Your opinion on the future of EMS

[Sasha]

Nope it actually benefits the patients and also helps lower the stress of being the only Paramedic on scene.

Yeah but you can get a medic who hasn't intubated since school. Intubation successs rates are already poor and declining to the point there are areas who may take that away from their medics. Why? They get no practice because of oversaturation of medics. The more medics the less skills you practice.

 

[SeeNoMore]

It does seem to make more sense to not have two Paramedics on one rig. Sasha is quite right concerning issues of oppertunities to use skills like intubation, and in many areas Paramedics are scarce enough as it is.

 

[Ridryder911]

There is a difference between two Paramedics on a EMS unit and 6 Paramedics at every scene. If those were the only ones to provide ALS procedures each and every time so experience and accountability could be valued and controlled it makes more sense.

Allowing a break of patient responsibility as well as a second person for reassurance and an second opinion.

R/r 911

 

[46Young]

I like posting off the wall comments on occasion, such as beginning an open ended socialism thread, or suggesting that PA's replace medics in the field. Someone even started a seperate thread in regards. It's better than drudging up old topics such as fire EMS vs third service, medics abusing EMT's, private vs municipal, medic mill rants and such.

 

[EMTinNEPA]

With a yearly call volume under 200 its just not possible to fund paid first responders.

Nonsense... two ALS calls per day where you transport will pay for your truck to be there. However, if you don't get a call volume like that, could you if you responded to ALS calls in neighboring communities? If not, could you afford to staff one EMT and enter an agreement with a nearby ALS service to staff a paramedic at your station? If not, have the EMT driver be a volunteer. And if none of these options will work, trust me, if it came down to no EMS or paying for EMS, the community would find the cash in a hurry. And why not pay a neighboring paid service to staff the truck? There are plenty of solutions besides leaving peoples' lives in the hands of hobbyists.

 

[EMTinNEPA]

As for the future of EMS, we can be a true profession if we just got rid of all of the hobbyists and those who view EMS as "just another patch". Those who lobby to keep the educational standards low. I, as well as many others, have been over and over and over what could be done to benefit EMS. But, it will take time. It will happen. It will happen or communities will just have to do without quality EMS... or EMS at all.

 

[Level1pedstech]

Maybe I'm not painting a clear picture of my departments needs. We as taxpayers in our area pay for the service of our ALS/BLS transport agency. They cover ALS/BLS calls for three different districts. We approved the levy ten years ago and the community has approved just about every levy presented be it fire or medical. The first responders be it fire or medical are all volunteer. I really don't see the voters approving additional funds for staffing what has always been a volunteer department. On a side note our transport agencies request for a levy extension comes up for a vote on 8/18 it will be interesting to see how the community which has grown in size over the last ten years responds to the levy extension request. If its voted down we will need to come up with a new plan.

 

[Sasha]

+1. for every one individual that represents the profession well, advocates and works for greater educational requirements, there are 10 (100?) that could care less, and only use the job as a stepping stone, or an "in" for a FD.

I don't really think those using EMS as a stepping stone are the problem. I know I and several other stepping stoners have higher aspirations then EMS alone but while we are "here" we do our best to get educated and be professional. JP, Daedalus, phabib, Vene and I, for example, are all shooting for physician or physician extenders, and we take EMS very seriously. I would take them over many of the "career" EMS providers.


I think the problem are those who like EMS the way it is. People who like volunteering to get their warm fuzzies, they LIKE responding in their POV with a t-shirt on. People who like knowing just enough to get by and to think that medicine is different inside the hospital than it is out in the streets, they don't see the need to learn anything beyond their textbook or think outside of their protocol. People who have no compassion for others and come off with a "better than you" attitude with racism or judgement for their own patients.

As it stands, EMS is not a career. People have to work two or three jobs to support their family in EMS. But seriously, how can you lobby for better pay when all you require for entrance is a short class and a highschool diploma?

 

[SeeNoMore]

I also think that for EMS to have a bright future the changes made can not just be external. We need to be dedicated to improvement and advancement. I see that with people on this forum, but many people I talk to in real life are either totally apathetic or openly hostile to change. This includes folks who are very compassionate, and do a good job. They just seem to want to keep things the way they are.

People seem to treat research like an attack. I understand it can be unsettling, but there are also bright spots like Paramedics improving outcomes for stroke patients or patients experiencing difficulty breathing.

No one wants to discuss ideas like the future of intubation, permissable hypotension, cspine etc etc.

I am afraid if we do not promote change and education, outside forces will decide Paramedics and perhaps the current level of BLS is not worth the money.

 

[PapaBear434]

I don't think anyone can possibly predict the future of EMS. Even someone with the supposed experience and insider insight as Rid.

Just look at this thread. We've got people once again waging the retreaded "Vollie vs. Paid" war, a land that has been well scourged over on these forums. We've got people saying two medics are better than one, while others saying that it would be over saturation. We have folks saying that education would be fine at an associates degree, other saying they want everyone to have a BS, and still others saying that we need to have a PA or Doc on board.

Hell, I'd love to see "paramedic" level training ultimately be in equal line to Nurse Practitioner, like they do in England, Germany, and France (though they have Docs riding around too, so go figure.) Give medics the training and diagnostic teaching to use treat and release abilities for your typical cases, allow them to Rx antibiotics and low grade pain killers and anti-inflammatory drugs (Non-narcotic, like Ibuprofen) and thus allowing for less needless transfers and less people clogging up the ED. But getting local areas to support a trauma nurse on wheels is about as likely to happen as me learning to fly like Superman.

