ABSTRACT: Like life, the only certain thing about EMS is that change will happen, regularly, and often without a lot of warning. Change happens to everyone, everywhere - no matter who they are or what they do. Merely growing and developing as human beings involves changes that cannot be avoided. However, very few professions undergo quite as many frequent changes as those encountered by emergency care providers.

Because the past and the future of EMS is all about the same thing - CHANGE - EMS providers must learn to enjoy the dynamic challenges of frequent change and growth spurts, if they want to remain happy, healthy people!

This exciting presentation begins with exploration of the many natural reactions experienced by people when facing any kind of change, including; feelings of awkwardness, feelings of isolation, and focusing on the "loss" of the "old way."

After discussing several ways to deal with these common change-reactions, this presentation reviews the most recent EMS history, emphasizing the many changes (advancements!) that have occurred within just the past 35 years. (Did you know that the standards for protection against blood-bourn pathogens were mandated only 9 years ago?!) This is followed by discussion of EMS research currently in development, and the dramatic changes such research and development may represent: things like "suction-cup" CPR (Active Compression-Decompression or "ACD-CPR"), the wearing of helmets while caring for patients enroute to the emergency department, "expanded scope of care" issues for the future, and the like.

Lastly, this presentation introduces the fact that change can be made less painful (more "familiar") if people accustom themselves to change by "exercising their change muscles" on a regular basis. Participants will receive suggestions of how to easily exercise their change muscles during their daily routines. In fact, they will be assigned a specific "change exercise" to perform soon after the presentation's conclusion.

LEARNING OBJECTIVES: After attending this presentation, participants will

1. recognize the inevitability - and the positive "value" - of personal and professional CHANGE.
   
2. recognize common responses to change, how these responses may interfere with their enjoyment of (or adaptation to) change, and how to conquer these responses.
   
3. learn to appreciate the special, ever-changing, nature of EMS.
   
4. learn the value of "exercising" their "change muscles," on both personal and professional levels.
   
5. perform their first "change muscle exercise" in order to begin learning to welcome change!

1. "The only person who likes change is a wet baby!" Roy Z-M. Blitzer.
   Discussion of change's inevitability and the potential for positive - or negative - outcomes,
   depending upon how change is approached.

2. The PAST & the FUTURE of EMS is all about CHANGE:
   Improvement requires change. Progress results in change.

3. IT AIN'T EASY: Change or Progress is rarely ever easy -
   even when the change or progress is specifically aimed at making tasks or procedures easier.
   Change threatens the "Status Quo"(the existing state or condition).
   None of us likes to have our "status quo" changed.

4. Common responses to change:
   • Almost everyone will feel AWKWARD
   • Some people will only focus on the "LOSS" of the old way
     and ignore the improvements offered by the new way.
   • Some people will feel isolated & alone.
   • Some people will feel OVERWHELMED
   • Some people will only focus on RESOURCE WORRIES

5. THE ONLY CERTAIN THING IN EMS IS THAT CHANGES WILL HAPPEN,
   Regularly & without a lot of warning! We have only just begun to grow as a profession.

6. Discussion of EMS history:
   • The Ambu bag was first introduced to prehospital use in 1960 - __ years ago.
   • Resusci-Annie was modified and adapted for CPR use in 1962
     (previously only used for rescue breathing) - __ years ago
   • The first Lifepak Defibrillator/Monitor (Model "33") was introduced in 1964 - __ years ago
   • Traction splints and the Jaws Of Life - 1967 - __ years ago
   • The first EMT-Ambulance course (with national standards). - 1969 - __ years ago
   • The first civilian helicopter use for medical transportation
     (had previously only been used in war) - 1969.
   • The first hospital-based helicopter wasn't until 1972!! - only __ years ago!
   • The first recognition of EMS as an occupational specialty by the
     Department of Labor was in 1972 - again, only __ years ago
   • The first ACLS course - 1973 - only __ years ago
   • The first vehicle designed to be an "Ambulance" as opposed to a minorly
     modified hearse - 1974 (the Wheeled Coach Type II ambulance - built by a
     funeral car and hearse builder!) - only __ years ago
   • The cervical collar was patented in 1974 - again, only __ years ago
   • MAST PANTS - 1976 - only __ years ago
   • The first PreHospital Trauma Life Support course - 1979 only __ years ago
   • KED - 1981 - only __ years ago
   • The first BTLS course - 1983 - only __ years ago
   • The first PHTLS course - 1984 - only __ years ago
   • PULSE OXIMETRY - 1986 - only __ years ago (and STILL not used everywhere)
   • BLOODBORNE PATHOGEN STANDARDS finally developed by OSHA
     for EMS - 1992 - only __ years ago!!!

7. Discussion of the "future" of EMS:
   • CPR SUCTION CUP for ACD (Active Compression-Decompression) CPR
   • HELMETS: It won't be long before helmets are required when working in the back of a moving ambulance (because of head injuries causing unrestrained provider deaths in ambulance accidents, and lack of a restraint system that doesn't interfere with care activities).
   • AED with 12 lead capabilities
   • EXPANDED CARE issues: Soon, we'll be x-raying, suturing, and inoculating patients
     in the field, without transportation to the emergency department.

8. Discussion of how we can prepare for change - helpful tips for "FACILITATING" change:
   • The change must clearly be for a good reason.
   • All the implications of the change must be considered.
   • Anticipate the different common reactions to change, and prepare a response for each.

9. Ensure that the people facilitating the change are effective counselors: If the people leading the people effected by the change aren't well versed, well trained, well respected, and ABLE TO COMMUNICATE EFFECTIVELY, the change will meet a greater amount of resistance.

10. Anticipate that any changes involving BEHAVIOR ALTERATIONS will be "dumped" in times of stress! "Lapses" must be met with understanding and additional training. Training must be coordinated, consistent, and repeated until the new behavior is no longer "uncomfortable."

11. During all training, the importance of the change must be repeatedly emphasized.

12. HOW ELSE CAN WE PREPARE FOR ALL THESE CHANGES? Recognize that people who are most comfortable with change are the people who experience change the most often.

13. How to exercise and stretch our CHANGE MUSCLES!
    Just as a cardiovascular workout will improve the muscles of the heart and body, CHANGE MUSCLES can be exercised! The more often we exercise our CHANGE MUSCLES, the more comfortable we will become with change.

14. CHANGE Exercises CAN BE SIMPLE.
    All of us do everyday things in a set pattern - whether we are aware of it or not!
    For example, after showering or bathing, we each dry ourselves off in the same manner, drying off body parts in the same order, every time we do it!
    We brush our teeth in the same pattern of attack every time we do it!
    We perform numerous acts using the same movements every single day.
    TO EXERCISE OUR CHANGE MUSCLES, simply ALTER the pattern of ONE of these acts each day!
    By doing something as simple as this, our body (and our brain) becomes more accustomed to "change!"

15. TRAIN YOURSELF TO HAVE FUN WITH CHANGE!!:
    Old age - like change - is inevitable! But it can be FUN! It's all in our ATTITUDE and how we approach change. When approached as "FUN," we can train ourselves to welcome changes in our performance of any sort of function.

16. FIRST ASSIGNMENT FOR A CHANGE EXERCISE Participants are directed to perform a change exercise involving their next meal.
    This presentation is most effective (and most fun!) when it precedes a conference luncheon or banquet!)

17. SUMMARY

Email Charly at: c-d-miller@neb.rr.com
Those are hyphens/dashes between the "c" and "d" and "miller"