# Biggest Leap Forward?



## MMiz (Dec 1, 2013)

What advancement in EMS technology has impacted you the most?

Was it the traditional stretcher to powered version?
LifePak 12 to LifePak 15?
Paper PCR to ePcr?
Analog radio to digital?
Wireless internet?
GPS?
Something else?


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## DesertMedic66 (Dec 1, 2013)

I would have to say the CAD system (Computer Aided Dispatch). It maps us to the calls (not always accurate) but it gives us a lot more detail from the 911 call. We can pull up past calls from that residence, notes about it (hidden keys around the house), copy a call/respond/arrive on scene/stage all without needing to say anything over the radio.

Our CAD system is linked with our ePCR program so information (addresses and times) are already entered in for us on the ePCR. Not a vital task but it does make it nice.


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## TRSpeed (Dec 1, 2013)

Road safety! .





Jk lol 
CAD for sure


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## TheLocalMedic (Dec 1, 2013)

Switching from paper PCRs to all computer-based reporting.  It takes longer, sometimes, but no more bubble forms to fill out!


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## unleashedfury (Dec 1, 2013)

MMiz said:


> What advancement in EMS technology has impacted you the most?
> 
> Was it the traditional stretcher to powered version?
> LifePak 12 to LifePak 15?
> ...



GPS for sure, we respond to various rural areas, and maybe a quarter of our call volume is in those regions, never the same area twice though. So the days of fumbling through books of maps is over. Plug the address in and go. Even though it may not recognize the house number at times, At least if i can get to the street I can figure it out from there. 

Powered stretcher,, wishlist item, 
Paper PCR's i didnt mind doing I got such a knack for them that I can bubble form a chart in a few minutes and have it closed by the time we return from the ED.


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## NomadicMedic (Dec 1, 2013)

Prehospital CPAP. without a doubt.


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## STXmedic (Dec 1, 2013)

Faster ambulances and accelerated paramedic courses.


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## chaz90 (Dec 1, 2013)

STXmedic said:


> Faster ambulances and accelerated paramedic courses.



Faster=Better. Always.


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## drdroopy15 (Dec 1, 2013)

I would say the method of doing paperwork from paper to electronic.  I am kinda bias being IT but can say a true advantage is the billing dept can already start the claim before the paperwork even comes in.  In the paper method, doing 200 calls a day was a true slow process.  We have reduced it from a week to a day for a claim to be processed.  In this money tight world, that is a true plus.


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## 46Young (Dec 1, 2013)

CPAP, retractable angiocath, ETCO2, and CAD

In some systems, paper PCR's are faster, and with the ePCR, the system can make you available for calls before the report from the current call is complete. I strongly dislike having to catch up on three or four reports because I get sent out of the hospital for another call less than 5-10 after arriving there, repeatedly. This is not so much of a problem in a rural system with long transport times, though.


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## 46Young (Dec 1, 2013)

chaz90 said:


> Faster=Better. Always.



lol

I'm sure STX was joking as well


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## mycrofft (Dec 1, 2013)

Leaving field EMS and becoming a nurse.


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## STXmedic (Dec 1, 2013)

46Young said:


> lol
> 
> I'm sure STX was joking as well



:unsure:


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## Mariemt (Dec 1, 2013)

Stryker power load system. It is great


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## Sparky79 (Dec 1, 2013)

Not EMS specific, but I think the Smartphone was a huge step forward (though sometimes it seems like a step in the wrong direction).

I could never go back to not having all of the conveniences a smartphone offers. Having the power and information of the internet in the palm of your hand 24/7, productivity apps, entertainment apps, social media apps, etc. I sometimes forget what life was like without it. 

Of course, I'm not that old, but I grew up before cell phones were commonplace. Actually. when I was a kid the internet didn't really exist either, somehow people still managed, but smartphones (when used responsibly) certainly make life much easier.


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## Sparky79 (Dec 1, 2013)

drdroopy15 said:


> I would say the method of doing paperwork from paper to electronic.  I am kinda bias being IT but can say a true advantage is the billing dept can already start the claim before the paperwork even comes in.  In the paper method, doing 200 calls a day was a true slow process.  We have reduced it from a week to a day for a claim to be processed.  In this money tight world, that is a true plus.



I hate ePCR's

A report that I could handwrite in 5 minutes, now takes me 30 minutes to do on the computer, half of which is filling out ridiculous NEMSIS data for government statistics.

As far as the billing thing goes, I could care less. But, that's mostly because we're a municipal service, not a for profit private service. We do bill and try to recoup as much of the costs as we can, but we are supported by the tax base and billing isn't a major priority.


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## 46Young (Dec 1, 2013)

Mariemt said:


> Stryker power load system. It is great



Totally forgot about that. I grew up on the old two-man stretchers.


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## DrParasite (Dec 1, 2013)

Sparky79 said:


> half of which is filling out ridiculous NEMSIS data for government statistics.


and this is one of the things holding EMS back.  people don't understand why we need to fill out government stats.  the fire service has NFIRS, PD has the FBI databases, ever wonder why that was?

wouldn't it be great to know how many patients EMS transported?  what calls were most common?  what treatments were used most frequently?  what interventions were used, and what voodoo shouldn't have been?

If you want EMS research, you need good data.  you need complete data.  if you want to compete with the big boys for grant money, you need to come to the table with the same amount of information they will be providing.  if you want to get new toys and see what works you need to show evidence that it both is used and patients have beneficial data.

and you might not care about billing, but I guarantee your department head does, as does your business administrator, as well as the guy who calculates how much money you have available to put more units on, and give you guys pay raises.


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## DrParasite (Dec 1, 2013)

Clinically, I'm a big fan of EtCO2.  Lifepack 12s are pretty awesome too.  Ditto the proliferation of AEDs.  Prehospital CPAP has prevented lots of CHF related intubations.

