Opinion on use of rapid response units

If the new baseline if paramedic, then IFT will fall to them sometimes. And it won't be a big deal.

So the ideal is have the first on scene an ALS qualified unit, then stabilize and either transport themselves, or delegate transport to a BLS unit?
 
mycrofft said:
So the ideal is have the first on scene an ALS qualified unit, then stabilize and either transport themselves, or delegate transport to a BLS unit?
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I think that will only be feasable if there is a transport destination other than the ED.

Really the cost of BLS transport compared to an ED visit is basically chump change.

It also begs the question, since right now ALS is reimbursed by transport, not by consultation and intervention, How do we pay for all of those high level providers exactly?
 
ANSWER: $65 Tylenol
 
Vene- I would have thought it to be common knowledge as well... However my system is moving in a "new direction" that doesnt really support that... And to my suprise, most people in my system support the movement... Im trying to locate something objective that says, just what you just did.
 
The emperor's new cloths

Trevor said:
Vene- I would have thought it to be common knowledge as well... However my system is moving in a "new direction" that doesnt really support that... And to my suprise, most people in my system support the movement... Im trying to locate something objective that says, just what you just did.
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If they don't think so now, nothing you present is going to change their minds.

Pearls before swine.
 
mycrofft said:
One of the Black Holes of EMTLIFE: the future of street EMS/prehospital EMS as a profession. As the discussion crosses the event horizon, it inexorably becomes a polarized exchange of ideas about where it is going, much as I imagine it went when the mice discussed being the cat.


"No more EMT-B's" means you have robbed hundreds of thousands of rural and IFT patients a level of care above first-aid and jacked up the personnel cost of prehospital EMS (PHEMS) by maybe thirty percent, unless with the resultant influx of credential mill paramedics you force down the pay scale for PHEMS overall.

I worked in two tiered response systems in the late seventies-early eighties. If ALS is close and can respond very quickly and there are enough, then fine. If not, then no, but you have then to figure out how to actually do it.
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I am afraid I don't agree with the US system at all. Call me a communist I don't care. There are a number of things that I believe the government should own, operate & not try to profit from.

Healthcare is one of them. People should not have to think about their pocket for calling an ambulance & getting assistance.

With this in mind, & the state makes the right decision & seperated fire & ems, treating them as distinct seperate professions, smaller rural communities then benefit. In fact they are better off.

There will always be a place for volunteers to work & be trained alongside paid officers. The mentality that we need to be chasing the almighty dollar needs to leave ems. Then we can progress as a profession.
 
Well after employee reviews today and a medic meeting this morning, my service has made the decision to take our RRU out of service till a plan that fits the needs and apporval of all employees has been meet. The point that really made it was saftey, two trucks blazing down the road as apposed to one, and also a medic or whoever is in the RRU responding alone and the dangers that 'could' follow.
 
downwunda, I hear you.

I cite my four hour ER visit, had a portable chest xray, EKG, about 1/4 liter NS IV TKO, one metoprolal PO, and MI lab panel (Chem panel and cardiac enzymes). Had to post a $1,000 deposit at the door of the ER ("Say what?!") and paid $500 (credit card) after insurance. Once they sent the EKG to my cardiologist, he said "That's a baseline for him, send him home".

A government hospital would not have had the motivation to do all this, as I told them going in it was a C4-C5 impingement...which it was.

Anyway, tiered response is one way to do it, but it has to be adopted on a case by case basis. Easier to send ALS each time.
 
then let's upgrade everyone to an ALS standard. Simple. Ems is a profession. As professionals an emtb is a driver. In my service a trainee can do more. Let's give end due credit, autonomy & increase the skills base. Easy.
 
rescue1 said:
IFT is a different beast, and I really haven't been exposed to it enough to really discuss it, but I will say that making paramedics with a bachelors degree transport granny back and forth from her dialysis seems a little absurd.
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Sending a basic crew doesn't make much more sense. An EMT-B course teaches one precious little about the world of IFT.
 
Up EMT-B to something more, then. If you increase training hours with a focus on medications and understanding chronic conditions, you can have an EMS provider tailored to IFT. CC IFT or IFT that requires ALS can be left to paramedics.

That way you can have dialysis transports, nursing home transports, etc that are not an inefficient waste of money (which a fully staffed ALS rig would be, almost all the time), but still have a reasonably trained provider. Hopefully salaries would also increase.

Though I'm curious to see how IFT works in the Commonwealth countries, or any of the Western countries where EMS tends to operate at the ALS level.
 
Re Emt-B

It isn't really a tough jump from Emt-B to Emt-A. I don't understand why anyone would stay put at a basic level. No intention of dogging anyone, just saying. You gain a lot more skills and the class isn't that long. Just as it makes no sense not to move up to paramedic eventualy.
Still think we need trained professionals at all levels. I simply think it keeps the system balanced.
 
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jgaddis82 said:
It isn't really a tough jump from Emt-B to Emt-A. I don't understand why anyone would stay put at a basic level. No intention of dogging anyone, just saying. You gain a lot more skills and the class isn't that long. Just as it makes no sense not to move up to paramedic eventualy.
Still think we need trained professionals at all levels. I simply think it keeps the system balanced.
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Agreed. From what I have read it seems like there will be more background knowledge for AEMTs in the new curriculum. Even at the end of my didactic portion of medic school I still don't feel like I understand physiology as much as I would like to.
 
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re: nvrob

I'm just now in my second semester of Emt-A class. Looks like we are expected to have quite a few more skills than the I99. It's gonna be tough on the physiology for me as well, just a lot to learn in a 1 year course.
 
jgaddis82 said:
It isn't really a tough jump from Emt-B to Emt-A. I don't understand why anyone would stay put at a basic level. No intention of dogging anyone, just saying. You gain a lot more skills and the class isn't that long. Just as it makes no sense not to move up to paramedic eventualy.
Still think we need trained professionals at all levels. I simply think it keeps the system balanced.
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In the volunteer world, moving up to paramedic can be a very costly proposition, unless you also plan on doing it as a profession.
 
Agreed. Thus the statement that we need all levels of training. If you did decide to go career, there are grants and student aide that make it much less costly.
 
NVRob said:
Agreed. From what I have read it seems like there will be more background knowledge for AEMTs in the new curriculum. Even at the end of my didactic portion of medic school I still don't feel like I understand physiology as much as I would like to.
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Guyton's Medical Physiology is an easy solution to that problem.
 
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