VentMedic

Do you know this for a fact? I would hope you are not one of the commentors at the end of the news articles. Even still, the FFs failed to look. This could easily have been a child. It doesn't matter what the guy's intent was, the FFs did NOT look. As spenac stated, 15 seconds isn't much but if it saves another life, it is everything. Don't be stupid as well as careless. Arguing against safety when you are public safety and then preach this at the health fairs is stupid. This is almost always mentioned by FF/Paramedics to the lay person about checking around their vehicle before moving. Practice what you preach as a public safety employee.

Forced? You realize that most of the other professions have learned to encourage a degree higher long before it happens. Forcing is counter productice. This conversation about education proves that. I don't see how my statment is incorrect. Don't teachers also have to take a certain amount of continuing ed to keep their certification? Does you wife not find it strange that a Paramedic with a 6 month education can make more than what she does with a 4 or 6 year degree? Our teachers in FL average $42k per year. The teachers had 6 years of college to "choose" their career path but yet they still did the education time. Does you wife believe her education is necessary or that it was a complete waste of time and does little to benefit her students? Maybe a teacher's assistant with a few weeks of training could do just as well as your wife. Do you think the parents would want someone with a few weeks of training teaching their kids over an educated teacher? It is unfortunate that the wages of the teachers are so low compared to their education and that they no longer enjoy job security. But, many of those who have been laid off have easily found employment due to their education. Here are the numbers for one county that has a third service and FDs. Starting pay (based on experience) is as follows: Part time EMT : $12.41 - $17.70 p/h (maximum 160 hours per 2 week pay period) Full time EMT : $44, 525 - $65,478 annual Paramedic I : $46,845 - $68,890 annual Paramedic II (credentialed) : $49,187 - $72,334 annual Paramedic Company Officer : $55,077 - $80,995 annual * Paramedic/Firefighter I : $52,220 - $76,794 annual Paramedic Firefighter II (credentialed) : $55,875 - $82,169 annual Paramedic/Firefighter Company Officer : $72,615 - $106,787 annual * Even healthcare professional must do continuing ed as well inservices just to stay current. I can easily clock 300 hours every renewal and spend over $3000 out of pocket besides what my employer pays just to stay at a working minimum. I guess what I find appalling is that those who argue against even getting the education for themselves is their failure to see where it could benefit their patients. Those in the other health care professions understood whatever excuses they could offer against education were useless as soon as patient care was made the issue. The primary reasons education for healthcare providers in other professions was raised were for patient care and safety. The higher wages just happened to follow. EMS seems not to be looking at what it can do for the patient but what the patient should do for EMS. This selfishness is the true downfall and failure of many EMS systems whether they are FD based or whatever. The NR is ONLY a testing agency. Every health care profession has its own national testing agency. The difference between other health care professions and EMS is the others use their national exam exclusively in every state where as EMS does not. Some states still have their own EMT and Paramedic exams as well as many other levels of certs inbetween. EMS needs a strong national association. The educators need to raise their standards and encourage more instuctors to take part in their national association. No buck passing. The NR is doing what it is contracted to do...write and adminster tests. RT has the NBRC. RN has the NCLEX. PT has the NPTE. They administer their credentialing exams nationally.

If the fire stations in Florida were just fire stations I might take a slightly different stance but even then they are "public safety". The FDs have been providing EMS for many years, doing BPs checks, hosting public safety fairs, have a first-aid symbol out front and are considered a safe place to drop you unwanted baby. People pull into a fire station quite often if they see it before a hospital. People in the neighborhood walk to it if they are feeling ill rather than calling 911. Thus, it is no surprise if someone who needs help of any type might stumble to a fire station. If this guy wanted to commit suicide, there are many other ways to do that in Florida with the busy highways and overpasses. And even if he was suicidal prior to the fire station it doesn't mean he didn't have second thoughts and realized what was going through his mind for ending his life. Thus, again the fire station could have been his destintation to get help. I don't agree with the comments I have read and heard first hand about this guy just being a worthless. If this person had been some prominent business man jogging by who experiences chest pain and lands in front of the door, this conversation would be different and the focus would be on safety. The discussion would not be about why a drunk landed where he did. I haven't seen a pay phone here in Florida or California in at least 2 -3 years possibly longer.

