Disaster medicine

[Jambi]

I believe you are under the impression that what I have in mind is taking things to a very deep level. It's not. It's about a better integration of EMS into the larger healthcare system, not as a "disaster response team," but just as another component with better utilization. Assembling and maintaining such a thing is not feasible, and not my point.

I can also understand your bitterness to the constant push-back in regards to EMS educational standards. I'm constantly amazed at how apathetic or just plain hostile people are to the idea of increased standards, particularly from fire departments.

Professions face two facts education is never just enough, and experience is never just enough. There must be a balance as one without the other is really meaningless. Otherwise we'd still be training doctors apprenticeship style.

Change is possible. Texas requires a bachelors to be licensed as a paramedic though it can be any degree, but it's a step.

I may be idealistic, but I am far from young or naive. Change starts with one person that persists. This is my plan. I have been an EMS educator for 10 years. Doing skills at first, and now as faculty. The entry requirements were low, and while I benefited, I think it needs to be changed and progressed forward. That is my goal, progress, no matter how slow. I can make the most impact my educating and changing the system from inside out. Likely an impossible task, but why not? :wacko:

There is a place for EMS to be better integrated in the larger healthcare system and into all phases of disaster and emergency response regardless of what you want to believe.

It's nice to have such analytical feed back without it being inflammatory. Thanks for the discourse so far.

 

[usalsfyre]

Change is possible. Texas requires a bachelors to be licensed as a paramedic though it can be any degree, but it's a step.

Errr, not quite...

LP is simply a type of paramedic in Texas. It is granted no special privileges above a certified paramedic. It can be achieved via an associates in EMS or a bachelors in anything. While I like Texas, educationly we have a couple of the lowest hour programs onthe nation.

 

[Jambi]

Errr, not quite...

LP is simply a type of paramedic in Texas. It is granted no special privileges above a certified paramedic. It can be achieved via an associates in EMS or a bachelors in anything. While I like Texas, educationly we have a couple of the lowest hour programs onthe nation.

It is still a step. A foundation upon which to build, and that encourages me. It's also a way to eventually transition to requiring a person be a LP.

What would you like to see happen with the whole CP/LP thing?

 

[Veneficus]

There is a place for EMS to be better integrated in the larger healthcare system and into all phases of disaster and emergency response regardless of what you want to believe.

Like what?

 

[mycrofft]

Just sidling in.
Using the Darwinian/ Dianne Fossey approach (go out live with the gorillas, smell their scat, and see what they actually are doing day to day), lets look at what happens to "EMS" (mostly we are talking about prehospital or in-house?).

It rapidly devolves into centralized care centers depending upon walk-ins, drag-ins (people carrying one another in their arms, not even using litters), or drive-ins (private autos, horsedrawn wagons, ambulances without equipment). Think an analogue to the old WWII system of dressing stations, battalion hospitals, etc.

By definition a disaster scene has broken infrastructure (roads, commo, security, utilities) so continuation of prehospital EMS (PEMS) as we think about it ceases. Also, a trained practitioner can see more people in a day by setting up shop than charging out to rescue individuals, and in so doing can also avoid being swamped physically. (bstone, you still out there? Chime in anytime). Once the disaster is over (defined by resumption of most services), then it becomes largely a public health and emergency/urgent care deal because the most emergent cases have undergone "triage by time", either died, got better or got away.

Study what has happened to areas like early Palestinian "camps", Afghanistan, Iraq, Lebanon (treating tetanus with hyperbaric O2 because no vaccine due to no refrigeration), Kosovo, and of course New Orleans and other Gulf Coast areas hit in 2006.

 

[Veneficus]

Study what has happened to areas like early Palestinian "camps", Afghanistan, Iraq, Lebanon (treating tetanus with hyperbaric O2 because no vaccine due to no refrigeration), Kosovo, and of course New Orleans and other Gulf Coast areas hit in 2006.

I have

 

[Jambi]

Like what?

Well, that's the point of my interest, I just don't know yet. My biggest area of ignorance is in disaster medicine. What I know is EDMG and EMS. I know that achieving such change is multifaceted and requires change in perspective, approach, education, and utilization. None of which are easy, and many that may prove impractical; hence my professional interest. My interest wouldn't be there if I didn't believe a place existed for all this craziness, but I refuse to accept the status quo while accepting the near impossible task of changing it without committing career suicide.

You said you studied refugee conditions in, "Palestinian "camps", Afghanistan, Iraq, Lebanon, Kosovo, and of course New Orleans and other Gulf Coast areas." I know the CONUS ones from an EDMG perspective, not from a disaster med perspective. Care to share any sources you think would be beneficial? Have you had anything published on the subject?

 

[Veneficus]

Well, that's the point of my interest, I just don't know yet. My biggest area of ignorance is in disaster medicine. What I know is EDMG and EMS. I know that achieving such change is multifaceted and requires change in perspective, approach, education, and utilization. None of which are easy, and many that may prove impractical; hence my professional interest. My interest wouldn't be there if I didn't believe a place existed for all this craziness, but I refuse to accept the status quo while accepting the near impossible task of changing it without committing career suicide.

You said you studied refugee conditions in, "Palestinian "camps", Afghanistan, Iraq, Lebanon, Kosovo, and of course New Orleans and other Gulf Coast areas." I know the CONUS ones from an EDMG perspective, not from a disaster med perspective. Care to share any sources you think would be beneficial? Have you had anything published on the subject?

I have not published on the subject.

I actually get paid to give a presentation on it.

I will send you some stuff when I get a chance via private message.