How can we improve EMS

My concern with federal regs is that we go to the lowest common denominator as far as standards are concerned. I do not anticipate the feds setting a standard at the level highest in all states, but rather setting the bar a bit lower.
 
Personally, I would love adopting Canada's system. They took our ideas and grew where we regressed.

R/r 911
 
gee....another paid v. volley, als v. bls, fire v. private v. third and lets not forget urban v. rural debate. thrilling..........
 
KEVD18 said:
gee....another paid v. volley, als v. bls, fire v. private v. third and lets not forget urban v. rural debate. thrilling..........
Click to expand...

This thread has mentioned some thought provoking points and there has not been intended to be an us against them attack.

I agree with Rid's comments especially about the Canadian system and BossyCow makes a good arguement for it being easier said than done in some areas.
 
KEVD18 said:
gee....another paid v. volley, als v. bls, fire v. private v. third and lets not forget urban v. rural debate. thrilling..........
Click to expand...

Probably the only post which contributed nothing to the discussion.
 
Ridryder911 said:
Personally, I would love adopting Canada's system. They took our ideas and grew where we regressed.

R/r 911
Click to expand...

Can you explain their system?
 
It looks to me as though the Canadian government is much more involved in the funding of EMS. The question then becomes one of trading autonomy for secure funding. This may be oversimplifying the situation, but it does look that way from afar.
At the same time, I do like the level of training that Canada requires even at their most basic level.
 
What good is autonomy...

if you're training people to the lowest possible common denominator and pts. suffer accordingly?

John E.
 
Good points even the uncomfortable ones.

Can we even define OUR "system"?


Maybe we need to look at this from another angle:

1. What is the problem? Describe it.

2. What is the history and current situation? Use hard figures such as per capita descriptions of outcomes, types of calls, survival, accidents, costs, etc.

3. Does #2 support #1? If so, go to #4. If not, take a break.

4. What are our outcome goals? Express them in quantifiable terms addressing the problem definition. Brainstorm first. Don't get caught in means/goals (i.e., your goal is "Over 90% of witnessed arrest cases will reach the hospital with viable blood pressure and pulse", not "Over 90% will get there with an IV" or "Line the current bunch of nincompoops against the wall").

5. Then how do we affect the situation (#1, #2) to effect change? (Ok, NOW, line your nincompoops against the wall).
;)
 
In my opinion some of these volunteer groups need to wake up & realize that they need to run paramedics on their trucks even if they have to pay them. I am not trying to step on anybodies toes by saying this I am a volunteer basic & a paramedic student. However, I think they need to realize things have changed & change with them. We need to use paramedics & pay them & for them to be able to use the paramedic drugs when they need to. If the volunteer organizations are going to act professional then let them be professional & not a mickey mouse club.
 
emtlady76877 said:
In my opinion some of these volunteer groups need to wake up & realize that they need to run paramedics on their trucks even if they have to pay them. I am not trying to step on anybodies toes by saying this I am a volunteer basic & a paramedic student. However, I think they need to realize things have changed & change with them. We need to use paramedics & pay them & for them to be able to use the paramedic drugs when they need to. If the volunteer organizations are going to act professional then let them be professional & not a mickey mouse club.
Click to expand...

Are you willing to pay for it, because somebody has to? Take my area, for example. We cover 240 sq. miles of remote desert (nearest hospital is an hour away in any direction), with a population of about 2000 tax paying residents. In addition, we probably have another 2000 or so non-tax paying people in our area. On average, we run 300-400 EMS calls a year.

So lets look at this. To provide 24/7 ALS coverage, we would need to hire a minimum of 3 full time and one part time paramedic. At a low end wage of $20,000/yr that would be in excess of $60,000 just for wages. This does not include the part timer's salary, benefits, or equipment and drugs to make them a true ALS unit. So let's say it would cost our dept. $100,000/year for everything. Divided amongst our 2000 tax paying residents, that would be an additional $50/year on their taxes. That is a tough sell around here for a department that averages one call per day especially if you consider that over 75% of our calls come from those 2000 non-tax paying residents. Add the fact that we run 3 stations, and everyone's taxes just jumped $150/year.

