Category Archives: Technology

Technology

Naming ceremony

As Knauft (2010) described, before seven months old, “a human spirit is not thought to be completely rooted in their bodies, and they aren’t even given a name” (p.39). This naming ceremony practice reminds me of the ausa vatni of the Old Norse cultures when infants were only named after inspection and acceptance of the father, giving the child the rights and inheritances of the family (Ward, n.d.). Through the ausa vatni, the child was protected under the law of murder; otherwise, the child could be abandoned and left to die without recourse. The differences between the Gebusi and the Norse, though, are obvious. In my culture, infanticide is surely taboo. In fact, my family cherishes the entire process of bearing a child and bringing a new life into the world. In stark contrast to both the Gebusi and the Norse, we tend to name our children very early, even before birth. Some of our children have even gained nicknames prior to birth.

It is difficult to objectively experience the beliefs and rituals of other cultures when they are by design emotively raw. The taboo of our society is important for us to understand for our acceptance and longevity within our own culture. As we learn to vilify practices that are not condoned within our society, we develop a visceral response when these practices are witnessed. It is understandable, but it is not helpful to juxtapose one culture with our own, subjectively, when we are attempting to understand more about it. The visceral reaction will certainly prove detrimental to our experience in creating a judgment versus creating an understanding. Perhaps this is the same reason that human cultures have abhorred other cultures throughout human existence.

References

Knauft, B. (2010). The Gebusi: Lives transformed in a rainforest world (2nd ed.). New York, NY: McGraw-Hill.

Ward, C. (n.d.). Old Norse names. The Viking Answer Lady. Retrieved from http://www.vikinganswerlady.com/ONNames.shtml

Technology

A Personal Ethnographic Narrative

I have always viewed my being from philosophy. I do not believe that I have ever appreciated myself from an anthropological viewpoint. Though I have always been more interested in where did we come from, anthropology and ethnography certainly does help to answer how did we get here.

On December 7, 1975, at 4:48 a.m., I was born in Providence, Rhode Island. A healthy boy of healthy weight, I never suffered much in childhood. I do remember the chicken pox, however. My mother was sure to make me play with every child suffering from the chicken pox until it finally gripped me. This was my first experience in active inoculation. I was always well cared for, received all of my shots in timely fashion, and the doctor’s office remains a fond childhood memory. Medicine was just practiced differently in those days.

My early childhood was based primarily around my grandparents. My mother was a single parent, and though it irked her to do so, she relied heavily on State-sponsored welfare. My mother was a strong and determined woman, however. She continued her schooling, found a job with a sustainable wage, and made a great home for us. Until this time, though, I spent the majority of time with my grandfather. From a very young age, I was learning his trade as well as his life lessons. Today, I do not think many five-year-olds would be able to cut and wet sand glass in a licensed shop. Working with my grandfather, once a week when I attended school, framed my work ethic and provided an early education in engineering. This opportunity allowed me comfort in engineering at an early age. In fact, my interest in engineering was so pronounced that I was already considering California Institute of Technology at age ten. Massachusetts Institute of Technology was my second choice.

My family had it hard. My grandparents raised five children and helped to raise 13 grandchildren. We were not an affluent family by any means, but we lived comfortably if not rustic. Though my ancestry is primarily Italian, my mother’s parents are primarily Irish, English, and German, and this is how we ate. Meat and potatoes were the staples of dinner while fresh vegetables were cultivated in my grandfather’s garden. Simplicity did not end at the kitchen door. My grandfather’s first meaningful gift to me was a knife. Very simple with a fork and spoon on the sides, the knife was very utilitarian in nature. His belief was that you could not be a good steward of the environment without a knife: “How can you take a walk in the woods if you can’t even whittle a walking stick?” (personal communication with Malcolm Webb, n.d.). It was very important to him that I had honed my outdoor skills.

For leisure and sport, my grandfather would hunt rabbit with beagles. He belonged to a club in Rhode Island that held competition trials, and I was always made welcome. After a few years, I started to enter dogs that I helped to raise and train. Immediately, I began accumulating trophies that were taller than me. To be honest, the trophies might have had my name on them, but the dogs earned them more than I had. It was this foray into competition that introduced me to the team concept. Thinking back on this today, however, I find that this concept is alien to most people. Many people today, I find, want to do no work and take most of the credit. It is only when you stand up to these people that you hear comments about being a part of the team. It is a shame. It seems that yesterday’s definitions need to be defended today.

