Inconvenient EMS Truths (Was: Call an Ambulance, Get a Taxi)

[Guest guest]

That's a possibility, but it will have to be a far, far different

critter than what we have today. It may well require a redesign of EMS

from top to bottom. But if we're going to do that, first we'll have to

actually admit, to ourselves and the public, what EMS *is* and *is not*

capable of doing. In other words, foster some realistic expectations of

EMS and health care in general. So I'll start by speaking a little heresy:

1. Very little of what we do is actually all that time sensitive, and

response time standards are essentially meaningless. The only meaningful

response time is less than 4 minutes for cardiac arrest, but it is

rather foolish to design an entire system around the 1% of calls that

are cardiac arrests.

2. ALS care is expensive, and generally wasteful. The default level of

EMS provider for most communities should be an EMT-B (albeit a better

educated one than the current model).

3. Every call does not deserve a paramedic. In fact, most calls don't.

4. There is no such thing as a paramedic shortage. In fact, we have too

damned many paramedics as it is.

5. Volunteer EMS, while honorable in its intentions, is actually holding

back the profession. No other health care profession routinely gives

away its services. And every time we do, we devalue what we can provide

to a community. Why buy the cow when you can get the milk for free?

I'm sure there are other inconvenient truths, and other people I've yet

to offend, so everyone else feel free to chime in with their own.

spenair wrote:

>

>

> Wonder if I count as both? If you deny both I will understand.

>

> Don't worry I do understand that the Paramedic education is enough to

> kill a patient and not nearly enough to properly assess them and treat

> them. But I still hold out hope that we can design a much better system.

>

> Renny

>

>

> >

> > My friends and former students (you know who you are! ) who have

> been advocating medic-initiated refusals will come around eventually,

> trust me.

> > GG

> >

>

>

--

Grayson

www.kellygrayson.com