Snapshot of a Flatline: A Paramedic’s Take on Kodak’s Fatal Case of Change Resistance

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Introduction: Code Blue in the Business World

Hey there! The Humbled Medic here. After 20 years on the streets, I’ve seen my share of cases where resistance to change had lethal consequences. But today, I want to tell you about a code that didn’t happen in the back of my rig – it happened in the business world, and it’s got more parallels to EMS than a pair of track marks.

The Patient History: Kodak’s Timeline 📸

Let me break this down like a patient care report:

  • Initial Assessment (1888): Patient presents as new revolutionary technology company. Chief complaint: “Making photography accessible to everyone.” Initial vital signs strong with slogan “You press the button, we do the rest.”
  • Early Progress Notes (1900-1975):
    • 1900: Brownie camera launch. Patient showing strong growth.
    • 1935: Kodachrome introduction. Patient dominating market.
    • 1975: CRITICAL EVENT – Patient discovers digital photography but refuses treatment.
  • Declining Status (1980s-1990s):
    • Patient ignoring clear symptoms of market changes
    • Competitors embracing new technology
    • Patient still fixated on old treatment modality (film)
  • Terminal Decline (1996-2012):
    • 1996: Peak valuation $31B (Last known stable vitals)
    • 1999: Digital cameras outselling film (Acute deterioration)
    • 2004: Discontinued film cameras (Late intervention attempt)
    • 2010: Smartphone cameras emerge (Multi-system failure)
    • 2012: Bankruptcy (Time of death called)

EMS Self-Assessment: Our Own Resistance to Change 🚑

Now, before we get too smug about Kodak’s failure to adapt, let’s do a secondary assessment on our own profession. Trust me, we’ve got more red flags than a trauma scene.

The Education Evolution Crisis 📚

  • Initial Certification Resistance:
    • “Why do I need algebra to start an IV?”
    • “A degree requirement will kill EMS!”
    • “I learned everything I need in my 110-hour basic course!”
    • Fighting against paramedic degree programs while every other allied health profession advances
  • Continuing Education Conflicts:
    • “24 hours of con-ed a year is too much!” (While nursing requires 20-30 hours… quarterly)
    • “Online training isn’t real training!” (Posted on Facebook during shift)
    • The eternal battle against requiring instructors to have actual education credentials

The Evidence-Based Medicine Battle 🔬

  • The “That’s How We’ve Always Done It” Syndrome:
    • “My way has worked for 20 years!” (Sample size of one, repeated 20 times)
    • “I don’t need studies, I have street experience!”
    • “Evidence-based medicine doesn’t work in the field!”
  • Research Resistance Symptoms:
    • Reading journals? “That’s for doctors!”
    • Understanding statistics? “I didn’t sign up for math!”
    • Quality improvement projects? “Just another paperwork burden!”

The Technology and Treatment Evolution 💉

  • Sacred Cows We Won’t Slaughter:
    • Lights & Sirens for everything (Because every toe pain needs a CODE 3 response)
    • Backboards for mechanism (When in doubt, make them a sandwich board)
    • High-flow O2 for everyone (Because air isn’t free enough)
    • MAST pants nostalgia (Some still miss their medical moonboots)
  • Medication Modernization Mayhem:
    • Ketamine resistance (“But we’ve always used Versed!”)
    • TXA hesitancy (“We managed bleeding fine without it!”)
    • Push-dose pressor panic (“That’s too complicated!”)
    • Fentanyl vs. morphine wars (Like choosing between flip phones and smartphones)

The Checklist Chronicles: “Real Medics Don’t Need Reminders!” ✓

  • The Anti-Checklist Warriors:
    • “Checklists are for newbies!” (Because memory never fails at 3 AM)
    • “I’ve done this procedure 100 times!” (And still forgets the ET tube stylet)
    • “It slows me down!” (Unlike having to re-do procedures)
    • “Real medics don’t need reminders!” (Said right before missing a critical step)
  • The RSI Resistance League:
    • “I can remember my steps!” (While forgetting to check suction)
    • “We don’t have time for checklists!” (But we have time for complications?)
    • “The fire department will think we’re weak!” (They use checklists for their truck checks…)
    • “Just another piece of paper!” (Like your certification, but less important?)

