X-ray Equipment needed in the Ambulance?

[XRayMan]

Full disclosure:  I work with an x-ray generator company interested in designing a product for use in rapid response units.  That makes me 1) totally ignorant of your world, and 2) biased. 

That said, I'm interested to know from the perspective of those in the field if having access to portable x-ray equipment in the ambulance is needed and if so, whether it should be battery operated or if it could be plugged in to an outlet.

[Just Plain Ruff]

Hey XRayMan, I hear where you are coming from but I'm not of the school of thought that we should have these in the ambulance.  My reason, it's more stuff to put on a already overworked medic.  Splint the injury as found, transport the patient to the hospital and let the hospital sort it out.  I already have enough to do and enough to learn to not have to add X-ray tech/reader to my list of certs.  Plus this will add a new level of billing and expertise that EMS is NOT equipped to tackle at this time.  Heck we have enough time dealing with being called ambulance drivers, can you imagine our brains exploding when we get called ambulance xray machine drivers?  Some of our peeps on this site (most are gone) would have a stroke and then we'd have to call the Strokulance to come get them.  

Who will get to bill the patient - the ambulance company, the medic who reads the x-ray initially, or the radiologist who does the final reading or all three?  Is this an ALS or BLS skill?  What happens if we read it wrong and the patient refuses based upon the incorrect reading and several days down the road the patient finds out that they have a actual fracture and needs surgery?  who pays for the mis diagnoses?  Lots of issues here.  

I vote NO

[rock_shoes]

It's barely possible to justify ultrasound on most units never mind an X-ray generator. Big expense with marginal applicability to practice.

[Off Label]

Radiographic interpretation is an advanced practice/physician level skill that requires credentialing and a formal privileging process.  Out of scope for pre-hospital use. 

[Just Plain Ruff]

One more thing,  our new ambulance we are getting is gonna cost 235K,  if you want to put an X-ray on that new ambulance the cost just went up to maybe 300K, no hospital or ambulance service will justify that cost.