Johnny is 72.

His brother and father both died of cardiac related issues.  He is currently feeling fine, no complaints, but was found near an energy drink, rare steak and a little blue pill.  The man sitting next to him has similar history and is experiencing an Anteriolateral STEMI.

Everything around Johnny is screaming that he COULD be having a cardiac event that we can’t see, that he can’t feel, and that we’ll be liable for if we don’t “treat him.”


“Absurd” you say?

“We’d assess him and only treat him if he had signs or symptoms.”



If you are required to strap a curved spine to a flat board based on how a person was found, then you should be required to treat Johnny for the MI he is surely experiencing based on his history, current situation and the fact that someone right next to him doing the same things is having an MI.

We seem content to compartmentalize our treatment based on the little boxes in the protocols.

As practitioners we must strive to use our assessment skills and tools to determine a patient’s condition and need for treatment or transport.  Focus less on the looming lawyer myth you’ve been sold by the anchors and do what your patient needs.

In this situation, we don’t even need to bother Johnny unless he asks.  Based on his history and environment he deserves a “You OK?” and his friend deserves your attention.

Evidence based medicine has slowly begun to trickle into EMS and we have to wait for it to make it all the way to the bottom where that cold, flat board that hurts our patients sits because of everyone’s fear of the “one” that might get away.

Is Johnny on the track to an MI?  Surely, but that’s no reason to make him worse now.

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