Don’t Run – David James Earley

It began as a call like any other. Many people think EMTs and Paramedics are constantly running from trauma call to trauma call, routinely saving lives by mere seconds. While that can happen, this is more frequently the exception rather than the rule. Many of the calls I’ve handled have been for more routine issues – abdominal pains, difficulty breathing, or a sprained ankle. That’s why when we received a call for a woman complaining of headache, I figured it would be another routine trip. It turned out to be anything but.

We arrived on scene at a hotel to find a married couple with one of them clutching her head. They were vacationing on their anniversary when the woman began experiencing extremely painful headaches and started repeating herself. All she seemed able to say was that “I’ve got such a headache,” over and over again. We checked her vitals but found nothing significantly amiss, and a brief interview with her husband reveal no recent injuries. As we began to package her for transport, we started to suspect something more was afoot, but did little to reveal our biggest fear to the patient or her husband: a stroke.

In emergency medicine, one of the cardinal rules of patient care, even for someone in critical condition, is also very simple: Don’t run, either literally or figuratively. By rushing your actions, you increase the likelihood you will drop something, miss something, or perform some procedure incorrectly. Furthermore, you signal anxiety to your fellow responders, prompting them to also rush and increasing their chance of mistakes as well. While it is true that “seconds count,” it is extremely rare that such rushing will ultimately improve the patient’s eventual outcome, and much more likely that you will worsen it instead.

We began transport, performed a brief physical exam (which again revealed no obvious injuries), and discreetly radioed ahead to the receiving hospital that they would be receiving a patient and to initiate stroke protocol. By the time we arrived at the hospital and unloaded the patient, the imaging team was already prepared and brought her back for a CT scan. I had the opportunity to watch the scan results develop in real-time, which revealed a large hemorrhagic stroke the size of a small orange. Given size and duration of the stroke, irreversible brain damage had almost certainly occurred, and it was a sobering thought to consider the lives the patient, her husband, and family had just been forever altered.

By remaining calm, however, we were able to quickly identify the likely cause, initiate a rapid transport, and give the patient the best chance at recovery. Had we let our nerves get the better of us and began rushing once we considered the possibility of a stroke, we might have created even greater delay at getting her the treatment she needed.

I have since learned to apply the mantra of “Don’t run” in business, technical, and other professional contexts. During critical situations, there is often a push to “respond faster” (or at least be seen as doing so), and it can feel counter-intuitive to push against that urge. Expediency can be desirable, but not when it jeopardizes the larger goal. Remember that anxiety is contagious to those around you and is rarely content to afflict a single person.

The next time you’re faced with an emergency, whether medical, business, or otherwise, take a breath and consider the ultimate impact to your “patient.” Don’t run.