How can we improve EMS

It can be and is done throughout many areas of the country and international. It is dependent upon how important EMS is to the community. There is ad valorem taxes that can be added to land, tag taxes that can be added specific to EMS, cigarette/liquor (sin tax) that can be specific.

It takes interest, it takes hard work, and legislation. Something that most EMT's do not want to work upon; rather they have someone else do it for them. Then when there is no funding, no respect, no benefits or longevity we wonder why?

We are now suffering to cover for communities that do not have or inadequate EMS increasing the costs for those that do provide. In other words services similar to mine having to cover communities that do not have (because they cannot afford). This is a new heated debate.

Our State EMS has decided that the "nearest" EMS must respond. In other words one unit may have to respond frequently to a community 30-50 miles away, although that may cause the primary area to be without coverage and as well the local community responsible for funding the EMS. So what does one do? Not respond, or keep responding to communities and areas where they are not in the original district and do not offer funding? I

So here is the dilemma: Not to answer to cries for help or for a community be responsible to provide care for another? Then why should a community ever think of supporting EMS if another will do it for them?
 
I agree with everything you have posted. I had most of that written earlier today but I was logged out ???? and couldn't post. Another thing EMS needs is to be recognized like Fire and Police. Ya know the Hero factor. People don't think about EMS being in the same catagory, most have a vague idea of what we do. When I am taking a pt to another facility and they ask about my job and I tell them the training involved and the conditions we encounter they are amazed.
Someone said to keep the training at a minimum for volunteers. No, we need to keep our skills sharp and continue our training. We are professionals and should be able to give the best pre-hospital treatment possible.
Knocking on our goverment official's doors asking for their help is alot of work but grass roots movements can get the ball rolling!
 
There's nothing wrong with...

taxes. As someone famous once said, and I paraphrase, "taxes are the costs to live in a civilised society".

As for protocols changing from county to county, all it takes is the will to make it work instead of an acceptance of mediocrity. Never said it would be easy, nothing worth attaining is easy to come by.

Again and again one hears arguments about why things won't work almost exclusively based on the fact that it hasn't been tried in the past. That's not just faulty logic, it's horrible public policy. "It won't work cause we just know it won't work" is a stupid way to go thru life.

Regardless of the logistical issues, the simple facts are the same, people need emergency medical care no matter where they live. Saying that we can't provide it because of where they live or what their tax base is, is an acceptance of mediocrity as the norm. All one need do is ask oneself, do I accept being mediocre in what I do and extend that to public policy. If the answer is yes, I do accept being mediocre, then get out of EMS and go find something else to do with your life where living life at the bottom is more acceptable.

John E.
 
You CAN make it happen

If you are patient enough, if you want it enough, you can make EMS happen almost anywhere. Twenty years ago, this island off the coast of the mainland by 32 miles of water decided that the medical provider needed some help. It took twenty years of hard work to go from a basic life support ambulance that was worn out to a brand new ambulance with advanced life support. The difference between not having any EMS and ALS service would not have been possible without dedicated people who wanted to make it happen. It just doesn't get any more rural than this community. The year round population is under 450 people, yet demonstrating the positive effects of having this EMS service in the community has been the reason it has progressed.

Yes, we have geographical constraints, much longer transport times, and are quite used to being with our patients for hours, not minutes. Yes, we know the national scope of practice is important for a baseline to be established, but we also know that a patient with a pulseless limb, and fourteen hours of waiting time before the weather allows transport, needs to have this issue resolved. Any set of protocols or scope of practice are general guidelines and not the laws of Moses engraved in stone. Every situation in EMS requires a thinking EMS provider whose talents are known and trusted by the medical control physician. Will you find shoulder relocation in the national scope of practice for the paramedic? Probably not, but rural paramedics have been entrusted to accomplish this type of task while in full radio contact with a medical control physician.

This type of trust of paramedics will not happen without many, many positive clinical experiences with the same physician, but it can and will happen with dedicated, willing EMS providers. Do I want to relocate shoulders or straighten grossly deformed, pulseless limbs every day? No, but I will do what is necessary to help the patients in my community under the direct orders of a medical control physician.
 
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