# How Often Do Paramedics Save Lives?



## SolidSnake (Sep 6, 2012)

I hear it's nowhere near as much as you'd think. I've been considering a career in EMS. Saving lives isn't my only reason for wanting to become an EMT-P, I'd be just as happy with non-emergency calls, but I have been wondering, mostly just out of curiosity, is there a percentage or something about how often a typical paramedic will be a decisive force in a life being saved?

Are lives saved very often just by transporting the patient to the hospital in a timely manner?

Sorry to sound like a starry-eyed kid who wants to be a hero, that's honestly not why I want to be a Paramedic. I've just been curious.




ALSO: Who would be more qualified to deal with an emergency medical situation? Are RN's better trained?


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## STXmedic (Sep 6, 2012)

SolidSnake said:


> I hear it's nowhere near as much as you'd think. I've been considering a career in EMS. Saving lives isn't my only reason for wanting to become an EMT-P, I'd be just as happy with non-emergency calls, but I have been wondering, mostly just out of curiosity, is there a percentage or something about how often a typical paramedic will be a decisive force in a life being saved?
> 
> Are lives saved very often just by transporting the patient to the hospital in a timely manner?
> 
> Sorry to sound like a starry-eyed kid who wants to be a hero, that's honestly not why I want to be a Paramedic. I've just been curious.


I don't know the percentage, but it's not high. I've been in a very busy 911 system for 3 years and can only say I've potentially saved a small handful of lives. 

Now, making people comfortable? Easing pain? Easing nerves? All the time. Every shift.


> ALSO: Who would be more qualified to deal with an emergency medical situation? Are RN's better trained?


Please don't open that can of worms. You'll start a riot on here...


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## Aidey (Sep 6, 2012)

In 8 1/2 years my live saving rate is up to around .00015% 

And yes, some lives are saved by transporting people to the hospital in the timely manner, but for the most part it has almost nothing to do with how they got to the hospital. It is the fact that they got to the hospital that saved their life, not the transport method. 

As for the 3rd question, RNs have better education, but aren't always better trained (don't ask, it is another thread). It totally depends on the RN and the emergency. There are a ton of different types of RNs. An RN who works in dialysis is different than a nurse who works in the ED.


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## Veneficus (Sep 6, 2012)

SolidSnake said:


> I hear it's nowhere near as much as you'd think



Depends.



SolidSnake said:


> I've been considering a career in EMS. Saving lives isn't my only reason for wanting to become an EMT-P, I'd be just as happy with non-emergency calls,?



A very good attitude, especially since less than 5% of calls most places are actual emergencies.




SolidSnake said:


> but I have been wondering, mostly just out of curiosity, is there a percentage or something about how often a typical paramedic will be a decisive force in a life being saved?



No, and I wouldn't believe it if there was.

It depends on many factors like education, ability, where you work, what your standing orders are, what equipment you have, and largely luck of the draw. 

You could save 100 lives in a week or you could save none in an entire career. We now know that most disease processes are chronic, so rather than "saving lives" a better way to look at it is intervention to make life better for a little while longer.



SolidSnake said:


> Are lives saved very often just by transporting the patient to the hospital in a timely manner?



Sometimes.



SolidSnake said:


> Sorry to sound like a starry-eyed kid who wants to be a hero, that's honestly not why I want to be a Paramedic. I've just been curious.



No worries mate, I was a starry-eyed kid who wanted to save lives. Some might argue I still am. (especially my wife)



SolidSnake said:


> ALSO: Who would be more qualified to deal with an emergency medical situation? Are RN's better trained?



This is not a simple answer.

Paramedics are trained (barely educated) to deal with emergency medical situations. They are very good at their niche role. Some are arguably better than anyone else.

RNs have a better base education, which is a foundation that allows them to branch out into different specialty fields. (like emergency) I have worked with RNs who are equal any medic in the emergency field. In some countries outside the US, RNs are "the paramedics" so to speak. 

But a fresh out of school basic RN is probably not going to be as competent or comfortable in an emergency setting than a fresh out of school medic. (providing they both started from nothing and didn't have prior experience) 

As life stands today, you will have a better future with a BSN who then additionally trains to work in emergency than a paramedic.


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## the_negro_puppy (Sep 6, 2012)

How can you even quantify such a thing?