I have always been aloof and wondrous as a child. With translation assistance from the Native Languages of the Americas website (2009), my name might have been mautáubon tamóccon nemík kéesuck túppaco (morning fog sees the heavens by night or one with many questions) if I was Narragansett. Rhode Island has a rich Narragansett and Algonquin heritage and history, and this is transmitted to every inhabitant of Rhode Island. Many of our streets, villages, cities, and towns are named with Indian words and names, such as Apponaug, Chepatchet, Metacom, Misquamacut, Woonasquatucket, and Pawtucket. We are very proud of the relationship that Roger Williams, our State founder, had with the local tribes. This lasting relationship may be the reason why Rhode Islanders are typically naturalistic and prefer a rustic life proximate to water over city life.

During my formative years, my mother married and we moved to North Providence from Warwick. My step-father was Italian, and it was from his family that I learned of my Italian heritage and culture. Beyond the Mediterranean-style food, the most important lesson that I learned was loyalty. Many people have a misconception about Italian loyalty. Hollywood often depicts Italians as mafioso who shakedown store owners on a daily basis. In fact, we are very supportive of each other. So long as you are considered loyal, as an Italian, people will do you favors. It is expected that you return the favor. I have applied this lesson many times throughout my life. Again, this is a trait that many hold as one-sided, like teamwork.

After moving to North Providence, it seems that I did not much care for school. I always felt that I was being cheated out of an education. I am a reader, a learner, a student, and a teacher. I do not appreciate being taught incomplete and erroneous facts merely because it is written in the textbook. I began my own education from this point onward focusing on the arts and music, taking up drawing, poetry, and studying music theory and some of the classical languages. These, though, were hobbies and I made sure to keep them that way.

Aside from school, I remained focused on the outdoors. I would walk everywhere within the State. Distance was not a barrier. Rhode Islanders are known for staying local. If a Rhode Islander had to travel 10 miles or more, the joke was that they had to get a motel room for the night. As true as this held for most, it was not descriptive of me. I always took the road less traveled.

Throughout my high school years, I gave up on the engineering dream. I started to focus more on giving back to my community. A friend of mine introduced me to one of the local volunteer fire departments and I was hooked. After graduating from high school, I enlisted in the Marine Corps, but when I returned to civilian life, I focused on the fire service. This was the impetus for my attaining my emergency medical technician license and, ultimately, my paramedic and critical care credentials.

Though I have traveled extensively, I always seem to return to New England. I am currently living just beyond the Western border of Rhode Island in Connecticut (another Indian name).

Considering the anthropological roles outlined in Omohundro (2008), I would have to align myself with all five roles. The reformer looks to make the world a better place, regardless of his or her motivations. The critic is necessary to use introspection to identify personal weaknesses ingrained in cultural learning so that he or she may contemplate self-improvement. This, I feel, is the best role to take on first. Only after seeking to improve one’s intrinsic nature should someone seek to change the extrinsic. The scientist role is important to really think about the factors relating to certain problems. Without this role, one could have lofty goals only to find failure in execution for a lack of understanding. The role of the humanist should be used as an umbrella. When considering anthropology, we need to have a certain understanding and tolerance. This role allows us be compassionate when considering cultural issues. Finally, the means to the end is the cosmopolite role. This role gives us more tools to further our understanding. Hand-in-hand with the humanist role, the cosmopolite has a truer understanding of origination and context when dealing with the various cultures of the world.

Personally, I take on more aspects of the critic and the scientist. I am not an anthropologist, and I do not consider myself as having a platform to affect cultural change, but I do like to identify and understand problems so that I do not contribute to them negatively. More so, being mindful of the critical and scientific anthropology roles leads me to understand that there is still much to learn about my own culture and heritage and how this identity relates to the world around me. Foremost, I want to know the effect that my ancestors have had on world. I want to understand the problems they faced and the means employed to overcome them. I want to know decisions that have been made and the fallout associated with these decisions. I have always found it important to learn from the past, and though the sins of the father shall not encumber the son, we should still strive to avoid repeating historical mistakes. Second, I want to find a means to assess my own life and better understand how my existence impacts my community. I have always believed that I should make positive contributions to my community, but there is no benchmark. As a critical care paramedic, I assume that alleviating suffering and saving lives positively contributes to my community, but how can I know the harm that I might be causing in other aspects of my life? We cannot only understand the good we impart, but we must know the bad in order to prevent it.

