NJ moving close to removing head from posterior

[NYC-EMS]

Just looked at this article from the Jersey Journal

http://www.nj.com/jjournal/stories/index.s....xml&coll=3

[CC64]

7. Changing rules to facilitate EMS research, which now requires multiple approvals for retrospective studies and is practically impossible for prospective research.

Research? EMS? That thar's that college boy pointy headed stuff. We done need faster vehicles and more lights, dammit.

Except...pre-hospital medicine really doesn't have any solid forms of research out there. The vast majority of the things that are done come from hospital-based research or anecdotal evidence. We do it "'cause that's the way it's done 'roun' 'ere."

Gotta disagree with you on the research thing.

[JPINFV]

Except...pre-hospital medicine really doesn't have any solid forms of research out there. The vast majority of the things that are done come from hospital-based research or anecdotal evidence. We do it "'cause that's the way it's done 'roun' 'ere."

Gotta disagree with you on the research thing.

I do believe that the entire "fast cars and freedom" response was firmly planted in sarcasm.

[BEorP]

Except...pre-hospital medicine really doesn't have any solid forms of research out there. The vast majority of the things that are done come from hospital-based research or anecdotal evidence. We do it "'cause that's the way it's done 'roun' 'ere."

Gotta disagree with you on the research thing.

I wouldn't ague that there could be more prehospital research, but there is definitely some good research being done. A great example would be the Resuscitation Outcomes Consortium studies being done at a variety of sites in North America.

[Medic2588]

I'm not sure much will change. My prediction is that following will change:

1. ALS will be allowed to more on standing orders

2. Encouraging mergers of smaller squads through financial incentives (these actually do exist in NJ for shared service projects)

3. Maybe more money for the EMS office being redirected by surcharges (EMT training is currently funded by the extra surcharges on traffic tickets)

4. A State Medical director and Regional Directors

There is no way:

1. EMTs and paramedics will be included in the state pension unless you work for UMDNJ or Rutgers

2. One paramedic/One EMT will fly... the paramedics would all walk out

3. Transporting patients to other facilities - sounds like a good theory (take non-emergent patients to clinics or doc in the boxes, but Asys is right - way too much abuse potential)

4. Requiring all EMS agencies to be licensed - the volunteers still have an incomprehensibly strong hold on the Office of EMS, and they would fight this bitterly

I have mixed feelings on the non-hospital services providing ALS. I want it, since it means I may get paid more money, but I don't see the Dept of Health changing this yet.

And I got to say, NJ can't possibly be the only state with problems. Ours are just more widely publicized.

Devin

[Asysin2leads]

I'm not sure much will change. My prediction is that following will

And I got to say, NJ can't possibly be the only state with problems. Ours are just more widely publicized.

Devin

Look, in East Bumblcrap, New Hampshire, a 911 call gets you a local ambulance staffed with paid, professional paramedics. Given NJ's overall income, their EMS system should be a national shame.

[CBEMT]

Look, in East Bumblcrap, New Hampshire, a 911 call gets you a local ambulance staffed with paid, professional paramedics.

Yeah, about that. Plenty of volunteer services up there.

[Asysin2leads]

Yeah, about that. Plenty of volunteer services up there.

Actually, most of its paid. The smaller towns have their own local first aid response, but when I say "small town" I mean "town where cows out number people", not "Suburb-where-the-median-income-is-$120,000-but-we-like-to-think-of-ourselves-as-

small-town-folksy-feely-types."

[Medic2588]

That's kind of a weak argument Asys. In NJ there are several paid services that run around the clock in towns with small populations.

Do I think everything should be paid? Yes and no. If the volunteer service manages to get volunteers out no matter what time of day (i.e. Teaneck Ambulance Corps in Bergen Co, NJ) then I see no reason to make them go paid. But if the squad can't maintain adequate numbers, then paying them may help put bodies on the ambulance.

Now, its got to be said, paying someone does not equal making them "professional." Professionalism is a state of mind and not a paycheck. I have worked with some paramedics who are the complete opposite of everything you envision professionalism to be.

And no one can take the stance that FDNY is without its own well publicized problems. And having done medic time with Philadelphia Fire, I know they have their own set of problems. The entire profession is dysfunctional, not just particular states. Within NJ there are people who manage to do it right, and areas that need some serious help. I believe you'll find that in any state.

Devin

[Dustdevil]

I dunno, man. The only place I can speak authoritatively about is Texas. In Texas -- and in most of the U.S., for that matter -- the problems are almost all in the big cities where it's run by firemonkeys. Yes, there are scattered smalll, small towns that still get by with sub-par EMS, but not many, comparatively. I've worked rural county services for a great deal of my career. Some counties where the biggest town is only a few thousand in population. None of them ran vollies. They have almost all been running full-time, paid, paramedic level EMS since the mid 1970s. Dr. Bledsoe (when he was just a medic) was instrumental in instituting this all over North Texas. Volunteer ambulance corps are almost non-existent in Texas. BLS EMS is also almost non-existent in Texas. Except for a few areas of the desert out west, and in the deserted border area, full-time, paid, paramedic level EMS has been the standard for over twenty years.

And here's the kicker; Texas has no state taxes. How is it that we can pull this off without state taxes, yet NJ cannot with HUGE state taxes?