The Argument for ALS Level Care

[mobey]

Due to the introduction of the LP15? Is the LP12 even available for purchase anymore?

Yes... we JUST purchased one..... fully loaded (all options) around $25000

[spenac]

Yes... we JUST purchased one..... fully loaded (all options) around $25000

Check here for refurb units. Might save you some money if they still have them. http://www.progressivemed.com/

[akroeze]

The first draft is up! I eagerly await feedback from you folks. My goal is to have this mailed out this e-mailed out to all of the council by this Sunday evening.

http://home.cogeco.ca/~rkroeze/ACP.pdf

[Arizonaffcep]

Akroeze, I know I'm being picky, but hear me out please!

I thought the letter was well written and at least provided a framework to start from. However, I did see one thing that was not accurate (nit picky part)

"Advanced Care Paramedics additionally provide

-Advanced airway management in both cardiac arrest and non-arrest patients (i.e. Intubation)

-ETCO2 monitoring (measuring carbon dioxide levels being exhaled)

-Removal of airway obstructions by direct laryngoscopy

-12-lead ECG interpretation

-Needle thoracostomy (treating certain types of collapsed lung)

-Intraosseous and external jugular IV access (more ways to get access if an IV can't be established)

-Manual defibrillation

-Synchronized cardioversion (for life threatening abnormal heart rhythms)

-Transcutaneous pacing (for dangerously slow heart rates)

-Cricothyroidotomy ('tracheotomy')

-Treatment of cardiac emergencies according to internationally recommended standards of care

-13 additional drugs (Adenosine, Atropine, Diazepam, Diphenhydramine, Dopamine, IV Epinephrine,

Fentanyl, Furosemide, Lidocaine, Morphine, Naloxone, Sodium Bicarbonate, Midazolam)"

These are not the same thing, and it seems to me that they are being presented as such. Please be careful, as this is a VERY important issue (getting ACP's, not if it's technically correct description). The reason I bring this to your attention is that if you send it with this, and there is someone who does know the difference, then it threatens if not really diminishes your credibility. It might read better if it reads something like--

-Cricothyroidotomy (similar to a 'tracheotomy')

or

-Cricothyroidotomy (which is a surgical incision in the neck to create an emergency airway)

or something similar. Just a thought! Good luck!

[akroeze]

You're right.... I was trying to simplify it but in doing so became inaccurate. I will correct that part for the next draft.

Thank you.

I want all forms of feedback as this IS such an important issue.

[rock_shoes]

The first draft is up! I eagerly await feedback from you folks. My goal is to have this mailed out this e-mailed out to all of the council by this Sunday evening.

http://home.cogeco.ca/~rkroeze/ACP.pdf

Great letter. I see you have already added in Arizonaffcp's suggestions. A little proofreading (noticed a couple spelling/grammar errors) and you'll be all set. This is a cause near and dear to me. My home town is also without ALS coverage and is of a great enough size it should. The difficulty here in BC is that I'd have to convince BCAS the sole EMS provider not just my local municipality.

[mobey]

If I also may add my 2 cents.... break it down as simple as possible eg:

1st year $42,140 / 2000 calls per year = $21/ call

Subsequent years $30,000 / 2000 calls per year = $15/call

When put like this it seems like a pretty petty amount of money (pulling on heart strings)

This letter looks like something that is fit for a newspaper if things do not go your way (although that may be career suicide)

Another thing you can do is play with data..... XXX EMS responded to X amount of calls where pain control was indicated

XXX EMS responded to X cardiac arrests, current studies show ACLS intervention improves patient outcome by X%

[akroeze]

If it isn't too much trouble could you identify the mistakes to me? Proofreading your own work is far inferior to someone else doing it as you made the mistake the first time because odds are you thought it was right

[crotchitymedic1986]

I agree with mobey, you need to bring it home. Somehow you need to show or define "the need", by saying something like in 2008, 27% of our patients (x number) needed ALS treatment but didnt receive it. Or when a neighboring province changed to ALS, they saw "xyz" improvement the following year. I know that is far more difficult than writing a letter, but if you want to succeed you have to convince them why they need to spend another 40-50k --- they will say, we havent heard any complaints about the current service level, why change ? In the US, you would be supported by the fact that you would increase revenues by offerring this level of care --- you have shown the cost, you havent shown the benefit.

[rock_shoes]

You asked for it Akroeze :wink:. Here are the changes I would make.

Primary Care Paramedics generally attend a 2-year college diploma program at a community college although several 1-year programs do exist while Advanced Care Paramedics take an additional 1-year certificate on top of their Primary Care Paramedic diploma.

This is a bit of a run on sentence. I would suggest breaking it up.

Primary Care Paramedics generally attend a 2-year college diploma program at a community college although several 1-year programs do exist. Advanced Care Paramedics take an additional 1-year certificate on top of their Primary Care Paramedic diploma.

For brevity's sake I will choose several key items to expand upon in the coming paragraphs in order to demonstrate the benefits that Advanced Care Paramedics would provide to Chatham-Kent.

This sentence seems to run and is a little wordy.

For brevity's sake I have chosen several key items to expand upon. These key items clearly demonstrate a few of the many benefits that Advanced Care Paramedics could provide Chatham-Kent.

In my previous example the patient wasn't pumping blood from their heart, a patient having a seizure isn't getting oxygen to their brain.

I would put a period after heart and make this line two sentences.

What I list below is what it would cost to initially stock the minimum amount of equipment required to have 24/7/365 coverage by one Advanced Care Paramedic.

I would say one ACP unit as opposed to one ACP.

All in all it's still a great letter. I think Mobey's idea of throwing in cost per ALS run figures could be a good sway.