References

Native languages of the Americas website. (2009). Retrieved from http://www.native-languages.org

Omohundro, J. T. (2008). Thinking like an anthropologist: A practical introduction to cultural anthropology. New York, NY: McGraw-Hill.

Politics, Public Health, Technology

Conquest of Indigenous Populations

The native Americans of the Great Lakes region were thankful for the opportunity to trade fur with the multitude of nations that presented themselves in friendship from the 14th to the 17th centuries (Reader’s Digest, 1978, p. 149). It was the conquest of land, ordered by King James I and King Charles II, that negatively affected the indigenous populations (p.149). It was this progressive agenda that marginalized the native Americans and ultimately caused King Philip’s year long war as well as other campaigns against the white settlers of the east coast (p. 152). Throughout this time, many tribal nations were decimated by other nations while competing for trade of the more powerful weapons the white settlers could provide. The tattered tribes would move and join in alliances with other defeated tribes to minimize the possibility of a recurrence and to ensure procreation and ultimate tribal survival (p. 152). This intermingling surely had an effect on the biological make-up of the various tribal nations. I feel that much of the negativity could have been avoided with a simple sense of respect.

Currently, there are many indigenous peoples facing a number of problems with colonization. The aborginal women of Ontario, Canada, are a specific example of how an overall lack of respect leads to the marginalization of a whole culture. “Aboriginal women have a lower life expectancy than non-aboriginal women, and higher incidences of diabetes, HIV/AIDS, tobacco addiction, and suicide (up to eight times the rate experienced by other women)” (as cited in Ontario Native Women’s Association [ONWA], n.d., p. 4). To address these concerns, the community has formed organizations like ONWA and the Native Women’s Association of Canada to provide a unified voice to advocate for improved status for aboriginal women in Canada. As their position paper states, “the ONWA makes recommendations for future actions to begin the process of initiating the necessary changes with a special focus on the need for grassroots control, activism, and leadership development for Aboriginal women” (p. 1). In addition to advocating for the equality of aboriginal women, the ONWA also advocates for the environment recognizing the increasing levels of waterway pollution and other environmental concerns.

Thus far, the ONWA has developed programs to address health concerns, gambling addictions, workforce development, housing and justice (ONWA, 2010). As a grassroots activist organization, the ONWA appears to be gaining ground for the equality of aboriginal women in Ontario.

References

Ontario Native Women’s Association. (n.d.). Contemporary issues facing aboriginal women in Ontario: An Ontario Native Women’s Association position paper. Thunder Bay, ON: Author.

Ontario Native Women’s Association. (2010, May 27). About us. Retrieved from http://www.onwa-tbay.ca/aboutus.htm

Reader’s Digest. (1978). In J. A. Maxwell’s (Ed.), America’s fascinating Indian heritage. Pleasantville, NY: Reader’s Digest Association.

Politics, Technology

What Would We Do Without Our Natural Resources?

Connecticut has a vast supply of wood and still records the existence of at least 22 operational sawmills (State of Connecticut, 2007). The area produces many different types of wood. The hardwoods produced in Connecticut include red oak, white oak, maple, ash, and birch. The softwoods include red pine, white pine, and hemlock. From the State of Connecticut (2007), “sawmills have played an important part in Connecticut history since the mid 1600’s. Early communities were constructed around working sawmills and their presence assured a steady flow of forest products for use in Connecticut’s homes, farms and businesses” (p. 4).

In addition to the economic benefits, the forests of Connecticut provide important environmental roles, such as the prevention of soil erosion and mitigation of air pollution. “A healthy forest promotes clean air, clean water, and a better-regulated climate” (Flounders, 2006, p. 13). It would be disastrous if Connecticut lost this valuable natural resource, right? Wrong.