Nevertheless your question is somewhat valid. TV has led to the impression that EMS is all CPR and rescuing people from car wrecks.

This sort of work makes up only a small portion of our work. People call 911/000 when they lose their ability to cope with a situation that may be vaguely medically related. 

You will spend far more time dealing with the elderly, those with chronic health problems and persons from the lower-socio economic status. Many of the calls won't require much intervention though occasionally you will get to give drugs or perform procedures that mean the difference between life and death for some patients.

Even indirectly by assessing patients and transporting them to the appropriate facility based on their conditions can make a significant difference- taking a STEMI to a cath lab, stroke to a stroke centre.


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## Shishkabob (Sep 6, 2012)

I can say without a doubt I have saved one person from certain death in the past year.  I've also prolonged life in a few more.  I can also say a handful of people have had better outcomes due to what I've done.


But no, it's not as often as the public thinks, it's actually pretty rare.  About 80% of our calls don't need an ambulance.  Of the 20% that do, less than half are life or limb threatening, and of that, only about half do we do stuff that actually potentially benefit the patient enough to be considered "life saving".




In a true emergency, I'd rather have an experienced medic than an otherwise equivalent ED RN, however, you'll make more as a nurse.


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## firecoins (Sep 7, 2012)

How many calls do we get where lives are actually endanger? Not many.


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## OzAmbo (Sep 7, 2012)

Im sure i read it but someone mentioned improving outcomes which is cool

Buddy, you wont save a life very often. In 5 years i can put my hand on my heart and say i have had the life changing experience of saving 1 life and i felt i could have just about walked on water afterwards, but its a feeling that seldom comes around and its something i dont think i will have the privilage of feeling anytime soon

What i can honestly say though is i have relieved a heck of a lot of pain and suffering in the least 5 years. Yeah, pain relief ad holding hands is not sexy medicine, but if put in in perspective and if you really are a true patient adviocate then deivering this basic patient need delivers an immense amount of satisfaction both at a personal and professional level.


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## Altair1017 (Sep 1, 2013)

What about a critical care paramedic? Does the increase the number of life or death calls?


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## STXmedic (Sep 1, 2013)

Altair1017 said:


> What about a critical care paramedic? Does the increase the number of life or death calls?



Critical Care paramedics are typically picking patients up from the hospital (ICU or ED). _Usually_ these patients are already stabilized for transport. The CCPs job is to monitor them and their interventions, and make sure they don't get worse on the trip.

Don't get me wrong, their job is by no means a cake walk; it takes a lot of knowledge and experience to be a good CCP. They handle incredibly sick patients on a regular basis. As far as saving lives, it kind of depends on your definition of a save. Again, it's usually more maintaining life than saving them from death.


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## J B (Sep 1, 2013)

My emt-b instructor said, "you don't have to save a life to make a difference".


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## Fire51 (Sep 1, 2013)

Paramedics do save lives when it comes down to it but those chances like ever one has said don't happen a lot. They do help make patient more comfortable when in pain. A great example is my father told me that he had a cancer patient that was in extreme pain and was pleading him to make her feel better, he gave her some good pain meds, she thanked him, telling him that she was in no pain and has not felt that great in years. She died a little bit later that day but she was pain free and comfortable. The family even thanked him for helping her go in peace. I would say that is just as good as saving a life, paramedics in my eyes do make a difference.


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## VFlutter (Sep 1, 2013)

As an RN I feel like I truly save a patient 2- 3 times a week. Most of those patients should not be saved. The vast majority of my saves are STEMIs which are one of the few conditions we can actually make a difference.


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## EpiEMS (Sep 1, 2013)

SolidSnake said:


> is there a percentage or something about how often a typical paramedic will be a decisive force in a life being saved?



Frankly, as far as I can tell, lives are sometimes (not often) saved by an EMS intervention. Some, not all, interventions are cost-effective. For example, placing AEDs in BLS ambulances can be life saving, and it is cost-effective. This is one of my favorite little readings on heath care cost effectiveness ("Five-Hundred Life Saving Interventions and Their Cost Effectiveness", published in 1995, admittedly, but still relevant) and it has some relevant info. But, to get to the point: it happens, but it's not that often, and certainly isn't as often as you'd see on TV. Most of the EMS world is related to caring for patients --making them feel better-- and helping them access the right health care resources, not saving lives. 




