# Frontier and Rural versus Urban/Suburban EMS



## mycrofft (Jan 25, 2009)

I sense a watershed between city-folks and country folks here. Our media-driven paradigms are largely urban/fire EMS or urban/hospital EMS. Do you think a (another!) separate section inviting rural/frontier EMS discussion would be good and more-inclusive, or should we all just remember that not everyone get Johnny and Roy or Dr Green and Frank whenever they call 911 or get on ther ham radio?


----------



## Veneficus (Jan 25, 2009)

I think we all have a lot to learn from each other so best to stick together.


----------



## flhtci01 (Jan 25, 2009)

Working in both settings, I do not think we need a seperate section.  I have both learned from and taught different techniques to the other setting.  What we need is more open communications not another link in the communication chain.


----------



## Sasha (Jan 25, 2009)

mycrofft said:


> I sense a watershed between city-folks and country folks here. Our media-driven paradigms are largely urban/fire EMS or urban/hospital EMS. Do you think a (another!) separate section inviting rural/frontier EMS discussion would be good and more-inclusive, or should we all just remember that not everyone get Johnny and Roy or Dr Green and Frank whenever they call 911 or get on ther ham radio?



If you kept them apart each side would be missing a wealth of information and insight from the other. It's best to remember that they're not totally the same, but they're not that different, either. It all boils down to patient care, doesn't it?


----------



## mycrofft (Jan 25, 2009)

*The poll is oddly even except for "I'm urban and it isn't needed"*

33%, 22% for all others. Be sure to punch those hanging chads.


----------



## jochi1543 (Jan 25, 2009)

I work rural, but I find it very interesting to read about urban experiences. We definitely tend to get different types of calls. I'm thinking about doing my practicum on the reserve, that should be yet another unique environment. If anyone here has worked on a reserve, I would be interested in hearing about it.


----------



## JPINFV (Jan 25, 2009)

Personally, I think a few of the divisions aren't really needed. When I hop on the board I simply hit the "new posts" link and open the threads that look interesting. If that means I'm reading and posting in a thread in the ALS section, then so be it. Similarly, if there was a rural EMS section (would that mean, then, that there should be a forum for urban and another forum for suburban EMS?), then I would still probably end up posting in a few threads in there simply because I don't constrain myself by which section it's in.


----------



## mycrofft (Jan 26, 2009)

*JPINFV, I'm like you.*

...except I try to remember to search mycrofft for the occasional buried reply.
Interesting how this has been interpreted as becomnig a wall between rural/urban instead of a means to tease out the specialties of non-urban response.
PS just for the books now the non-urban/nonneeded responses are up to 35% taking a slight lead over urban/nonneeded.


----------



## mycrofft (Jan 26, 2009)

*My two polls*

Oddly the ratios of folks identifying themselves as rural and urban differ. Go figure.
PS: 64% urban and nonurban feel a nonurban division is unnecessary.


----------



## mycrofft (Jan 26, 2009)

*Of course with a sample of fourteen...*

............


----------



## Sasha (Jan 26, 2009)

mycroft is trying to turn us into emtcity!! Get him >:[!!!


----------



## karaya (Jan 26, 2009)

I just looked though my bookcase full of EMT, EMR, and Paramedic textbooks from just about every publisher.  I looked for "Emergency Care for Hay Seeds" as well as "Paramedic Care for City Slickers" and I cannot find any that are produced specifically for EMS in a demographical setting.

I think we are fine with the categories already in place.


----------



## JPINFV (Jan 26, 2009)

Sasha said:


> mycroft is trying to turn us into emtcity!! Get him >:[!!!



Do you have a problem with people who frequent both sites? :sad::glare:


----------



## Sasha (Jan 26, 2009)

JPINFV said:


> Do you have a problem with people who frequent both sites? :sad::glare:



Nope! I've been lurking on emtcity for a couple of weeks, actually.


----------



## keith10247 (Jan 26, 2009)

I live in a unique 1st due.  We have cows and mcmansions now.  If you go 5 miles east, you run in to more mcmansions... 10 miles east and you are on a road lined with stores surrounded by the ghetto.  Now if you go out west, OMG the mountain folk scare me; thankfully, they do not call us much because they believe that a little infection builds charecter.  

