Nothing personal.

Nothing personal.

“One other thing is prioritized dispatch and then some. The Richmond Ambulance Authority’s dispatchers are all Paramedics (who are/were field paramedics and know the job). This cuts down on the amount of ambulances running lights and sirens to calls. It doesn’t cut down on BS calls though, because the RAA bills for transports and also takes care of the majority of non-emergent transports in the Richmond area. The BS calls might be culled to transport agencies if you don’t do non-emergent transports”

I have mentioned on my blog in the past about the system for disptach we use called 'NHS Pathways'. This is a brand new 'first of its kind' traige system for Ambulance Services, that provides the EMSO (Emergency Medical Services Operators) with the option to inform the patient that they do not need an ambulance, could be seen by a more appropriate provider of a service, make there own way to hospital or a walk in centre or just refer them on to one of our clincal supervisors for phone advice.

It took some getting used to and initially the safeguards were set very high, and it was more likely that a patient got an ambulance than not for something minor, however, with training and experience it seems to be working really well.

More information can be found here:
http://999medic.com/2009/03/06/nhs-pathways/

Im excited to see where EMS 2.0 can go. As I have mentioned in my last post, I really think that it is a world wide concept, not just for the U.S. We have alot to learn from each other, and forums like this can only work to enhance international co-operation to help push our profession to where it needs and deserves to be.

EMS 2.0, as I first envisioned it, was the ability of the on scene practitioner to access other elements of the system other than the ER.
I respectfully disagree with CK about the “No BS calls” and using his hot dog analogy, most of my customers are coming to the hot dog stand looking to buy frozen dinners.

EMS will always be activated for reasons other than an emergency, but we need to give those who encounter these folks more options. Along with tthat will be completely new training to identify the situations when people don't need an ambulance.

No matter your views about what is wrong, we all need to bring solutions, like CK and others in the movement are doing.

I too will expand when I have more time. I snuck onto the classroom computer and everyone is reading along.

There's a lot of people I respect that are already here, FC, TOTW, and RM, you've all got excellent opinions and are going to be leaders in the movement. However, I have to respectfully disagree with you all on a point. Smitty touched on this in the above comment while I was writing this (My computer crashed… Thanks Windows!).

I don't believe in BS calls. There, I said it. Sure, in the decade or so that I've been doing this I've ran more than my share of hangnails and even a “lost condom” or two. However that is a small price to pay for trying to avoid what it is that really bothers me… and that is when people having true medical emergencies don't call us when they could really benefit from our care.

Look for my expanded ideas on this in a post that I'll get up later today. However, the salient point is this: EMS cannot be angry when our customers (patients) choose to use our service in a way that we don't want to be used. It is our responsibility to adapt to how the public chooses to use our services. What other business model (and yes, healthcare reform must look at the fact that all healthcare is indeed some form of a business) would launch sweeping and angry diatribes on the fact that more customers are coming than they want to come? Any other business model would adapt, overcome, and improvise to meet the challenges and onslaught of new business. We can't… yet. because we're not nimble and we're bound by lots of regulation and pressures from other interests.

I wouldn't chase customers away from my hamburger stand simply because they enjoyed my hotdogs. I'd change it to a Hotdog AND hamburger stand. Today's EMS would continue to try and sell hamburgers and would get ticked off everytime they sold a hotdog.

Onward and upward.

When I got into the fire service I was very unsure of how I would like the EMS side. I like the fire side better, but I get more action on the EMS side. I think the increased schooling and training for EMS can be a great thing. However, EMS needs to be paid like a career and respected like one. Otherwise, EMS will continue to be a stepping stone to respectable careers like a RN or a PA.

There are some systems that do tiered response. Paramedics are only sent to some of the calls. They have much fewer medics, but they seem to be much better skilled than the medics in systems that send a medic on every call.

We have too many medics. Not enough of the medics are skilled enough. To me, this seems like a two birds/one stone problem. Unfortunately the clueless politicians are not likely to see things the same way.