SolidSnake said:


> Are lives saved very often just by transporting the patient to the hospital in a timely manner?



On scene interventions stop the clock. Rapid transport to the right facility is what saves lives. At least, this is what it seems like to me, I'm not exactly an expert on the matter.



SolidSnake said:


> ALSO: Who would be more qualified to deal with an emergency medical situation? Are RN's better trained?



If I have a cardiac arrest on an airplane, and there's an RN, paramedic, and physician on board, I'd rather have the paramedic run the code. Now, that being said, if the physician was, say, an ER MD or an anesthesiologist, say, that might be a different story. But your average paramedic is better trained insofar as skill-based competencies to handle a patient in an emergency in a non-hospital setting than most other personnel.


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## EpiEMS (Sep 1, 2013)

Chase said:


> Most of those patients should not be saved.



This is a very important point. Are these often patients who don't have, say, adequate living wills in place or something like that?


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## MackTheKnife (Sep 1, 2013)

I've been out if the prehospital arena for awhile, but here's my $1.50 worth: The PMs that gave less than 1% save rate aren't looking at the pt in acute CHF or full blown PE they treated and transported. Or the pt with non-specific chest pain that wound up needing a CABG and survived because they were convinced to take transport. They are focusing on the cardiac arrest or multi-trauma pt who was already "tits up". As for PMs vs RNs, overall PMs. They are more able to operate independently without the support of ER staff or hospital support. That's not saying that's 100% the case. Flight nurses are a prime example of being in the same league as PMs.


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## STXmedic (Sep 1, 2013)




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## MackTheKnife (Sep 1, 2013)

STXmedic said:


>



Hmmm?


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## VFlutter (Sep 1, 2013)

EpiEMS said:


> This is a very important point. Are these often patients who don't have, say, adequate living wills in place or something like that?



That is usually the case. Many people are not adequately prepared for end life decisions, families do not want to let go, or religious/cultural preferences do not allow for DNRs. We have a large Jewish population who are almost always full codes. 



MackTheKnife said:


> As for PMs vs RNs, overall PMs. They are more able to operate independently without the support of ER staff or hospital support. That's not saying that's 100% the case. Flight nurses are a prime example of being in the same league as PMs.



Ah the classic pissing contest. I usually try to avoid it but to say only flight nurses are in the same league as paramedics is humerous. 

I will totally admit most paramedics are great at running textbook ACLS codes and are better at emergencies than non critical/acute care RNs. But in the Units we do not run "ACLS" codes. They are quite different than what you are used to seeing. And we are more independent than you would think. 

Being my arrogant self I think I can handle emergencies/codes at the same level, if not better, than most paramedics with similar experience.


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## MackTheKnife (Sep 1, 2013)

Chase said:


> That is usually the case. Many people are not adequately prepared for end life decisions, families do not want to let go, or religious/cultural preferences do not allow for DNRs. We have a large Jewish population who are almost always full codes.
> 
> 
> 
> ...



No pissing contest. I qualified my statement by not being absolute and offering a comparable equivalency.


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## SpecialK (Sep 2, 2013)

I think something like only 1% of our call volume (~400,000) is classified as immediately life threatening and this is reserved for patients in cardiac or respiratory arrest.


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## EpiEMS (Sep 2, 2013)

Chase said:


> That is usually the case. Many people are not adequately prepared for end life decisions, families do not want to let go, or religious/cultural preferences do not allow for DNRs. We have a large Jewish population who are almost always full codes.



I had a conversation with a (more so than me, anyway) expert on Halacha, and apparently the full code, among some very religious Jewish communities, is seen as a requirement -- the attitude is "We should do everything we can to prolong life." 



Chase said:


> Being my arrogant self I think I can handle emergencies/codes at the same level, if not better, than most paramedics with similar experience.



Well, exceptions don't make the rule 
I'm curious to see if there are any studies comparing MD/DO vs. RN vs. medic codes under the same conditions...though I doubt it.


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## Carlos Danger (Sep 2, 2013)

MackTheKnife said:


> The PMs that gave less than 1% save rate aren't looking at the pt in acute CHF or full blown PE they treated and transported.