You actually want to compare a 3 month wonder or even a 6 month wonder Paramedic with an RN who at least did a 2 year college degree? The Paramedic takes a PDQ course with a few hundred hours of training at a tech school without even a college level A&P cours required. That Paramedic may stay at that same "tech level" of entry without ever advancing their education. The RN already had to get at least a 2 year degree with many students now opting to get a BSN without even being made to do so. Does that not say alot about how the Nurse perceives the importance of an education for quality care as well as preparing for the future? Even if that RN stays on a low acuity floor, he/she still has the education to do whatever and understand the care being provided rather than just reading protocols. There are so many things a Paramedic could learn. I can not believe you would pick something such as decompression sickness and ND. What about Pharmacology? Vasular access devices? Cardiac technology such as VADs? IABP? A&P? Pathophysiology? Hemodynamics? The one little text book used for the Paramedic class does not even begin to address these subjects in any depth. Actually, it barely qualifies as a basic overview for most of these topics. But then, there is just so much you can do in a few hundred hours of training. Are you only on a 911 service with no opportunity to see IFT patients of high acuity? There are 911 services that also do CCT. What is sad is when the Paramedic must watch the RN set up all the meds on their pumps with hopefully enough medication to last to the distination hospital. The Paramedic can only look at the pumps but NOT touch. If the line gets occludes or beeps air in the line, the patient just won't get their IV med during transport. Of course there are other places like CA where the Paramedic can not even monitor most meds and the RN is told to accompany the patient. But, what medical director would be willing to put his/her license on the line for Paramedics who barely have 6 months of training and don't have the ambition to even take a few college classes that might make them a little better educated. So I just find it absurd that you would pick such a lame example when there are so many things for the Paramedic to learn. Maybe we should have left EMS with the embalmers and funeral homes. I believe they have raised their education level without all this fuss. Even for the dead they still believe in providing a quality service with knowledgable providers. Exactly! Those who are waiting to be told to get at least a college level A&P class are doing this profession a great disservice.

But for EMS, the 911 medic is the entry level. Many go straight to that position after a few hundred hours of training. Since services vary, their overall experience may be rather limited. They may never advance in protocols or take additional education. They may never do a CCT or see many drips. California Paramedics are a good example of this. Thus, it might be the equivalent of a nursing working med-surg in a very "slow" hospital that ships anything but "clinic" patients to another facility. Nurses with CCRN or whatever have advanced beyond their basic training. For choosing a flight team Paramedic, which do you think would be better? Someone who works many calls each shift for a busy service but with limited protocols and nothing but the basic Paramedic training? Or, someone working in a rural area who has taken college classes as well as extra certs to gain knowledge and has expanded protocols to do ALS CCT to the city hospitals?

Your statements led me to believe you did not read my posts as I did not say the 4 year degree should be the entry level. Associates will do to start. Teachers don't make much more than that and they make their decision to go to college on purpose. Many entry level professional jobs in the working world start out low. Health care just happens to be in demand and those that meet the requirements desired by the insurances will gain. Do you honestly think a higher wage is going to encourage some to go to school? Why should they if the money is flowing in? Again, review the history of EVERY other health care profession including nursing to see how they have accomplished their status. EMS is now well over 40 years old and other professions have made their stance noted, with education in as little as 15.

