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  1. thegreypilgrim

    EMS System Design Survey

    Hey everyone. I know I haven't posted here in ages and there are a good deal of new users whom I don't recognize, so nice to meet you all! Anyway, I was hoping the board would be so kind as to take a very short (it's only one question) suvey for me. It's completely anonymous and is for...
  2. thegreypilgrim

    Honolulu EMS

    I looked into it a while ago, but never went through with it. I suppose it depends on what you're looking for. I've been to Hawaii several times and I love it, but I'm not sure I could live there full time. Honolulu EMS serves all of Oahu for 911. They have nice units, excellent protocols, and...
  3. thegreypilgrim

    The states need to take over EMS

    No, this would apply to the entire state. So a population of 37.6 million will be subsidizing a population of 600. Which it already does for numerous other services at little cost to each individual due to economies of scale. Of course, but that just isn't going to happen. No, and you're...
  4. thegreypilgrim

    The states need to take over EMS

    Gah! No it isn't! I'm so tired of hearing this. They just aren't significantly different enough to warrant this level of nonsensical planning. Yes they do! And because of that the overall burden to you is less!
  5. thegreypilgrim

    Volunteer EMS needs to become non-existent.

    True, and this is rightly so. Implicit in choosing to live in a rural area is acceptance of this risk. It just isn't feasible to reproduce the same accessibility of metropolitan centers in rural communities. However, under this model a town like Independence, CA can at least have a full-time ALS...
  6. thegreypilgrim

    The states need to take over EMS

    It is becoming apparent that EMS represents a tremendous cost to local communities - both in terms of user-fees and in consuming significant portions of government budgets in the form of public safety funding. The civil grand jury report published by the County of Santa Clara last year makes a...
  7. thegreypilgrim

    Volunteer EMS needs to become non-existent.

    The fact that this is still an issue is utterly disappointing. This problem by no means approaches the level of a conundrum or vexation. It's an easy fix. I guess I should say it's an easy organizational/structural fix. Unfortunately, as evinced by this thread, it's a ridiculous hornet's nest...
  8. thegreypilgrim

    Different angle: why basic level technicians?

    No I mean upgrade both at the same time. The new EMT = BS degree New paramedic = MS degree
  9. thegreypilgrim

    Different angle: why basic level technicians?

    Right, do HEMS paramedics make better money than their ground medic counterparts? No, not substantially. Why do paramedics only make on average around $30k/year? The answer is employers can get away with it - because the barrier to entry into the field is so low. You can become a paramedic in...
  10. thegreypilgrim

    Different angle: why basic level technicians?

    Well, it isn't at all clear that PD and FD can be efficiently operated at the local level! Cities go bankrupt all the time, and I would argue that the cause of their fiscal problems are traceable to the burdens of having to provide police & fire services to their populations. Now, for PD it's...
  11. thegreypilgrim

    Different angle: why basic level technicians?

    National would be even better, even if it was under the same rubric of the old 1973 EMS Act.
  12. thegreypilgrim

    Different angle: why basic level technicians?

    We need to abandon the whole dichotomy between "BLS" and "ALS". It's no longer a useful concept. So, while it's true that very few 911 patients actually require "life saving care" however you wish to define it, it remains true that they are going to require some level of medical intervention...
  13. thegreypilgrim

    Different angle: why basic level technicians?

    You can't have a tiered system that consists of EMT-Bs and Paramedics. To be blunt, EMT's have no real utility other than being sort of like "assistants" on scene as most areas their scope literally is O2, backboard, band-aids and for good reason. It's not a solution to just graft extra skills...
  14. thegreypilgrim

    Different angle: why basic level technicians?

    This is why you fund at state-level. As long as local communities have to pay for EMS you're going to have this disparity in resource availability.
  15. thegreypilgrim

    Different angle: why basic level technicians?

    Not if funding and resources are limited to local entities. What we would have in this scenario are statewide ambulance services (eg California Ambulance Service, Wyoming Ambulance Service, North Dakota Ambulance Service, etc.). So resource allocation wouldn't be an issue. This is what Australia...
  16. thegreypilgrim

    Different angle: why basic level technicians?

    What has to happen is the EMT-B level has to be scrapped altogether and replaced with something else. It simply has no utility in a modern ambulance service (O2 and band aids are not all that useful for much). It has to be upgraded to something like a "Basic Paramedic" level which would have the...
  17. thegreypilgrim

    NREMT-P International Reciprocity??

    You're going to have to contact each organization independently and ask what their policy is on recognition of prior learning. Most EMS organizations outside the US have an established process for assessing foreign credentials, so just shoot them an email and ask how they do it.
  18. thegreypilgrim

    Things in your protocols/CPGs/scope that your hospitals don't like

    You mean the patient's hospital?
  19. thegreypilgrim

    Things in your protocols/CPGs/scope that your hospitals don't like

    I hinted at this in another thread, but wanted to see to what extent this exists in other systems. In my system, there appears to be some considerable discord between what the receiving hospitals here expect or want out of EMS versus what the EMSA and medical direction does. The main one like...
  20. thegreypilgrim

    C-Spine rearing its ugly head

    Ah, you're killing me Melcin! I'll grant you she's probably not pristine in terms of mental status, but for 83 it's hard to do better I imagine. She was completely alert and oriented to time/place/person/event. She understood what was happening, why she was in urgent care, remembered events...
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