Patient Care in the Rural Setting

[medic53226]

The service that I work for just went Paramedic on June,1 2006 and had been a Basic service for many years, and every since they went paramedic the dispatch has been having a habit of not calling the FD. I think that this is very intresting, because before that wasn't the problem it was just automatic, and now has the FD wanting to know why, now in the rural setting in my neck of the woods the vol fd is much closer 90% of the time and beat us hands down because of location. So I ask you fellow members of EMT CITY, have any of you ran into this problem, or have some ideals on how you would solve this problem keeping in mind that you don't even see the dispatchers they are based elseware. Thank you for your time.

[Ace844]

The service that I work for just went Paramedic on June,1 2006 and had been a Basic service for many years, and every since they went paramedic the dispatch has been having a habit of not calling the FD. I think that this is very intresting, because before that wasn't the problem it was just automatic, and now has the FD wanting to know why, now in the rural setting in my neck of the woods the vol fd is much closer 90% of the time and beat us hands down because of location. So I ask you fellow members of EMT CITY, have any of you ran into this problem, or have some ideals on how you would solve this problem keeping in mind that you don't even see the dispatchers they are based elseware. Thank you for your time.

"Medic,"

There could be many reasons for this. MOst of the more plausible ones involve 'politics' on the part of whatever interests the dispatchers ultimately serve (i.e.: Management sent a memo or directive to dispatch saying. Do not call the local FD. For any number of nefarious reasons). The other two I can think of are gross negligence and or incompetence.

Hope this helps,

ACE844

[medic53226]

Ace844,

We had some vol. FD guys ask us why they weren't getting called and we could only suggest what you suggested, but it seem from the look as though they had. I is bad when you go into a small town were everyone knows everyone and the pt says were is such and such on the FD, and then they show up because they either heard us or just saw us go by, that is very awkward

[rat115]

I understand exactly what you're talking about when the pt looks at you and askes were a specific person is. I normally get the "who are you and how long have you lived here?" becuase I've only been in town two and a half years. It's funny and frustrating at the same time.

Here, we don't have the fire dept. called out unless there is something to do with chemicals, an accident, or we call for lift assistace and no one else on the EMS crew 10-4. We normally have one of the PD show up to check out the scene unless they are really busy and it doesn't sound like they are needed. I have had scenes where someone on the fire crew was driving by and knew the person, so they dropped in to help. I have no problem with that, and it helps keep the pt happier.

[Ace844]

Ace844,

We had some vol. FD guys ask us why they weren't getting called and we could only suggest what you suggested, but it seem from the look as though they had. I is bad when you go into a small town were everyone knows everyone and the pt says were is such and such on the FD, and then they show up because they either heard us or just saw us go by, that is very awkward

I understand, your very much stuck in the middle. My .02, don't get involved, stay out of it as it will only bring trouble for you. Potentially in the form of eventual unemployment..Unless of course you or your pt are put in jeopardy from this then write it up, and see how they address your 'concern'. As always with this type of thing YMMV, JMLO, .02.

Hope this helps,

ACE844

[medic001918]

I understand exactly what you're talking about when the pt looks at you and askes were a specific person is. I normally get the "who are you and how long have you lived here?" becuase I've only been in town two and a half years. It's funny and frustrating at the same time.

I can understand a patient looking for a familiar face in their time of need, but they also need to understand that they're not guaranteed to have people they know on the ambulance. I'm not sure how I would react to a patient questioning me with a question like "who are you and how long have you lived here?" Who I am...sure, I'll tell you who I am and what I do. But a "how long have you lived here" question is 100% irrelevant to the call or my ability to provide the emergency care you requested or required. My thread hijack is over...

On to the topic, someone probably made a poor decision in requesting that the FD not be sent to the calls; especially if they are closer most of the time. My initial thought was that the FD is no longer toned because they were the paramedic provider in the area which was taken over by the ambulance service. That doesn't appear to be the case. I have to agree that it's probably a bad idea to get involved in the politics of the decision.

And as a side note, and possibly another topic...do we do patients any good by having so many different providers on an emergency scene? Here's an example from the service I work in. It's not uncommon to have a BLS engine first respond, a transporting ambulance, at least one (usually two) police officers, and depending on the location of the call an intercept paramedic unit. So let's go on the short side and say it's a 3 person engine (usually 4-5 people though), two police officers, two members from the ambulance crew and one intercept paramedic (even if the transporting ambulance is an ALS unit). That's a minimum of 8 different people coming to someone's house for one medical call. Is this really the most effective use of resources? And does it really provide any level of benefit for the patient? Something to think about...

Shane

NREMT-P

[Lisa659]

Hello, I am new to this site. I work in a rural area also. Our FD always responds with us on most all our calls. They are dispatched out with the tones, and we are very grateful to have their help. We have a very good work relationship with these guys and as you already know, extra help is ALWAYS appreciated. Our call volume has picked up extremely over the past few years. I can remember when I firts started as a Basic, we could go all day and maybe 1-2 calls. That's very rare now!!!

[JPINFV]

I just wanted to point out to those reading this thread that it was just resuscitated from a year and a half of asystole.

[mrmeaner]

I just wanted to point out to those reading this thread that it was just resuscitated from a year and a half of asystole.

It's just an epi rhythm. Wont make it to the ICU.