Why
does the
ambulance sit parked after picking up my friend/family member?
What
took the
ambulance so long to get to the scene?
Why
does the
ambulance not come to the scene with lights and siren on?
Why
do I receive a
bill from SMCAS when I pay for the service through my taxes?
What is the
difference between an EMT and a Paramedic? Isn’t everyone an
“Ambulance Driver”?
Why
does
the
ambulance sit parked after picking up my friend/family member?
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.
What
took the
ambulance so long to get to the scene?
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.
Why
does the
ambulance not come to the scene with lights and siren on?
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
Why
does the
ambulance not go to the hospital with lights and siren, even if they
responded
to the house or scene with lights and siren?
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.
Why
do I receive a
bill from SMCAS when I pay for the service through my taxes?
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.
Why
does SMCAS
operate out of bases and not post in various spots in the coverage area
like many
other ambulance services?
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.
What
is the
difference between an EMT and a Paramedic? Isn’t everyone an
“Ambulance Driver”?
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.
|
|
MFR |
EMT-B |
EMT-S (I) |
EMT-P |
CCEMT-P |
|
Designation |
Medical First Responder |
Emergency Medical Technician - Basic |
EMT – Specialist or Intermediate |
EMT - Paramedic |
Critical Care Paramedic |
|
Minimum Duration of Training |
60 Hours |
194 Hours |
100 Hours |
1024 Hours |
80 Hours |
|
Prerequisite License |
None |
None |
EMT-B |
EMT-B |
EMT-P |
|
License or Certification |
License |
License |
License |
License |
Certification |
|
Knowledge Base |
-Emergency
Vehicle Operations |
MFR Plus: |
EMT-B Plus: |
EMT-S Plus: |
EMT-P Plus: |
| Traditionally in the United States the logo was used as a stamp of authentication or certification for ambulances, paramedics or other EMS personnel. Internationally, it represents emergency medical services (EMS) units and personnel. For a more detailed explanation click the star to the right. |  |