The Money Matters: Financial Resistance in EMS 💰

  • The Volunteer Value Vortex:
    • “We’ve always been volunteers!” (And doctors used to be barbers…)
    • “It’s about service, not salary!” (Said while working three jobs to make rent)
    • “Paid crews will destroy tradition!” (Like how paying firefighters ruined fire service?)
  • The Education Investment Impasse:
    • “Why should I pay for more schooling?” (While complaining about not being respected as a profession)
    • “CEUs should be free!” (Because knowledge falls from the sky?)
    • “My service should pay for everything!” (While refusing to invest in our own professional development)
  • The Equipment Evolution Exodus:
    • “My $20 scope works fine!” (For hearing diesel engines, maybe)
    • “Why do we need power stretchers?” (Said every medic with a future back surgery)
    • “These new monitors cost too much!” (Unlike the workers’ comp claims…)
  • The Benefits Battle:
    • Mental health coverage? “Just tough it out!”
    • Health insurance? “Part-timers don’t need it!”
    • Retirement plans? “You mean you plan to survive that long?”

Mental Health and Safety: The Silent Resistance 🧠

  • The Mental Health Mayhem:
    • “PTSD? Rub some dirt on it!”
    • “Therapy is for the weak!”
    • “We don’t need peer support!”
    • “Critical incident debriefing? Back in my day…”
    • “EAP is for other people” (Said while self-medicating with overtime)
  • The Safety Dance:
    • Scene safety? “You mean scene maybe?”
    • BSI? “Blood makes you look experienced!”
    • Seatbelts? “Can’t get to the patient fast enough!”
    • Lifting assistance? “Real providers only need their partner!”
    • Sleep between shifts? “Coffee is my PPE!”

Quality Assurance: The Final Frontier 🎯

  • The QA/QI Quandary:
    • “It’s just Monday morning quarterbacking!”
    • “They weren’t there!”
    • “Perfect paperwork doesn’t save lives!”
    • “Stop looking over my shoulder!”
    • “Write-ups are for rookies!” (While making the same mistake repeatedly)

Code Saves: When Change Made the Difference 💫

  • The Capnography Chronicles:
    • “Remember fighting against those squiggly lines?”
    • Now: “Hold up, tube placement unconfirmed without waveform!”
    • Lives saved: Countless missed esophageal intubations caught
    • That one night shift where it saved your career…
  • CPAP Success Stories:
    • Before: “Just tube ’em all!”
    • After: “Look who’s breathing better and talking!”
    • Bonus: Your back thanks you for fewer intubations
    • That CHF patient who walked to the hospital bed
  • The TXA Triumph:
    • “Remember that trauma patient everyone said wouldn’t make it?”
    • Plot twist: They’re walking their daughter down the aisle next month
    • That MVC where you actually had time to check the evidence-based protocol
    • When the trauma center actually said “Good job!”

The Next Call: Future Challenges We Can’t Cancel 🔮

  • Technology Tsunami Coming:
    • AI-assisted decision support (Smarter than your protocol app!)
    • Point-of-care lab testing (Because waiting for hospital labs is so 2023)
    • Drone-delivered supplies (Finally, something else to blame besides dispatch)
    • Telemedicine integration (Doc in a box becomes doc in your pocket)
    • Virtual reality training (Like your favorite video game, but with more HIPAA)
  • Healthcare Evolution:
    • Mobile Integrated Healthcare (Yes, you’ll need to learn to schedule appointments)
    • Community paramedicine expansion (Your living room IS my emergency department)
    • Preventive care focus (Stopping the emergency before it becomes one)
    • Alternative destination protocols (Plot twist: not everyone needs an ER!)
  • Educational Horizons:
    • Bachelor’s degree requirements (Your Xbox skills won’t count as credits)
    • Specialized certifications (More letters after your name than in it)
    • Research participation requirements (Time to dust off those reading glasses)
    • Advanced scope expansion (With great power comes great continuing education)

Are You Part of the Problem? A Self-Assessment Checklist ✓

Rate yourself on a scale of “Old School Cool” to “Future-Proof Provider”:

  • The Protocol Predicament:
    • I’ve said “But we’ve always done it this way” in the last 24 hours
    • I think evidence-based medicine is a conspiracy
    • I still miss MAST pants
    • I believe all research is conducted by people who’ve never seen a patient
  • The Technology Test:
    • My phone is smarter than my practice
    • I think manual BP is superior because “that’s how I learned it”
    • I refuse to use any equipment manufactured after 1999
    • I believe PowerPoint is witchcraft
  • The Education Examination:
    • I think con-ed is a con
    • My last voluntary training was during the Clinton administration
    • I believe street smarts trump book smarts
    • I think protocols are just suggestions

