EMS World

AUG 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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EMSWORLD.com | AUGUST 2018 39 The concept of palliative care a s a facet of prehospital care was dif ficult to develop. The idea implie s a much longer-term relationship with patients than the average prehospital emergency allows. Our function is in an "emergent" span of interaction and gives rise to the argument that there are other priorities. We don't have time to treat something non-life-threatening like pain. Even as the impact of "patient satisfaction" on reimbursement began spurring radical changes in treatment guidelines in the clinical setting, as a field we remained steadfast—tough it out, kid. As much as we'd like to claim we're healers of the people, no person operates purely without judgment or bias—it's part of the human condition. One unique bias within the medical community at large has to do directly with gender: Women are treated differently, especially when it comes to pain. The reasons behind it are complex and heavily influenced by cultur- al and societal norms and assumptions, but the result is the same. Women in pain are frequently undertreated—or, worse, their symptoms are dismissed or deval- ued, resulting in years of unnecessar y agony, misdiagnosis, and even death. It's not solely your fault as the provider. Women are taught to express themselves differently, to understate and not incon- venience. As natural caregivers they will deflect and defer their own discomfor t in self-sacrifice to care for others. There is an inherent trus t in the healthcare system, accompanied by the fact that nobody taught them how to advocate for their bodies. "Not just on the side of the medical establishment—where female pain might be perceived as constructed or exaggerated—but on the side of the woman herself: My friend has been reck- oning in a sustained way about her own fears about coming across as melodra- matic." 1 So they tr y not to burden oth- ers, preferring instead to tr y to function, until they cannot. By the time they ask for help, they are filled with self-doubt and become more willing to accept delays in testing or treatment. When your suf fering patient sighs, it is in acceptance of the fact that you do not believe she is in pain and she must explain away the re s t of her a s se s s- ment first. You are one more person in an extensive line of medical profession- als she's had to convince her illness is not some psychologically created phantom menace but a genuine experience that is disrupting her life and indicates sys- temic damage or dysfunction. The pro- cess even has a name, "Yentl syndrome," wherein women are generally found to be treated less aggressively within the healthcare system until they "prove they are as sick as male patients." 2 In the United States women wait an avera ge of 65 minute s for anal ge sia in response to acute abdominal pain, compared to 49 minutes for men. One study even showed women who received coronar y bypass surger y were only half as likely to be prescribed painkillers as PROFILES IN EMS October 16–20, 2018 | Music City Center in Nashville, TN For details, visit FirehouseExpo.com Reserve Your Space Now! Early-bird savings expire on Aug. 15. Register today and enter Promo Code: FHMAG for additional savings of $50 on the full conference package and FREE exhibit hall admission. While you are at it, book your hotel today to get the location of your choice. WE'RE MAKING THIS PERSONAL! Firehouse Expo is the industry event of choice for fi refi ghters like you. Why? More individualized training Great opportunity for personal contact with peers and solution providers Leading-edge educational training and conference with more one-on-one time with infl uential instructors This year, Firehouse Expo's hands-on training and precon- ference sessions are bigger than ever. Review the lineup and reserve your place now since spots are limited.

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