Is EMS an "essential service"?

Tnaemt94

Forum Crew Member
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There is debate as to whether or not EMS is deemed as an essential service.

"
In the case of “routine” emergencies, the threat posed by the disruption of emergency
medical services is less clear. For instance, although an individual may die for lack of
emergency medical treatment, the broader public is not threatened in the same way that it
would be by a fire left unchecked. This routine scenario suggests agreement with the ILO,
which identifies emergency medical services among a group of services that do not meet its
definition of essential service.22
"

Only 4 states recognize EMS as an essential service.

What do you think ?
 

Aprz

The New Beach Medic
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I can't think of the word right now, but it is when there is a definition for something that doesn't really mean what the word means. For example, a lot of companies in my area consider it a "no call/no show" if you don't call prior to the start of your shift and you're late or you are excessively late (>2 hours). Even though you did call AFTER the start of your shift or you did end up showing up eventually, it was marked as a "no call/no show" and then people would get upset "I did show up! I did call!" Yeh, that's just the name. It's not saying you didn't call or didn't show up. They have it defined in the policy here. Of course the people who don't show up on time for work or don't call to let the company know they are gonna be the late are the ones that get upset about this. :p

So it doesn't sound like a very nice thing saying that EMS is not essential, but that is just going by their definition of essential. There definition I guess is would it cause problem for the public itself. If one person has a heart attack, will it cause other people to have problems? Probably not really other than maybe emotional problems to the family members or if the person loses consciousness while driving a car, which EMS is probably not gonna prevent that, but problem respond to that accident instead. Obviously more people with heart attacks would probably drive to the hospital if EMS didn't respond to their home and they had to drive themselves to the hospital so you could say that. It is just their definition of essential, whatever you are quoting. You didn't put a link to what you were quoting. I don't think they are trying to put down EMS in any way.

The more I work in this field, the less I find EMS essential in general. It is really more like comfort rather than necessary for a lot of calls. Very few of our calls actually require an ambulance.
 

Aprz

The New Beach Medic
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Why does it matter? What is at stake here?
Just something to talk about. Maybe he is trying to convince his community that EMS is an essential service. *shrugs*
 

Giant81

Forum Lieutenant
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I don't think EMS is an essential service in comparison to police or fire.

Nice to have, yup. Should have if at all possible, definitely. but will cause massive catastrophe if not provided? nope.
 
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Tnaemt94

Tnaemt94

Forum Crew Member
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Well I just thought about this.

In a climactic atmosphere, what do people tend to do? Panic, right? What happens when people panic? They can unknowingly jeapordize the safety of themselves and others and make poor, impulsive decisions.

Think of an injury or illness that occurs in the public. For one, the general public is not a controlled atmosphere like a hospital. When you put a situation in front of someone that they do not know how to handle, they panic. Again, when you have panicked people, a lot of destructive decisions are made.

And if people knew help was not coming, it can exacerbate the situation and people take matters into their own hands. Do you want a panicked person that is tunnel visioned and in a state of panic out on the roadways trying to get a crirically sick or injured loved one to the hospital? For us, this is not our emergency. For them, it IS their emergency.

Also, in a disaster or a large scale incident, there has to be control and deligation of tasks. People that only need to be there should be there. What is people's normal reaction to a person in peril? You will get some that will run away but you will also get many that will selflessly try to help. If they don't know what they are supposed to do or handle a situation, it can make things more difficult for other public safety personnel and again, can create more chaos and harm.

So in a direct way, no, I don't think what we do keeps the public safe as a whole. But in an indirect way, yes it does.
 

Underoath87

Forum Asst. Chief
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Keep in mind that civilian EMS didn't even exist in this country until the '70s, and they didn't run around panicking and dying everywhere. But many would argue that people were more self-reliant and resourceful back then because they had to figure **** out for themselves, since help wasn't at the touch of a button 24/7.
 
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Tnaemt94

Tnaemt94

Forum Crew Member
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Keep in mind that civilian EMS didn't even exist in this country until the '70s, and they didn't run around panicking and dying everywhere. But many would argue that people were more self-reliant and resourceful back then because they had to figure **** out for themselves, since help wasn't at the touch of a button 24/7.

But think about this too. We live in a society that is much more populated and hostile and continues to grow. With 9/11, that influenced the implementation of the ICS/NIMS. It created a more structured response, where in a situation of chaos and impending doom, you need deligation of tasks.

I agree a lot of the calls we get called on are complete bull ****. But in a way it prepares us to handle emergency situations and to be able to work with other emergency responders, which in returns benefits the "readiness" for larger scale incidents.

Again, thinking about this more, I believe that we are essential to the public as a whole in an indirect way. Will the death of someone put others lives in danger? No. But would the actions of others in an attempt to save that person pose a risk? It very well could and panicked persons who don't know how to handle the situation can pose a larger risk which in return would be counterproductive.
 

