Are you really part of EMS - Part 2

[Dustdevil]

interestingly elsewherei nthe world that model of provision is frowned upon and events relying on this without using the NHS Ambulance serivce or a preferred partner ( usually SJA and /or red cross) might find themselves a bill - especially if it;s a regualr occurance

Zip, can you clarify what you mean? Are you saying the NHS or preferred partner must be used for on-scene care, or for transportation, or for both? And are there established laws and legal sanctions for this practice, or does it never really come up? In the US, most municipal services won't do event standbys, except at city sponsored events like festivals and such. Private functions like concerts, pro sport events, even a lot of non-profit events, all have to utilise commercial services, and there are many such services that do nothing but special events. They are equipped with golf cart style ambulances for navigating crowded areas, four-wheeler response cycles, portable clinic-in-a-box setups, and even medical trailers for instant clinics. They usually utilise off-duty medics, physicians, and nurses that work within the local EMS system, so it's the same people you'd get if you called local EMS anyhow. Of course, there are also quite a lot of private, non-emergency ambulance services that will contract out to do the same thing, but aren't really set up with the specialised equipment for clinical ops or crowd mobility. And they usually utilise the same inexperienced new-grad EMTs that they use for their dialysis and nursing home runs all day.

[zippyRN]

Zip, can you clarify what you mean? Are you saying the NHS or preferred partner must be used for on-scene care, or for transportation, or for both?

if you contract in the NHS service or one of the 'preferred partners' the NHS doesn't complain about being called onto an event to provide backup ...

if you contract in other providers calls for the NHS service can end up with incideint forms being submitted by the NHS crews, and potentially the provider being billed for not meeting their obligations under the codes of practice for events ( there is HSE guidance which says event cover provision should minimise impact on the NHS provision - but event licensing is done by local councils so they don't have to follow the HSE guidance to the letter... but are supposed to take advice from the Emergency palnning depts of Police / fire /ambulance / acute hospitals )

And are there established laws and legal sanctions for this practice, or does it never really come up?

see above

In the US, most municipal services won't do event standbys, except at city sponsored events like festivals and such. Private functions like concerts, pro sport events, even a lot of non-profit events, all have to utilise commercial services, and there are many such services that do nothing but special events. They are equipped with golf cart style ambulances for navigating crowded areas, four-wheeler response cycles, portable clinic-in-a-box setups, and even medical trailers for instant clinics. They usually utilise off-duty medics, physicians, and nurses that work within the local EMS system, so it's the same people you'd get if you called local EMS anyhow.

many / most of the NHS Ambulance services will do private hire for event cover - some have dedicated crews and vehicles which they supplement with other staff on over time , others just use 'spare' vehicles and overtime to cover the work

in temrso of providing specialist 'event EMS' resources this is where the decent Private services that cover events and the VAS secotr come into their own ( for instance the SJA county i volunteer with has 4 mobile first aid units - 2 large trailer units ( one with a small controllarea , a 10 m mast and repeater facilities), one small trailer unit and one ambulance derived unit) a better C3I vehicle than the NHS service ( 3 controller workstations, 6 base set radios, 3 or 4 cellphone lines, 3G mobile broadband with local WIFI twin pump up masts

mobiel repeater ... ) as well as a full range of ambulance, PTS, RRVs , equipment tenders, and 'ordinary' minibuses

Of course, there are also quite a lot of private, non-emergency ambulance services that will contract out to do the same thing, but aren't really set up with the specialised equipment for clinical ops or crowd mobility. And they usually utilise the same inexperienced new-grad EMTs that they use for their dialysis and nursing home runs all day.

herein lays the problem - virtually anyone canset up a 'private ambulance service' , label their staff how they choose - amazing how many UK PAS operatiosn only have 'EMTs' - people who in the VASes would be accurately described as 'advanced first aiders' or 'first responders'

[NREMT-Basic]

Special Event Coverage is not EMS, unless you transport. EMS is a stage in between recognition of something wrong, and definitive care. If you're not transferring care to a hospital or other place of definitive care, and only transferring care to a person trained to your level or higher, then you are not fulfilling the purpose of EMS.

