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Rural County EMS System--Scares me


SSG G-man

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Forgive me if I digress a bit but a few earlier posts in thread seem to call for response. The posts to which I refer are the ones pertaining to rural meidc / urban environment or vice versa. This entire line of discussion personifies the reason we remain in the dark ages as a profession. Having a contest of who is better than who is an adult version of kids comparing the size of their private parts.

This reminds me of when a nearby county added RSI, which immediately resulted in a five fold increase in intubations in just one week. The medics were strutting around comparing notes and I overheard one of them state "you better not miss a breath or I'll RSI your ass". Its this kind of thinking and uneducated bravado that causes medical directors to remain reluctant to permit expansion of our scope of practice.

Medical directors and others with a stake in the "stuff" we do aren't interested in folks that are reckless and simply perform a skill because they can. These folks as well as true professionals within our own ranks must understand the science, biology, pathophysiology, cause and effect of all that we do and gravity of the decisions we make to truly become respected as professionals.

RSI is a really good example for this discussion since it is likely one of the most dangerous skills we perform if done improperly. And remember in most systems if you are a paramedic then you are permitted to utilize all of the paramedic skills, regardless of your ability or lack thereof. Think of the worst employee in your service then apply this.

All I'm saying here is that instead of worrying about who can accomplish what in the shortest period of time "I can name that tune in three notes" focus on whether you can deliver appropriate care to the patient and safely deliver them to definitive care.

Finally I must tell you that i find it hard to believe the assertion of things that can be accomplished in five minutes. It seems as though you are saying you can perform a thorough patient assessment, make a treatment decision, begin appropriate treatment, evacuate the patient from the residence and begin transport in five minutes. If this is true you are arguably the fastest most efficient pre-hospital provider in the nation.

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Finally I must tell you that i find it hard to believe the assertion of things that can be accomplished in five minutes. It seems as though you are saying you can perform a thorough patient assessment, make a treatment decision, begin appropriate treatment, evacuate the patient from the residence and begin transport in five minutes. If this is true you are arguably the fastest most efficient pre-hospital provider in the nation.

Yep can be done and I'm sure someone will post just how they did it. If they do let's make sure we get them in the paragod thread.

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Rural first responders are made up of more than just first responders we have EMTs Nurses and paramedics. Yeah those twenty minutes for the ambulance to get there may seem like a lot but at least on my VFD first responders are there within five to seven minutes of us receiving the page meaning the patient gets medical treatment just about as fast as in the city.

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Barrelgirl, welcome to the site.

Can you explain just what your VFD first responders can do for a sick patient? I can see some merit in a MVC, but honestly, what can they do for say, CHF, diabetic complications or respiratory distress?

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Finally I must tell you that i find it hard to believe the assertion of things that can be accomplished in five minutes. It seems as though you are saying you can perform a thorough patient assessment, make a treatment decision, begin appropriate treatment, evacuate the patient from the residence and begin transport in five minutes. If this is true you are arguably the fastest most efficient pre-hospital provider in the nation.

Yep can be done and I'm sure someone will post just how they did it. If they do let's make sure we get them in the paragod thread.

My question is why would you want to?

Rushing without thinking to make a scene time is poor patient care and just plain stupid. Deliberate and thought out care is not necessarily a bad thing people. Rushing off scene with a fast run to the hospital is so 70's. Yes it has it's place in trauma but even then you shouldn't move faster than you can think.

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I have heard of such a asystem but have never been around one. We run a rural ambulance district. It is comprised of three stations and four full time als units and a bls or als day car (9am to 9pm) which usually is plenty for our area but sometimes an all call is used to bring in part-timers or off duty full timers to man reserve units.

VFD can be a very useful tool on medical scenes. I carry a jump bag with me, and though I am no longer affiliated with the local VFD I do carry glucose gel and various other things with me, if prepared a VFD can provide adequate patient care until als arrives

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.

VFD can be a very useful tool on medical scenes. I carry a jump bag with me, and though I am no longer affiliated with the local VFD I do carry glucose gel and various other things with me, if prepared a VFD can provide adequate patient care until als arrives

And if they are unresponsive are you still going to use oral glucose?

Maybe the diabetic thing was a bad example. What I was trying to say was, there is very little a VFD can do in a medical emergency without the proper education. You may be an exception, but the majority of these departments are ill equipped to deal with medical emergencies.

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