How many times have you seen a “doctor” on TV shock asystole? Or patient intubated with IV tubing? These are all normal occurrences for TV and movies involving medical services. But why are there no real life shows about EMS?
What we do isn’t “TV worthy”. For the most part, over half of our calls involve taking patients to the hospital that most likely don’t need to be there. Rarely do we have actual emergencies that require EMS. But why do these shows not show that? Well, it’s boring – that’s why. No one wants to watch a show where an ambulance crew takes a frequent flyer to the hospital because he was given the “hospital or jail” by local police. People THINK they want to see our worst calls, but it’s just a curiosity; they don’t want the emotional turmoil that is associated with some of the calls we run. So what they are left with is fake EMS calls for people to get a false idea of what we actually do.
On top of that, a lot of errors are made in these shows because the production crew has no clue what they are doing when it comes to medical knowledge. They like to throw in pieces of equipment that have nothing to do with the actor’s “condition”, or just incorrect pieces of equipment all together. I recently was watching the Blacklist on Netflix. In the show, Agent Elizabeth Keen believes that Alexander Kirk, aka Constantin Rostov, is her father. When Kirk becomes ill from his genetic blood disorder, he is admitted to the hospital for observation. In the background of the shot, you can see Kirk on a Dell hospital telemetry monitor (yeah, Dell doesn’t make telemetry monitors, but they do make computer screens) that is connected to a LifePak 15. The ECG, SPO2, and all of the vital signs are displayed on the monitor’s screen, yet none of the wires are connected. It’s crazy how advanced Bluetooth is, now isn’t it?!?! Not to mention, what hospital has LifePaks at the bedside?
One “mistake” made by film crews is Return of Spontaneous Circulation (ROSC) following cardiac arrest. As a BLS & ACLS instructor, I cannot tell you how frustrating it is to combat the mindset that people get up following cardiac arrest with no deficits. In my years in public safety, I have only once had a patient become somewhat responsive after CPR was initiated. This individual had a MASSIVE pulmonary embolism, and after 15 minutes of CPR, regained a pulse and opened his eyes. He was able to tell me his name, and told me his medical history, but that was it. That will most likely never happen again, and I am one of few that will ever have this occur. According to the American Heart Association, the survival rate for cardiac arrest is less than 12 percent. Yet, every class I teach I have to inform my students that no matter how good they run an arrest, chances are that the patient won’t survive.
This does a good amount of damage to newer EMS personnel, but imagine the damage it does to the public, the people who think that CPR is “just another skill EMS can do to help”, and don’t understand the severity. This isn’t an overstatement, last year I had to inform a patient’s wife that her husband was in cardiac arrest following an episode of Supraventricular Tachycardia (SVT). The wife seemed concerned, yet didn’t quite have the reaction I was expecting upon hearing this news. Later on in the call, when we achieved ROSC, the wife was upset because her husband wasn’t talking. She later blamed us for doing a bad job because he should be sitting up and talking. Come to find out, the patient suffered cardiac arrest a year prior while in the hospital, and made a full recovery with little to no deficits. Luckily, his wife hadn’t seen any of this, due to it occurring in the middle of the night. So this time, she expected her husband to be fine like he was last time. This is the damage that this misinformation can cause. Imagine if this patient had been a child at a birthday party, with a whole group of bystanders walking around. They don’t understand what we do, or what the results can be. They only see what is on TV and in the movies, so you can’t be surprised with their lack of knowledge on the subject.
Another problem is the general public assuming the tests and procedures that we can do on an ambulance. I have been yelled at for everything from not performing a CT scan in my truck, to not placing a C-Collar on a patient that was in a minor car accident. Any time you see a behavior performed over and over again, you’re going to assume that it is the correct way, regardless of if it actually is. These patients see EMS in TV and the movies doing these skills that are either completely wrong, or have been outdated for years. I personally have been questioned numerous times why we don’t just “grab the patient and go”. Most people (and some facility staff) don’t realize what we actually can do. They aren’t aware that patient care can begin with us and be continued throughout transport. According to the public, the patient isn’t being “treated” until they are literally in front of a doctor. I get looks all the time when I mention that an ER doctor can’t do much more than we can in the field in regards to a cardiac arrest. This comes to light when we attempt to cease resuscitation. In these family members/bystander’s eyes, we haven’t done everything we can do to save their loved one, because we never got them to a doctor. They have no clue that we have done everything for this patient that can be done, and by transporting the body we are doing nothing more than adding turmoil and more medical bills for people that don’t need it. It’s a hard truth, but it is just that, the truth. I’ve also run into the problem of not immediately transporting a patient. The risk of harming your patient and/or yourself during transport are already elevated, so why add the risk of playing around with a needle? I choose to get all of my baseline vitals, IVs, and any initial treatments done on scene, unless it would be detrimental to the patient (i.e. CVA, MI, or severe trauma). This causes a lot of problems on scene, like I said before, because family members and bystanders don’t understand that these treatments are needed for their loved ones, and can do a lot to help in their recovery if done as soon as possible. But yet again, every ambulance you see in the movies or on TV, the crew jumps out, grabs the patient, and runs off to the hospital with lights and sirens.
So, the next time you get frustrated with a family member or a bystander because they are concerned about their loved one, remember that they don’t know any better. It’s what is drilled into their subconscious every time they turn on their TV, or go to the movies. The best we can do is educate them about what we actually do and be there for them during their time of need. Also, always remember to ALWAYS point out these medical mistakes when watching TV or a movie with your spouse, they LOVE it!!!
Medic Minute 