I work
in Illinois EMS and I complain about how it is administered. If you know me you
know that is not surprising. Illinois EMS has a system where 90% of EMS is
administered by nurses. A lot of these nurses are good people who try to
perform their job with the best goals in mind. EMS agencies are required to
join EMS systems that are administered by these nurses. While there is a
physician above them, this Dr. has no real knowledge of the people that work
for him or her unless they transport to his or her hospital. So we wind up with
cookie cutter solutions that only work for the people they see. Because there
is no real interaction, the protocols tend to be designed to hold back the
exceptional to ensure that people they never see do not screw up.
So, how
can we fix this problem? My solution is that we require the systems to become
modular. Each resource hospital has a set of base line protocols, and then has
modular enhancements. These modular enhancements might include mechanical CPR, field
clearance of C-spine, community paramedicine, and Critical Care Transport. These
are just examples obviously, but it would be a start. Allow the providers to
know what they have to do in order to allow these things to happen. Then you allow
them to do it. Voila, a simple solution to a real problem.
The
best solution is to allow agencies the option to allow EMS providers to hire
their own Medical Director. This would allow for EMS agencies to put into place
the protocols that actually serve their patients and communities best. But the reality is that this is not going to
happen soon. Despite this being the reality on all surrounding states, Illinois
resists change more than any other state. So we need to consider modular
systems. It at least allows us to move in a more modern direction, instead of
being stuck in 2002.
Now this
is only slightly related, but I am going to encourage you to join the NAEMT and
your state EMT association. The NRA is one of the most effective best lobbying
groups out there for a reason. That reason is membership. NRA members donate
and teach the majority of the gun safety classes out there. These things raise
revenue for the NRA to lobby for gun rights. The NAEMT is that for EMS, yet less
than 1% of EMS personnel are members. NAEMT membership pays for its self in
discounts and benefits, while allowing for better representation at the Federal
level. Most states have similar statewide organizations. NAEMT also provides AMLS and PHTLS as both an
educational and fundraising opportunities. Please take these courses. They
benefit you greatly.
As always, I value your comments and feedback,
Lone Medic
Sad to see. I am originally from Illinois and was a paramedic there. I moved from the state 15 years ago. I worked in a few very progressive system there. Some of the "great ideas" being introduced now were being done there before I moved such as EMT Basics administering certain medications. Heck, one system I worked the EMT-B/D's could Intubate. I was lucky though as most of the EMS Coordinator's I ever had were Paramedics or RN/EMT-P
ReplyDeletehttp://lifeunderthelights.com/2009/10/dear-state-of-illinois-emshellip/
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