Your Controversial EMS-Related Opinion

[MMiz]

What controversial opinion(s) do you have about EMS?

I'll go first: those that refuse to be vaccinated shouldn't be in EMS.

 

[NomadicMedic]

Candidates should have no more than two attempts to pass a cognitive exam.

 

[E tank]

Fire should have nothing to do with EMS (besides carrying people down stairs and shocking people), EMS should be hospital based, HEMS should require hospital based medical control approval prior to all call departures.

 

[Fezman92]

Private EMS (including IFT) should not exist. Putting profit over people is wrong.

 

[EpiEMS]

Private EMS (including IFT) should not exist. Putting profit over people is wrong.

I agree that private EMS is a suboptimal model, but not for ethical reasons. What’s your alternative when taxpayers don’t care?

My controversial opinion? EMS (paramedicine?) should be independently regulated by EMS providers and not under a board of medicine.

 

[Fezman92]

What’s your alternative when taxpayers don’t care?

Don’t care about EMS? Do you honestly care about where every single cent of your tax money goes?

 

[GMCmedic]

Do you honestly care about where every single cent of your tax money goes?

Yes

 

[Fezman92]

Yes

1) Nice
2) For those that do care and don’t want their taxes going to EMS, they’re just going to have to deal with the fact that they’re paying for EMS.

 

[DesertMedic66]

HEMS should require hospital based medical control approval prior to all call departures.

This is pretty much how it’s done for hospital to hospital transfers. Hospital A contacts Hospital B and gets acceptance. Doctor at Hospital A decides HEMS will be the best option.

 

[E tank]

This is pretty much how it’s done for hospital to hospital transfers. Hospital A contacts Hospital B and gets acceptance. Doctor at Hospital A decides HEMS will be the best option.

Yeah, so if the receiving hospital makes a determination like that for an interfacility transfer, it would make sense if they did it for patients in the field as well.

 

[akflightmedic]

Zero to hero is a bonafide and acceptable pathway.

Paramedic should be an Associate Degree entry level.

While both these positions sound contradictory, they are not. If no degree is ever required, I am absolutely ok with the first opinion under our current prevailing model.

 

[DesertMedic66]

Yeah, so if the receiving hospital makes a determination like that for an interfacility transfer, it would make sense if they did it for patients in the field as well.

So you want a ground EMS unit to call the hospital and get the on from med control at the hospital to fly a patient? Instead of the ground EMS crew making that determination on their own?

 

[VentMonkey]

Endotracheal intubation should be removed from the national scope of practice. It should be a system/ program choice with adequate and appropriate (re)training. This applies to RSI as well.

All provider levels should have solid fundamental knowledge of basic airway care in the prehospital environment, EMR to paramedic.

 

[Summit]

AEMT should be the minimum to work on a 911 ambulance.

AEMT should have needle decomp.

Paramedic should be a 2 year degree and CCP or CP should each be another year.

 

[E tank]

So you want a ground EMS unit to call the hospital and get the on from med control at the hospital to fly a patient? Instead of the ground EMS crew making that determination on their own?

Or the flight crew themselves...for anything that would not be determined to be a reasonable lights and siren return by ground in any other circumstance. Just 'cause the helicopter shows up doesn't mean they have to take someone, which, I know you know. But that isn't always how it plays out.

This is the controversy thread, remember...

 

[DesertMedic66]

Or the flight crew themselves...for anything that would not be determined to be a reasonable lights and siren return by ground in any other circumstance. Just 'cause the helicopter shows up doesn't mean they have to take someone, which, I know you know. But that isn't always how it plays out.

This is the controversy thread, remember...

Oh I would absolutely love to land and then say “we can’t justify flying this one” and then leaving. I don’t ever see that happening unfortunately

 

[E tank]

Oh I would absolutely love to land and then say “we can’t justify flying this one” and then leaving. I don’t ever see that happening unfortunately

Thus putting it on medical control at the receiving hospital.

 

[Tigger]

If you arrive in ambulance, you should be able to provide pharmacological pain relief.

If you’re intubating, you should have access to a ventilator.

Not wearing high viz something on traffic accidents should result in some kind of discipline, period.

The best for last:

The current tiered system is totally backwards. Sending someone with apx 120 hours of training to see if someone needs an actual assessment from a provider with formal education is backwards. You don’t know what you don’t know.

 

[Tigger]

Oh I would absolutely love to land and then say “we can’t justify flying this one” and then leaving. I don’t ever see that happening unfortunately

The helicopters here will do that regularly. Volunteer BLS first response requests a helicopter on dispatch. Helicopter arrives, provides an assessment, and if warranted, waits until the ALS ambulance shows up and gives a handoff and flies away.

 

[EpiEMS]

Don’t care about EMS? Do you honestly care about where every single cent of your tax money goes?

I care about EMS, but the optics often will be "you're raising my taxes for what?!" in many places. That said, most of the public does agree that taxes should fund EMS (see pg. 2 of Carson & Shepperd, 2020)

Public perception of EMS is fascinating as an area of research (e.g., Crowe 2016, Carson & Shepperd, 2020).

The current tiered system is totally backwards. Sending someone with apx 120 hours of training to see if someone needs an actual assessment from a provider with formal education is backwards. You don’t know what you don’t know.

I love this. It is indeed a totally backwards model. This is where fly car medics come in! That said, I do enjoy a good critical BLS call...