According to the Flounders (2006), before the European settlers arrived in Connecticut, the land was a vast forest. The advent and proliferation of farming across the State deforested 75% of the land by 1820. Much of the environmental fall-out caused some of the farms to falter. Industry and the Civil War had even more negative repercussions for the area’s farms.

As an increasing number of farms became abandoned, nature took over (Flounders, 2006). Flounders (2006) describes how ”without human interference, the vegetation of abandoned fields underwent a series of changes” (p. 35) to create Connecticut’s “Second Forest” (p. 35). Ultimately, the original deforestation eventually lead to a forestry boom in the late 1800’s. Currently, Connecticut’s forests “[cover] 1.9 million acres, or 60% of the State” (p. 37).

When dealing with renewable natural resources, the economy is the primary impetus of change. When plentiful, the focus is to utilize the resource. As the resource becomes less available, it becomes more difficult to earn a living producing the resource, and there is more pressure to change occupations. This is purely supply and demand.

In conclusion, the inhabitants of the State of Connecticut relied heavily on the forests before the area was colonized by the European settlers. This colonization required such a use of wood that it resulted in the devastation of all but 25% of the State’s forests. As the wood supply decreased and demand for workers in other professions increased, the land was abandoned and left to a natural course. Forests grew once again, and the land is now well distributed with forests. Though it is not the center of the economy for Connecticut, there remains about two dozen sawmills that continue to produce wood for a variety of purposes. It is important to both consider the ramifications of depleting our natural resources and remember that it might be wise to leave some things to nature.

References

Flounders, H. T. (2006). Connecticut Statewide forest resource plan. Retrieved from http://www.ct.gov/dep/lib/dep/forestry/forest_resource_plan/fplanall.pdf

State of Connecticut, Department of Environmental Protection, Division of Forestry. (2007, June). Connecticut primary processor directory. Retrieved from http://www.ct.gov/dep/ lib/dep/forestry/forest_practitioner_certification/primaryprocessors.pdf

Technology

Creation (Revelations of Genesis)

Beginning the week anew, I still search for the meaning of indigenous identity and how it might apply to me. This week allows me to search, not only my ancestry, but my cultural beliefs in the Creation. If only I believed in the Creation as taught to me in my childhood, the biblical teachings, I could describe the wondrous event that first saw mankind on Earth. Alas, I have grown an independent and scientific mind, and I not only question the existence of a god, but with boldness I question my own existence. This is a very philosophical question for me, and while it is not so important to the comparison of cultural beliefs, per se, that I describe my unwillingness to believe the story that I was told as a child, it is important to me that this distinction be made.

As a child, I was taught a simplistic variation of the Book of Genesis from the King James version of the Christian Bible. The allegory tells of a god, personified, who creates a man, Adam, from dust and a woman, Eve, from Adam’s rib. Unfortunately, after being told this story, I spent a great amount of time and energy convincing my fellow disciples that, in deed, men and women have the same number of ribs. Further reading reveals the story describes a human ascent into an age of agriculture where respect of and responsibility to the land are of great import (Dalley, 1998; Langdon, 1915). I fear that the oversimplification of such a beautiful tale of our coming of age led to its diminished significance.

The Jewish faithful, who share the Genesis story with Christians, celebrate Rosh Hashanah, a feast to celebrate the creation of Adam and his female companion on the sixth day (Leviticus 23:24). Christians, on the other hand, celebrate Easter at about the same time; some with the fervor of the pagan civilizations that celebrated Easter originally before the indoctrination of the Catholic Church. Many of the same traditions and rituals used to celebrate fertility are done during the vernal equinox. This is seen widely during the Spring season. Pardoe (2006) tells of the origins of one of the most peculiar traditions of a Christian celebration: the Easter bunny. Carried to the United States by the German and Dutch immigrants involved a bunny delivering eggs to boys and girls. The story tells of the goddess granting the easter bunny the ability to lay eggs once a year because the bunny was upset after being transformed from a bird. The Easter bunny particularly missed laying eggs and flying, so during the vernal celebrations of the creation of life, The Easter bunny laid colored eggs and hid them in nests designed by children. The Easter bunny was also granted flight as the constellation Lepus through Autumn and Winter.

However, as my family is a fair-minded and clever clan, the biblical description of our origins was juxtaposed with the tellings of science. It is this scientific belief that I will present in comparison to the religious tale.

