101 Things the Fire Department wishes you knew



Tuesday, August 4

Where are we going with this?

Life under the lights has taken up the EMS 2.0 cause as of late with another great post about how he would like to see EMS evolve in the future. Have a read and come back.

Fired up? Ready to do something about it? Good, because you're a part of this.

As CKEMTP mentioned, there are a lot of things he and I disagree about, but I love this field and how seemingly opposites can agree on the fundamentals of their profession.

Profession. I can't stress that enough. We are no longer a trade and need to stand up to those who try to treat us as such.

A community based model is a fantastic idea and can work. At my first paid position, we operated the ambulance out of the Community Health Office and had a list of folks we did home visits on each day. Every morning we went to 3-5 houses to visit folks at high risk. Diabetics, known asthmatics who were in poor health and similar situations. At the time I hated it. I was a Fireman "forced" to ride the bus. It was a few years later when I knew most of my clients before we arrived at the scene, knew their sugar ranges and just how much albuterol would make them better. It made me a better care giver.

That was around the time I began my Bachelor's in EMS program. Half way through it I envisioned expanding the EMS system to include a clinic based element for rural and suburban areas. An ambulance can respond from a clinic and transport appropriate patients to the clinic for minor procedures or along to the proper hospital. On their downtime they assist in the urgent care clinic.
I incorporated a fire based model to respond from the clinic and the system made little sense with dualing command structures and confusion in supervisory authority.
The basic plan still sits in my little notebook I used to keep my ideas in back when I thought we could change things.

I re-read it after reading CK's post.

EMS 2.0, for those of you not familiar, is a concept of changing the delivery and abilities of EMS to adapt to the changes in patient presentation and tools at our disposal. EMS 2.0 is named such because we need an overhaul and upgrade of the current system, not just a polishing and reshuffling of the same old ideas. Painting the ambulances red doesn't make the men inside them part of the fire service, no matter how shiny it gets.

Talking to the Angry Captain about some personal and blog issues the other day I commented about needing to get "less political" in the coming months. Since my command staff is aware of this place (Hi, Chief) I do need to watch what I say, but when it comes to improving the way we do our business, it is my responsibility to be a patient advocate and get things moving in the right direction.

I don't have a political axe to grind, represent any trade group or company, I'm just a practitioner seeking a better way of doing things. I'm currently in a fire based model that is undergoing a transition and can see a lot of room for change and improvement, but I am young in the business.

Let's fight the good fight.

4 comments:

mwheatley said...

"Stay and Play" rather than "Scoop and Run"?

The Happy Medic said...

"Treat and Leave" instead of "Grab and Go."
Re-examining why we have to transport people who need minimal interventions and treating them. Changing the way people view EMS from taxi to health care professional.

Ckemtp said...

Hey Happy, we agree on a lot of things too! I'll bet that we might agree on food and beverage choices. Maybe even fishing techniques. Might even agree on our favorite 18th Century composers as well. I'll bet that on EMS we agree on a lotta things.

Although we haven't talked about combination nozzles vs. straight streams yet...

Your idea for the community health paramedic system is a great one and is very close to what this could be. I see great potential in "ER diversion" care and in urgent (read, non-emergent) care clinics accepting BLS/ILS ambulances and wheelchair vans.

Gary Wingrove has been working with the Community Paramedic program: http://www.communityparamedic.org/
that has been doing a lot of stuff like what you're talking about with that program. When you thought about it, you were ahead of your time. Now, the time is here.

Stay tuned tomorrow. I've got the first step in the plan. I'm going to need some serious help here.

Mystery Medic said...

I read that post left a little comment, and feel free to read it, but before ALL of that there is only one thing in the immediate future for paramedics I would like to see. If it means a few months more of education or a grandfather system but I would like medics to be medics as long as they are current in CE and Certs regardless of were they are located. EMS Haiku posted about how he was first on scene for an MVC and he would be happy to continue to help with continued care but as a BLS level only because he cannot practice at his level of training without command. How sad is it that our medical system doesn't allow us to perform at our actual level. Until we are recognized as an independent professional capable of performing at our level of training independently then anything else is just a dream.