One of the biggest EMS dilemmas of all time

[medicRob]

we have'm, and i hate it when the medic is listening to and singing away with the music.. granted, if im in back, its obviously not serious but have a little respect and dignity. just rubs me the wrong way.

Come ride with me, you'll really enjoy me singing at the top of my lungs, "Here I am, rockin likea hurricane!"

 

[adamjh3]

Hey, hey, you better call Kenny Loggins

'Cause you're in the DANJA ZOOOONE

 

[MusicMedic]

a Few of our Van Ambulances had them.. they were pretty cool

except when your partner wants to blast Hip-Hop while transporting granny back from dialysis... then it gets kinda awkward

 

[adamjh3]

a Few of our Van Ambulances had them.. they were pretty cool

except when your partner wants to blast Hip-Hop while transporting granny back from dialysis... then it gets kinda awkward

That's when you slap your partner on the back of the head and tell them to exercise some common sense.

 

[8jimi8]

While i appreciate music just as much if not more than the next person.

it is a distraction. It can cause you to miss that feeding pump alarm.... it can cause you to miss a "yellow" alarm... pt moving from 98% to 93% spo2 (yah, when i am monitoring you, i keep my alarms high into WNL limits. I want to know the very SECOND that you start decompensating...) *then again, the other day when i was transporting for my stat 3 step Bonescan, my relief coverage noticed when my alarm starting dinging... that my patient had her trach collar displaced... before she ever got into trouble... (which would have cost her 3 more days in the ICU)

I often play some EMcrit or EMRap podcasts while i'm charting. but i play it on my loudspeaker, rather than in an earphone. Nightshift does have its benefits... besides the hotties.

 

[JPINFV]

Are you're alarms super silent or do the speakers in the ambulance only in the range that cause permanent damange?

If music is so dangerous, why is it played in operating theaters? Alternatively, is an operating team just better at multitasking when it comes to watching the patient, operating, and listening to music? Sure, there's more people, but everyone still hears the music.

 

[Melclin]

I don't care for it.

I don't like background music at all. I hate that people talk to you with one ear buried in their iPod. I think its rude. Psychiatrists rarely have music on and you'll often find their clocks are positioned just behind pt's heads so they can check the time without appearing to divide their attention. You don't find music in most doctors consultation rooms, at least, not hear. I think its important to ensure people that they are the focus of your attention whether it be in the back of the ambulance, interviewing a prospective employee or ghost writing someone's memoirs. Its nothing to with decision making or EMS specifically, I just think its poor manners to conspicuously divide your attention during one on one conversation of any kind.

I've no problem with music during longer transports and I'm happy to music on for patients, especially younger patients. The latest vacuous rhythmic pulses from LA makes the foreign and sterile environment of the ambulance feel a little more familiar for some, but only after I've finished working.

More specific to me, I can't concentrate with music. I can't read or write while listening to anything else. So it wouldn't work for me even if I didn't hate it.

 

[8jimi8]

Are you're alarms super silent or do the speakers in the ambulance only in the range that cause permanent damange?

If music is so dangerous, why is it played in operating theaters? Alternatively, is an operating team just better at multitasking when it comes to watching the patient, operating, and listening to music? Sure, there's more people, but everyone still hears the music.

i'm coming from an ICU perspective, where there are CONSTANT alarms of varying tones and frequencies. in an OR everyone is focused on their one job, a little theme music goes along way with 100% concentration.

When you are monitoring two critical patients /c varying disease processes, you never know which way they are going to crash. Not to mention, you need to be ready to respond to an emergency in one of any of the 30 rooms. If you are too busy singing along, you may not notice those subtle signs, like a tiny dinging alarm for a MAP of 55. I don't disagree /c music in a completely focused environment, like an OR or the patient compartment. But where I'm at... I need to be sharp, focused and vigilant. Our alarms cut through my podcasts quite nicely. If i were to have one of my ears occupied, along with my thoughts, i just might fall into the complacency of not looking at every alarm.

 

[Aidey]

I have worked in ambulances with the ability to play the radio in the back, but I don't remember ever taking advantage of it. None of my current ambulances can do it. Honestly, even if they could I doubt I would use it unless it was a long trip or something.