The theory of evolution and natural selection as researched and published by Darwin (1859) was presented to me at a very early age. Darwin’s theory, in conjunction with many others before and during his time, believed that we as humans exist in the contemporary manner solely on the basis of a series of changes and adaptations that promoted our growth and dominance of our environment. Arguably, no one can say with any certainty how life came to exist from non-life, but Darwin’s research offers a path from just beyond that singularity to the present explaining all life on Earth.

The biblical story of the Creation seems to disagree with science if read without understanding. A closer look, though, tells of man entering into an era when he can use intelligence above cunning and strength over force. Darwin (1859) tells of a process of biological adaptation while the biblical Genesis story imparts the importance of using the mind and body to promote mankind while considering our place on the Earth. Science, however, is not celebrated with grand ritual in the likes of religion. As I was brought up with both stories, I am impartial to neither. Both stories, I feel, are valuable contributions to contemporary life (in the grander scheme of our existence).

References

Dalley, S. (1998). Myths from Mesopotamia: Creation, the flood, Gilgamesh, and others. New York, NY: Oxford.

Darwin, C. (1859). On the origin of species (Sixth ed.) [Adobe Portable Document Format version]. Retrieved from http://www.netlibrary.com/Reader/

Langdon, S. (1915). Sumerian epic of paradise, the flood and the fall of man. Philadelphia, PA: The University of Philadelphia Museum.

Pardoe, E. (2006, April 11). A look at Easter symbolism and the holiday’s pagan roots. Retrieved from http://www.associatedcontent.com/article/27142/a_look_at_easter_symbolism_ and_the.html?cat=74

Technology

Making the Strange Familiar – A Cultural Identity

Scouring the literature in an attempt to define indigenous identity as it relates to me has been futile. Weaver (2001) describes the difficulty of obtaining a consensus on the definition of indigenous identity and how to apply the term. She continues to outline her frustration and finally gives in to using less exact terms. Corntassel (2003) shows how a multitude of definitions has arisen that are both incomplete and politicized. Neither Weaver nor Corntassel nor any of the other scholars that I have read in the past two weeks would agree, based on their writings, that I would have some indigenous identity. It seems that this would otherwise offend them. It is obvious, however, that I have a cultural identity as do all people, but I fail to see myself as indigenous, so I will concentrate on this cultural identity using the fieldwork methods outlined by Omohundro (2008).

My cultural identity is, in part, related to my ancestry, or genealogy. As far as I can tell, my ancestry is a combination of Italian, French, English, German, Irish, Scottish, and Portuguese, though living New England, specifically around Boston, Providence, and New York, I have more of an affinity to my Irish and Italian heritage. However, it does appear that I share my English heritage with nobility of Queen Catherine’s privy court, Sir John Alexander Webb, and William Shakespeare.

Developing as a child in my household, I have learned a few ideals that have more import and others: loyalty, character, and resolution. Honesty, temperance, and justice I have learned on my own, or more evidently from my environment growing up. Much of this wisdom of our forefathers is still evident in and around Rhode Island, thankfully. Understanding why my ancestors migrated as they did certainly underscores the importance of freedom, liberty, and tolerance.

The ethnosemantics of Rhode Islanders can be quite intriguing to outsiders. I am not sure that I have ever met anyone who enjoyed the dandle as much as my cousins and I. Others, though, would have used a see-saw or teeter-totter. Likewise, I remember looking forward to enjoying a cabinet on a hot summer day with my grinder. Others might have enjoyed a milkshake with their submarine sandwich, hoagie, or hero. It seems that we stole the terms bubbler and soda from Wisconsinites as they moved to the area as my ancestors did. A bubbler being a water fountain and soda refers to any carbonated beverage.

