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Why do urban EMS fear on-site treatment?


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As NJ bls where als in usually too far away or unavailable on critical pt's i often place them on o2 and do the rest of the assessment in the bus just for sake of not wasting time! Treatment on the road is also just interventions the only way ur pt is going to really get "better" is in the hospital. As wise man once said "no one truely sick gets cured in the back of an ambulance! But I can not speak for Philly seeing as Ive never worked there.

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As NJ bls where als in usually too far away or unavailable on critical pt's i often place them on o2 and do the rest of the assessment in the bus just for sake of not wasting time! Treatment on the road is also just interventions the only way ur pt is going to really get "better" is in the hospital. As wise man once said "no one truely sick gets cured in the back of an ambulance! But I can not speak for Philly seeing as Ive never worked there.

Yep. New Jersey EMS at its finest. What exactly have you vollie squads done lately to your medics that they are now telling you "Eh, no one's gonna get better in the back of the ambulance anyway..."

Actually I think you're right. I'm 86'ing the monitor and med bag. Screw it.

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Yep. New Jersey EMS at its finest. What exactly have you vollie squads done lately to your medics that they are now telling you "Eh, no one's gonna get better in the back of the ambulance anyway..."

Actually I think you're right. I'm 86'ing the monitor and med bag. Screw it.

They would actually have to get out the door first if it's not a "hot" job.

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  • 10 months later...

Why risk the lives of those who need your care by wasting time with those that don't require it as neededly by killing time on scene?

Why treat on scene if you can do the same thing in the back of a truck? if you can do those treatments in the back of a truck, why not do them while driving to the hospital? Here you are within 20 mins of any hospital so I might as well start treatment at "home" in the back of my truck than someone's stinky house. Be at the hospital quicker, have a quick turn around time and be ready to go for the next call?

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As someone much wiser than myself told me in response to me "How the HELL are we supposed to get all XYZ done in 5 minutes"... if you're taking 3 sets of vitals, initiating O2, starting an IV, getting a history, initiating interventions and documenting "change" in the 5 minute period it takes to get from the pt's house to the hospital, you're not practicing medicine...

You're just rushing through everything because it's what you're "supposed to do" to remain available for other calls.

I think you can get an awful lot more done and actually do your patient some good if you slow down a bit and initiate some stuff before you get to the truck, or at the very least, in the back of the truck before you get moving.

But that's me.

Wendy

CO EMT-B

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Another factor is call volume. Most urban services are pushed to the limit daily with their call volume, and most of their calls are low-acuity, so spending an extra 10 minutes on every call to start an INT may not be good for the system as a whole. I am in no way suggesting that not treating a patient that needs it is correct (MI), but at the same time everyone that gets in the ambulance doesnt need an INT and labs drawn. Every drunk doesnt have to have fluid and thiamine via EMS.

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Of course it would defeat the purpose of us being there but you're not going to see me help grandma pack her suite case, do a few sets of vitals, start my lines and initiate all these treatments prior to being in the truck. Of course there will always be a "what if" where its going to be warranted but if I have a pt who warrants a need for being at the hospital I'm not going to be staying on scene longer just because I have the time to, that's what home care is for.

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i like bringing them to my truck because its MY space. it shuts out the lameass ignorant family members, keeps some 5th cousin answering the questions i asked my patient, prevents some douche giving me 'advice' on how to do my job, gives me and the patient a/c or heat and light to see. if they 'need' immediate intervention ill work em on the scene, no bigee. but like i said, my bigass truck is MINE and i can lock the doors. :D

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i like bringing them to my truck because its MY space. it shuts out the lameass ignorant family members, keeps some 5th cousin answering the questions i asked my patient, prevents some douche giving me 'advice' on how to do my job, gives me and the patient a/c or heat and light to see. if they 'need' immediate intervention ill work em on the scene, no bigee. but like i said, my bigass truck is MINE and i can lock the doors. :D

So you have my space in your truck. Interesting. To each his own I guess. I do wonder why you take patients to your truck though? I prefer to take them to my ambulance since it has the equipment I need.

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