What should we do to improve EMS

[AJ Hidell]

Whoa! You blew my mind there for a moment! I was like, "When did I start that thread, and how did it get to five pages this fast?"

Thanks for the assistance!

 

[ffemt8978]

Please, please let's cite credible information. C'mon. Look at the citations. Zoll & Montgomery County EMS? Let's research through the State EMS Directors and see the numbers and what projection should be. Within the same Internet quotation there are 35k with monitors or AED and that leaves only 10,000 without them? B.S.! I am sure there more than 10K without AED or Monitors. Are they also including private ambulance or non-911 or multiple EMS within a city?

The USA today article that was cited was also taken way out of context. Something those involved with OKC & Tulsa (which is cited) still regrets. This is the reason they are service I was referring to that are paying salary for a person while attending school for their Paramedic. Even moving and recruiting bonuses are negotiated . More is less...I don't think so.

Now, figure this there is alone over 5,000 EMT's alone in my state and its a rural state. There are over 17,000* NREMT/P alone; this does not include those that are not Registered or involved as a NREMT.

Does this mean there is a shortage, you bet. Since there is; should we allow a compromise to short change our profession, the system, and worse patient care? There is far more a shortage of nurses as the average age of a RN is now 49*. Thus approximately over 15% will be retiring within the next ten years.. so we shall allow volunteer nurses aides to perform RN jobs. Yeah, I can see the nursing industry allowing that to happen. NOT.

The difference is they are a profession composed of professionals. They will not allow such compromises. They will not "dilute" their system or profession. Even the "crash courses and on-line" programs will be coming under more scrutiny and we will probably see less and less states allowing license from these. I know that my state alone has added additional requirements to ensure that the RN candidate has met the "minimal" safety requirements.
Ever seen who governs their profession? Nurses and no one else. Each state has a Governing Board. Now, compare that with EMS.

I wish EMS had the gonads to do such. Nope, we will develop some form of pseudo acronym or another excuse (we are good at that) to cover up the blunders. Public assume that because it has lights & sirens there is a Paramedic in it. We also make sure that they are unaware of this as well. Yeah, there is one thing we are good at... not educating the public and definitley not making them aware of the difference.

Maybe a new insignia should be incorporated with the Paramedic (without the EMT referrence) and marketed and publicized. If you don't see this, you don't have Paramedic. Hmmm.. wonder what the community perception would be?

R/r 911

* NREMT 2007 Fiscal Reports
** ANA 2008 Review

So, which statistics do you think aren't credible? I was just trying to get a ball park figure to work with, but if you have any more accurate ones, than I'm more than willing to use them. For the record, I too, believe there is a shortage of medics. But I also realize that saying every agency should be paid ALS without considering all apsects of it is just as irresponsible as dumbing down the educational standards just to put bodies in the vacancies.

There are 25,000 towns, villages, and cities in the US, and that is from the US Census Bureau. Given that any quality paramedic program is a two year program, and that you need at least 3 medics to provide 24/7 coverage, how many years will it be before enough medics are trained to provide everyone ALS coverage? Or would you prefer that some communities not have ALS present in them, and have to wait for an ambulance from the next town over to respond?

Take my county for example. We have a total county population of around 25,000 and are one of the largest in size in the state. We have three paid ALS services in the county...two of them in the largest city (one city fire and one a fire district). The other ALS agency is a hospital based agency in the 3rd largest community in the county. Interestingly enough, the second largest community contracts with the fire district to provide their ALS coverage. These three agencies between them are only able to staff 5 to 6 ALS rigs 24/7. Another interesting tidbit...the hospital based ambulance is the only one that can't always provide 24/7 ALS...the FD's can.

 

[AJ Hidell]

If places start eliminating their ALS engines to save money it will be interesting to see what the statistics start showing.

Don't expect the IAFF and IAFC to let that happen without a major political fight!

Here's how the thinking goes:

Not enough ambulances = send fire trucks
Fire trucks on EMS runs = not enough fire trucks
Not enough fire trucks = add more fire trucks
Add more fire trucks = no money for the ambulances that were needed to fix the problem in the first place​

The fire chiefs create their own artificial shortage and demand this way, doubling their budgets while leaving EMS with the same problem it had to begin with, which is not enough ambulances. Then they run around bad mouthing all the evil capitalists who try to make money off of EMS, as if their motives are somehow more altruistic than AMRs motives are. Puhleeze.

 

[Aidey]

I'm aware of that, and how fire can play the system to justify their existence.

However, if voters wake up and say "Hey we are paying twice for paramedics. once to the city and once for the private company, and the private company only charges the people who use it, lets stop funding the city" things are going to change whether IAFF IAFC likes it or not.