The highly skilled emergency medical professionals are performing skills in the “controlled” environment of the ambulance and performing a primary, focused, and/or an advanced medical/trauma assessment on the patient to determine a field impression or “working diagnosis” and to treat that illness/injury appropriately in a prompt and effective manner.
The EMT or Paramedic may be taking vital signs, establishing an IV, recording and interpreting an ECG, administering oxygen, or administering drugs dependent on the medical condition of the patient. While we can and may sometimes perform some of these skills while traveling down the road it can be much more effective and safe to perform skills with limited movement.
Many factors may delay an ambulance to arrive on scene including, road conditions, traffic, busy dispatch center, time of day, and other emergency incidences. We at SMCAS strive to limit delays in response to a minimum.
While, these factors do sometimes contribute to ambulance delays, one of the factors to consider is perception of time. When a person dials 911, from the time the call is made to the time the ambulance arrives may only be 6-8 minutes, but due to an increased anxiety and stress, the perceived time appears greater.
As a part of our quality assurance, we at SMCAS are continually reviewing our response times to ensure that all emergency calls are handled in a prompt and timely manner and to meet and exceed all response protocols.
Berrien County uses priority dispatch to determine the type of response that is warranted. When you call 911, the dispatcher, after a series of questions that he/she asks you, uses evidence based protocols, determines if the level of priority requires the ambulance to proceed with lights and sirens. We always consider the risk versus the benefit of response priority.
National studies have shown that driving with lights and siren will reduce the response time, on average, by approximately 90 seconds for every five miles of travel. While this time savings may be warranted on some calls, science has shown that this time savings is not needed on all calls. Any emergency vehicle that travels in excess of the posted speed limit with lights and siren on has a considerable increase in risk of injury to not only the responding ambulance crew but other motorists on the road.
"Even supposing the chief good to be eventually the aim for the individual as for the state, that of the state is evidently of greater and more fundamental importance both to attain and to preserve. The securing of one individual's good is cause for rejoicing, but to secure the good of a nation or of a city-state is nobler and more divine." - Aristotle
Or, to simplify that quote:
“The needs of the many outweigh the needs of the few.” – Spock
While this may seem the appropriate thing to do, we transport only those who are near death or critically sick or injured to the hospital with the fastest possible means while having due regard for safety of ourselves and others. As in the above question, we rely on our medical knowledge, our assessment of the patient, experience, and evidence based care to appropriately treat each and every patient.
We at SMCAS, pride ourselves as highly trained medical professionals who have a great deal of experience and knowledge of evidence based practice to provide the best possible outcome to your friend/family member. Our primary responsibility is to the health and welfare of the patient and to convey him/her to the closest, most appropriate facility for definitive treatment in the most stable condition possible.
Much of what we do is not mere transport, but to initiate quality, effective, and efficient medical assessment and treatment prior to the patient arriving at the hospital. On most calls, the patient stability does not warrant the need of the use of lights and siren, or we were able to stabilize the patient prior to transport to the hospital.
Operating an ambulance service is very costly. An individual’s taxes pay for the service to be in operation and available. The taxes only provide SMCAS enough to keep operational by providing a base of operation, licensure and equipment (and their upkeep) to provide the much needed service.
The bill you or your insurance receives provides SMCAS the capital to pay wages and continuing education of the personnel that responds to any and all emergencies that may arise. Most insurance companies will pay a portion of the cost of an ambulance transport. SMCAS employees always attempt to get a patient’s insurance information so SMCAS can bill the insurance directly.
SMCAS operates out of a central location to provide the best service available. Since the advent of “sitting post” or SSM (System Status Management), there has been some disagreement about which service is better for the community. There is evidence based data that indicates that, on average, sitting at a post in the area vs. from a central base saves 5-10 seconds in response times. It also indicates that, while providing a minimal decrease in response time, sitting point has an increased wear and tear on the personnel and equipment which increases equipment upkeep and personnel turnover.
The adaptive computer algorithms attempt to ascertain where the majority of emergency calls may be at any given point in time using past trends. While this may seem like the best option, it is like trying to predict chaos. Scientists have determined that 100 years of quality usable trend data would be needed to attempt to predict where the majority of the calls may occur. Using this evidence based data; SMCAS believes that to best serve our community, a central base is the best option to provide the best possible emergency medical service.
In EMS (Emergency Medical Services) there are several levels of licensure and certification that an emergency responder can obtain and there is quite a difference in medical knowledge and training that goes into each level. While everyone on an ALS ambulance is licensed as an EMT (Emergency Medical Technician) and we all drive the ambulance on occasion; there is no longer a designation of “ambulance driver”.
When ambulances first were utilized to convey patients to the hospital in the 1960’s and 70’s, the minimally trained and unlicensed personnel were considered ambulance drivers that operated with those services. Since the advent of training and licensing all pre-hospital medical providers, there is no such thing as an “ambulance driver”.
The following table lays out the different level of pre-hospital medical licensure and training with a non-all-inclusive set of knowledge base each level has attained.
Copyright © 2010 SMCAS Ambulance; Southwestern Michigan Community Ambulance Service
2100 Chicago Rd. Niles, MI 49120 Phone: (269) 684-2170 Fax: (269) 684-2152