions are necessary. They make one consider future results. Consider driving with your eyes closed, experience suggests the inevitable crash. Determination is the act of opening your eyes to prevent an unfavorable outcome. In this case, prediction educates a determined action. Participants of EMS Agenda 2050 were asked to imagine prehospital care and public service in the distant future. It was not easy. The one instruction we received was to avoid today’s solutions as ways to fix future problems. This doubled the difficulty. We were to consider today’s problems in order to both fix and prevent them for future EMS professionals.

What is EMS Agenda 2050?

In November I attended the EMS Agenda 2050 session held in Minneapolis, Minnesota. You may still participate in a couple of ways. In person, at one of two upcoming public meetings or through a form on their website. I suggest contributing in person. However the online form is always available.

For more information check out The Straw Man Document.

The Straw Man broadly covers numerous categories of EMS system design. It is written to both prompt predictive consideration and encourage professional determination. These public meetings explore many paths through discussion.

To keep discussions fresh and dynamic, EMS Agenda 2050 organizers use the World Cafe approach. The concept is fresh dialogue as participants rotate at times intervals. For each six future think topics, participants move to a new table every 30 minutes. The goal is to sit with new individuals with each move. At this event, technical expert panel (TEP) members facilitated sessions and took notes.

It was daunting to think of an EMS workforce thirty years in the future.

As we moved around the tables, solutions were being considered for today’s problems. Kudos to futurists who dreamt of autonomous cars and pocket-sized computers as powerful as a 1950’s mainframe. All we could muster were future tools such as upgraded iSTAT blood monitoring or point-of-care ultrasound (POCUS) devices. In other words, we simply want improved versions of tools currently available.

Across several tables and topics, I synthesized a future EMS more interesting than revolutionary. First, to raise paramedics to the level of physician assistant or advanced practice nurse would enhance our profession. Second, higher training would allow stabilization of patients on scene or in their home. For instance, treatment with fluid, antibiotic, and a pressor if needed would reduce need for emergent transport of a septic patient. This enhances safety of crews, patient, and public. But as I pointed out, these are the next stages of profession advancement and beneficial results to all stakeholders. Who knows, perhaps by then we can beam them to Dr. Bracket on the U.S.S Rampart.

What next?
I highly suggest contributing to the ongoing round table discussion that is EMS Agenda 2050. Read The Straw Man Document. I will not go as far as calling it controversial, but it is indeed thought-provoking. We all ponder the good and bad of delivering prehospital emergency care. Do something about it! As providers, we are intimately familiar with barriers and solutions. Get involved farther away from your sphere of influence. If you are unsure how lobbying and petitioning your legislators works, find someone who can. Learn from and join with them to become a determining influence. Join groups and associations; maximize personal efforts by participating in groups.

Continue to examine current problems; solve them for future providers. With this, bring solutions not just complaints. Do not just predict “nothing will change.” Be the determinant that things will be different!

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