12 Leads and Capnography…Who needs that crap? Yeah, I said it.

 12 Lead, Capnography and Violence; A Culture Change

Kip Teitsort, Founder DT4EMS, LLC



Many of you know I got my start in EMS in South Florida. You know, retirement heaven. The place where the parents of the elderly go to retire. Chest Pain, Shortness of Breath and VD were more than just common, they were all-day every day! No, not venereal disease “VD”, the “Veak and Dizzy Darling” type of VD complaint… their verbiage, not mine of the “General Weakness” complaint.

What started with a LP5, turned to the LP10 and I thought, because of my training and experience, I was the king of cardiac. So a couple of years go by and I move to Missouri. Pick up a medic gig and off I go. A few years pass by and in between all of my law enforcement continuing education and teaching I still worked EMS. We all are aware of how we have to stay up on training in EMS right? So my EMS employer made a 12 lead class mandatory.

Well, I puffed up pretty quick. “Hell, you are going to force a class on a guy like me, I mean with all of my chest pain running experience?” Seriously, me? The guy who actually had a Carotid Sinus Massage WORK for him? I have blah, blah and blah and have taught blah, blah, blah so I don’t need no stinking 12 lead class. Yup, you guessed it, if I wanted to keep my EMS gig, I had to take the class.

So I show up all hacked off to take the class. Arms folded, leaning back in my seat with a scowl on my face. Within the first hour, everything I had ever been taught by brilliant, experienced EMS educators, my off-the-charts preceptors and fellow EMSers I looked up too regarding ECG and chest pain/MI, was changed forever.

I immediately thought “Uh oh, I have been doing so many things wrong” and “Why didn’t anyone tell me this sooner, where has this been?”

I am sure that many of you veterans of EMS, Fire or ED nursing reading this right now have had that same experience when you took your first 12 lead class. Then ultimately is was the same with Capnography… we changed how we did things.

I tell you this personal story of experience because I see the very same reaction every single time a group of people finish an EVE class. They say the same things “Uh oh, I have been doing so many things wrong” and “Why didn’t anyone tell me this sooner, where has this been?”

12 Lead and Capnography classes essentially changed our culture in emergency medicine. It took a while, there was resistance, but changes were made and we became better for it. Patients are safer for it.

Violence and the use-of-force in medicine is no different. We have blinders on until, like the 12 lead class, we think because of original training or our own experience we know what we are doing.  We have violence directed at us and we use force to detain/restrain people on the job. Both with little or no actual training on how to deal with either of them. This has led to a serious problem within our culture. It has lead to staff being beaten by people they mistakenly continue to call a patient or it has had staff treat true patients with excessive force. Learning to use force, in the middle of a use-of-force situation is just plain dangerous. Not just physically but legally and morally as well.

More than survive

I can assure you, EVE is a culture changing program. Once you get past your initial resistance to take the full EVE  class, you too will be changed forever. But don’t just take my word for it. I get it, you think since I createded the course, it’s a sales pitch. Well, then ask someone who has taken our course. You can read what people have said here on the Testimonials page. People say those things because we created a course for us, for what we really face in emergency medicine. We had to research the problem, make sure it was physically, legally and morally sound. Then we pressure tested what we teach. We have and will constantly address the issues we face. We refuse to do the “it’s what we have always done”. We didn’t copy anyone. We blazed a trail that others are copying. We didn’t create the idea staff needed training, we just train them for what they really face. It’s a culture thing, not just a class.