My fantastical dreams of superpowers aside, you can see my point. We, as a field of medicine, are relatively new. We don't agree on anything even within our own community. There is no way we can predict what is going to come of our field twenty years from now. Especially with the current "reforms" in health care the current administration is trying to work through, things are up in the air.

Who knows, maybe under a universal health care system (if it ever comes to fruition), more rural areas will finally be able to staff up a paid ambulance service, because a lot of the overhead will be covered by a much larger tax base. We won't have to worry about finding a budget to replace supplies and raising what we charge patients/insurance companies for service.

Or, if you lean the other direction, a universal health care coverage will lead to a heinous amount of BS calls, overtaxing of the system, and ultimately push people out of the field into something that pays better with a lot less stress and work.

Whatever your views, my point is this: The future is uncertain. We can only hope that when the dice stop tumbling, that they fall somewhere that isn't disastrous to us all.

 

[Ridryder911]

True, no one can predict with certainty but if they are involved in projects and criteria that will be introduced in the future they will be able to have the insight others will not. Believe it or not, there is much more to this profession than being a cot jockey.

Patient care is and always should be the main emphasis; but on how and the integrities of the workings of EMS is another matter. For example the majority that posts here is ignorant of the current national legislation or new methodologies that will be implemented upon testing stations. With such implemenatation of programs one can have at the least a predictability of what will be occurring if they stay active within the EMS profession other than just providing patient care.

Universal health care will not occur at the way first thought, people witnessed how poor government programs are just by the "cash for clunkers" was managed. Even if Universal Healthcare program was approved, the earliest the implementation would be at least ten years.

I agree, more care can and will be implemented but the educational system will have to change. Training with only emphasis on the skill portion will be eliminated as the testing will correlate an understanding of general science and medicine and critical thinking skills. In other words, if you are not properly you will not be able to pass the test. Harsh way of cleansing the system but if trainers cannot properly screen applicants and teach accordingly; so be it.

R/r 911

 

[PapaBear434]

True, no one can predict with certainty but if they are involved in projects and criteria that will be introduced in the future they will be able to have the insight others will not. Believe it or not, there is much more to this profession than being a cot jockey.

I should probably also mention, Rid, that I wasn't trying to take a dig at you in my post when I said "Supposed" experience and insight. What I meant is that you seem (obviously) to know what you are talking about, and as far as your assertions that you are in all of these high level meetings determining future policy in EMS... Well, again, you seem to know what you are talking about and your stories seem to check out with what comes out the pike a few weeks later.

But because this is the internet, everything is taken with a grain of salt. You don't know me, and for all you know I am lying about my credentials, my system, and even my hair color and gender. For all I know, you are a fourteen year old boy in his basement with EXTREMELY good Google skills and a medical dictionary. All we have is our word, as it is.

That all said, I am going to steer FAR clear of the universal health care debate, as that will derail the thread worse than an Amtrak through the mountains. Let's just leave it to say that we have very different views of how UHC would go down.

 

[Ridryder911]

I should probably also mention, Rid, that I wasn't trying to take a dig at you in my post when I said "Supposed" experience and insight. What I meant is that you seem (obviously) to know what you are talking about, and as far as your assertions that you are in all of these high level meetings determining future policy in EMS... Well, again, you seem to know what you are talking about and your stories seem to check out with what comes out the pike a few weeks later.

But because this is the internet, everything is taken with a grain of salt. You don't know me, and for all you know I am lying about my credentials, my system, and even my hair color and gender. For all I know, you are a fourteen year old boy in his basement with EXTREMELY good Google skills and a medical dictionary. All we have is our word, as it is.

That all said, I am going to steer FAR clear of the universal health care debate, as that will derail the thread worse than an Amtrak through the mountains. Let's just leave it to say that we have very different views of how UHC would go down.

No problem, far as Universal pro or con it really is out of our hands at this time. In regards to EMS, I am fortunate to be in the position I am in that it is my business to know what is coming down the pike. To prepare my staff and develop protocols and brief our medical control as well as billing possibilities. As an educator, I feel it would be hypocritical of me not to know the latest changes and methods. Truthfully though, most of the "high level" meetings are not secret or a hidden agenda alike EMS in general only a few gets involved and actually causes something to move forward. If we could curtail the whining and griping and placed a small portion of that energy into developing programs and changes, we could all retire wealthy and have little problems in EMS.

R/r 911

 

[akflightmedic]

I can vouch that Rid is not a 14 year old boy as I met him in person on my cross country trip in 2005. We have pictures together as well...

 

[PapaBear434]

I can vouch that Rid is not a 14 year old boy as I met him in person on my cross country trip in 2005. We have pictures together as well...

And my assurance that YOU'RE not a 14 year old boy too?

For the record, I believe you guys, but I take everything with a grain of salt on the internet. Thus the "supposedly" qualifier.

 

[Achromatic]

I would love to see a move to a separate agency. I loved how things were set up in Victoria, Australia, with a three agency system.

One of the first comments was how many people use EMT/P as a stepping stone into a FD. Ironically, depending on willingness and ability to relocate, many are forced to use FD as a stepping stone to EMT/P (vis-a-vis the many agencies that require their EMTs to go to Fire Academy).

 

[atropine]

a decent opinion would be, No more FAT medics or Ricky rescues allowded in ems

 

[Ridryder911]

a decent opinion would be, No more FAT medics or Ricky rescues allowded in ems

Well, this would eliminate about half the F/F then.

R/r 911

 

[atropine]

Well, this would eliminate about half the F/F then.

R/r 911

well half of the non west coast f/f

 

[VentMedic]

well half of the non west coast f/f

You do realize most of the studies for weight related health problems and firefighters were done in southern CA?