The Perfect System?

I sat down last night and watched Chronicles of EMS again and realized that there is an EMS system operating right under my nose that just might be the perfect EMS system. Let me tell you about it:

It is a fully functional ALS transport system which staffs both ALS and BLS and usually has 6-8 people on duty on any given day.

The population served fluctuates from around 10,000 people to as many as 25,000 people and covers an area that is about 5 square miles in size. It serves both the young and the old, the rich and the poor and has a decent sized migrant worker population.

In 2009 the service had nearly 4,000 patient contacts and, are you ready for this? It only transported 100 patients.

Average response times to all calls is under 7 minutes and it drops to under 5 minutes for higher priority assignments. Severity of the calls ranges from bee stings and knee scrapes go trauma activations, cardiac arrests and STEMIs.

There are a number of different patient pathways available to the paramedic who has a large influence of the final disposition of the patient. They include:

-Ambulance transport to an ER
-Private vehicle transport to an urgent care facility
-Monitoring of a patient and then releasing them back into the public
-Treat and release of minor injuries
-And reevaluation and continued care of prior injuries.

When a patient IS transported they have access to ALS care and there is no charge for the ambulance service provided. ER services still need to be addressed but the ambulance services are completely free of charge.

When the staff isn’t taking care of patients they turn towards preventative measures to help the community they serve. This includes auditing the safety and durability of buildings roads and attractions, and conducting free CPR classes to insure that as many people as possible are certified at the laypersons level.

I’m sure by now you’re saying to yourself “come on, Scott spill the beans! Where is this EMS Utopia?” okay I will tell you but you’ll never believe it. It’s actually at my part time job at the New England branch of a large national Amusement Park chain.

It’s really quite a unique sytem. The majority of my job revolves around prevention. We audit rides and stands to make sure they are OSHA compliant and safe for use. Injured employees often are either treated in house with ice and rest for minor injuries or sent out to Urgent Care centers for evaluation for moderately serious issues. If needed we obviously will transport however the majority of our calls result in other outcomes. Most of our injured guests would much rather get patched up, rehydrated and go hop back on a roller coaster than sit around in an ER.

The majority of our job doesn’t revolve around which hospital they would like to go to but it gravitates towards making the guests day better after an unfortunate event. It’s actually quite refreshing.

The staff is very experienced. Most of our senior ALS staff has 8 or more years experience as Medics and our most experienced EMTs have been at it for 20+ years.

Every full-time Park employee is CPR trained and many of our security staff and all of our life guards have basic first aid/first responder training.

So there you have it: a system where EMS has a large amount of oversite, and multiple potential outcomes for patients. There is a huge focus on injury/illness prevention and a very low ER transport rate.

If that doesn’t say EMS 2.0 then I don’t know what does.