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brentoli

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So would you propose SCBA, Level 1 suits, and CBRNE kits on all ambulances, since we could be responding to a possible terrorist attack?

What about hazmat? The next county over has a 3rd service EMS, they have their own HazMat decon team. What if any specialties would we want our people to have?

Ummm... I thought you said you didn't want to get too far off topic. I thought we were talking about emergency MEDICAL service, not emergency anti-terrorist disaster service.

Just like the book says, "Emergency Care and Transportation", nothing more.

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special event work tends to produce more 'minor' stuff from an M+M point of view - especially when you get camping (and camping stoves) beer and illcit drugs ... ( sounds like a lot of music festivals, multi day motor racing events ... )

so there is a place for 'first aid' provision and also for first response on foot / bikes/ horses whatever...

if you look at the UK model of major event coverage we are 'guided' to produce cover that minimises the impact on the NHS service, so for a large event such as a multi day music festival we bring an awful ot of respurces and kit on site ( field hospital, multiple minor treatment centres, a dozen or more Ambulances, same again in support vehicles, mobile x ray system ... ) and staff it approrpaitely

i've been involved with the V festival for the past 5 or 6 years and the staffing put in is quite phenomenal - over 100 people from admin support staff, through first aiders, SJA ambulance crews, NHS ambulance crews, Nurses, paramedics and ODPs and doctors from registrar levle up wards to include at least a couple of consultant grade Emergency medicine doctors on site during the 'day' ( midday to midnight) and and very senior SpR or one consultant at night ...

Wonderful. And meanwhile, the EMTs twiddle their thumbs for ten long minutes as the crowd looks at them expecting them to actually do something for the person. Real good PR for our organisation. No thanks.

depends on the size of the event ... and the risk profile - larger events / higher risk activities are going to have ALS units on site and once you get to a certain 'score' you are going to want to have your formed medical teams or even a 'field hospital' on site with assocated staffing ... ( look at the set up for F1, indycar and the equally high profile / vlue closed wheel and two wheel motorsport)

Sounds more like a public disservice to me. Put your best foot forward, or don't show up at all.

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Ummm... I thought you said you didn't want to get too far off topic. I thought we were talking about emergency MEDICAL service, not emergency anti-terrorist disaster service.

Just like the book says, "Emergency Care and Transportation", nothing more.

the UK has gone down the route of providing 'health' resources for the hot zone as it was felt that the levle of care available under a 'only firebods in the hot zone' model was insufficient especially if it;s not a full blown 4 -service major incident ( police, fire ambulance and the rest of 'health')

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Unless that prediction software comes with "injury providing, traffic distracting, drug pushing goon in area of prediction" then it's the same as any other statistical analysis... suited to the intentions of the analyzer.

I have to agree with the event stuff... the likelihood of a serious medical emergency occuring is at least as likely as it is at any other place where you have lots of people... like... oh say the mall... which means your well educated paramedics had *better* enjoy the band-aids and minor injuries aspect of it as well as the intense medical stuff.

Speaking from personal experience, my crew averages 1-3 serious medical emergencies that we hand off to EMS at any given event we cover (depending on how frisky Mr. Murphy feels that day.) *If* we handle any at all. We handle a plethora of "squeaker" injuries, including minor bruises, cuts, scrapes, "I'm homesick", "my tummy hurts :(" which all get a full evaluation regardless... just in case.

Now, of course, there is the Loveland bike race... and that's what we call "Hell day." But that's another story (and why I really wish some of us would hurry up and get through paramedic school already!)

EMTCity EMS... BLS for interfacility transfers, ALS for emergency response with BLS providers having the ability to ride as 3rd riders to gain experience, regardless of when they plan to go to paramedic school. They can practice as paramedic students once they decide to go into medic school.

Wendy

CO EMT-B

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How would it be ran?

ALS first response with paramedic supervisors in chase cars [in part to provide ALS intercepts if needed] with BLS units to be used for interfacility transports [funding in addition to tax funding]. The BLS units could be used to supplement the 911 units [supervisor+BLS unit=temporary ALS unit] on an as needed basis as well as in disaster/mass casualty situations.

In addition, CCT units would be dedicated units with crew makeup dependent on volume and type of service calls [utilizing EMT-P, EMT-Bs, RNs, and RTs as needed].

Medical direction would be primarily by standing orders with the option for online medical control to be used as needed.

Would it be strictly 911? Would we have a division devoted to inter-facility transfers? What about protocols, medical direction? Would we even allow an EMT-B to work in the service? What about in house training? Paramedicne Academy of Anytown, USA?

911 and non-emergent/non-EMT-P critical care would be separate. I would like to see the ability to have the EMT-Bs who are continuing their education [either in college or a paramedic program] have the ability to ride third man with a 911 crew on a voluntary/non-paid basis.

For training, I'd like to see a partnership with a local hospital as well as a local university or college [preferably one with a medical school]. A paramedic program would offer a steady supply of paramedics that could be tapped as needed as well as give EMT-City EMS a chance to directly affect the educational makeup of the nation's paramedics. In addition, paramedic preceptors and educators would be a promotion position [merit based] that could help reduce turnover.

Furthermore, by partnering with a hospital and an institute of higher learning, the instructors in the program need not be paramedics, though, but instead experts in the field being taught. As well, the regular "pre-req" programs could be rolled into the paramedic program by utilizing the courses already offered by the partnered college. This would help ensure "quality control" of the educational process. This would be a degree granting program.

Continuing medical education would be provided in various topics by the partnership with the partner hospital. This would help to include "flavor of the month" health scare topics [recent example: MRSA]. As well, it would help to maintain skill proficiency as needed [the full time paramedics wouldn't just be another faceless student passing through].

Finally, the partnership between both the college and the hospital would provider a fertile research ground to advance the science behind EMS. Again, this would provide another opportunity to attract solid providers [especially ones with a science degree] and increase retention.

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