Speed and Time in Prehospital Trauma Care

[Seaglass]

Exactly.

Providers should be able to do all of the commonly needed treatments for their anticipated transport times. Rural services therefore, probably need the most well educated clinicians, and the most skills/medications. However, as mycrofft said, these are the areas that have the hardest time recruiting and maintaining ALS resources and keeping up their providers' skills.

Keeping up skills does present an interesting challenge--I already wonder about how I'll manage after becoming a medic, since it's hard enough as a basic. There are some important things that I just never have a chance to do, and dummies aren't great substitutes for real patients.

A lot of local services have their intermediates and medics take a certain number of shifts each year in the ED beyond those required to legally maintain the cert. It's a start, but I'm not sure how much it really helps, since our hospitals are often slow too. Makes me wonder if the higher-ups could talk some of the larger hospitals outside of the county into participating in this.

Our ALS providers do have a fairly wide scope of practice, especially with online medical direction, since they might be in the truck for a rather long time if a patient needs anything especially specialized and the weather is too bad for a helicopter. Our county has some decent hospitals that can handle most things, and recently developed the capacity to handle most vascular issues, but a lot of things still need to go pretty far. We also backfill or run mutual aid in even more rural counties fairly often, where transport times get really scary.

 

[redcrossemt]

Of course not, but we're not exactly going to benefit our patients and communities by disregarding that and having providers suspended. Responding at about the speed limit with l/s seems like a reasonable compromise to me. All we're essentially doing is asking other drivers to yield the right-of-way, which makes sense when the initial dispatch is often misleading.

Do you know why they decided to have psychiatric emergencies as the sole exception? Seems like an odd choice to me... some of them can be rather time-sensitive.

Not saying to disregard your protocols or procedures. Just saying, in theory, and possibly in practice, your protocols/procedures might need an update!

I agree. The jurisdiction I work in is finally going to require MPDS after many years of each city's on-duty dispatcher deciding what is and is not an emergency. Psychiatric calls get an emergency MFR response, followed by non-emergency ALS response, as of now, in our city. If it seems like it could be more than a committal, the dispatcher will send us priority too; but really, there's no real oversight on dispatch around here yet.