European EMS

[678 Responding]

I just wanted to share the difference between EMS in Europe, particularly the Netherlands (where I'm from), and how much more advanced and organized the system is compared to the United States and even Canada. If you want to share other information, go right ahead, the more the better. Hopefully, we in the U.S. can learn and improve to get close to a level like this, but without drastic changes, it will NEVER happen.

Here is the Link.

EMS in the Netherlands

[Just Plain Ruff]

Nice article, inflammatory post

What I read in that article is not new at least I don't think so.

What I mean is this. They staff their ambulances with nurses and basics - ok, I worked at a service whose second responding ambulance usually had a nurse and paramedic

They send doctors out on major calls - we have a local childrens hospital that used to send dr's on the helicopter to pick up the patient and they still send doc's on their ground transport units. So not new in my area.

The list of drugs - not overly large but nice.

I worked in a system where they were beginning to admin thrombos. 12 leads are the norm. Certain procedure such as needle cric's chest decompression, RSI and the like is the norm for progressive systems anymore.

I don't see anything truly revolutionary goin on in the netherlands.

If you want to spout off saying that the netherlands is best and that we have to get our act together please provide some cognizant ideas that we can implement. Until you offer some suggestions you are just another of the many people who complain about things but don't offer suggestions to get those complaints done.

one could say - let's start by putting nurses on every ambulance. Who pays for this. What about the medics who have been out there for years and now the new rule if we follow the netherlands model, we have to put nurses on every ambulance. Who pays for it? Who helps them get thru classes when they can't find someone to cover their shifts.

[Dustdevil]

I'm depressed.

[Dustdevil]

I don't see anything truly revolutionary goin on in the netherlands.

Come on, Man. I don't believe you, of all people, just said that!

You don't think four to five years of entry level education is revolutionary?

You're one of the last people here I thought I'd ever see judge an EMS system's quality by the size of its drug list! :?

[678 Responding]

Ok, I didn't mean for the response to be inflammatory. When I'm talking about the advancements, I'm talking about standards, abilities, and staff.

How many services do you know that can literally do amputations on a location with a surgeon and anesthesiologist within minutes? How about a chest tube?

Also, compared to the United States and Canada, it's a NATIONAL system, with a national scope and standard. No differences between provinces that say one service is allowed to do this, and the other not. Budget is also controlled by a single entity, along with education. This is what everyone here has been screaming for, some kind of conformity. Possibly this could be a model to take after, to be able to understand how a true standardized national EMS system works. Same credentials across the board, same protocols, same scope.

Nurses need ATLEAST a minimum of a "Bachelors Degree" to work in a hospital, which takes approximately 4 years, PLUS you need atleast 2- 3 years experience in anesthesia, intensive care or cardiac. THEN you need to take a pre-hospital course in order to work on the ambulance. Add it up. Average paramedic training in the U.S., approx 1 - 2 years. hmm.

Nurses on every single truck is great, but like you said you were in systems that have Medics and Nurses. Think about how practical that really could be. It would be great for stabilization, but what about transporting? Someone has to drive the truck, the medic or the nurse? So you're still only getting one advanced provider taking care of the patient at once during the ride to the hospital.

Another thing I like, is that they aren't going to get called to every stubbed toe, and hurting tooth. I've heard plenty of stories about these, and have experienced them myself as well as you have I'm sure also. None of that goes on, as patients are told directly to go visit a doctor as this would not constitute an emergency for which an ambulance is needed. This keeps the system for being tied up with nonsense calls.

This wasn't intended to be a BASH, but yet a model in which everyone would like to take after. After all, everyone seems to want some kind of standardization and conformity in EMS in the US.

[Just Plain Ruff]

Dust, didn't you read the nursing comment I made. I think thats a great idea but I don't see where we are going to get the resources to pay for that transition. Do we offer a grandfathering in phase or will it be mandatory.

I can see the nursing schools jumping on this.

I am re-reading the article as I skimmed it earlier and I'll say I'm corrected. I'm prinitng it now and will re-read it in more depth tonight.

I'll concede your points as what you set out to do.

There is still a lot that they do over there that we do but they seem to be better organized.

[Ridryder 911]

Don't see nurses hopping into EMS units very soon... let's see, half the pay, longer hours, and uncontrolled environment..naw.. we can't even get to work in a hospital. Remember many nurses do not like emergency or critical care patients.

R/r911

[Just Plain Ruff]

yes that will be the biggest issue to get nurses on board.

we will have to train the paramedics to be nurses - lots of money involved there.

If the requirement to be on the ambulance is either basic like it said and nurse medic level, and the requirement would start with the next round of schooling then that might be doable but it's going to be a huge feat to get done.

One other thing I see is the netherlands showed in the article 1900 or so nurse medics. Thats as many medics as there are in the state of Missouri. Take that times 50 and then the issue comes up "HOw the heck do we do this????" :shock:

[jw-c152]

As far as a national service...

The Netherlands is about 41.5 thousand square kilometers.

Canada is over TEN MILLION square kilometers with ten separate provinces and two territories which cover everything from the flat plains of the praries, the Canadian Shield, Mountain Ranges, Arctic Tundra, the Badlands of Alberta.

Based on size alone a National EMS service in Canada would be next to impossible. Besides, a National services doesn't necessarily mean a Better service.

You're comparing apples and oranges.

[678 Responding]

One other thing I see is the netherlands showed in the article 1900 or so nurse medics. Thats as many medics as there are in the state of Missouri. Take that times 50 and then the issue comes up "HOw the heck do we do this????" :shock:

And the Netherlands is even smaller than the state of Missouri.

Don't forget, there are about 16 million people stuffed into a space about the size twice of New Jersey. So, take that and compare to what it would be per person. Approximately 1 EMS Nurse per 9000 inhabitants. Give or take. Now, take the amount of medics you have and compare that to your population. It's not that far off. Just the proportion is different.

I can see where others are going to say about size of a country. If the standard is implemented across the board, along with the same policies and procedures in Alberta as it is in New Brunswick, size wouldn't matter.. why would it? You still have a single system overall.

Like DustDevil and many others have said, EDUCATION is the key, NOT TRAINING. Rather than switching exclusively to nurses, we'd need to adapt the current system, INCREASE the educational requirement for a paramedic. Make it a mandatory 4 year Bachelor Degree program.

As for the advantages of a national system, I think that benefits outweigh the negative aspects. I'd like to hear every ones view, what would a national system offer like the one in the article that we don't already have, and vice versa.