Oh and 40ish miles east, you run in to our nation's capital.  

That being said.  Our blend would make it so that I would have to post half of my questions in one category and the other half in another category.


----------



## BossyCow (Jan 26, 2009)

keith10247 said:


> Now if you go out west, OMG the mountain folk scare me; thankfully, they do not call us much because they believe that a little infection builds charecter.



ROFL, You would sooooo not be happy in my neighborhood. We actually had some loggers coming down out of the hills with their buddy in the front seat of the pickup, doing chest compressions on him against the seat... bouncy, bouncy, bouncy, bouncy... not much actual compression going on though. Then the guy who truly believed that if an AED wasn't around, you could sure try to spark 'em with a car battery couldn't you?

As to the OP, I don't want to see rural EMS separated from urban. While our protocols may vary a bit, I hesitate to remove rural from the equation. I think we need to admit that rural is part of what we do. Same pt, same symptoms, totally different situation. Rural areas need to be considered and addressed when formulating policy and creating training modalities. To pretend that we're just different and separate is doing us and our pts a disservice.


----------



## eric2068 (Jan 26, 2009)

I have worked urban, suburban, and rural, and the one thing I have noticed is that an MI does not know where it is, and it will try to kill your patient just the same. Yes in a rural setting you have a longer transport time, but the calls are the same, the only difference is the volume. To be honest, now that I work in a combination suburban/ rural area, and I love it. Don't have the volume that I had in the city, but for the most part, the calls are interesting.


----------



## marineman (Jan 26, 2009)

I don't feel the division is warranted. The definition of urban, suburban and rural will be different depending on who you ask so it would get very muddy as far as deciding where to post a question that could benefit from several viewpoints anyway.


----------



## keith10247 (Jan 26, 2009)

Can we do this in real life?  I would love to see a few certain rural EMTs seperate from the urban side of things! :lol:  

And no, not ALL rural folk...just a couple.


----------



## BossyCow (Jan 26, 2009)

keith10247 said:


> Can we do this in real life?  I would love to see a few certain rural EMTs seperate from the urban side of things! :lol:
> 
> And no, not ALL rural folk...just a couple.



cutting us out from the herd???


----------



## keith10247 (Jan 26, 2009)

BossyCow said:


> cutting us out from the herd???



Nah, not anybody from here.  I am talking about people out here and keeping them away from urban settings


----------



## marineman (Jan 26, 2009)

keith10247 said:


> Nah, not anybody from here.  I am talking about people out here and keeping them away from urban settings



I would prefer that they cut me out of urban settings.


----------



## mycrofft (Jan 27, 2009)

*Next time I post a poll I'll try for demographics.*

I'll bet you a nickle the "rural/nonurban" folks who are against the tbhoght of being treated separately are young and impressionable, while the majority of nonurban folks not favoring an area of acent (not "purdah") are older and not as likely to one day move to or be swallowed up by an urb, suburb, or ex-urb.


----------



## mycrofft (Jan 27, 2009)

*Next time I post a poll I'll try for demographics.*

I'll bet you a nickle the "rural/nonurban" folks who are against the tbhoght of being treated separately are young and impressionable, while the majority of nonurban folks not favoring an area of acent (not "purdah") are older and not as likely to one day move to or be swallowed up by an urb, suburb, or ex-urb. 
Total sample to date 29, rounded responses against, 34.5% urban against, 27.5% rural against.


----------



## BossyCow (Jan 27, 2009)

I guess I just play the continual role of socratic gadfly to remind our urban brotheren and sisteren that the rules shouldn't be made just to suit their situations.


----------



## artman17847 (Jan 27, 2009)

*mycrofft great thread!*

I have worked urban EMS most of my career, did most my TX on scene and transported 10 mins to any hosp. 15 mins to level 1 trauma center. Now i have moved out to the country and I'am now begining to learn that rural EMS can be very challenging.

Its 45 mins by ground to a cath lab or trauma ctr. I get to spend alot more time managing my pt. and thus end up doing more than I was used to working in a city system. Most stuff is done enroute, IV's, blood draws, etc.

I got to experience my first deer season out here. 

1-diabetic found lying at the base of tree he was just off a main road.

