An Open Letter from the EMPACT Authors

We have recently seen a publication by the NAEMT AMLS committee that offers a comparison between the EMPACT and AMLS textbooks. Many may be aware that Brady and the NAEMT once published the AMLS text together. They parted ways several years ago, resulting in what are now two competing publications and courses. While we respect our colleagues in the AMLS project, we feel we must take a moment to correct some serious misconceptions that may be caused by their comparisons.

Twink Dalton, Dan Limmer, Joe Mistovich, and Howie Werman are the authors of EMPACT--and the originators of the entire AMLS concept. We created the book and approached NAEMT about the course
 more than a decade ago. Our original concept--using a complaint-based approach to the medical patient, coupled with a solid differential-diagnostic reasoning process--has been overwhelmingly well received and continues in our EMPACT book today. We believe that while treatment is important in the medical patient, the assessment and diagnostic components of coming to the right conclusion are perhaps the most vital and necessary concepts for the provider to possess.

To this end we have added a chapter on “Critical Thinking and Decision Making“ and honed our focus in airway from a simple procedural chapter to a decision-based chapter called “The Difficult Airway.“ Our focus is on empowering those who read our book and take the corresponding course to develop the solid clinical reasoning skills required in EMS today. Our EMPACT book is truly complaint-based (the way patients present) and follows the successful model we have used for almost 15 years. 

Part of the AMLS criticism of our book is that it doesn't cover things like bariatric patients, wilderness conditions, and hazardous materials. Our stand is that there are other books that cover this primarily, and it isn't our intent to cover these issues--except when it applies to the fundamental assessment and diagnosis of the medical patient. Furthermore, the implication that we don't cover respiratory disorders, abdominal conditions, and endocrine disorders is absurd and misleading. These items are covered under the complaints where they are relevant and in the detail that we believe is necessary to both provide valuable diagnostic information and insightful clinical material without providing redundant or inapplicable material.

As an author team (as opposed to a committee), we were able to provide the most focused, consistent, and appropriate material for a new or experienced provider to improve his or her approach to a medical patient and hone vital thinking and diagnostic skills traditionally only taught through experience.

As the toolbox of the Paramedic increases in powerful assessment techniques, medications, and modalities, the hallmark of the competent Paramedic will be the ability to appropriately assess and come to the correct clinical diagnosis so that the proper therapeutic care can be delivered. Our product has, and will continue to keep, this singular focus to help you approach, assess, and understand the medical patient. We are proud of our book and the course that has been developed to accompany it. We ask only that you carefully compare the two products before making a decision. If any of us may be of personal assistance with questions or comparisons, please do not hesitate to contact us directly.

Twink Dalton         
Dan Limmer           
Joe Mistovich         
Howie Werman, MD