Non-urgent Matters

[infoseeker]

Hello everyone. I'm currently working for the Detroit Wayne County Health Authority, an organization dedicated to assuring access to health services and improving the health status of residents in Wayne County, MI. As part of our mission, we aim to better coordinate existing services and explore new solutions to better serve the safety-net population (Medicaid and uninsured patients).

As a result, I'm interested in learning a little more about EMS, inappropriate use of EMS, and how your respective units handle non-urgent patients/calls. What is your standard protocol for non-urgent matters? If the patient desires to go to the ER in spite of the fact that you determine no medical need, what can/do you do? Can you take them to a nearby primary care clinic? Urgent-care clinic instead of the ER? Is inappropriate use of EMS a real/common problem?

Do any of your units have a medical van/shuttle which handles non-urgent calls or patients? If not, what type of measures/programs would you suggest to reduce unnecessary ER visits? If a non-urgent medical van/shuttle were created, how would you envision it functioning in conjunction with current EMS practices, protocols, etc.?

Any response to my questions would be greatly appreciated. In addition, do you know of any good Web sites, articles, etc. which shed additional light on unnecessary ER visits from inappropriate use of EMS?

Thank you for your insights and expertise. Feel free to check out our Web site at www.dwcha.org for more info.

[Richard B the EMT]

May I suggest you contact the Office of Medical Affairs, of the Fire Department of New York (FDNY) Emergency Medical Services? Or, the EMS Operations Office, at the same location? The main hyperlink for the FDNY is http://www.nyc.gov/html/fdny/html/home2.shtml

[shookwell]

I transported 5 patients today, I don't think any of them needed an ambulance.

"Hello, 911? I got bitten by a dog 10 days ago and I think I have rabies."

"Hello, 911? I have a fever of 100, I need to go to the hospital."

Our protocol says that we must recommend to every pt we have contact with that they should go to the hospital. I'd say at least 80-90% of the jobs we do are not true emergencies.

[battlemedic345]

I would tend to agree that in suburbia about 30% of all our calls could have gone by POV, a friend's car, or a cab...

but I am told its closer to 80% in the cities.

A lack of primary care is probably at fault...and a lack of community education as to what is, and is NOT an emergency.

[kemt217]

Working for a service that only has about 350-400 calls a year, it rarely happens but it does still happen. The last one was a man who hurt his elbow.

[Ridryder 911]

Probably greater than > 85 % of our calls are really non-life threatening. These of course are called in 911. We also have a transport truck for wheel-chair etc..

Before medics ramp & rage... although I do too.. let us remember do we educate the public, on the needs & when to call for emergency services. I suggests public service ads for "What to Do" ads, such as when to call .. what defines an emergency, even what to do when an emergency vehicle approaches ....

Be safe,

Ridryder 911

[infoseeker]

Thanks for your input so far. Keep 'em coming.

[Alcomedicism]

In my own humble opinion EMS providers ought to be able to treat the non-life threatening stuff and tell the pt to follow up with the DR in the AM.

such as the kid that cut his foot on some glass, about a half inch laceration on this 2nd and 3rd toe on left foot. No impaled objects. This isnt really an emergency but the kid probably does need some sutures and some antibiotics to fight any infection. Looking at this, the Paramedic could probably sew him up and tell the mother to follow up with pediatrcian in the morning. This will allow EMS to free up a bus for an actual emergency, plus the less use of equipment thats unnecessary will likely drive down EMS bills for the public. Besides most companies around here dont bill you unless you are transported. Remember this all goes back to using your resources wisely.

-Dix