How will Trump effect EMS?

Tigger said:
Yes, which is why the AAAs initiative is important. We are a transport benefit and not a provider benefit and that prevents us from billing for what we do.
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Giving it a closer read, it seems like (at a high level) a decent proposal...I will have to spend some more time on it!
 
One of my paramedic lab instructors was double digit certification number from Washington state. She said when she started in EMS, she arrived to car accidents and loaded as many people as possible in the back and got paid "per head" like a commission. I remember laughing and thinking how old school that was... But the sad truth is reimbursement is often still transport based...
 
Hell, when I started in EMS in the late 80s, we would still transport four people in the ambulance to dialysis in one trip. One on the stretcher, three on the bench, EMT would sit in the airway seat.

We did the same thing with intoxicated individuals. Roll into the downtown area, scoop up three or four and make one run to the hospital detox.

No vital signs, no assessment. A small 3 x 5 "trip ticket" that would get the simple narrative, "patient conscious and alert, sat on bench seat, transported to ____ without incident."

I don't know how we got away with that…
 
DEmedic said:
Hell, when I started in EMS in the late 80s, we would still transport four people in the ambulance to dialysis in one trip. One on the stretcher, three on the bench, EMT would sit in the airway seat.

We did the same thing with intoxicated individuals. Roll into the downtown area, scoop up three or four and make one run to the hospital detox.

No vital signs, no assessment. A small 3 x 5 "trip ticket" that would get the simple narrative, "patient conscious and alert, sat on bench seat, transported to ____ without incident."

I don't know how we got away with that…
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I once transported 4 patients from an MVC in one ambulance. Two were "ALS" (got an IV).

I loved mid-90's EMS.
 
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DEmedic said:
Hell, when I started in EMS in the late 80s, we would still transport four people in the ambulance to dialysis in one trip. One on the stretcher, three on the bench, EMT would sit in the airway seat.

We did the same thing with intoxicated individuals. Roll into the downtown area, scoop up three or four and make one run to the hospital detox.

No vital signs, no assessment. A small 3 x 5 "trip ticket" that would get the simple narrative, "patient conscious and alert, sat on bench seat, transported to ____ without incident."

I don't know how we got away with that…
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We can still transport multiple drunks to detox at once. We have to write PCRs on them, but if I get the van out, they can take more than one at once and it's just an 8x11 form. Detox is "non-medical" though. And we can't bill if we transport there, because transport benefit!
 
Most I've transported was two...and I had another EMT in the back with me - in retrospect, I am a lucky guy. Two clearly BLS patients, mind you.
(Fly car medic kindly drove - I could have had Fire drive, but they don't drive so nicely).
 
Now, if we have two patients at a minor MVA it means two trucks out of service. We have a "one patient per truck" policy.
 
I transported 5 a few times....

But it was during a disaster and/or evacuation.
 
We transport numerous patients in one ambulance pretty frequently, usually they are all simple complaints and easy to manage. I have been on minor MVCs where we transport 2 or 3 patients and complete another couple refusals on scene. Nothing like racking up 5+ PCRs on one call.
 
Remi said:
I once transported 4 patients from an MVC in one ambulance. Two were "ALS" (got an IV).

I loved mid-90's EMS.
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I remember taking 5 people: 2 were backboarded, 1 in the CPR seat, one in the captains chair, and one in the front seat next to my partner. I was standing leaning against the cabinet while we drove the 15 minutes to the ER. looking back, it probably wasn't one of my best decisions.
 
DrParasite said:
I remember taking 5 people: 2 were backboarded, 1 in the CPR seat, one in the captains chair, and one in the front seat next to my partner. I was standing leaning against the cabinet while we drove the 15 minutes to the ER. looking back, it probably wasn't one of my best decisions.
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In my case transporting 4 wasn't my choice. The city was slammed and the crash happened at rush hour. No one was injured beyond bumps and bruises, but fire had talked everyone into going "to get checked out". It was a 10 minute drive to the ED and would have taken longer than that for another ambulance to get on scene. Dispatch didn't want me waiting on scene until the other ambulance got there, so my supervisor called me, confirmed that nobody was sick, and told me to take all 4. It wasn't at all uncommon at the time for us to transport two, so while 4 was quite a stretch it didn't seem like the most outrageous idea. I had two backboarded (one on the stretcher, one on the bench seat), one seated on the airway seat, and one in the front seat. I wrote run sheets and gave report on each one. I did start IV's on the two who were backboarded, making them "ALS" patients. Maybe that was just to show off a little.
 
I've had up to six in the back of my truck before, but we typically will load as many as can fit if nobody is seriously sick or injured. Still had to call another unit for more patients who collapsed further down the road and we couldn't move to their location to get to them. All of those patients got IVs and were given fluids, morale of that story was heat and humidity at night was still too high for a ruck march.
 
I've done 5 out of a CO poisoning. Both of my O2 trees, both of my portables, and our vent in CPAP @ 5 on 100% FiO2.
 
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