Voice at the Table

Four calls today (1) an asthma, a woman who works in a school where there is new construction going on. She inhaled some fumes and tightened up. Same thing happened to her three weeks ago. Today was her first day back. (2) A woman vomiting, who was stable enough to meet us at the door, fully dressed, holding her pocketbook, ready for the ride to the hospital. (3) a dialysis transfer and (4) a two month old baby with abdominal discomfort.

I went to my regional EMS meetings (Educational Standards and Medical Advisory) today and we discussed the issue of some volunteer services using lights and sirens to go to the hospital on non life-threatening calls. Their reasoning was so they could get back to their towns to provide coverage. While I am against the use of lights in sirens in just about all circumstances except true life threatening emergencies, I do sympathize a little bit -- and only a little bit -- with the volunteers. The real problem is that there are not enough ambulances to provide coverage or rather there is not a system in place to put a mutual aid ambulance in towns whose ambulance is out. All towns have mutual aid agreements, but they merely reflect who will be called when a 2nd call comes in and it does not necessarily mean that service will be available to respond rapidly or at all – they may be out on a call. It is a problem with an area of the country that instead of using county government, uses local town and municipality government so there are a proliferation of small volunteer services and multiple private systems. It is not really the best way to respond to people’s needs. On the basic issue of lights and sirens I think as I said they should be used rarely, and I in fact think we(all ambulances no matter the service) are sent lights and sirens way too often for anyone's safety.

We also talked about letting basics use the spinal immobilization protocol paramedics use to allow them discretion over who to immobilize (I’m for it), a new exam for paramedics seeking medical control (I’ve been tasked with writing the exam and today I presented the cardiac section), and several other interesting issues. I enjoy these meetings because while not everything gets fixed (the coverage problem will not be fixed by us) we can make some changes that do affect the quality of care.

I am the paramedic representative on the committee, but may have to resign my post because the regional paramedic committee has stopped meeting and I feel somewhat like a fraud representing a defunct group. I will still go to meetings and do work, even if I will lose my vote, which isn’t that important as most everything is done by consensus. As long as I have a voice at the table, that will suit me.