Contemplating life.

Keeping it real


In the EMJ Podcast from April 23, 2013 “The Wells scores for VTE” (iTunes link), a notion that is briefly mentioned and discussed is the move away from the “rule in/rule out” strategy for (possible) disease management in emergency medicine, instead employing clinical probability, the burden of disease and considering false negatives and false positives.

And how does this tie in to the world of Paramedicine? Let me demonstrate.

I’m sure most of us have responded to calls where patients have punched their minor ailments in to a computer, and the wonderful world wide web has diagnosed them with cancer, the black death, and being pregnant with triplets.

In a sense, paramedics often do similar things. We are quick to turn up to patient, assess them, expect the worst, then make them expect the worst, and transport them to hospital. Just in case. To be sure, to be sure.

The only thing that is sure is that it is clogging up the hospitals.

Instead of ruling a specific disease in “because we can”, how about emphasising clinical probability and disease severity, and weighing them up against each other? We need more training and education focussing on minor injuries and diseases, allowing us to recognise issues, and deal with them appropriately. More diagnostic kit is becoming increasingly mobile, with blood analysis now not only for glucose levels, but for white blood cell count, and more. A framework of robust clinical decision making guidelines for the well educated paramedic, together with optional online (phone/video) consulting for a second opinion and appropriate referral pathways is the way of the future.

The “You call, we hall, that’s all” paradigm is outdated.

Paramedics are specialists in unscheduled and emergency healthcare. Care right at your doorstep. An you won’t necessarily even have to cross it.

Learning styles

A post provoked by uni studies and listening to podcasts. I wanted to post this on the facebook wall of the EMS EduCast, but it wouldn’t let me. So I decided to publish it here!

Hello EMS EduCasters,
In one of your episode you mentioned different styles of learners. It reminded me of an EM Crit podcast (Weingart, 2013), where a study by Pashier, McDaniel, Rohrer & Bjork (2008) is brought up. The authors conclude after their experimental trial that the concept of different learning styles doesn’t exist in such a way that common knowledge may have led one to believe. Weingart bluntly puts it in his recording that there is no such thing as an audio or a visual learner, and that books are hard to read for a reason – because study is difficult!.

I believe he makes a good point. I like to watch a video and listen to podcasts, and sometimes shy away from reading the hard stuff – but at the end of the day, reading gets you through a lot more information, but it is hard work. A mix of all ways of parting information is ideal in my opinion.

What does everybody think – are you surprised? I was initially, as I just took what I had heard about different learning styles for the bare truth, without having any credible sources to back me up.

Keep up the good work, and autumnly (chilly) greetings from London, UK,




Pashier, H., McDaniel, M., Rohrer, D., & Bjork, R. (2008). Learning Styles: Concepts and Evidence. Psychological Science in the Public Interest December 2008 vol. 9 no. 3 105-119, doi: 10.1111/j.1539-6053.2009.01038.x

Weingart, S. (2013). Podcast 105: The Path to Insanity. Retrieved from