Operationally, 1 1/2 man stretchers vs the old two man cots.  Oh, and seatbelts.  they really do save lives

System wide, having a CAD with integrated GPS so dispatch knows which unit is closest, can give out cross streets, can send run numbers and times to the units without them needing to keep track or call and ask for them.


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## Tigger (Dec 2, 2013)

You beat me to it. Without data, we can't prove our worth.


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## Carlos Danger (Dec 4, 2013)

DEmedic said:


> Prehospital CPAP. without a doubt.



This.

Back in the day before CPAP and RSI were common in the field, I can't tell you how many 2am 911 calls I ran for the 60 year old cardiac patient who woke up coughing up pink froth, struggling to breathe, with sats in the 80's. 

All we could do was slap a NRB on and drive fast to the ED. Of course we'd give the obligatory NTG, lasix, and morphine. 

And there were the 10mg morphine / 10mg valium / 10 mg brutane intubations, as well...

But CPAP changed all that and then some.


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## richardharris908 (Dec 7, 2013)

Yeah...I think so...


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## ZombieEMT (Dec 12, 2013)

46Young said:


> CPAP, retractable angiocath, ETCO2, and CAD
> 
> In some systems, paper PCR's are faster, and with the ePCR, the system can make you available for calls before the report from the current call is complete. I strongly dislike having to catch up on three or four reports because I get sent out of the hospital for another call less than 5-10 after arriving there, repeatedly. This is not so much of a problem in a rural system with long transport times, though.



Are you suggesting that you would rather delay patient care so that you can finish a report? Patient's do not generally choose when to get sick and can not possibly know when you are ready for them. 

On an added note, most ePCR software is compatible with tablet PCs, PDAs or laptops. Toughbooks work great.

I feel that ePCR is definitely one of the best improvements. It collects data and is organized, LEGIBLE and has spell check. I use EMScharts and I can pull up any patient that my department has transported before. It will show me history and meds (as of last transport). This works wonders for patients that are not able to tell EMS providers, not to mention the time saved. Specifically in IFT companies, it saves from writing recurring patients demographics and insurance info. Most dialysis patients generate 6 trips alone within one week.


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## DesertMedic66 (Dec 12, 2013)

ZombieEMT said:


> Are you suggesting that you would rather delay patient care so that you can finish a report? Patient's do not generally choose when to get sick and can not possibly know when you are ready for them.
> 
> On an added note, most ePCR software is compatible with tablet PCs, PDAs or laptops. Toughbooks work great.
> 
> I feel that ePCR is definitely one of the best improvements. It collects data and is organized, LEGIBLE and has spell check. I use EMScharts and I can pull up any patient that my department has transported before. It will show me history and meds (as of last transport). This works wonders for patients that are not able to tell EMS providers, not to mention the time saved. Specifically in IFT companies, it saves from writing recurring patients demographics and insurance info. Most dialysis patients generate 6 trips alone within one week.



Not all ePCR systems work like that. Take my system for example: if I do a paper PCR I can have that done in 5 minutes easily. With our ePCR system it takes me around 30 minutes to do 1. 

Yeah it's good that it collects and gathers data. That is amazing for our CES and QA/QI department but it makes it a pain in the *** for the field crews. Our ePCRs can only be used by computers with the software installed (toughbooks). If our computer breaks or runs out of battery while we are writing a report we have to wait for that exact computer to be fixed before we can finish the ePCR or we will have to start a brand new ePCR.


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## Handsome Robb (Dec 12, 2013)

I really like Eso. We use Health EMS right now and connectivity is a nightmare. I tested Zoll too but I wasn't a huge fan


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## ZombieEMT (Dec 12, 2013)

DesertEMT66 said:


> Not all ePCR systems work like that. Take my system for example: if I do a paper PCR I can have that done in 5 minutes easily. With our ePCR system it takes me around 30 minutes to do 1.
> 
> Yeah it's good that it collects and gathers data. That is amazing for our CES and QA/QI department but it makes it a pain in the *** for the field crews. Our ePCRs can only be used by computers with the software installed (toughbooks). If our computer breaks or runs out of battery while we are writing a report we have to wait for that exact computer to be fixed before we can finish the ePCR or we will have to start a brand new ePCR.



But why does the ePCR take longer than the PCR? Its all about the information included in the paper PCR vs the ePCR. Sure you can finish the paper PCR in 5 minutes but it probably includes less information than the ePCR. When we switched from paper to ePCR, it takes longer because there are more fields. It helps to ensure that you don't miss documenting important things.

Is it a bad ting that it helps CES, QA/QI and billing? As a street provider, dont you want to be able to advance your skills and documentation. Both can go a long way.


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## cruiseforever (Dec 12, 2013)

TRSpeed said:


> Road safety! .
> 
> 
> 
> ...


Road Safety has improved the ride in back of the rig.


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## DesertMedic66 (Dec 12, 2013)

ZombieEMT said:


> But why does the ePCR take longer than the PCR? Its all about the information included in the paper PCR vs the ePCR. Sure you can finish the paper PCR in 5 minutes but it probably includes less information than the ePCR. When we switched from paper to ePCR, it takes longer because there are more fields. It helps to ensure that you don't miss documenting important things.
> 
> Is it a bad ting that it helps CES, QA/QI and billing? As a street provider, dont you want to be able to advance your skills and documentation. Both can go a long way.



There are drop down menus after more drop down menus. For C/C we don't have the option of typing it in. We have to choose from a list (which has horrible selections). 

The only important thing the software looks for is the proper info to bill a patient. 

With our current medical director, no  skills are being added. He has been removing skills from the EMT and Medic level. Next year we have a new medical director but are also switching ePCR systems.


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