I think to be counted as a "save", however, you'd have to show that the treatment provided prior to arrival at the hospital was a defining factor in the patient's survival, and that the patient would definitely not have survived if they had just been driven to the hospital by BLS personnel. That's tough or impossible to do with a CHF or PE scenario.



MackTheKnife said:


> Or the pt with non-specific chest pain that wound up needing a CABG and survived because they were convinced to take transport.



That is an excellent point, and it illustrates why focusing on "saves" to define worth is pointless. Reductions in morbidity, pain, suffering, and cost are very valuable, but are left out of any equation that just looks at "number of saves".



MackTheKnife said:


> As for PMs vs RNs, overall PMs. They are more able to operate independently without the support of ER staff or hospital support.



Not sure how this relates to "saves", but the idea that nurses don't function with a fair amount of independence is a big misconception on the part of paramedics. There is really very little that I did as a paramedic that I didn't as an ICU nurse, and the many resuscitations I was involved with in the ICU were typically much more complicated than simply following ACLS.


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## tchristifulli (Sep 2, 2013)

I was told 90% of the people we come in contact with will have the same outcome no matter what we do. That 10% we make a difference for,  is worth my entire career and training. If I could make a difference in 5%, I would go in to work everyday with a smile on my face. The people you get to meet, the conversations with people who have weeks to live , the warm hand you give a old man who just lost his wife. That's why we do this! The number of people we save .... Maybe 10%.... The number of people we touch 100%


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## chaz90 (Sep 2, 2013)

tchristifulli said:


> I was told 90% of the people we come in contact with will have the same outcome no matter what we do.



Probably more like 90% will be fine regardless of what we do, 9% will die relatively soon of their terminal condition regardless of what we do, and perhaps 1% have an acute condition or an exacerbation of something chronic that we can make a life prolonging impact.


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## kindofafireguy (Sep 2, 2013)

chaz90 said:


> Probably more like 90% will be fine regardless of what we do, 9% will die relatively soon of their terminal condition regardless of what we do, and perhaps 1% have an acute condition or an exacerbation of something chronic that we can make a life prolonging impact.



This.


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## mycrofft (Sep 2, 2013)

The vast majority of saves are made by laypersons or the victims themselves who refrain from doing something injurious and get driven safely at an early stage to the nearest medical facility.


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## unleashedfury (Sep 2, 2013)

Define Saving lives,

If you mean the CPR, to bring back the patient who then becomes extubated and returns home with no deficitis, Rare

The trauma patient hung up into a vehicle who is suffering from major head and chest trauma and needs interventions immediately to have a life. Even Rarer

If you talking about the person who got them selves into their own mess, you got called because they OD'd or got beat by their man or something and you talk to them and give them motivation to turn their life around.. Tons.. 


In my 13 years of EMS I have had 3 cardiac arrest saves that actually had some quality of life after the fact, I think 1 severe trauma that ended up being at the right place right time and made it to the OR within 2 hours. 

OTOH I had a young girl, who was freshly 18 and decided to drop out of school and go be with some guy she met off the internet well she got messed up into some serious illicit drugs, and beaten by the guy on a daily basis. Well when she was thrown through their front bay window. PD was finally called with us. She wasn't critical or even Urgent. Just needed some stitches and a few xrays. and turned out ok. On the way down The only thing I thought about is my little girl and how I'd kill someone if they treated her like that. We chatted and told her my story. and about maybe she made some mistakes but now she needs to turn it around. about a month ago she stopped by my station looking for me. turns out she listened. She left the dude. got off the dope. got a job, is finishing school and getting custody of her daughter. And she wanted to thank me cause she said no one gave a crap enough to say something to her. And hitting rock bottom along with someone to give her some down to earth non sugar coated advice is what she needed. So did I save a life. in a way yes. Sometimes its not always the glorious interventions that fix things. Sometimes its being what someone needs at that very moment 

90% of the job is taking minor injuries or acute exacerbations of chronic illness to where they need to be. 8% is moderate injuries. and 2% is the real deal.


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## mycrofft (Sep 6, 2013)

unleashedfury said:


> Define Saving lives,
> 
> If you mean the CPR, to bring back the patient who then becomes extubated and returns home with no deficitis, Rare
> 
> ...



Money shot.


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