Since my background is as a FF and an educated one, I think you haven't seen all FDs to speak in such general terms. I graduated with an A.S. degree in 1979 with a degree in EMS. I then finished another A.S. and B.S. degree while working in the FD. Not once did they try to stop me. In fact, the degree was highly encouraged and there were many community colleges that offered it during the 70s and 80s. The private ambulances had just as big a part as the FDs in encouraging medic mills. EMS had every opportunity to have the 2 year degree as standard even before nursing if it had not been for the greed of the private ambulance services. FDs had yet to start taking them over. Fire Fighting is largely a tech job. However, that does not mean there are not degrees offered in it also. Welding and plumbing are tech jobs also and now there are degrees offered for them. However, do you really want to compare the complexities of the human body to fire fighting, welding and plumbing? I will admit I do not like the way the FDs have gone with making every FF a Paramedic. But then, the low education standards have allowed them to do this. Face it, at as little as 600 hours to be a Paramedic in some states, it is just a "cert" like all of the others they "train for". Now that there are more studies such as the intubation one from Miami which acknowledged some FF/medics only get 1 tube a year if that, I think they might, hopefully, start to rethink the way they choose those for the EMS part. Just like any of the other health care professsions, once the degree was made mandatory for entry level, that is what it took to get the license. Period. Hospitals probably didn't like it either when the LVN was forced to upgrade to RN or be bannished. LVNs are cheap labor. But, the hospitals adjusted. I also had an RT manager tell me he saved $250,000 by only hiring certified and not RRTs. Of course that department wasn't that much to brag about either. Guess what? He had to change his budget and get creative just like all the other RT departments had to find that budget. His department finally came to life and acquired the technology and took over services to exceed what they needed to maintain budget once everyone was RRT. Again, all of the health care professionals that work at small rural facilities have had to get educated. Don't expect the IAFF or anyone to spoon feed you. I personnally find this whole discussion and reluctance for education just a tad weird. My parents started saving in the early 1960s for me to get a college education to have more opportunities than what existed in a small town. Myself and my friends all started saving for our kids' education shortly after they were born. This was not just for a "cert" but at the very least a Bachelor's or Masters' degree. If any of them wanted to be FFs and/or Paramedics, they could do it with an education just as easy as without one. When I sign with my alphabet soup, I put my highest education level first and then the licenses or specialty certs if they apply. The reason the education is listed first is because it is the one thing nobody can not take away from you. Certs/Licenses can expire or be revoked and jobs can be terminated or changed. You have just proved my point with your statement. Changing the minds of those who oppose education but do not have an education to know exactly what they are opposing may never happen.

So are you saying that those working in the hospital don't need none of that there book learnin' stuff? Your paragraph here makes absolutely no sense. RNs, RRTs, PAs and NPs already saw their need for advanced education to work outside of an ED or ICU. This could also bring us to the Paramedics that attempt to do CCT half-arsed with a pathetic 80 hour overview of a few basic concepts that pertain to ICU. No Paramedic should be allowed such responsibility without more education. At least that is one thing CA did do right by having predominantly RNs on CCTs and Flight. That state at least knows its Paramedics are not educated to accept that responsibility. RRTs, Radiology Techologists, RNs and a whole list of health care providers in rural areas have managed to get their 2, 4 and 6 year degrees while living in rural areas. Why is it that EMS seems to attract those that are so incapable of seeking education and use everything they can as an excuse. Believe it or not, education might just bring a change to some of that volunteer stuff. Florida has very rural areas also that were once covered by volunteer. Now it is an all paid ALS state for 911. If you ever get a college degree, it is something to be proud of. Those who have yet to obtain that accomplishment usually make statements like yours. Nobody is asking EMTs to get a Ph.D. Although, if a few did they wouldn't have to use the nurse educators for their academic leaders. An Associates degree is not going to make you an independent practitioner. Why should doctors extend advanced privileges to those with so little education? You are also not going to force a doctor to grant privileges to Paramedics who are not capable of advanced protocols. The type of system, oversight and area will also play a role. Not all Paramedic ALS systems should be doing RSI regardless of the national standard. But, those who are capable can be given great responsibility. Flight Paramedics and some CCTs do have expanded protocols but also have closer oversight and are often extensively trained. Others may just be given 2 hours of orientation in the back room of an ambulance service and that is all. The basic education of a two year degree should be there so the PRIVILEGE of advanced protocols can be granted to the Paramedics by their medical directors. Just because you can does not always mean you or everybody should. Another example: look at what the RNs and RRTs can do on transport for patients of all ages that most Paramedics have never heard of. They also aren't just responsible for that patient in a truck, plane or helicopter for 10 minutes but may be with that patient for 12 hours. They were able to build upon their basic 2 or 4 year degree to be clinicians that can function anywhere. Again, does the IAFF come to you personally and forbid you to go to college? You are using them as an excuse. Once more saw the importance of an education and quality did improve, the 3 month wonders might be scrutinized closer. You need to get past your attitude againt the FDs. And no it is not the IAFF that is keeping your wages low. For the amount of education it takes some to become a Paramedic, you should be happy with what you are paid as those making minimum wage at other jobs involving more hours of training. You might complain about how bad your working conditions or how much responsibility you have but if you even looked at some of the others jobs out there, you might have a different opinion. If you want to try the argument about responsibility for the patient that is invalid also as you don't see it as enough of a responsibility to see that yourself and those around you should have a decent baseline education to see what type of quality care that can be provided. I don't know what it is going to take for EMS to see it is about health care and medicine. It is NOT "so different" as some would like to believe. The only thing that makes it different is all the labels EMS uses for avoid the word "medicine". Thus, all we get is excuses for some to not take responsibility for their own destiny. Waiting for someone (or IAFF) to make you get an education is not the correct attitude or path.

