New Digs and Old Friends

The short story is this: within the next few weeks, this site will be moving to the First Arriving blogger network. Hopefully, this process will be relatively seamless and invisible, and you won’t notice anything change. There may be a brief downtime.

The longer version is this: the EMS Blogs network, where we formerly made our home, is shutting its doors. Dave Konig, the network founder and administrator, has made the decision to close up the existing host and relocate the constituent blogs. He can explain better than I can, but things have been a little rocky recently, and astute readers will probably still notice some intermittent outages and broken corners of this site. Hopefully this will all be repaired, or at least repairable, after the move.

The sentimental version is this: the fact that Dave is no longer able to dedicate an unreasonable amount of his free time to serving us authors is not a personal failing on his part. Actually, it’s the opposite. It just highlights how much he’s done for us over the years.

I’ve remarked upon this before, but I believe it’s the folks like Dave in the world who deserve whatever attention we can point their way. They will never ask for it, and if you let them, they’ll remain an invisible part of the backdrop. Yet here are the facts: you would not be reading this blog, nor any of its independent content, nor its sister site Lit Whisperers, if it weren’t for many, many hours of work by Dave. We are not paying him, and he has never made any efforts to monetize the network or profit from us in any significant way. Our names run in the banners, not his. He doesn’t even get a thank you, because mostly we forget he exists.

So now that we’re parting ways, I hope we can all take a moment to remember his efforts.

Dave has done a huge service for the EMS blogging and FOAM community; I am grateful; and you should be too.

Worthy Words

Quotation Marks

I admit that I’m a sucker for a good quote. Truth be told, medicine is exactly the type of enterprise that needs quotes. It’s a basically noble endeavor that’s nevertheless rife with the sort of frustrations, obstacles, and everyday nonsense that tends to make us forget why we’re doing it.

Quotes help us remember. A few concise, perfect words from people smarter than us — they needn’t be real people, either, because sometimes fiction is more true than fact — can paint a picture that reminds us in a flash how to do this job, why we’re doing it, and to whom it matters.

To that end, we’ve set up a page to collect the best medicine-related quotes we can find (you can find it in the menu above as well). Some are about EMS, some aren’t, but if you’re on the job, I bet many of them will ring true. Take a look and check back when you can; we’ll try to keep adding the good stuff as we come across it.

Surly Librarians and their Rants

The Digital Research Library has really grown legs over the scant weeks since its creation, and we couldn’t be happier about it. But as useful as it is to present the bare facts and data, it’s also valuable to read deeper, discovering context and patterns. Try as we might, we couldn’t find an elegant way to include this in the library as it stands, and it would clutter up the front page here obnoxiously.

So we made another blog. Introducing: Lit Whisperers. Check it out, know it, love it — updates will be posted to our Facebook page or via EMS Blogs.

Cutting the Ribbon: The EMSB Digital Research Library



Around here, we’re big believers in evidence-based medicine. Yes, it has flaws, and yes, it can be challenging to properly interpret and apply, but like they say about life, it’s the only game in town.

And sure, you can let other people read the research and tell you how to treat patients. And since by and large, we work under protocols written by physicians, that is inevitably what we do. Yet everybody understands that within that framework, there’s still a great deal of leeway — there are decisions that need to be made every day, and you cannot make them intelligently without understanding what you’re doing and why. If you’re not basing your decisions on science, you’re basing them on personal prejudice, anecdotal experience from your career (which is inevitably weaker than you think), and the similar poor compasses of colleagues and coworkers.

No good. We should all strive to have reasons for the things we do, because that lets us modify our actions, omit them, prioritize them, and otherwise tailor our care to the unique situation and unique patient in front of us.

Unfortunately, directly engaging with peer-reviewed medical research is challenging. Searching through it is an acquired skill, reading it takes practice, and in many cases, we simply don’t have access to published full-text articles unless we’re affiliated with a university. The result is that many prehospital clinicians who want to practice intelligent, evidence-based medicine aren’t able to do so, at least not easily.

In response to this, we’ve launched a new project. Drum roll please…

The EMSB Digital Research Library!

This is an index of medical papers on topics relevant to EMS, ranging from spineboards to sepsis; it’s easily searchable, and can be organized or filtered by the user according to whatever characteristics are desired. Rather than a raw data-dump from all the world’s journals, it’s hand-curated by our volunteer editors, who read each piece from cover to cover, summarize the contents, file them and rank them by quality and relevance. The result? If you want to discover what we know so far on a specific topic, instead of facing a blank, unending sea of medical research, you’ll have a structured library of material organized for your convenience.

