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I think this is an age old problem for all ems services worldwide. The biggest problem is we have to cater for a worst case scenario & as such expenses are high. Imagine the outrage if we were not dispatching multiple resources to an MVA & only sending one to find 4 patients or worse? We work in a reactive industry & there is no way we can beat this into politicians heads. The only way to force change is for an eminent person to be seriously injured & have an inadequate response. Are the same questions of profitability put onto police? They have more opportunity to generate revenue than we do. If you find an answer let me know. :shock:

I work on a small rural station, we make sure our vehicle is clean & stocked after each case. In between we try to have some fun with the nurses (the station is at the hospital), watch TV or play on the computer, as well as study. If we get bored with that we go for a drive & look at the scenery.

I have but once. We were called to a male pt with a history of bowel cancer. Turned up at the address & was hit by the stench of Melina as we walked through the door. Got to the patient & he was unable to control himself & was farting constantly, however each fart also contained fresh blood that was bubbling. So far so good. We knew he was a transport for palliative care & loaded him onto the stretcher, got him outside & into the truck & the bacon & eggs I had had for brekkie an hour earlier decided it was better out than in. Ended up driving to the hospital with the widow open & my head out the window. No a proud moment, but hey it happens.

I think that we need to maintain perspective & look at what tools we are given. The most important of these is our protocols and, to ensure we 1. do the best for the patient & 2 CYA, we need to follow them, irrespective of religious beliefs or not. This does not mean we blindly follow the book, but to refuse treatment to someone because you have a religious objection in my opinion is reprehensible. It is your choice not mine to take this stand & your beliefs should not be forced onto me as your patient. Also, here we are in the worst case, answerable to the coroner who would defer to our protocols & tell us that we are to use them and if we don't agree with them, argue for change showing clinical proof and outcomes resultant from alternative therapies or leave. Stay safe

Our protocols stipulate here that for extended transport you are to take the pt off the spine board as roads etc could cause more spinal damage en route

Because our country is so sparsely populated, rural areas are large. Our station has 3 full time staff on 7 day rotating rosters & our area covers approx 400-500 square kilometers. A lot of that area is only accessible via 4WD and we have specialist equipment for it. We generally have 2 on shift each day.

Our service has discontinued use of all PASG in Metro areas although they are to be used in metro ongoing at this stage.