What challenges do you see paramedicine and EMS facing?

[TechMedic05]

Cosgrojo - Been around a while? It was only in the 1950's and 1960's that we were run from funeral homes, and "You call, we haul, that's all." Compared to, say, nursing, we haven't been around all that long. Just now people are realizing what EMS can and should be doing. And just now research is focused on prehospital measures, not just hospital based applied to the prehospital arena....say, like, 2 amps of sodium bicarb as the first line arrest drug.

We have a long way to go, still.

[Dustdevil]

Actually, things were a lot better in many respects during the funeral home days. The service was managed by responsible businessmen who were more concerned with customer satisfaction and public image than they were with turning a profit on their runs. In fact, most of them fully intended to lose money on each run, even if the bill was paid in full. Yet they still managed to give us the latest and nicest ambulances and any equipment we said we needed (which, of course, wasn't much in 1973). Only since Medicare and insurance companies started getting involved in EMS has the industry become overrun by wildcatters whose only motivation is the chance to turn a buck and don't care a thing about their employees.

Any of you guys who think things are better now that the funeral homes are out of the picture obviously weren't around when they were or you'd know better.

[cosgrojo]

Cosgrojo - Been around a while? It was only in the 1950's and 1960's that we were run from funeral homes, and "You call, we haul, that's all." Compared to, say, nursing, we haven't been around all that long. Just now people are realizing what EMS can and should be doing. And just now research is focused on prehospital measures, not just hospital based applied to the prehospital arena....say, like, 2 amps of sodium bicarb as the first line arrest drug.

We have a long way to go, still.

A long time from a business perspective. We are talking about a sector of society that commonly has businesses (and entire niche industries) that last less than a year. 30-40 years is a long time in business to last without proper business management. The importance of EMS and prehospital care notwithstanding, I was talking about the business aspect.

And I don't know whether anyone is going to call us on this, but I just got a chuckle about a 22 year old lecturing a 28 (almost) year old about the way "things used to be." Neither one of us is truly qualified techmedic.

[Ridryder 911]

Cosgrojo - Been around a while? It was only in the 1950's and 1960's that we were run from funeral homes, and "You call, we haul, that's all." Compared to, say, nursing, we haven't been around all that long. Just now people are realizing what EMS can and should be doing. And just now research is focused on prehospital measures, not just hospital based applied to the prehospital arena....say, like, 2 amps of sodium bicarb as the first line arrest drug.

We have a long way to go, still.

Actually, some EMS was in the funeral home until late 70's & some even in the 80's.. from some of us that have been around. And 40 meq/ HCo3 was the inital treatment of cardiac arrest until late 80's... FYI

R/R 911

[chazmedic]

I fear a reduction of EMS services provided. Money is getting tight. Hard choices are being made in the medical field. Medicare is cutting back. Studies are coming out hitting ALS hard. Just look at this site: hits against CPR, intubation's in the field. JEMS and the Military channel both have had stories about prehospital care in Iraq. Both brag about aggressive basic care and rapid transport to the hospital as the life saver. Area hospitals still run commercials about if your having chest pain to "immediatly drive yourself to our hospital". Calling 911 is always the last ditch effort.

I remember a class the local hospital sponsored a while back taught by a nurse from Alabama. It was over neonatal transport. She popped a cork when she found out paramedics were invited. She bragged about how the nursing group she belonged too lobbied a reduction of skills a paramedic could perform. In fact, I can still remember her stating that we should stick to driving and "cot fetching" and leaving the real care to the nurses. I'm afraid the politicians and leaders will choose keeping hospital staff over EMS any day. Most still view us as simply a taxi ride and don't realize the good we can do. Money is always the final decision maker.

Damn, ain't I a downer?[/font:0306e1627e]

[Dustdevil]

I'm afraid the politicians and leaders will choose keeping hospital staff over EMS any day. Most still view us as simply a taxi ride and don't realize the good we can do.

They realise what you can do. They simply also realise you don't have adequate education to be doing it with.

There is not a single problem that EMS faces which cannot be rectified by education. None. Education is the one and only answer to every question in EMS.

[paramedicmike]

There is not a single problem that EMS faces which cannot be rectified by education. None. Education is the one and only answer to every question in EMS.

Can I get a collective, "AMEN!"?

Thank you.

[paraloco]

What I fear will happpen is that paramedicine might be dialed a back a few hash marks to about intermediate level. Not optimal, but most urbans areas could get by with it.

[chazmedic]

paraloco wrote:

That is exactly what I'm talking about. The bean counters don't care about education. They want the cheapest they can get by with. Citizens demand public safety and essential services, but don't understand the costs involved. Municipal leagues will tell cities and counties to reduce fire and EMS back to a volunteer level, no matter the size of the city because it's cheaper. If on the books it's better to run intermediates or basics, they will try. Came up here in the PUM discussions. Remember, a city council member asked "Can't they just call a cab?" in reference to a 911 call for an ambulance. All they expect us to provide is in simple terms, they call, we haul to the hospital. Same as trash guys pick up trash, fire departments put out fire, cops shoot bad guys. Remember, when it comes to money, you have no allies. If the nurses think their jobs are in danger or paramedics are invading their turf, they'll gut use in a heartbeat.

Many will say EMS is not a public safety department. That may be true in some areas, but in all areas EMS is a part of the public trust. The public has an expectation that when they call for an ambulance, one responds. That's the public trust. We must confirm this.

[Ace844]

Hello Everyone,

we have been discussing the Future of EMS, the education and need for more of our colleagues and ourselves, as well as having a professional body. Currently the UK is tackling this issue and i thought you all might like to get an idea of some of the ways 'they' are tackling this issue...Here are the links...::

http://www.jephc.com/full_article.cfm?content_id=337

http://www.jephc.com/full_article.cfm?content_id=356

http://www.findarticles.com/p/articles/mi_...i_90987569/pg_3

Now, what do you all think??

ACE844