EMS can be a confusing industry even for those of us involved in it. When 911 is called, do you know where that call is answered? The public probably doesn’t nor do they understand why the call may need to be transferred. An EMD trained dispatcher may have to ask many questions to fully understand the nature of the call, yet to the caller they are just delays.
The second year of the EMS Trend Report continues the effort of EMS1, Fitch & Associates and the National EMS Management Association to assess and monitor changes in the EMS profession. They surveyed a cohort of EMS agencies – representative of different service models and geography – about clinical care, operations and the future of the EMS profession.
Many of us have seen the use of drones increase dramatically in law enforcement and fire suppression, but they are also being deployed to augment EMS. In 2014, Alec Moment, developed a prototype of an ambulance drone. Designed to travel up to 60 mph, its purpose was to carry a small defibrillator to people who had suffered cardiac arrest.
You are treating an elderly patient with nausea and ask your partner to draw up some ondansetron, you take the syringe from him and deliver what you believe to be 4 mg. While cleaning up your ambulance after the call you realize that what you actually pushed was 50 mg of diphenhydramine. And just like that a medication error has been committed.
If you’ve been in EMS for any length of time you no doubt have had a conversation with somebody about response times. Perhaps you are a field provider who was spoken to about your extended response time, or as a manager you discussed your systems average response time with a town manager. It’s a metric we all live by and it’s a number we are all familiar with, but should this be a key indicator for our systems success?
Safety has become a continued focus in EMS, especially as it revolves around communication. The techniques found in Crew Resource Management (CRM) have helped develop a framework to improve safety through effective communication. The term Crew Resource Management was coined in the late 70s by the airline industry and was developed as a solution to a series of preventable incidents.
New York City had an ambulance service for sick horses, in 1867, two years before there was an ambulance service for people. The American Society for the Prevention of Cruelty to Animals decided that ambulances were needed for horses, two years before Bellevue Hospital decided the same thing. (Needless to say, neither horses nor humans were offered a patient satisfaction survey.)
Astonishingly, even after many cities and towns had ambulance services, there were few federal laws regulating them until the 1970s.
When we think we have it bad today it is good to remember how ambulances were called for and dispatched when they were first invented. When Manhattan’s Bellevue Hospital began its ambulance service in 1869, the second in the country (after Cincinnati), they were impeded by the absence of telephones, which hadn’t been invented yet. Calling an ambulance in New York City worked like this: A patrolman would discover someone who is ill or injured and use a public telegraph station (itself a recent innovation) to contact his precinct, which would send out policemen with a stretcher.
During the Napoleonic wars at the turn of the 18th century, Surgeon Dominique-Jean Larrey developed new emergency procedures, many of them still in use today in modernized forms. Not only did he create “flying ambulances” that brought immediate and well-provisioned aid to the battlefield, but he also imposed order on the treatment that was taking place in the most disorderly of environments.
Modern emergency medicine began on the battlefields of the Napoleon wars in the late 1700s. Physician Dominique-Jean Larrey was dismayed at the practices of the time, which left wounded soldiers on the field until the battle was over. By this time the danger to those who would pick them up lessened. Unfortunately, by this time many of the wounded were already dead.