Jeff Jarvis
Appearances
Revisionist History
Running Hot
If you would have asked 18-year-old Jeff when I first drove lights and sirens, I would have said that they are always life-saving, and we absolutely need to use it. But I'm not 18 anymore.
Revisionist History
Running Hot
Absolutely. So think about it this way. On emergency, every call was a life-threatening emergency. Now, I say that knowing the first call they went on was not, but in the first episode, the pilot. But the vast majority were life-threatening emergencies. So, sure, people got that response. That notion and expectation that that's what would happen.
Revisionist History
Running Hot
There are a lot of paramedics who joined up for those life-threatening emergencies only to find out that 85% of the calls is holding somebody's hand.
Revisionist History
Running Hot
Sometimes that three to four minutes is clinically valuable. Most of the time it's not.
Revisionist History
Running Hot
Seven and a half million records 5.9 million of those were non-violent responses. We analyzed every one of those and calculated the proportion that used lights and sirens, and 85.8, 86% of them responded to the scene with lights and sirens. Oh, my God. The fundamental question we ask is, of those responses, were you using lights and sirens? No.
Revisionist History
Running Hot
How many of them did we do something potentially life-saving? And what we ended up finding is 6.9% of those 911 lights and sirens responses did we do something even vaguely potentially life-saving. And we were rather generous with our description of what potentially life-saving is.
Revisionist History
Running Hot
Most folks are using some type of emergency medical dispatch where there are scripted questions and they will give each type of call a number and a letter. And the letter is called the determinant. And it goes from your echo level calls, which are most likely to be life-threatening to down to omega level calls, which are not very likely at all to be life-threatening.
Revisionist History
Running Hot
And those criteria have been evaluated multiple times with multiple data sets. Again, they're not perfect, but they are pretty accurate. For example, there is a call nature called eye problem. 0.67% of those calls resulted in a potentially life-saving intervention.
Revisionist History
Running Hot
All of them. It's just dangerous. And it's dangerous, and it's not really doing what we think it is. So it seems like it is an intervention whose time has come and gone.
Revisionist History
Running Hot
There is in emergency departments everywhere, ICUs, there's this concept called alarm fatigue, where when everything is an alarm, nothing is an alarm, to paraphrase the Incredibles, the cartoon movie. So you just get immune to these sirens. They're not doing the job.
Revisionist History
Running Hot
So it's turning out it's not making that much of a difference and we're being much safer.
Revisionist History
Running Hot
So I'll put my scientist hat on and say that's an interesting hypothesis that needs to be tested. I will put my realist and my pragmatic public health hat on and say absolutely giddy up. I absolutely think you'll see that.