My transports are short enough I can spend the entire time talking with the patient, and in between that I'm trying to listen for BPs and lung sounds and what not. If the ambulances blocked out road noise better it wouldn't be a big deal, but with as noisy as it can get in the back, I couldn't ever hear anything if there was music playing. I have chronic allergy/sinus problems and my ears are continually stuffed up, which makes it even worse.

 

[Journey]

Why is there no musical devices in the patient compartment of an ambulance?

Music to sooth the savage beast right?

Anyway...

Several of the people I worked with in my past ED employ would have Ipods with only one ear piece in. They were happier at work. They obviously would have to remove it in order to do things like listen to lung sounds, etc.

This sounds like a very lax work environment. Those ear pieces and Ipods can also be taken by the patients and other staff members as that you are not into listening to what they might have to say. Ever have someone nodding to their Ipod while trying to take your restaurant order or make change when you pay? It can be taken as rude.

When you go to a doctor's office, there is often some background music.

There is usually no music in the exam rooms. The waiting room is different and even then with the many different age groups of patients, it is difficult to satisfy all. Some of the music is actually just annoying and can be more of an irritation.

Even when you are in a surgical theatre, one of the most important roles of anesthesia is to find something on the stereo everyone will agree on.

The patient will not have any participation in this and the music usually starts after the patient is sedated.

Music in the MRI machine.

MRI machines are very loud and the test may take over 2 hours. With or without music the patient will get ear plugs to help them tolerate the procedure.

Nurses walking around the wards and even ICU now plugged into their Iphones.

If caught doing this now in the patient care area in many hospitals, they will get a reprimand for the first offense and be subject to dismissal the second time. The same for cellphones Their job is to listen for alarms, IV pumps and the patients. There is also an infection control issue with these devices and each time you remove the ear pieces from your ears in patient care area you risk contaminating you own ears and set yourself up for a nasty infection. The apps on a cellphone can be of value but one must realize that constantly touching that phone in the patient care areas can lead to a very unclean device. There are enough studies now done on that to have concern. Finding a good cover for the phones that can be cleaned between each patient would be great for those of us who use the apps for patient care and not entertainment.

Nobody gets upset over the white noise in the coffee shop and I can assure you that my coffee being made right is matter of life and death.

You will also probably go to the coffee shop that has the music to your liking. There are some coffee shops that I really like their coffee but will become irritated if I have to wait to long listening to the crap they are playing for music. If you are placed on hold with music you don't care for, chances are you'll walk a good distance away from the phone or just hang up.

What is the hold up with the back of an ambulance?

You already have many distractions going on in that patient's moment. This may be an emergency. The patient is already distracted by what has happened to them. They may have altered mental status and any more distractions will not help that situation. Some patients have hearing problems and certain frequencies in the background may only enhance that making your question and answer session difficult especially if the music is softly played in the back ground.

You also will not find any music, TV or unnecessary distractions in most stroke or neuro centers in the patient care areas. The same for a Rehab center that specializes in stroke and TBI patients. Imagine a TBI patient for a routine transport who has been in a quiet neuro unit being transported to a Rehab facility with the music playing in their ears. In the Rehab center thay will probably be in a darkened, very quiet private room. There are a couple of ambulance services that do transport these patients with music since the ride is over an hour. It may take several hours or even days and much medicating to get that patient back to their baseline when they left the other facility which may rob them of precious rehab time.

For a short transport, you should be able to be the only distraction a patient needs. For a long tranport, you must consider the diagnosis and comfort of the patient. The older patients now are not necessily classical music fans either since they grew up with the real rock and roll but that again may not be appropriate for the patient's condition.

Those of you who have grown up in the electronic age may have to learn face to face communication and being in the moment without gadgets and constant noise, music or whatever to distract you. Maybe listening to an Ipod might be appropriate for you if you are injured but then again, the type of injury or medical condition would have to be taken into consideration.

 

[medicRob]

i'm coming from an ICU perspective, where there are CONSTANT alarms of varying tones and frequencies. in an OR everyone is focused on their one job, a little theme music goes along way with 100% concentration.

When you are monitoring two critical patients /c varying disease processes, you never know which way they are going to crash. Not to mention, you need to be ready to respond to an emergency in one of any of the 30 rooms. If you are too busy singing along, you may not notice those subtle signs, like a tiny dinging alarm for a MAP of 55. I don't disagree /c music in a completely focused environment, like an OR or the patient compartment. But where I'm at... I need to be sharp, focused and vigilant. Our alarms cut through my podcasts quite nicely. If i were to have one of my ears occupied, along with my thoughts, i just might fall into the complacency of not looking at every alarm.