Even more interesting than our vocabulary, though, is our pronunciation. Traveling around the country, I have noticed that when residents of other States hear an accent, they usually just comment on it. For the typical Rhode Islander, we are made to repeat ourselves often. Sometimes people truly do not understand our vernacular, but mostly it is for the novelty of it all. Rhode Islanders seem to remove the letter ‘r’ from words and place them in words that do not have any. Additionally, we run many words together unnecessarily. For example, “A Rhod’aylindah would flip a breakah if the lights’n out an’ say suntin’ like ‘I’ve an idear… let’s getindacah’n go fe’ bananar splits wit vanillar ice cream,’” or my favorite, “Immunna gessin gaggahs, djeetjet?” This question would usually be replied with, “No, joo?” More obvious, the first set of statements refers to resetting a circuit breaker after losing power then taking a ride in the car to get a banana split. The second, more cryptic, phrasing simply translates, “I am going to get some gaggers (or, hot weiners; see also http://www.olneyvillenewyorksystem.com), did you eat yet?” The reply being, “No, did you?” We tend to ask even if we know the answer.

As our strange vocabulary and pronunciation are very colloquial, I think I might understand how it has developed. Rhode Island has always been known for tolerance, both religious and political; therefore, the heritage has always been a rich mixture of various cultures attempting to flee from various types of oppression. My assumption is that much of the dialect and vocabulary is simply based on misunderstanding and ethnosemantic distortions of the multiple cultures residing at any given time in Rhode Island, a pidgin. I may be mistaken, but the thesis seems viable.

Understanding my cultural identity allows me to view the world and other cultures with temperance and acceptance. My heritage is rich with both culture and despotism. Likely, many other people have a similar story. Most important in understanding cultural identity is the ability to benchmark one’s self against society. Doing so allows me the ability to focus on the moral strengths that I have learned while attempting to temper the weaknesses. With a more complete understanding, I am able to justify the life lessons that I might pass on to others.

References

Corntassel, J. J. (2003). Who is indigenous? ‘Peoplehood’ and ethnonationalist approaches to rearticulating indigenous identity. Nationalism and Ethnic Politics, 9(1), 75-100. doi:10.1080/13537110412331301365

Omohundro, J. T. (2008). Thinking like an anthropologist: A practical introduction to cultural anthropology. New York, NY: McGraw Hill.

Weaver, H. N. (2001). Indigenous identity: What is it and who really has it? The American Indian Quarterly, 25(2), 240-255. doi:10.1353/aiq.2001.0030

Politics, Technology

Indigenous People

In order to define a term, such as “indigenous peoples”, one must examine the words that make up the phrase. “Peoples” are collections of societies, and “indigenous” implies nativity or autochthony. I have always considered “indigenous peoples” to be those societies that have an intrinsic relationship to the land inhabited. Ergo, when a society is provided for by the land, the act of habitation changes the land, and that land changes the society in a fundamental way. Whenever this is true and can be applied to a society, then it is a society of indigenous people.

The largest difficulty in defining or categorizing human beings is the resultant scale upon which they are measured as a group. I do not hold such inclinations as to group and sort people based on ethnicity, societal values, economics, or any other humanly devised subjective measures. The United Nations (2008) requires a society to be impoverished or suffer some other gross inequality in order to claim indigeny. I feel that this approach only serves to feed ideologic notions by marginalization and deprives the society from a rightful claim. By attempting to create a system to help indigenous peoples from inequality, the United Nations has sought to identify these peoples and have instead cast a definition upon them. Certainly, this is a problem.

References

Secretariat of the United Nations Permanent Forum on Indigenous Issues, Division for Social Policy and Development, Department of Economic and Social Affairs. (2008). Resource kit on indigenous peoples’ issues. New York, NY: United Nations. Retrieved from http://www.un.org/esa/socdev/unpfii/documents/resource_kit_indigenous_2008.pdf

Academia, Clinical, Culture, Emergency Management, Emergency Medical Services, Health Care, Public Health, Technology

Patient Safety Considerations for EMS

 In the out-of-hospital emergency care setting, patient safety is paramount. Initially, victims of trauma or illness are already suffering in an uncontrolled environment. It is this same environment where first responders, emergency medical technicians, and paramedics must operate to stabilize and transport the victim to the hospital, a more controlled environment. Unfortunately, there is little research in the area of patient safety in this setting (Meisel, Hargarten, & Vernick, 2008; Paris & O’Conner, 2008).

Importance

Focusing on patient safety and developing processes to ensure optimal safety would allow the study of inherently dangerous, yet potentially beneficial therapies, such as rapid sequence intubation where the clinician uses a series of medications to rapidly sedate and paralyze a critical patient for ease of inserting a breathing tube. Focusing on safety, an EMS department in Maryland successfully instituted such a program (Sullivan, King, Rosenbaum, & Smith, 2010).