Why do you put so little faith into education? Do you think all the professions I mentioned were wrong and they just got their nice salaries out of the blue for no good reason? Their education made them marketable. Once more EMS professionals start taking their own careers seriously, the IAFF will not be able to keep their strong stance. The more you use the IAFF as an excuse for not continuing your own education or discouraging others, the longer they will have a say in YOUR career. If you have not gotten higher education, it is difficult to sell this concept you. If you have never attended a committee meeting at the state or national level, it would be difficult for you to understand how professions are evaluated. For RT at a national level, we can say all RTs entering the profession must have an Associates with a large percentage now having a Bachelors. This is the push we have made for a Bill that puts the RTs with a Bachelors or Masters as an Independent Practitioner realm for reimbursement for certain services. That bill in now its final stages of reimbursement. For EMS at the national level, "we have 50 plus different certs and for the Paramedic level the training starts at 500 hours and one state does require a degree". Now which one sounds better? Yes it is about marketing but only if you allow lobbyists like the IAFF to rule YOUR own destiny. The more in EMS that realize the IAFF does not control what education they get, the sooner the educated can gain some ground. Once RTs took control of their own destiny, all that was left was signing the paperwork at the state and national levels for the Associates degree. The RTs themselves did all the preparation prior by getting their education as they saw a benefit to it for the profession and to their patients. Now, most see how lacking we are with just a mere 2 year degree in the world of medicine.

You are making $14 dollars an hour because the Paramedic has not achieved professional recognition in legislative issues that concern the insurances. With over 50 different certs in EMS and all of them at a technician status there is no way for the legislators to even figure out what exactly a Paramedic is or does. This is not about advertisement. This is about achieving professional status that is recognized by the insurances. Do you realize that for the "tech" health care programs, there are only the Medical Assistants, Nursing Assistants and Paramedics left. The EKG techs have moved on to the 2 year CVT and the Massage Therapists are now petitioning for the 2 year degree in many states. For goodness sakes it is only a 2 year degree that some are discussing for the Paramedic. But, it seems that it will be a long time with the reluctance that exists. Do you realize even nursing and RT are embarrassed by having a mere 2 year degree for entry into their profession? Thus, both professions are pushing for as many of their students to get the Bachelors. RT long ago saw the 2 year was going to be the minimum and started pushing people in that direction long before the change took place. RT, SLP, OT, RN, PA, PT, NP and MDs are not crazy for getting degrees and lavishing in their professional status for reimbursment. How many of them still make $14/hour since their profession achieved that? And, while times are rough, do you know the number of people that are still willing to make the sacrifice to get a decent education? You could also look at any other profession. Bookkeeping cert from a tech school or Accountant with a degree? How about teachers? Most require at least a 4 year degree to teach 1st grade and usually a Masters. But yet for the Paramedic we are content with 700 clock hours of training from a tech school. Cosmotologists, Massage Therapists, pet groomers and manicurists require 2x more clock hours than that for their tech schools. The fact that some even want to argue that is "best" for the patient gives the wrong message about EMS to those that hold the purse strings of reimbursement.