2- was a guy 2 miles in that fell out of his stand and FX his tib-fib

3- guy shot himself in the tib and top of his foot he was 5 miles in that was fun trying to get to him.

the guys at the station keep ribbing about geting my first agricultrual rescue. there are bets it will be either someone falling into a manure pit or rolling thier combine, I guess we will see.:wacko:


----------



## Hal9000 (Mar 6, 2009)

*Keep it the same...*

I say that, though, and I work both rural and large urban area.  The difference that matters to me most is that in rural, a 12 hour shift is 12 hours, not 13.5


----------



## medic417 (Mar 6, 2009)

Hal9000 said:


> I say that, though, and I work both rural and large urban area.  The difference that matters to me most is that in rural, a 12 hour shift is 12 hours, not 13.5


But actually in rural a 12 hour shift ends up being 16 or more as you get a call after 11.5 hours of quit and have to take them to the hospital which is nowhere near the station.


----------



## Hal9000 (Mar 6, 2009)

medic417 said:


> But actually in rural a 12 hour shift ends up being 16 or more as you get a call after 11.5 hours of quit and have to take them to the hospital which is nowhere near the station.




You know, that's actually true.  Due to lack of units in rural, I've been stuck with an LDT toward the end of a twelve, too.  Thankfully, I have a white cloud for that, and it's not too often.  I generally find the call diversity and type to be much more enjoyable at my rural service.  Also, lack of nearby definitive care places additional responsibility on you.  I get much more satisfaction from my patients there.


----------



## medic417 (Mar 6, 2009)

Hal9000 said:


> You know, that's actually true.  Due to lack of units in rural, I've been stuck with an LDT toward the end of a twelve, too.  Thankfully, I have a white cloud for that, and it's not too often.  I generally find the call diversity and type to be much more enjoyable at my rural service.  Also, lack of nearby definitive care places additional responsibility on you.  I get much more satisfaction from my patients there.



Our nearest hospital is more than an hour away.  It is satisfying to diagnose, treat, then see the results of your treatments.  Of course if your treatment does not make them better it can also get a little tense.


----------



## mycrofft (Mar 16, 2009)

*Interesting to see how the poll has stabilized. Thanks!*

I'm in a "rural" area for the next week and the mindset you adopt is different.
Isn't someone from Clackamas County (home of Tonya Harding) on EMTLIFE??


----------



## mycrofft (Sep 16, 2009)

*Sorry, I think we ought to reconsider this.*

*Reasons rural people can benefit from networking and urban people can benefit from seeing their concentrated experience and outlook:*
1. Urban tends to be professional and frequently civilian; rural tends to be semi-pro or vollie, and fire based.
2. Urban tends to have a higher proportion of ALS versus BLS, versus rural.
3. Urban tends to have more government support if fire-based or independent service, while rural tends to get a portion of its $$ through fundraisers, shareholders, subscribers, etc.
4. Rural response times to closest facility tend (increasingly) to be longer. (Not neccessarily to the best facility, but to ANY facility).
5. Rural has more days per year when conventional road transport is "iffy".
6. Urban responders rarely have to cope with gorings, stompings, bites, tractor turnovers, corn auger entrapments, woodstove poisonings (carbon monoxide), exposure, chainsaw and ax accidents ("axidents"?), massive chigger or poison oak cases, and prolonged extractions on foot/via sled/on a litter. Rural folks see their share of meth lab accidents, alcoholism, family disputes, GSW, MVA's, MI's, child abuse, etc. too.

Nothing is there to prevent folks from reading and responding to other threads and posts, it wouldn't be a ghetto, but it IS a different paradigm in some ways and facilitating the exchange of ideas and experience through concentration I think would be a good deal.

PS: Any Amish EMS out there? No, wait, this is the Internet...you could relay their stories!).


----------



## Seaglass (Sep 16, 2009)

keith10247 said:


> That being said.  Our blend would make it so that I would have to post half of my questions in one category and the other half in another category.



Same. I work in one area that's pretty rural, and another that's pretty urban. As long as people generally remember that posters may well be in very different circumstances, I don't see any need for separate forums.


----------



## mycrofft (Sep 17, 2009)

*OK, fugettaboudit.*

...............


----------