With more research in this area, the Emergency Medical Services (EMS) can improve the care they seek to deliver to their patients.

Challenges

There are many challenges facing EMS as they seek to deliver safe and effective care to their patients. Motor vehicle accidents (including air transportation accidents), dropped patients, medication and dosage errors, other inappropriate care, and assessment errors all contribute to the number of adverse events in the EMS out-of-hospital care setting (Meisel et al., 2008). Unfortunately, it has proved difficult to identify both the existence and the cause of each event (Meisel et al., 2008; Paris et al., 2008). Additionally, there are adverse events that are impossible to track, such as the iatrogenic exposure to a pathogen. It would be very difficult to distinguish how and when a patient was first exposed to the infecting pathogen without considering community-acquired infections and hospital-acquired infections, which are both equally difficult to ascertain (Taigman, 2007).

Strategies for improvement

As EMS seeks to increase the professionalism among its ranks, the stakeholders must acknowledge responsibility for providing evidence-based processes to ensure patient safety.

References

Meisel, Z. F., Hargarten, S., & Vernick, J. (2008, October). Addressing prehospital patient safety using the science of injury prevention and control.Prehospital Emergency Care, 12(4), 4-14.

Paris, P. M. & O’Connor, R. E. (2008, January). A national center for EMS provider and patient safety: helping EMS providers help us. Prehospital Emergency Care, 12(1), 92-94.

Sullivan, R. J., King, B. D., Rosenbaum, R. A., & Shiuh, T. (2010, January). RSI: the first two years. One agency’s experience implementing an RSI protocol. EMS Magazine, 39(1), 34-51.

Taigman, M. (2007, July). We don’t mean to hurt patients. EMS Magazine, 52(4), 36-42.

Academia, Health Care, Public Health, Society, Technology

Direct To Consumer Advertising: Patient Education

Today, we are familiar with mass-media marketing of prescription drugs not only to physicians but to patients as well, known as direct-to-consumer advertising (DTCA). Though, many argue that a better informed patient allows for more autonomy in physcian-directed care (Buckley, 2004; Lyles, 2002; Sumpradit, Fors, & McCormick, 2002), “the evidence for DTCA’s increase in pharmaceutical sales is as impressive as is the lack of evidence concerning its impact on the health of the public” (Lyles, 2002, p. 73). Concerns abound regarding the ability of the physician to direct the care of a patient driven by DTCA. Many researcher’s, including Buckley (2004) and Green (2007) believe that many physicians prescribe medications solely on the request of the patient without providing guidance or education to the patient.

As a paramedic, I hear the concerns of patient’s regarding physician refusals to prescribe name-brand drugs to patients. These patients are almost militant about their beliefs of their illness and that the physician should honor the requests of their patients. While these patients never seem to find a resolution, I also see many people who trust in their physicians’ role and, with education, discuss with their physicians the possibilities and concerns of advertised medications. As one secondary data analysis (Sumpradit et al, 2002) suggests, though there is no demographic difference in the propensity of patients to ask their doctor for a medication based on DTCA alone versus seeking more information from their doctor, those with chronic conditions and who have poorer perception of health status tend to engage their physicians more often to clarify information garnered from DTCA’s.

I feel that DTCA is can be an empowering tool for the patient as long as it is educational, honest, and forthcoming. Empowering the patient to take an active role in his or her medical care is very important, but this empowerment comes with responsibility to be as fully educated as possible, allowing the physician his or her role in the relationship as the ultimate patient advocate, which some physicians lack.

References

Buckley, J. (2004). Pharmaceutical marketing: Time for change. Electronic Journal of Business Ethics and Organization Studies, 9(2), 4-11.

Green, J. A. (2007). Pharmaceutical Marketing Research and the Prescribing Physician. Annals of Internal Medicine, 146(10), 742-748.

Lyles, A. (2002). Direct marketing of pharmaceuticals to consumers [Abstract]. Annual Review of Public Health, 23, 73-91.

Sumpradit, N., Fors, S. W., McCormick, L. (2002). Consumers’ attitudes and behavior toward prescription drug advertising. American Journal of Health Behavior, 26(1), 68-75.