What's another gas in the toolbox of RT... I have heard rumblings about this from UCSF but it is still a long way off from a definitive trial in humans. But, we still have O2, CO2, Nitrogen, Nitric Oxide, HeliOx and a few others to use in the mean time and that doesn't include the ones from the OR that occasionally find their way to the ICU. Some of these gases haven't been around that long either like Nitric Oxide and was controversial. Some hospitals are still afraid to try it. Others don't leave home without it on transport. I also will remind those in EMS not to take it for granted that the tank the home care patient is running is oxygen. You might be surporised.

No misunderstanding there. All one has to do is look at almost any college catalog as I did for the definition and explanation. Usually those that have not spent time in a college might not understand the difference between "tech school clock hours" and "college semester credit hours". To require every FF to be a Paramedic is not practical. To require someone to be a Paramedic without all the inbetween steps is the only professional thing to do. There shouldn't be the "sorta like but not really" patches that have cluttered the profession. You either want the responsibility of being a Paramedic or you don't. Of course, the AEMT is an improvement for entry level but no more EMT-Is, Bs, Cs, Ds, or whatever. Actually, it matters alot. Thus, the word professionalism comes to be. Why do you think all of the other health care professions got their training out of the tech schools? There is no correlation with any degree or degree of standards. Why do you think even the traditional tech trades like welding and coal mining are now in the colleges? It is much easier to place a value on a profession when there is a consistent analysis for the education and time spent in a program. Insurance companies don't want to hear it took someone 2 years to do 700 clock hours of training. They want to know how that relates to the Federal guidelines for education which the code was updated a few years ago. Thus, the other professions have made sure their programs are in compliance which gets noticed in committee meetings for funding through the insurances such as Medicare. Once EMS gets over its hang up about education, the reimbursement may follow for "professional services" and not a tech level. As far as quality education, many of the EMS programs have one instructor who only has the same cert as what the students are trying to obtain. Thus, EMT-Bs teaching EMT-Bs and Paramedics from medic mills muddling along trying to explain A&P. Thus we get "lido numbs the heart" and "CPAP pushes lung water". Those who often judge a Paramedic program may do so by how easy the insructor is or how laid back the clinicals are around the coffee pot or on the ALS engine sleepover. Often the instructor who tells all the exciting stories about "Trauma" like situations gets nominated teacher of the year because he/she didn't waste their time with the boring physiology crap. Yes, there are so good tech programs out there but those schools do not give a health care profession the qualifications it needs to be recognized in the world of business and medicine. It is time EMS education stops taking the path of least resistance. The college programs may hold both the student and educator more accountable in the long run. If we don't start to change at least the qualifications for the instructors so they can be recognized as educators, EMS will continue to accept the lowest common denominator as the standard.