Your monitors and pumps don't come with iPod docks?

 

[medicRob]

In the ICU where I work, we have a 1:1 patient to nurse ratio, and between every other pod there is a workstation, the University has subscribed to a campus-wide music service called VuMix that includes subscriptions to popular services like Netflix, Napster, iTunes, Joost, and Amazon Mp3.. It is non uncommon for us to have music on at each of our individual workstations (At an acceptable volume of course). One station might have Godsmack playing, while I prefer doo wop or Rockabilly on mine.. We have a system called SIMON that was created in a joint effort between the school of medicine and the school of computer engineering where we can set alert params and our beepers will vibrate on us and read out the data such as MAP, IBP, Sp02, etc.

SIMON
http://simon.project.vanderbilt.edu/ICUSystem.htm

 

[Journey]

SIMON
http://simon.project.vanderbilt.edu/ICUSystem.htm

You'll soon learn the quirks of that system.

Are all of your ICU patients 1:1?

Is the music for the ears of the employees only? Do you try to reduce patient interruptions between hands on with limiting unnecessary noise?

 

[medicRob]

You'll soon learn the quirks of that system.

Are all of your ICU patients 1:1?

Is the music for the ears of the employees only? Do you try to reduce patient interruptions between hands on with limiting unnecessary noise?

Just in the trauma ICU until we get them to stepdown or they go to another ICU

We are right in front of the patient at the workstation, as a courtesy, we try not to turn the music loud enough for anyone outside of us to hear it. My patients are usually heavily sedated or comatose

 

[Journey]

We are right in front of the patient at the workstation, as a courtesy, we try not to turn the music loud enough for anyone outside of us to hear it. My patients are usually heavily sedated or comatose

If a patient in our Trauma, neuro, medical or surgical ICUs has any signs of a TBI, we'll will respect the minimal stim for any outside noises even if they are sedated.

 

[medicRob]

If a patient in our Trauma, neuro, medical or surgical ICUs has any signs of a TBI, we'll will respect the minimal stim for any outside noises even if they are sedated.

Oh no, the volumes are nowhere near as loud as you are thinking. Think about a radio at a doctor's office that you can just barely hear when not right in front of it.

 

[LucidResq]

We encouraged patients to bring their mp3 players and headphones to stressful procedures.... I appreciated that because it definitely made the patients calmer and still allowed us to communicate as necessary. Of course no headphones while we needed to assess/explain/etc... and we asked they kept one ear free so we could still check on them and such during the procedure.

For those who are opposed to music on speakers in the back... would you feel ok if your patient alone had their music? Of course this is after you've got all the important history taking and stuff done...

 

[Journey]

For those who are opposed to music on speakers in the back... would you feel ok if your patient alone had their music? Of course this is after you've got all the important history taking and stuff done...

If the patient is well enough to play their own music or ask for it then great. I sometimes have music at the dentist and sometimes not if I want to pay attention to what is being done.

I recently saw someone get hit by a car and knocked to the ground. He would not let go of his iPhone. His behavior was odd (at least to me) about his obsession over wanting to listen to whatever was on his phone while people, including EMS, were coming to his assistance. At first appearance he did not appear to be badly injured with mostly abrasions. I later saw him in the ICU on a ventilator with an EVD. For an emergent situation, I think you should communicate with the patient and assess and reassess until you get to the hospital. For long transport it might be appropriate provided the patient is not a head injury who needs minimal stimulation while the brain heals. Some families do get offended when told their loved one can not listen to their favorite music or watch a football game on TV for a week or two since that is what they always do in the movies.

 

[Outbac1]

I can't say I've thought about music in the back as I seldom listen to the radio. I have thought that a DVD player mounted over the rear door would be nice for some pts on long trips.

 

[HotelCo]

I can't say I've thought about music in the back as I seldom listen to the radio. I have thought that a DVD player mounted over the rear door would be nice for some pts on long trips.

My company has those ... they're great. Ours come with two sets of cordless headphones, so the pt, and provider can watch a movie.


.