Gurby

Forum Asst. Chief
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Not having EMS means that we are essentially completely giving up on all out-of-hospital cardiac arrest patients. The survival rate is fairly negligible anyways, and dependent on bystander CPR, so maybe more public AED's and training the public to do compressions could help in that regard. But we would still lose more viable young patients who have a freak arrhythmia that isn't discovered until they have an idiopathic cardiac arrest at age 10-25.

I'll make up some statistics based on my experience thus far in EMS: for 90% of calls, sending a taxi instead of an ambulance wouldn't change patient outcome. For 5% of calls, having an ambulance transport modestly improves patient outcome, and for the final 5% of calls EMS dramatically improves patient outcome.
 

escapedcaliFF

Forum Lieutenant
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Living in the middle of nowhere I can tell you I get along fine without the police, fire, and EMS. Granted one time I did call the police it took them 45 minuets to show up while I held a crack head at gun point. Did I need the police? No I could of shot the crack head and made his body disappeared. So to me personally I dont really need any of them.
 

reaper

Working Bum
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A lot depends on where you live.
For a lot of people EMS may be the only medical care they have to deal with. This is true for both urban and rural areas.

On the other hand. In rural areas FD and LE are not really considered essential. Their resonse time negate any beneficial use. By the time LE shows up the emergency would be over. By the time FD shows up, your house would be gone.

So, it all comes down to how you view things in your world.
 

Carlos Danger

Forum Deputy Chief
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I think EMS is non-essential the way that running water and heat in your home are non-essential.

Sure, we don't need those things in the same way that we need water and oxygen, but in a modern, "civilized" society, they are generally viewed as basic necessities because of the dramatic impact they have on quality of life and potentially on health.

For that matter, I don't see how EMS is any less essential than fire or police. We don't technically need those services either.
 

DrParasite

The fire extinguisher is not just for show
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how do you define an essential service?

for example, I know of many towns that don't have a police department. they either contract with a neighboring town, or the state police/sheriff has 1 officer covering a 20 sq mile area (translation, you aren't getting a quick response), but they have coverage. Does that mean LE isn't an essential service?

Asking the question, if EMS doesn't exist, what happens when someone calls 911 and has a medical emergency, what happens? Is anyone sent? if EMS takes 45 minutes to arrive (because they are coming from 20 miles away), is that adequate? Is there a call volume requirements to qualify something as an essential service? What would need to happen if EMS was to be considered an "essential service?"
 

rescue1

Forum Asst. Chief
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Perhaps it's better to ask, rather than debating the semantics of "essential", how many patients who call for an ambulance show benefit from it?
In other words, is EMS important just because we can take people to the hospital safely (so that panicking relatives don't have to), or is it because we actually improve outcomes?

Either way, I would argue that police and fire are more essential to modern urban living than EMS. Without enforcement of laws there can be no organized society, and without fire protection cities would be incredibly dangerous, as fires, infrequent as they may be these days, would threaten whole city blocks.
 

SandpitMedic

Crowd pleaser
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Perhaps it's better to ask, rather than debating the semantics of "essential", how many patients who call for an ambulance show benefit from it?
In other words, is EMS important just because we can take people to the hospital safely (so that panicking relatives don't have to), or is it because we actually improve outcomes?

Either way, I would argue that police and fire are more essential to modern urban living than EMS. Without enforcement of laws there can be no organized society, and without fire protection cities would be incredibly dangerous, as fires, infrequent as they may be these days, would threaten whole city blocks.

I would say EMS plays an equal part in that. Folks tend to think of EMS as part of the fire department.

If you removed the EMS component from fire... Then what?

There is no separate but equal.

We have a function vital to our current society. There are more ill and injured than there are supression requirements. That is an opinion, that is factual. Even if 25% of patients truly require ambulance transport or prehospital intervention, that is still heavier on the scale of necessity.

There are a lot of bogus patients, there are also a lot of sick patients.
 

rescue1

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Sick, sure, but I'm asking how many patients benefit from a well funded, well educated ambulance service vs being thrown in Uncle Bob's truck or the back of a squad car and driven down to the ER, that's what I'm asking.

As for fire vs EMS, while medical calls far outstrip fire calls, a building fire (or at least an urban one), rare as it is, is a public emergency, threatening not only the homeowner's property but everyone around it. A medical emergency is not a public emergency, it affects only the patient(s) involved and not the community as a whole.
 

RocketMedic

Californian, Lost in Texas
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Adding to this is the fact that we don't really see the immediacy of the good we do. Police neutralize criminals and help keep us safe. Firefighters put out fires. We....save lives that might maybe be something and help people. It's certainly noble and good and desirable, but it's not as flashy.
 

Ensihoitaja

Forum Captain
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I think just about everyone in the United States expects that if they call 911, an ambulance will show up to take them to the hospital. Beyond that, I don't think there's a definition of essential that matters.
 
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