Innovative EMS Services, Where Are You?

[paramedicmike]

You know...

I would not at all be surprised to see a new level arise in EMS over Paramedic, maybe a Paramedic Advanced or Paramedic Practitioner. They would be allowed to push more drugs and perform more advanced procedures. This is only expected though since as technology expands the scope of practice expands too.

Dude:

You *really* need to do a search of these forums.

-be safe

[Dustdevil]

Yeah, that's not called an expanded scope. That's just called new drugs in the system.

Advancement that is technology based is not really advancement. It's just change.

As for real advancement, it was solidly shot down by the firemonkeys nationwide last year. It ain't gonna happen.

[stcommodore]

I guess nobody remebers the national scope that had a "advanced paramedic" in it...

[kevkei]

I guess nobody remebers the national scope that had a "advanced paramedic" in it...

To help a Canadian brother out, what is an "advanced paramedic" and what do they do. More importantly, is anyone employing them, and if so, where, and what are they doing?

[Dustdevil]

It was the new level of practitioner that was proposed in the National Scope of Practise draft that I spoke of the firemonkeys shooting down last year. Again, it'll never happen in the U.S.

Yes, there are companies hiring medics to perform advanced practise, but there is no such level officially established. It's just crazy-in-the-head medical directors putting their licences on the line to let morons practise medicine without a licence in remote care, like the oilfields.

[kevkei]

Yes, there are companies hiring medics to perform advanced practise, but there is no such level officially established. It's just crazy-in-the-head medical directors putting their licences on the line to let morons practise medicine without a licence in remote care, like the oilfields.

Are you calling me a moron??????????

What we would be looking at doing though is trying to change what needs to be changed regarding scope of practice (although that isn't as big a hurdle because it is pretty much already expanded as I'm sure you are aware) as well as legislation. It is futile to expect to utilize something 'special' if there isn't a system or process that formally supports it. Hence the work we are doing.

[nsmedic393]

I'm not sure if its what you are looking for kev, but NS currently has a "community paramedic" program. Medics working in certain remote areas are tasked with working along with a NP in the community. They have an expanded scope that includes CHF assesment, fall prevention and home safety assesment, blood draws, urinalysis, suture/staple removal, wound care, immunizations, medication compliance, diabetic assesment, antibiotic administration and b12 injections. They also visit patients in their homes to asses the normal vitals.

[tniuqs]

Does anyone else have anything to add to this at all?

Hello....I am over here.

Ok well out in the Bush anyway and providing care to an "very important demographic group" as a publicly funded but privately owned entity, providing services to government employed workers and in remote practice to boot!

As much as I hate to agree with the Past Dictator of the this Province there can be "a turd way"! A fellow by the name of Preson Manning convinced me of this idea in a presentation about 1 month ago, its not too extreme to believe that Public administered Delivery of Health Care "could" be the end of social health care as we know it, as the rapidly soaring costs and means of delivery must be reevaluated.

The Idealistic "Public vs Private Argument" is simply POLITICAL EXTREMISM as health care has always been blended here in the great white north.

One can make a difference if one is determined to provide "improved services"... Dust I take a bit of exception here to your comment of "just adding a drug" #$@^%$! You do want a Canadian Pasport dont you...te he!

For example I have just reciently added a "drug" to my inventory AND with the my medical overhead approving, that being tetracaine (fluorescein is next) not only in adding "this drug" I did accomplish additional education for Paramedics in an operation that is providing advanced remote care. BUT the previso is that one must have additional training, and be examined in house... what a concept "checks and balances" extending scope of practice within current guidelines. (My convincing argument was to decrease the possible use of systemic Narcotics for "pain control" and forcing a 6 hour transport (or medivac) then waiting 4 hours in ER when a non-fixed foriegn body or arc flash cojuntivitis can be safely and comfortably be removed on my site) Yikes I think I am growing up but PLEASE dont tell anyone as it will destroy a perfectly good reputation of renegadism... Yikes I think I am growing up!

Now as Paramedics are already "approved to administer the drug called lydocaine", is it far reached that this drug does can be used in variety of applications like suturing......te he. Hey and don't let on that this could be precident setting to boot..... if the Health Proffessions Act ever gets through the legislative mumbo jumbo it may release some of the strict control, and just whom is opposing this HPA anyway ? Please don't tell me that College of P+S will let go of any control of the reins in this traditional territorial wars, well without a good fight anyway. They are lossing some minor battles to the Pharmacists.... and good for them, not a 5 hour wait in the Pharmasave lineup just yet.

If one can PROVE cost effectiveness and decreased lost time injuries THIS could become the new critria and not extreme idealism.....$$$$ does talk. "If a foot can be put in the door" so to speak, perhaps we can deliver improved services through Paramedicine. The fact of the matter is that our health care system "is sick" just may be an incentive in itself as the facts are that in some provinces may go broke very shortly.

Alternative means of delivery MUST be reviewed, to that debate I ask this question:

What MD in this country does not bill the health care system as a non-busniess manner?

Hint: You know of any strictly salaried MDs in your "hood"...... NOPE "fee for service" is the bottom line.

cheers

ok enough rambling/ babble.

[kevkei]

Hello all,

I thought I would put out one last plea due to the dismal responses so far.

Some of you must know of some EMS systems that are doing things differently than what everyone else is doing. Things like not responding to low priority calls or transferring them to a more appropriate telehealth system, ability to refer patients to other serivces, or how about the a policy or the ability to refuse to transport a patient?

[Dustdevil]

Wait... I thought you were asking specifically for INNOVATIVE services, not just services doing things differently.

I don't find any of the above mentioned schemes to be particularly innovative. I've seen them all tried and failed many times over the years. Perhaps they have a better shot at success in a land where paramedics are decently educated and lawyers don't live off of contingency fees. But in America, those are all just paper theories that never really worked out well in practise anywhere that I am aware of.