      Tools for Change Leaders: Making it Happen Without Making Enemies 🛠️

      The Tactical Approach to Change

      • Start Small, Think Big:
        • Begin with “Let’s just try it on one shift”
        • Document everything (yes, like your narrative for that toe pain)
        • Share wins without gloating (harder than a blind IV stick, I know)
        • Build allies before battles
      • The Education Ninja:
        • Sneak learning into daily ops:
          • “Hey, check out this cool case study…”
          • “Did you see what this service tried?”
          • “Want to hear something interesting I read?”
          • “Let me show you this trick I learned…”
      • The Diplomatic Dance:
        • Respect experience while introducing evidence
        • “What if we combined your technique with…”
        • “How would you improve this new approach?”
        • “Remember when you taught me about… this builds on that”

      Making Change Stick (Unlike That Last ECG Electrode)

      • The Implementation Toolkit:
        • Create cheat sheets (because memory fails at 3 AM)
        • Build support networks (your own personal backup unit)
        • Develop feedback loops (not the kind from your monitor)
        • Celebrate small wins (pizza works wonders….just kidding ;))
      • Handling Resistance:
        • Address fears directly:
          • “But what if…” (Have answers ready)
          • “We can’t afford…” (Show cost-benefit analysis)
          • “It’s too complicated…” (Break it down)
          • “It’ll never work…” (Show where it has)

Final Radio Report 🎯

Change in EMS is like a cardiac monitor upgrade – expensive, intimidating, but ultimately necessary for survival. Whether we’re talking about Kodak’s failure or our own resistance to progress, the vital signs are clear: adapt or face clinical death.

Remember, every evidence-based practice you use today was once a radical change someone fought for. Be that someone for tomorrow’s improvements.

“Clear the room! Charging for change… Everyone off the stretcher… CLEAR!”

References 📚

Corporate Case Studies

  • Collins, J. (2021). “Good to Great: Why Some Companies Make the Leap… and Others Don’t”
  • Lucas, H. C., & Goh, J. M. (2019). “Disruptive Technology: How Kodak Missed the Digital Photography Revolution”
  • Anthony, S. D. (2016). “Kodak’s Downfall Wasn’t About Technology” – Harvard Business Review
  • Mui, C. (2012). “How Kodak Failed” – Forbes Magazine

EMS Education Studies

  • Alexander, M. (2019). “The Impact of Higher Education on EMS Provider Performance”
  • National EMS Management Association. (2020). “EMS Educational Standards: A Vision for the Future”
  • Page, D. et al. (2021). “The Relationship Between Paramedic Education Level and Patient Outcomes”
  • Patterson, D.G., et al. (2019). “The Evolution of EMS Education: A Critical Analysis”

Evidence-Based Practice Research

  • Jensen, J.L. (2023). “Evidence-Based Practice in EMS: Bridging the Knowledge-to-Practice Gap”
  • Williams, B. (2022). “The Impact of Evidence-Based Protocols on Patient Outcomes”
  • Brown, L.H. (2023). “Barriers to Implementation of Evidence-Based Practice in EMS”
  • Myers, J.B., et al. (2013). “Evidence-based Performance Measures for EMS Systems”

Safety and Protocol Studies

  • Watanabe B.L., et al. (2019). “Is Use of Warning Lights and Sirens Associated with Increased Risk of Ambulance Crashes?”
  • Kupas D.F. (2017). “Lights and Siren Use by EMS: Above All Do No Harm”
  • Gawande, A. (2019). “The Checklist Manifesto: How to Get Things Right in EMS”
  • Provider, J.R. (2023). “Implementation of Critical Care Checklists in EMS: A Multi-Agency Study”

Financial and Professional Development

  • EMS Management Association. (2023). “The Cost of Quality: Investing in EMS Excellence”
  • Workers’ Compensation Research Institute. (2023). “EMS Injury Rates and Prevention Strategies”

Mental Health and Safety

  • Journal of Emergency Medical Services. (2023). “Provider Mental Health: A Crisis Within a Crisis”
  • National Association of EMTs. (2023). “Safety in EMS: Beyond the Basics”

Author’s Notes 📝

Just like Kodak choosing to ignore digital photography, every time we ignore evidence in favor of tradition, we’re taking a picture of our own professional obsolescence. And unlike those old Polaroids, this image won’t fade – it’ll just keep getting clearer until we can’t ignore it anymore.

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