What is the best EMS system model

[kevkei]

The best system is one that professionally and competently services the needs of their community.

I think that this is one thing that is commonly missed. Each service, municipality or location has their own needs and factors. What works in one area is not guarenteed to work in another.

How about thinking about what is in the best interests of the people that utilize the service?

[tniuqs]

I think that this is one thing that is commonly missed. Each service, municipality or location has their own needs and factors. What works in one area is not guarenteed to work in another.

How about thinking about what is in the best interests of the people that utilize the service?

An excellent point my friend and every area is very different absolutley agreed ... but logically the next question would then be: Just WHO knows what is in the "best" interests of the people ... the government either federal, provincial, municipal ? .... or the hospitals ? unions or paramedic association(s) "of very loose sorts" should we let the MD's ? those who have never worked in the back of a truck call the shots either? Or matbe the hospitals boards that we all know are run by bean counters only.

Involvement of Fire Deptment should be extracation or when one needs more hands ... not just because they carry a 'flash box" or O2 to every trouble breathing call to boost their response stats, send another gut wagon not a 50 ton sprinkler system ... sheesh.

A side note .. yah know if we made sprinkler systems mandatory in EVERY new building, heck go one step further and retrofit all building's 10 years old ... most likely many funds could be released to provide improved level of services to EMS / Healthcare overall, we would not need anywhere near the vast numbers of FFs on a nation wide basis.

In our "hood" recent events are now seriously challenging what is the best system for EMS with a new "transition concept" (all warm soft and fuzzy) but no tangible plan, well unless complete privatization is the goal (and ye gads sure looks like that in my crystal ball right now) ... sorry to digress but we in Alberta are very shortly, like APRIL 09 face a supossed huge overhaul/ transition and all that I have witnessed (so far) has resulted in a COMPLETE standstill for any development to improve EMS (and many fire based EMS services are witnessing a huge jump by medics to fire side ONLY) ... the devide and conquer technique of union busting and fracturing a system that once was a fairly effective model, well this has all been stopped DEAD in its tracks ... or maybe completely derailed now with the threats of cutbacks with the downturn in the economy.

cheers

ps there is no perfect system .... but there is lots of dumb ass systems out there.

[Ridryder 911]

As one that is very familiar with OKC and Tulsa, one of the first things is ensure that EMSA treats their employees well and remove the "EMSA way" attitude. Unfortunately, many believe that it is the only way and have never worked or explored elsewhere. Actually I have never seen them not hire anyone that was closely qualified; true they may wash out in the academy but they were hired. Attempting to teach in-depth care is frequently difficult at times. Mainly because it is a strictly protocol cookie cutter system. I don't know if having one medical director over everyone is also a good idea. Too many hats for one person (OKC FD, Sheriff, EMSA East & West, Tulsa FD, etc). We will have to await and see how the new one turns out.

As usual, every five years or so the Fire Department makes it ugly head stick out to want EMS. This time they planned a little better, but from my personal resources do not plan until about another three to five years when they are more staffed. Of course no one wants to discuss the costs that it would be to promote the change. With the city budgets being crunched and the new water surcharge many may not want a change feeling they are paying enough! Some of the responding companies are okay, but unfortunately the experienced ones allow the Paramedic expire since the pay incentive is no longer attractive after ten years, why keep it; when you are already making a great salary? Unfortunately your union is not the best representation as well and never has been.

In regards to SB 357 it is not an active bill. It will never change metro areas EMS services. I do not who informed you of such there are four current bills in legislation. http://www.ok-emscoalition.org/legislation As Monday is legislation day, please inform all peers if possible to be at the State Capitol 0830 Blue Room. There is only four but important legislation bills in place.

I don't disagree with some of your recommendations. Yes, more units is needed but alike anywhere else in the metro area everyone else is responding 10-12 calls per unit. The advantage is you get to go home after 12 hours. Twenty four trucks are and should be a thing of the past unless you are in the very rural area. Pull 24 and respond to 12 calls but have a turn around over an hour, it's the same. Your extremely tired and worn out. Even in those areas you discussed are too busy for a 24 hour truck.

What many administrators fail to understand is the shortage. Many assume that it will soon pass and I can assure it will not. Right now, Paramedics have an opportunity to change the systems but most will be involved.

I wish you the best of luck.

R/r 911

[Arizonaffcep]

A side note .. yah know if we made sprinkler systems mandatory in EVERY new building, heck go one step further and retrofit all building's 10 years old ... most likely many funds could be released to provide improved level of services to EMS / Healthcare overall, we would not need anywhere near the vast numbers of FFs on a nation wide basis.

Only problem I see with this...first, it would decrease even further the number of fire runs FD's go on. Second...it would force them to further justify their budgets and lack of calls, etc., forcing them to take over more EMS!

[JPINFV]

Come on a 26,000lb truck flying down the road for no intended purpose. Whats the problem?

Brakes failed while returning to the station. One fire fighter killed. Yes, the ladder truck was on a medical call.

[triemal04]

Only problem I see with this...first, it would decrease even further the number of fire runs FD's go on. Second...it would force them to further justify their budgets and lack of calls, etc., forcing them to take over more EMS!

Actually...the 2009 NFPA Fire Code/Uniform Fire Code now requires sprinklers in all new residential construction. Not that every city follows that code, but hey...it's out there...

On topic, the best system I can think of would be a fully-funded third-service that still allows, one way or another for an adequate number of providers to be called to a scene when needed. If this means that a second ambulance is called for say, a code, then so be it (though that would mean that the system is now short a unit that could otherwise be used...unless they are over-staffed...and I know how much people hate that), or, if needed, call for an engine company from the local fire dept. Regardless, and no matter what people's personal opinions are, cooperation with the fire dept is still essential, because like it or not, both will be going on the same calls, albeit in a perfect world that number would be pretty small; MVA's, possible codes, extra manpower needed, technical rescues and the like.