Academia, Culture, Emergency Management, Emergency Medical Services, Health Care, Technology

Improving Traffic Safety for Emergency Responders

The Emergency Medical Services (EMS) is an occupational field wrought with opportunities for workers to become ill, injured, or succumb to death while performing the functions of their job (Maguire, Hunting, Smith, & Levick, 2002). In the mid-1980’s, Iglewicz, Rosenman, Iglewicz, O’Leary, and Hockmeier (1984) were among the first to perform research into the occupational health of EMS workers by uncovering unhealthy carbon monoxide levels in the work area. This appears to have been the impetus for further research into uncovering some of the causes and contributing factors of illness and injury incidents, as well as safer alternatives to current work practices.

One of the more recent efforts to protect EMS workers relates to traffic-related injuries and fatalities of EMS workers while responding to calls and working on the scenes of traffic accidents. As important it is for the EMS workers to be able to get to the scene of an emergency and work without threat of injury, the safety of the community is important to consider. Solomon (1990) realized the need to improve safety in this area and recommended changing the paint color of emergency apparatus to more visible lime-green. Emergency workers were continuing to fall victim to “secondary incidents” at roadway scenes (Cumberland Valley Volunteer Firemen’s Association, 1999). An analysis of EMS worker fatalities between 1992 and 1997 reveals an occupational fatality rate that continues to exceed that of the general population (Maguire, Hunting, Smith, & Levick, 2002).

Across the pond, in the United Kingdom, efforts were also underway to improve the visibility of police vehicles by considering various paint design schemes, including the Battenburg design: alternating blocks of contrasting colour (Harrison, 2004). Harrison concluded that the half-Battenburg design showed promise as it increased visibility and recognition of police cars in the United Kingdom, and the United States National Institute of Justice was considering research on the efficacy of the Battenburg design here in the United States to promote officer safety. EMS administrations are known for paying special attention to the bandwagon, that is they frequently make changes based on inconclusive and sporadic evidence. This is the case with recent ambulance designs.

Many ambulances in the New England, as well as other parts of the country, are being designed with the half-Battenburg markings applied to the sides of the vehicles in attempts to improve the safety of EMS workers. Unfortunately, we may find that these markings might have an unintended effect of confusing other drivers and causing more problems. A recent study found that Harrison (2004) was correct in that the Battenburg design assisted British drivers in quickly identifying British police vehicles, but the “effectiveness of the ‘Battenburg’ pattern in the UK appears primarily related to its association with police vehicles in that country” (Federal Emergency Management Agency, Department of Homeland Security, 2009, p. 6) having little effect on the recognition potential of American drivers.

Perhaps with the evolving data, we can begin using an evidence-based approach at helping the EMS worker perform his or her job safely at traffic scenes.

References

Cumberland Valley Volunteer Firemen’s Association. (1999). Protecting Emergency Responders on the Highways: A White Paper. Emmitsburg, MD: United States Fire Administration.

Federal Emergency Management Agency, Department of Homeland Security. (2009). Emergency vehicle visibility and conspicuity study [Catalog No. FEMA FA-323]. Emmittsburg, MD: United States Fire Administration.

Harrison, P. (2004). High-conspicuity livery for police vehicles [Publication No. 14/04]. Hertfordshire, U.K.: Home Office, Police Scientific Development Branch. Retrieved from http://scienceandresearch.homeoffice.gov.uk/hosdb/publications/road-policing-publications/14-04-High-Conspicuity-Li12835.pdf

Iglewicz, R., Rosenman, K.D., Iglewicz, B., O’Leary, K., & Hockmeier, R. (1984). Elevated levels of carbon monoxide in the patient compartment of ambulances. American Journal of Public Health, 74(5).

Maguire, B.J., Hunting, K.L., Smith, G.S., and Levick, N.R. (2002). Occupational fatalities in emergency medical services: A hidden crisis. Annals of Emergency Medicine, 40(6), 625-632. doi: 10.1067/mem.2002.128681

Solomon, S.S. (1990). Lime-yellow color as related to reduction of serious fire apparatus accidents: The case for visibility in emergency vehicle accident avoidance. Journal of the American Optometric Association, 61, 827-831.