One Technological Advance You'd Like to See in EMS

[UMSTUDENT]

Over the summer, while sitting in an unfamiliar hospital, I was reading a Popular Science article that made mention of a new type of device being developed in the U.K. for use on ambulances. The device uses "the properties of light to detect infectious diseases such as pneumonia and Tb." The product is being developed by a company called "Smart Holograms" in Cambridge, England.

Description:

"A drop of blood is placed on a sensor embedded with a hologram, a polymer film imprinted with dots that refract light. If target bacteria are present, they bind to receptors; the reaction makes the film swell, changing reflection."

"The Upshot:"

"Emergency medical technicians will use a handheld scanner to diagnose bacterial diseases in the field."

Source: Rosenwald, M. (2005, September). Will You Be Able to Predict--and Prevent--Your Demise? The future of diagnostics. Popular Science, 267(3), 57-63, 119.

Are there any technologies that you would like to see in EMS? Perhaps more diagnostic materials, better stethoscopes, better stretchers, or safer ambulances? Kind of interested to see the response from everyone here.

[Ridryder 911]

Maybe if we had better educated Paramedics then we would have the other to follow. We definitely are our own enemies... and close our minds if it does not fit within our box or perimeter. As one who started in the dinosaur age, I remember we used to tease each other as being "pioneers".. oh, how true it was. But, we never had the vision to limit or box ourselves in..not like I see some of the new members of EMS now. If we had you would still be wearing white smocks and both would ride in the front of the ambulance.

The drive of being a true profession and providing care does not appear as strong as it was in the beginning. Now it appears to be more egocentric than as a service to others. This is not being of professional versus volunteer, but in general of "what can I get out of it" rather, what do I need to do, learn and educate to provide better patient care, as well as develop my profession.

Hopefully, as the profession matures, we will see more research and development for our profession rather than absorbing from another medical profession.

Be safe,

R/R 911

[AZCEP]

As it stands right now, there are plenty of tools in the box. The problem is more a matter of having enough providers that know how/when to use them.

As an example, only using capnography on a cardiac arrest patient. Why not use this device to prevent the arrest in the first place?

I agree with Rid. We have to get past the appearance that we are minimally educated, and shouldn't be expected to know too much. Whether you like it or not, we are practicing a very specialized form of medicine. It just so happens to have some fairly significant restrictions because of size and weight of the equipment that we must use. There are very few people with higher levels of education-supposedly-that would be able to function in our environment, with the equipment that we have.

[Nate]

Since I was only allowed to select one option, I picked "better education" as my choice. The reason behind this is because I feel that our current level of education for paramedics is not enough. I do not feel that a paramedic can be produced in two years when we have the ability to extend the education. Personally, I believe that four years of college/training and four years of clinical rotations is a good start.

The second thing we are going to have to do is provide better education for the EMT-B and EMT-I as well, and make it so that an ambulance has to have a paramedic. Otherwise, I fear that services will staff only EMT-B and EMT-I for the simple fact that they are "cheaper" to pay then a four year degreed paramedic. Texas has delt with this issue for some time, and the number one road block that we have is small municipal services that do not want to see this happen.

[SSG G-man]

I chose "other." I think that better educated Basics is as important as better educated medics. I do not necessarily agree with staffing every ambulance with Medics. Did we need a medic on the call the other day for a teenager with a sliver of wood in her foot? I think that would have been a waste! I would like to see Basics get more training, but I think we need to keep it reasonable, or we are going to end up short-changing the public when they lose coverage because localities can not afford to pay enough medics. The county I live in is semi rural, only one hospital and all fire and most EMS is volunteer. The county is getting some paid medics and putting them where they are most needed when they are most needed. Most of the paid units are a EMT-B to be the driver and the EMT-P. My station is going to get a paid crew to be there from 8am to 4pm, which is the period of time when we have the most trouble getting a unit on the street. I don't think the county could afford 24 hour coverage at every station in the county!! If you put too many restrictions on all this, stations are going to close because they can not get enough crews to be viable and the citizens will lose!

[Dustdevil]

Did we need a medic on the call the other day for a teenager with a sliver of wood in her foot?

She doesn't need a basic either! She needs her mom to get off of her fat ass, quit watching Oprah, and drive the girl to the doctor's office, if the girl is not old enough to drive herself, that is. So, your example doesn't really work.

And the excuse that so many rural services are volunteer doesn't work either. That's like saying we can't have paramedics because we don't have paramedics. Well duh! The point is to change the status quo, not to accept it as a fact of life.

And the monetary concerns are bogus too. You don't see the county or city running any other positions or services with volunteers, do you? There aren't any volunteer city secretaries, water engineers, mechanics, road maintenance crews, janitors, or lawn mowers are there? The police and sheriff aren't dispatched by volunteer dispatchers are they? Do you think the school bus drivers get up at 0500 everyday for free? Hell no. Yep. There is money. Plenty of money. They just don't think YOU are worth it. And you know why? Because any idiot can pass a 120 hour EMT course. And more than half of those that do are perfectly willing to work for free because they think the lights and sirens are cool.

The nurses at that little bitty hospital you are talking about somehow managed to go to nursing school. And I can assure you that most of them weren't from rich families. The cops all managed to finish a police academy. So don't tell me there is no way that the people can get educated. It's all bogus. It's mindless excuses for the inexcusable.

Patients who need ALS need ALS now. They don't need it twenty to thirty minutes after first calling for help. They don't need it after some advanced first aider called a EMT does an incompetent assessment to determine whether or not the patient needs something that he doesn't even understand. And that is the BIG problem with this whole theory of tiered response. Basics are simply neither trained nor educated enough to determine who needs ALS and who does not. Hell, as evidenced by a lot of the stories here, a good many medics aren't even capable of doing it!

So no, there is no need in transporting EMS for "better basics." There may be a need for better first responders, but in transporting EMS, the need is for basics to be replaced by paramedics so that people will get the care they think they are getting from watching television for the last thirty years. And those paramedics should very definitely be much, much better educated than they currently are.

[UMSTUDENT]

Since we've beaten the education thing to death, let's assume that every paramedic in the country has at least an Associates degree. Now what would you like to see? Vote as before.

[Dustdevil]

Meh... I'd still have to go with better educated paramedics.

But after that, I'd be all over safety. Them boxes is dangerous, inside and out!

[Nate]

Eh, I'd work in the country if the pay was worth it.

[Ridryder 911]

It does not matter how many toys you give a medic, if they don't know how to play with them. Knowing, how, when, and interpreting the readings, is what really matters. It is like the Docs that read the "idiots interpretation" on XII leads, basically idiots.

So basically your equipment is only as good as the person that uses it...

Be safe,

R/R 911