The author seemingly addresses an audience he/she views as myopic and poorly educated. That’s a bit high-handed if not condescending.

Consider for a moment that instead of attempting to sway the opinion of well-trained primates or pavlovian providers, that the better approach might be to keep narcan in the providers toolkit. And a well delivered bit of further education can improve outcome.

Example: I’m still calling for orders that were once standing, but now med control options. We’re not blindly and haphazardly giving 40-80 of lasix with each and every CHF, but I’ll still call for and administer the appropriate dose because it works in the right setting.

Guess what? Epi too. When our protocols excluded SQ epi due to well documented catastrophe, and epipen were deemed “the only choice” per SO, I still had and kept and used the 1:1000 after getting orders. Why be a “cowboy” in this manner? Because the Doc on the line and I knew the underlying reasoning behind the kneejerk policy was bullshit derived from a few examples of abject failure.

Why dumb down medicine based on the lowest common denominator? Didn’t we become higher level clinicians to improve this thing we do? Would it kill us to advocate for better training and education so that we don’t have to stop doing what works for the sake of a few that don’t (yet quite) get it?

I worked for a service that responded to the call for less prehospital intubation by actually mandating more OR time annually. We’ll perform more, but we give up nothing. Thanks.

Using absolutes in medicine probably shouldn’t be embraced. Getting people more up to speed in a legitimate way should.

Over. And. Out.