Something elss

[Zredmond]

Hello all,

I've been having this thought recently, and I'm looking for some options or at least goals and ideas. I'm an AEMT working in a relatively busy system (15 calls in 12 hours). Unfortunately 80% of our call volume is intoxicated homeless people, or that population that takes advantage of the system and will call 911 for inability to "feel their fingers, unless they touch them." I know this seems like every EMS 911 system nationwide, but I want to use my skills on people who are truly in need, and truly deserve the help. I was curious if anyone had any suggestions or ideas.

 

[Chewy20]

relatively busy system (15 calls in 12 hours

What the hell would you consider busy?!

 

[DesertMedic66]

It seems like the only way to avoid those calls are to become a medic and work on a CCT unit, helicopter, or ALS intercept role. Or try to find a system that does triage based on the 911 call and will send BLS units to the non critical calls and ALS units to the critical ones.

 

[chaz90]

If you'd like higher acuity, consider additional education and some kind of CCT service. Even then, most of your patients may not require many interventions from you. Overall low acuity is the reality of EMS, particularly in "busy systems." Busy services are more commonly in urban environments, and a large underserved and frequent flyer population comes with that territory.

I work as a paramedic in an ALS intercept system that responds only to 911 calls, and the ALS providers are only ever (theoretically) dispatched to ALS calls. I only run 5 or so calls in an average 12 hour shift in the off season, but I'd say my acuity is higher than average.

Realistically, if you require some kind of "high speed low drag" career full of adrenaline rushes, EMS may not be right for you. You have to find satisfaction in something other than patient acuity.

 

[CALEMT]

relatively busy system (15 calls in 12 hours)

And to think that I've felt broke off when I run 9 calls in 12 hours.

 

[Zredmond]

If you'd like higher acuity, consider additional education and some kind of CCT service. Even then, most of your patients may not require many interventions from you. Overall low acuity is the reality of EMS, particularly in "busy systems." Busy services are more commonly in urban environments, and a large underserved and frequent flyer population comes with that territory.

I work as a paramedic in an ALS intercept system that responds only to 911 calls, and the ALS providers are only ever (theoretically) dispatched to ALS calls. I only run 5 or so calls in an average 12 hour shift in the off season, but I'd say my acuity is higher than average.

Realistically, if you require some kind of "high speed low drag" career full of adrenaline rushes, EMS may not be right for you. You have to find satisfaction in something other than patient acuity.

I appreciate the feedback. And yes okay, it's a busy system. I definitely am going to further my education level. I'm fairly young, really just looking for goals to set within EMS.

 

[RedAirplane]

Hello all,

I've been having this thought recently, and I'm looking for some options or at least goals and ideas. I'm an AEMT working in a relatively busy system (15 calls in 12 hours). Unfortunately 80% of our call volume is intoxicated homeless people, or that population that takes advantage of the system and will call 911 for inability to "feel their fingers, unless they touch them." I know this seems like every EMS 911 system nationwide, but I want to use my skills on people who are truly in need, and truly deserve the help. I was curious if anyone had any suggestions or ideas.

I'd venture that someone calling 911 frequently for minor issues needs help. They may be lonely, depressed, have an undiagnosed medical condition, etc.

And everybody truly deserves help. That's one of the things I like about EMS. Nobody is ever told "no."

Sorry. Just my $0.02 on the ethics of this.

 

[STXmedic]

Nobody is ever told "no."

Actually, we tell people "no" quite a bit. EMS and the ER are still finite services. Not everyone needs an ER, and not everyone needs an ambulance. Do you really want the last available ambulance tied up on a healthy, young adult male with flu-like symptoms while your mother is having an MI? And taking care of that uncomplicated flu patient in the ER is like killing a fly with a sledgehammer. Education and redirection are often very appropriate.

 

[RedAirplane]

Where do you say no?

As it stands in many places, if you dial 911 and want to go to the ER, you can.

I have no problem with triage at dispatch and in the waiting room at the ED. That's different from saying no.

Some progressive systems are working on directing minor calls to local clinics--but they key is (at least in the example I saw) the dispatcher will arrange a cab or whatever to the clinic and have an agreement in place with the clinic in case the pt cannot pay. This leaves EMS and the hospital out of it, but still makes sure that the caller gets help.

 

[STXmedic]

We have both a taxi-voucher service for minor complaints that may still be appropriate for an ER (taxis will give rides to the ER only), and what we term "no-loads". A no load is essentially telling the patient "no." They don't need an ambulance or an ER, and we don't give them anything- think the aforementioned uncomplicated flu patient.

 

[Ewok Jerky]

Go to med school...or something.

 

[SpecialK]

Don't know about other places but in Australasia, in general, ambulance personnel are under no obligation to treat or transport patients if not clinically indicated in their judgement. This is also extending to not mounting an physical response to those calls not in need of one.

In essence this is saying "no" however "but do this instead ..." will be thrown in.