Rules of Patient Care

The image above represents a man considered "near royalty" in the trauma and pre-hospital arenas. This gentleman had an illustrious four decade run at Tulane and was the long-time medical director for New Orleans EMS. Long ago, he established his 18 Rules for Patient Care and evangelized them far and wide. From the mind of a gifted surgeon and staunch EMS advocate, Norman McSwain, MD. His rules are included below and have a lot of EMS relevance.

1. Death is Your Adversary and Your Competitor - Fight to Win!

   1. Don't cut corners - many times we do WIN
      

2. Treat the Patient as if They Were Your Family Member

   1. Call them by name, this job is centered on trust/communication
      

3. Each Minute Has Only 60 seconds - Don't Waste Any of Them

   1. Leverage mobile technology in time sensitive emergencies
      

4. Assume Nothing, Trust No One, Do it Yourself

   1. Trust is necessary for collaboration, but it shouldn't be blind/unquestioning
      

5. Know Anatomy Cold

   1. You don't need it - until you need it
      

6. Be Technically Quick

   1. Own the patient assessment, be familiar with data analysis
      

7. Don't Panic at the Sight of Blood

   1. It will get messy - don't get distracted
      

8. Work with Physiology, Not Against It

   1. think about how interventions like CPAP, ASA, TXA actually work
      

9. Maintain Energy Production

   1. You can't pour from an empty cup
      

10. Know What to Fix and What to Leave Alone

    1. One example. Minute volume in metabolic acidosis - leave it alone
       

11. Know When to Run

    1. Provider violence is an occupational hazard - keep situational awareness "ON"
       

12. Paranoia Prevents Disaster

    1. The patient's disease is out to embarrass You
       

13. Never Talk Anyone out Of - OR - Into a Procedure

    1. Provide facts/recommendations - remember patient autonomy
       

14. The Nurses Notes Don't Say What the Nurse Told You

    1. Communication is KEY - consider "time-outs" during handoffs
       

15. Don't Procrastinate - Make a Decision and Carry it Out

    1. Analysis paralysis offer NO solutions
       

16. Learn from Your Successes as well as Your Failures

    1. Stay humble, Fall forward, QA/QI isn't Punitive
       

17. Question Everything You Do

    1. Be a life-long learner and find a great mentor
       

18. Don't Whine - Just Get the Job Done

    1. You will miss this Job -- Just Ask the Retirees

April 8, 2024

Author: Joshua Ishmael, MBA, MLS(ASCP)CM, NRP

Pass with PASS, LLC.