When you find the research you’re looking for, what then? If you lack academic or institutional journal access, we’re here for you. Simply email us a request for the papers you need, and we’ll provide them to you privately. We wish it were possible to simply post them online for the world to access, but that would violate copyright law in an egregious way. (When specific papers have been made freely availably by their publisher, we do link them directly in the index.)

How effective is aspirin for chest pain? What’s the chance a patient with head injury has a C-spine fracture? Does it matter if your stroke patient walks to the stretcher? Is supplemental oxygen important during sepsis? What’s the number-needed-to-treat for endotracheal intubation? These are the kinds of questions that are hard to answer now, but will be easy to answer using our library — at least, once it’s grown enough to address those topics. There are tens of thousands of papers out there, and one day we’d like to list them all, but we’re starting with a seed of about a hundred — a very well-developed body of spinal immobilization literature (probably over 90% of the quality research on the subject), plus a scattering of interesting material in other topics. Everything starts somewhere, and it’ll continue to expand.

The Library is managed at this time by my colleague Vince DiGiulio, Head Librarian and Master of Evidence-Based Codices. I help him out, along with a team of associate librarians. In any case, general library-related queries, research questions, or paper requests can all be submitted to librarian[at] Please remember that we’re all volunteers over here, so give us a little while to reply. And if you’re willing to contribute some time to help curate the database, let us know — we need help!

Folks, this will be a constantly-growing project. We’ll be striving to continually add more material, both new and old, and updates will be announced on the library page (as well as the Facebook group). The entire system is still in the early stages, so bear with us through any changes or hiccoughs. And remember: if you’re not thinking about how you know what you know, you’re not a clinician, you’re a monkey. And if the way you know what you know isn’t through science and reason, you’re just a witch doctor.

Use this stuff. Don’t be a witch doctor.

Year Two



Two years!

The inaugural post on this website was published two years ago to the day, and starting tomorrow, we’ll be moving forward into year three.

Time flies like a banana, doesn’t it? Over the past year, the site has grown and evolved. Due to personal obligations (I’ll be heading up in a few short months to matriculate at a PA program), I confess that the output of general content has dropped off. In comparison to the 81 posts made in the first year, this past year I cranked out only 34. Despite that, annual traffic has swelled from 30k unique visitors to over 72,000.

Some things stay the same. The most popular pages are still the What it Looks Like series (which we continued with a popular edition on Cardiac Arrest and CPR), the Drug Families: Anticoagulants and Antiplatelets tutorial, and our guide to orthostatics. We keep talking about how to be a good EMT, and ran some posts about the basic challenges of patient care and how to manage them. In keeping with the basic mission of the site, we discussed things like performing great BLS-level resuscitation.

But some things change. We ran a new multi-part guide on glucometry that was well-received, and a series of posts examining BLS airway and ventilation that have become some of the most popular on the site. We tried our first collaborative community podcast and experimented with video lecturing.

Perhaps most excitingly, we launched our most ambitious project yet: Scenarioville, an alternate reality allowing us to present frequent everyday patient scenarios in a consistent environment. Although we’re still tinkering with the format, after the first 16 scenarios I’m very happy with how it’s working out, and I think it allows for learning in a unique way. The only downside is that it’s also a time sink — by making a commitment to post a new scenario every week, with chapters added Monday-Wednesday-Friday, I’ve had less time for producing new front-page posts with real meat behind them.

What’s next? It remains to be seen how the site will continue to unfold, particularly as my spare time becomes increasingly thin. But I’ll keep punching out as much good stuff as I can — and there’s a new project unveiling soon that’ll bring things in a whole different direction. I think you’ll like it.

The good folks I acknowledged last year still deserve a nod. And I want to extend my thanks to everybody in the audience who’s been reading, commenting, and sharing across social media; this content wouldn’t have reached nearly as many eyes otherwise, and perhaps I wouldn’t still be creating it.

I also want to give a wave and a tip of the hat to a smaller gang of friends. There’s a circle of some very smart and passionate folks who I’m proud to know, namely Christopher WatfordVince DiGiulio, David Baumrind, Tom Bouthillet, and others. Through collegial discussion, sharing circulating noteworthy cases, bouncing ideas hither and yon, and overall collaboration in the best spirit of EMS 2.0 and the internet age, they’ve had a tremendous influence upon my way of thinking, my bank of knowledge, and my belief in the education of prehospital providers. Keep an eye on them, because people with this much dedication and brainpower can’t help but change the world.

I hope everybody has learned something from these pages and enjoyed the process a little bit too. And I hope to see everyone again, and new faces too, as we move forward into another year.

Stay safe and sane, and check back soon.