How to fix the mess that is NJ's EMS system

[Flasurfbum]

Many of us here are working in, or have experienced the pile of crap that is NJ's antiquated EMS system.

Now, instead of whining about it, how about we come up with a few constructive ideas to fix it, and improve the quality of service that we provide to the citizens.

First and foremost, increase the amount of ALS units on the street. There should be certain number of ALS vehicles per population, or square mile. Having no ALS on many calls has hurt patient outcomes.

Resource share. How many VACs, or FACs, or Rescue Squads are out there that have 3 or 4 ambulances, and the next town over, same thing. All top of the line, best money can buy. That is being fiscally irresponsible to the taxpayers. Having a regional EMS system that shares resources (ONE Chief, :eek:, placing resources where they are needed, why have 3 ambulances in an area that runs 400 calls a year?)

Radio interoperatability. One dispatch center per county that takes 911 calls, processes them, and dispatches them. All on the same band (VHF, UHF, 800 mhz, whatever they choose). Has anyone taken a look in a MICU lately? Seen how many different radios they have to deal with? Unacceptable.

Here comes the biggest pot stirring one of all....Volunteers.

I love the whining that goes on in the newspapers, "we have to have 120 hrs of initial training, plus 48hrs of CEUs." Right. What matters more, your hobby, or patient care?

When multiple pages are sent out, and no one answers, and the calls rolls over to the mutual aid agency, who is being held accountable? You can bet your ass that if it was a FD, or PD that failed to answer the call they would be strung up by their entrails, and paraded through the streets!

The First Grade Council needs to be disbanded, and in its place, a NJ EMS Council needs to be formed, with the needs of ALL EMS providers, from the Volunteer EMT to the MICN covered, all the time focusing on improving patient care.

Our legislators need to be educated on the disaster that is the EMS system, and we need their help if any of this is going to happen.

Granted, I haven't covered things like the "mother may I" ALS, but lets fight one battle at a time. Write your legislator, and lets try to improve patient care!

AJ Zuccarelli, EMT-B, soon to be EMT-P.

[paramedicmike]

Can't we just place some explosives, blow it and let it drift off into the Atlantic?

You do know what the best view of NJ is, right? The view in your rear view mirror as you're leaving!

-be safe

[Flasurfbum]

But for some reason, some of us keep getting sucked back there....

[FormerEMSLT297]

One of the first things you can to to "fix' NJ is to change the law.

I am by no means an advocate for a fire based EMS system, I tyhink everyone here knows my views, but a system that only allows ALS providers to work out of hospital based systems is crap too.

The hospital, because of medicad reimbursment cant get enough money to turn a profit, so they drop an ALS unit here or there.

Alllowing Paid FD,'s 3rd service municiplaities to run ALS units, or allowing the volunteer companies (FAS) to hire paid ALS people, would greatly enhance to ALS coverage...

I think this can be accomplished fairly simply, What NJ state legislator does not want MORE ALS coverage. It's a win win situation, change the law so that any agency with a Medical Director and support and or sponsership from a municipal government can run ALS units.

Give me one good reason why Hospitals in NJ should have a monopoly on ALS units when patients are dying on the streets because of the shortage of medics.

This is crap. Also FAS members, local FD's, PD,;'s municipalities should publicize the S&*$ out of the fact that this monopoly exists to the detriment of the general public.

Win the crowd and you may effect change.

[Chief1C]

The only reasonable fix I can see, is going nuclear.

[flight-lp]

The only reasonable fix I can see, is going nuclear.

beautiful!

[Asysin2leads]

I concur. New Jersey, between the corruption and bureaucracy, is utterly unfixable in all aspects. Unfortunately, NJ is so far gone that corruption is pretty much day to day business. I read the papers all the time from Jersey and it is fairly common occurence, judges, legislators, and administrators being hauled off to the pokey for fairly petty bribes and graft, $500 here, a new car there, which tells me that taking bribes and handouts is just part of the way of doing things. Ain't no way you're going to shut down a vollie squad that rakes in a couple of million dollars a year in "donations" when money is changing hands like that. Just not going to happen.

[dahlio]

NJ EMS could improve through a few changes.

The County 911 systems aren't a bad idea at all. I was driving a medic truck the other day, and had to choose between four different radios to let their dispatch center know where they were going. Take Hunterdon County as the example. and implement it. Everything radio communication wise is done by a single 911 receiving point, and all dispatched from there as well. I remember reading the NJ EMS Report, and seeing a picture of 7 different radios in St. [s:57e27d515d]Claire'[/s:57e27d515d] Joseph's MICU.

Second, The First Aid Council should be disbanded, and every ambulance should be regulated by the state. There are ambulances in NJ, that don't even have EMT's on them. This does not provide good patient care, and gives the public a false impression. But then again, the municipalities don't care, they get EMS for free.

If only the public knew what substandard care they were getting, then maybe things could get better.

[CBEMT]

Give me one good reason why Hospitals in NJ should have a monopoly on ALS units when patients are dying on the streets because of the shortage of medics.

Can you prove that?

I agree that the failure rates of many of the volunteer agencies is unacceptable, but I don't see how a system with high-quality, closely-monitored/QA'd ALS providers seeing acutely ill patients is somehow worse than the ALS-everywhere horror show that would surely ensue if things were taken too far.

Let's not have NJ turn into CA, mmkay?.

[Flasurfbum]

Can you prove that?

I agree that the failure rates of many of the volunteer agencies is unacceptable, but I don't see how a system with high-quality, closely-monitored/QA'd ALS providers seeing acutely ill patients is somehow worse than the ALS-everywhere horror show that would surely ensue if things were taken too far.

Let's not have NJ turn into CA, mmkay?.

OOH OOH I CAN!

I have had a pt. die at the hospital from CHF who, IMO, could have benefitted from early intervention, not limited to CPAP and Lasix.

Not to mention the one crew who I worked with who cancelled ALS, and the pt later died from CHF. Fluid up to the tops.

And I am not advocating another Florida, or Cali. Just another couple trucks where they are needed.