If the U.S. BLS was the equivalent of BLS in other countries, this would not be such as issue. Those in the U.S. who try to argue for BLS have attempted to use the OPALS studies which used the BLS qualifications for that area of Canada. Their education and training is longer than the ALS Paramedic in the U.S. Increasing our BLS eduation and eliminating "inbetween" levels must happen to see any advancement in the U.S. system. The patchwork, make do stuff has go to be eliminated. The EMT-B is wrong for MEDICAL transports. The medically complex patients need someone who is educated/trained for medical situations with knowledge of disease processes and not a first aider. The EMT-B's clinic time would also be better spent with a hospital nursing assistant logging in a couple hundred sets of vitals on many different types of patients as well as learning to move medically complex patients with brittle bones and many tubes or lines. The skill of communication between provider and patient might also be acquired. Sitting around a coffee pot waiting for a cool trauma call that may never happen or hanging out in the corner of the ED serves very little purpose for educating/training one to adequately and appropriately care for a sick elderly patient. The fact that many will transport several dialysis patients in their trucks but can not tell you why the patient is on dialysis except for "renal failure" or know why some of these patients do need an ambulance speaks volumes of the inadequacies in the EMT training for the job of medical transports.

Incorrect in your analysis. You are viewing the college semester credit hour as the equivalent of "tech school" where the expectation is counted as literal clock hours. The number of credit hours assigned to a course quantitatively reflects the outcomes expected, the mode of instruction, the amount of time spent in class, and the amount of outside preparatory work expected for the class. These consistencies have made it possible for accrediting groups to compare programs at multiple institutions. Additionally, federal and state reporting requirements can be analyzed, achieved, and communicated. For lecture, each classroom hour is expected to have 2 hours of prep work. For lab, each credit hour can be up to 200 minutes per week or almost 4 hours. For clinic, each credit hour can be up to 300 minutes or about 5 hours per week. Thus, a 3 hour class is about 16 hours of clinic per week. When you look at tech school clock hours, they are usually literal. Also, when someone says their program was 2 years long but only 700 hours, there but is a 1 night per week 2 hour class, there is no comparison to a college credit system with the work of an Associates degree. Thus, when legislators attempt to evaluate worth, the clock hour system is not feasible. The other advantage of a college system is the different in educator education. The instructor must meet minimum educational requiremments. Thses same standards are lacking in the tech schools.

But often unless you have a good bedside spirometery setup, you may never know the extent of his bronchoconstriction. The one thing about some asthmatics/COPD patients is they have security issues especially if they have crashed and burned before to buy a ventilator. For some, I can see the validity as I've had patients turn quickly. And like I said about the H1N1 patients, this is an ARDS like I haven't seen in young people for awhile. We had seen ARDS before in young people with serious trauma but even that has been managed better as it is expected. Thus preventitive measures are taken. And yes I can also set my watch by my COPD and asthmatic patients also but with legit reasons. Our QIDs start at 0600 since most start calling at 0630. O300 is a well documented time for nocturnal dyspnea. The same for CHF which is why sleep apnea machines are marvelous inventions. I even find for myself, now that I am "middle-aged", with a little wheeze depending on what I had for dinner and when and can set my clock to what time it will happen.

The one thing I have learned about treating asthma patients for over 30 years is that breath sounds do not tell the whole story. Doing PFTs have taught me a valuable lesson about airway constriction. Wheezes are not always a first sign of asthma. In fact, for these patients, by the time you do hear wheezes you had better be looking at some of the big meds, gases and devices in your toolbox. Often these patients know their bodies than you and if they suggest a hospital admission, chances are they are correct. This H1N1 flu has also fooled a few health care providers. While the lungs don't sound impressive on initial assessment, the CXR tells a different story and less than 12 hours later the patient may go from a 2 L NC to a HFOV (high frequency occilating ventilator) with nitro oxide running.

I can see this being a problem if it is not the "patient" who made the call. What if a well meaning family member, friend, neighbor, passerby or LEO at an MVC/bike/skateboard or whatever accident who just wants to cover him/herself makes the call? What if the patient says they were told by the EMT(P)s they shouldn't go? Technically, that is not their refusal especially if it is done because the EMT(P)s don't have the protocols amd/or the confidence to just state no transport or just don't want to transport. This is were some of those signed refusal forms could be tested if the signature was not properly obtained.

