Perfect EMS

[Timmy]

If you could change anything, anything at all in EMS what would it be :?:

What’s your perfect idea of EMS :?:

[Thunderchild145]

Funding. Right here, right now, it all boils down to the fact that my service is out of money. This leads to layoffs. Layoffs lead to fewer employees (obviously). Fewer employees means the ones who stay get payed less for doing more. Our equipment is falling apart and so are we. So yea.

Funding.

[JPINFV]

3rd government agency that combines interfacility (gotta pay for it somehow, and the less tax dollars used, the better) and 911 response. Interfacility would be done primarily out of van's without lights or sirens on it (staffed by basics). All private ER calls would be in an ambulance with at least an EMT-I on board [this also provides a buffer for call surges and mass casualties). All 911 calls would be handled by a minimum of a paramedic.

Paramedic education would be at least an associates degree. Working with local colleges and universities, a program would be developed up through a masters at least. Higher levels would be used for education, management, and field treatment programs [i.e. treat and release, or treat and refer to urgent care] and have an advanced scope of practice (not necessarily the same degree for each program) . Bridge programs would be developed for non-degreed paramedics and for entry degrees for non-EMS college graduates.

Actual stations would be used (i.e. not motel rooms or posting) to give more of a public presence.

I'm envisioning that this system would take care of several current problems. First and foremost, public education. By having more of a permanent presence in the community (ex. fire stations) and increased involvement in the community, the public becomes more aware of what we do, and what we're capable of. The investment in EMS becomes worth it. Public awareness would also increase the amount of people interested in entering EMS. Degree requirements would weed out some people, but also increase the amount of people interested in joining by tapping into the large pool of college students who have no clue what they want to do yet, or become interested part way into college.

By increasing and diversifying the services provided into medical transportation, you increase the revenue stream which will let you increase pay. As with public perception, a higher pay means larger applicant pool, which means more high end applicants in the end (as well as more low end applicants). Yes, interfacility transport might suck, but no career is all fun and no work.

[vs-eh?]

The education of Canadians, with Ontario being a model...2 years minimum college for entry (PCP), then 1 year for ACP (Alberta, BC, Ontario), then one year for CCP (Ontario, BC). With CCP being far less expensive and practical scope to 911 calls. CCP is currently basically only reserved for essentially acute interfacility and RARELY 911 (Ontario helicopter). Euro's, Brits, and Oceania's seem to have good education too.

The scope of practice of Americans. It seems that the majority of American EMT-XYZ has a scope that far exceeds their education. An Ontario PCP (2 years college) for example, the majority can't even start an IV on the road, yet it seems the majority of EMT-P's (vast) have less formal education (i.e. less than an equivalent AAS).

[vs-eh?]

Actual stations would be used (i.e. not motel rooms or posting) to give more of a public presence.

Really? Yikes...

Lisa: This is hopeless. They're going to demolish our house for sure. We're going to have to move into a Motel Six.

Bart: But Dad can't afford six dollars a night!

[Timmy]

Thanks for your post guys

Personally, I would like to see, more volunteers, better quality volunteers not just wankers!

Not to have so many ranks!! Most people only care about what’s on there shoulders and not the patient. I have seen patient care put in danger while the officers had an arm-wrestle seeing who would treat him. A state officer who has no more training that what I have nilly hit our doctor.. Rule no 1. Never argue with the doctor were only first aid lol!

And yes offcourse funding. Were a non-profit organisation so we depend on public donations and duty money. We only get 1% of government funding which really sucks.

[Michael]

Related threads here and here.

[NREMT-Basic]

I agree with both the ideas of funding and increased public visibility/presence. I also think that EMS should follow the lead of Law Enforcement and require that individuals have at least an associates degree in some field (preferably related to EMS, but not required) before entering an EMS training program. I have read so many run reports in which the author cant find a coherent sentence with both hands and a flashlight. I also think more uniformity not only among the different states but within states would be highly beneficial. Finally...the education of the instructors themselves. If it had not been for my class being essentially taken over by a paramedic, I never would have gotten through it. The original instructor hadn't been on a call in 10+ years and couldn't spell let alone pronounce the simplest medical terminology and often had such a complete misunderstanding of simple procedures and information that the students were essentially teaching each other. So, in this order: education, funding and visibility.

[Dustdevil]

Education. It is THE answer to every question facing EMS.

And we already have permanent stations with a huge public presence. They're called hospitals.

This is MEDICINE. The sooner we embrace this, the sooner we will be a profession, and not just another government service that people take for granted with no respect.

Where is law enforcement requiring an associates degree for entry?? You must mean individual departments, because I know of no state that requires it.

[JPINFV]

"Really? Yikes...

Well, the medics stay at the fire house. The private ambulance crews that are contracted to provide transport get the local motel provided by their company.

And we already have permanent stations with a huge public presence. They're called hospitals.

When I think of hospitals, I think of doctors and nurses, not EMS. All the education in the world won't fix anything if you aren't going to pay enough to attract people to this career. If you plan on using tax dollars, then you need to show the public that a professional and educated service is needed and beneficial. If that means that we need to pull out the dog and pony show every so often, then it's the price that needs to be paid.

This is MEDICINE. The sooner we embrace this, the sooner we will be a profession, and not just another government service that people take for granted with no respect.

So, your city's management isn't professional? Your local water district/sanitation district engineers aren't professionals? It sounds like your saying that there are no professionals involved with government services. Sure, the employees that you're most likely to encounter aren't professionals, but I'm sure there is someone that is considered a professional above them.

Medicine is a government service for a lot of places. In fact, you could argue that EMS IS a government mandated service under EMTALA since true emergencies [MI=emergency. Stubbed toe=not an emergency] are treated without regard to the patient's ability to pay. Unfortunately, this is why a lot of ERs are full.

Unlike police, fire, other healthcare fields [RN, MD/DO], law, politics, etc, EMS is not a field that jumps out towards college students. If you want college educated paramedics, then you can't just rely on people looking at EMS as a high school student. With out its own identity, EMS will never be able to attract the grads and the undecided/undeclared demographics like it needs too.