This does not even address the issue of skills maintenance. How proficient are you going to remain with your ALS skills if you average 1 call a day?

I agree that we need to progress towards a medic on every rig, but making blanket statements like yours and calling vollie agencies mickey mouse clubs does nothing to further your arguement.
 
ffemt8978 said:
I agree that we need to progress towards a medic on every rig, but making blanket statements like yours and calling vollie agencies mickey mouse clubs does nothing to further your arguement.
Click to expand...

Grab stick, remove from rectum.

I do believe that she made the statement regarding Mickey Mouse type agencies.

In situations such as yours, making a FT career ALS agency is very had to justify. However, there are TICKS in my area of the country that take jobs away, recall Medics because they are paid, and drive like assclowns to get to a job, just cause they can.
 
BLSBoy said:
Grab stick, remove from rectum.

I do believe that she made the statement regarding Mickey Mouse type agencies.

In situations such as yours, making a FT career ALS agency is very had to justify. However, there are TICKS in my area of the country that take jobs away, recall Medics because they are paid, and drive like assclowns to get to a job, just cause they can.
Click to expand...

Done, now where would you like me to put it? :P

Maybe I misunderstood her post, and for that I apologize. However, my point remains. Making generalized and blanket statements does nothing to further the argument because there is always an exception, and a lot of times they are wrong to start with.
 
Well, its rather chilly out, so chop it up for firewood!B)

I do respect vollies if they are in it for the right reasons.....to serve the community, and help their fellow man in a time of need.

However, it had been my first hand experience, that that is, for the most part, not the case, and that is one of the reasons why I have little to no respect for volunteers, at least in my state.


Not to mention that the First Grade Council has kept NJ EMS in the dark ages....<_<
 
Another mistake...

this time it's thinking that the only way to pay for remote/rural ALS is strictly thru the taxes of those served.

It's like schools being funded by local property taxes, why? Cause that's the way we've always done it? Rubbish. Education benefits the entire community/county/state/country, let all who benefit fund it.

Why not set up a system whereby the state funds EMS for the entire population of the state? Why should those who live in rural areas suffer from a lack of health care when it is in our power to change? Why do we have to do things county by county? Answer, we don't but we always have and god forbid we broach the idea of spreading the cost of EMS/health care around. "Looks like socialism to me..."

John E.
 
There are hidden and high costs missed here by many...insurance, and employee benefit

Insuring a medical practice and the vehicles which run for it is not cheap, and there will be a number of suits annually, so figure that in as well. Plus employees don't just need a paid job, they need time off, sick leave, insurance, malpractice coverage (see above). What would the cost of an employee turnover be in advertising/recruiting, orientation, etc?,
 
John E said:
this time it's thinking that the only way to pay for remote/rural ALS is strictly thru the taxes of those served.

It's like schools being funded by local property taxes, why? Cause that's the way we've always done it? Rubbish. Education benefits the entire community/county/state/country, let all who benefit fund it.

Why not set up a system whereby the state funds EMS for the entire population of the state? Why should those who live in rural areas suffer from a lack of health care when it is in our power to change? Why do we have to do things county by county? Answer, we don't but we always have and god forbid we broach the idea of spreading the cost of EMS/health care around. "Looks like socialism to me..."

John E.
Click to expand...

While you may be able to spread the costs around the rest of the state, how do you distribute the funding fairly? The agencies that run the most calls and have the most overhead (i.e. the more populated areas) are going to need a larger percentage of that money to maintain their operations. And where do you think the state would get it's money to pay for this? TAXES.

As to your county by county comment, we can't even get statewide protocols because all of our medical directors have their own county wide protocols. The reason for this is simple...what works and is appropriate in, say, Seattle is not always appropriate for here due to transport times and receiving facility capabilities.
 
You must log in or register to reply here.
Back
Top