Limitations

With Emergency Medical Dispatch becoming the gold standard across the country we need to remember its limitations while appreciating its virtues.  EMD is far from perfect.  An example of this is the recent call in New York City that was reported by The Daily News where a woman died with an associated 14 minute response from the ambulance crew.  The initial nature, sick and not eating, warranted a non-emergent response, but 8 minutes later, when the woman began vomiting blood, the response was upgraded based on the information received.

The public outrage from this fourteen minute response was so severe that one of the EMT’s was assaulted by a family member.  Although being upset does not justify assaulting someone, especially a person who is there to help out your loved one, I can understand to some extent why this woman’s son was as angry as he was.

In a situation like this though who is to blame?  Was it the EMTs who arrived as quickly as they were sent?  I’d say no.  Is this woman’s other son who presumably has no medical training the one that we should look to when seeking someone to blame?  Again, I would think not.  How about the Emergency Medical Dispatcher who asked the questions and went off the information given to him or her from the non-medical trained witness to this tragedy?  Nope, wrong again.

Although mistakes are going to happen especially in a system as large as New York City’s I think it is actually the FDNY’s administration’s fault that something like this happened.

When a person picks up the phone and calls 9-1-1, their expectation involves ambulances, fire trucks, police cars, and anyone else they might want to be racing across the city, lights and sirens blaring coming to help them no matter how major or minor the situation is, and we allow this expectation to continue.  We allow people to determine what an emergency is rather than letting the experts make that determination.

The emergency rooms have it right.  If you’re having chest pain, if you’ve been stabbed or shot, or have something time sensitive that needs immediate treatment you theoretically jump as close to the front of the line as can be reasonably expected.  Stubbed toe?  Need some stiches in your hand?  Feeling a little suicidal?  Have a seat, it is going to be a while.  Prior to that person rolling through the ER doors though, it is still a different story.  Municipalities don’t get it, and neither does the public.

 Response does not matter.  Patient outcomes do.

But I digress.   The article itself is not what really gets under my skin.  The thing that bugs me most of all are the comments from the public that follow the article.  It is a mix of EMTs and paramedics defending their peers, and some folks questioning why the crew did not rush to this woman’s side, or how they could not handle this one person who became upset and assaultive.  It leaves me shaking my head, but it is no one’s fault but our own.  And all of this happens on the heels of EMS Week?  Come on, folks.

Once again, we have failed to educate the public about what EMS does and what our role is as health care professionals.  Once again, we are seen as gurney jockeys and ambulance drivers.

And once again, I feel like I am sounding like a broken record. . .

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