You might ask, well, what's the difference between that and a first responder? A first responder can go to the hospital if needed. Those working at the special event do not have the ability to go with the transporting unit, as they would no longer be providing special event coverage.

Im not sure this is very logical. If you are standing by at an event, someone collapses with a massive MI and you begin treatment and you are in the employ of a company that provides emergency medical services, then yes, you are, by definition, EMS. EMS is pre-hospital emergency medical care. The venue makes no difference, nor does whether those providers on standby transport or not. There are EMS agencies out there that do nothing but standby at special events, on movie sets (the one that comes to mind is Medics at the Movies) or sporting matches. As I said in the first part of this thread, this is just another my stethoscope is bigger than yours, Im a real EMS responder and youre not argument. Its no different than the discussions about volly departments, firefighter EMTs, etc. The only thing that makes the thread mildly tolerable is the intent of the person who started it. I work with a team that doesnt transport but we perform emergency, pre-hospital medical interventions. DOes that mean we are not EMS?

[dahlio]

Im not sure this is very logical. If you are standing by at an event, someone collapses with a massive MI and you begin treatment and you are in the employ of a company that provides emergency medical services, then yes, you are, by definition, EMS. EMS is pre-hospital emergency medical care. The venue makes no difference, nor does whether those providers on standby transport or not. There are EMS agencies out there that do nothing but standby at special events, on movie sets (the one that comes to mind is Medics at the Movies) or sporting matches. As I said in the first part of this thread, this is just another my stethoscope is bigger than yours, Im a real EMS responder and youre not argument. Its no different than the discussions about volly departments, firefighter EMTs, etc. The only thing that makes the thread mildly tolerable is the intent of the person who started it. I work with a team that doesnt transport but we perform emergency, pre-hospital medical interventions. DOes that mean we are not EMS?

No, you are providing Emergency Care. What about the cut across the finger? Someone applying a band aid, are they considered EMS? To me, the definition of EMS is supportive care until definitive care. Trust me, I'm not trying to say one provider is better than the other. An EMT is an EMT despite what environment they are in. EMT's in the hospital aren't providing EMS, but they are EMT's. It's just my opinion that I don't consider a stand by EMS.

[AnthonyM83]

Why does one need to provide treatment AND transport to be EMS? It's all part of the system and if you're part of the system, you're EMS. From dispatcher to ER personnel, right?

[dahlio]

It's all by your personal definition. Mine is different then others, obviously.

[AnthonyM83]

I know and I understand how it fits your definition, but just wondering why you chose that criteria.

[dahlio]

I know and I understand how it fits your definition, but just wondering why you chose that criteria.

That's how I've viewed EMS from the beginning. I feel it's an extension of the hospital, which includes getting a patient to the hospital. At least around my area, many times we treat more on the way, then on scene. That meaning, we do things on the go, until we can get them the definitive care. It's been drilled in my mind, and I'm not completely sure why, in all honesty.

[dahlio]

Was pondering a bit after I posted my last reply. I once stood by at a soccer tournament (Actually, I sat for quite a bit of it). We had so many RMA forms from that, it was unbelievable. We were more of a first aid stand, then anything else. We would get the, "We need a band-aid" or "I got stung by a bee". In most cases these situations would not warrant Emergency Services, and would not have normally called. But the fact that they come walking over to us, it makes it seem like we need to be there. Hopefully that makes sense.

Stay safe.

[AnthonyM83]

Right, I can see how you end up turning into a First-Aid booth just because you're there. I think when you do standby you end up doing dual function unless they have a separate First Aid booth and have you guys in a separate area. But that's just like field EMS where patients call me because they have the infected toe or a cold (when I have full on flu)...but you're fully equipped to work a code and even call it in the field....