The pneumonia seen in H1N1 is very different than that which the Pneumonia Vaccine prevents. The Pneumonia Vvaccine is given to prevent pneumonia caused by the pneumococcus bacterium. H1N1 flu is especially dangerous for young healthy adults because the H1N1 virus may cause a “cytokine storm” – a sudden release of inflammatory chemicals. This is the pneumonia type infection and inflammation we are now dealing with in the ICUs and which requires the more impressive technology.

The city of SF is just a little over 700,000. There was a number quoted earlier for 1.4 million but that may be the number for the entire county. San Francisco has gotten its ranking now in crime and violence. The Mission District is no longer safe for tourists except from 10 - 2. Bayview-Hunters Point (by old Navy Shipyard) neighborhoods are considered beyond hope for crime...and contamination. Even the Mayor of Scramento, Kevin Johnson, retired NBA, got robbed at Union Square during a visit to SF last week. The gays make up just a very small population in San Francisco. Unfortunately gang violence has hit them directly when it occured a couple years ago at their famous Halloween Street Festival. That party has been shut down which did cost the Castro and the city some serious tourism dollars. I would say it was much more than what the Mayor has forked out to get his wife that tiny part on Trauma. $270,000 for a tent so the crew of Trauma could have lunch is a little ridiculous and that was due to someone not reading the fine print. These productions crews aren't idiots but the eager politicians can be. BTW, Mayor Newsom also has his bid in for Governor so this keeps him and the city in the press. Good or bad it is publicity just the same.

You can read more of Sebastian Wong's comments here: http://connect.jems.com/profile/SebastianWong

Back in the 1970s seat belts were yet to become mandatory. That may have been a reason also for the helmets.

We don't have to. The advertisers have probably seen the Nielsen Ratings posted this morning. It came in below Heroes which is pretty bad. Probably the only ones watching this show are those in EMS who want to see just how bad it is or the young and enthusiastic POV light bar collectors. The rest of the viewing public don't seem to be wasting their time.

Wow! A 3 year adventure? Nice! That is a valid question for someone planning a trip that long. The primary doctor might contact the ACEP (American College of Emergency Physicians). They have a maritime section. I just learned that myself from one of our ED doctors tonight when I asked your question here. http://www.acep.org/acepmembership.aspx?id=27940&coll=1&collid=192 You might also ask your questions on this forum: http://www.sailnet.com/ Other countries may have different laws and also carry medications in different forms for ease of use. I believe Meridan Medical Technologies might also be of help and they may have been at the EMS expo.

A good link for Elder Abuse laws throughout the U.S. and advocacy: National Center for Elder Abuse http://www.ncea.aoa.gov/NCEAroot/Main_Site/Library/Laws/InfoAboutLaws_08_08.aspx If the patient was in immediate danger and was not capable of making any decisions then the PD might need to get involved. However, there is nothing sadder than seeing an elderly person being forcibly removed from their HOME. I have had the displeasure of doing this when working as a Paramedic on ground EMS and you often wonder who the real criminals are. If another solution can be found through Social Services and Home Health to where the patient can maintain some dignity and independence, at least in their own minds, that would be a better situation. Other health care professionals do actively participate in the advocacy for home health and Social Services issues. RT, Nursing, PT, SLPs, OTs, NPs and PAs all have a vested interest in advocating for legislation to protect the patients and provide more services. Unfortunately EMS has not gotten a large voice in this area or they are too focused on their own agendas.

You initate a paper trail and get the names/numbers of all involved. You can then followup with the Case Manager or Social Services or have you supervisor do so. It would be nice to have a system in place like Washington D.C. is attempting (although I believe that is just a media distraction from the real problems in taht department) or have a social services plan of care/action such as Lee County, FL has. You might email Nifty911 and see if he can send you his EMS system's protocols. A few EMS systems have in the past tried to expand their roles in Public Health and also do welfare checks but often those working in EMS view these the same as they do nursing home transports. Lee County used to take a more active role and at one time several agencies were looking to them as role models for the future. At least they still have some contact with the Social Services agencies to provide some followup.