Flawed

Posted: January 4, 2011 in EMS
Tags: , , , ,

The following does not represent my employer, nor does it represent the views of my employer. Rather it represents EMS in general. And my opinion.

I am new to EMS, only being in it for 2 years. So disregard this if you want.

The EMS system is flawed. There I said it. Many of us know it already though.

The biggest flaw I can think of is a simple one really. Some one with the sniffles calls 911, 911 dispatches an ambulance, the ambulance takes them to the ED. Now, that took an ambulance out of service, took up a bed and staff at the ED, and cost the patient hundreds if not a thousand dollars. I don’t have a problem with the ambulance doing the transport really. Most of the time another crew is standing by to take the next emergency call. My problem is transporting that patient to the ED. Why not just go to a local Urgent Care, or even the patients doctor if allowed? How much money would that save the patients insurance company? Effectively lowering insurance premiums? It would free up room and staff at the ED as well. How many times have you driven yourself to the Emergency Department, just to wait 2-10 hours to get seen? We all know that while you wait in the waiting room, whether it be with sniffles your self, or a more serious condition, there is someone sitting in a bed, sniffing or holding their stomach with indigestion. If we could transport to an Urgent Care, the more serious patients would get better care in the ED.

There are other flaws of course. Time on scene is one I hear about often from my patients, and family members. I have worked with some partners who get on scene, and as soon as the patient is in the rig, we are moving. There have been others who spend a rather large amount of time on scene. I have been on scene for 45 minutes before, while my partner works in the rig. Now, there are certain things that need to be done before transport begins, I understand this. I, myself, like to get a set of vitals before transport begins. Even if I got a set in the house or outside. I get in that rig, and take another set. Then we go. It doesn’t take long for a good set of vitals. ALS providers have things to do. IVs to start, 12-leads to do. I understand that as well. And it is fine to do them before we go, just as, I as a BLS provider, do certain thing’s before moving. But there comes a point where just sitting on scene gets ridiculous. Some things can be done during transport. Just think of how it looks to the family or bystanders. The ambulance comes screaming in, the medics jump out, grab their stuff and go in. Do their thing and wheel the patient out on the stretcher. Load them into the ambulance. Then sit there, and sit there, and sit there. If you do spend a while on scene, let the family know why at least. It is the professional thing to do.

Education I like to learn, I can sit down with a manual and just read it. But when I was attending class, there where something’s our instructor covered real fast, saying we don’t need to know it. But then, it was on the test. And besides, why would it be in the book, and on his syllabus, if it wasn’t important? Maybe this was just my instructor, I do not know. As I am new to EMS, this may be just me. But from what I read online, it is a big deal. The US in general could revamp education.

EMS2.0- This is a big topic for EMS bloggers. And I figure it is my turn to chime in. Some people look at ems2.0 as expanding our box and scope of practice. I figure, we a need new a box. A lot of the old timers in EMS don’t think anything needs to change. I disagree, we should be able to transport to Urgent Cares, time on scene should be modified, education should be revamped, BLS providers should have capabilities such as the King airway. But none of this will happen while we are looked at as “Ambulance Drivers”. To get EMS2.0 to truly take effect, we must get the publics support. Until the recognize this as a career, and demand better care. It will not happen. The more EMS providers we got onboard, the better. But with out the publics support, the old-timers will not recognize the need for change.

Thoughts? I would love some feedback.

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Comments
  1. Kelly says:

    Zach,
    I have enjoyed reading your blog posts. I do have a few comments on this one. First, could you do a list somewhere of what all your abbreviations mean? As just a public person I am a bit clueless on some of them.

    It seems to me that part of the flaw that you cannot change is the hypochondriacs that call for an ambulance because of the sniffles. While being able to transport to urgent care rather than ED might free up ED, it will not free up the ambulances for those truly important calls…in fact you might become even busier as a glorified taxi service.

    Also, the Dad comment. We were not there, but when we did go you will recall they were pretty much in the middle of nowhere compared to where you and I are. I am sure they did the best they could. Also, we always had to take Mom’s retelling of events with a tablespoon of salt (not a grain of salt).

    Thanks for the post, I do like reading your thoughts and they are well written.

    • zterwill says:

      Kelly
      Thanks. Here is a link, you can always ask if the medical term is not on this link. http://www.monroecc.edu/depts/pstc/backup/parabbr.htm

      If a hypochondriac does call an ambulance, that is fine. As I said in my post there is almost always another truck in the area to take the next call. Plus there is always mutual aid available.
      I removed the Dad comment, I had debated on whether or not to have it in there anyways.

  2. […] lowly EMTs can learn from it as well. And I have posted on this before, so if you have read my blog Flawed, then you don’t need to read this if you […]

  3. […] lowly EMTs can learn from it as well. And I have posted on this before, so if you have read my blog Flawed, then you don’t need to read this if you […]

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