Still in England, trying to gather as much as I can about a different way of doing what I do. We just finished a video update (vlog Im told to call them but that sounds too Klingon) about some of the differences between us, from radio communications to resource allocation to treatment and transport decisions. I feel bad for you guys when I get back and settled and write this all up. I’ll have to break it into a number of posts spanning weeks. The video is loading to youtube as I type, it’s almost 9 minutes long so may take anywhere from 6 weeks to 10 years to upload.
UPDATES-
We finished our third day on the rapid response car today and are due one ambulance day later next week. The car is a neat resource to have if staffed by the right kind of pro-active Paramedic who can be trained and trusted to recognize when a person doesn’t need to go. Now we just need a system willing to trust their paramedics to make those decisions. We don’t need more ambulances, we need less patients. This system is operating with more medics but less ambulances than similar US communities, and yet no response from the fire resources on medical calls. This system is not locked into the antiquated BLS before ALS response model adopted by so many communities. The current system is front loaded and allows the best allocation of resources based on a highly trained person first in the door to make the next decision regarding response, whether that is to cancel the ambulance based on presentation or to continue the ambulance.
Unfortunately, this model does have it’s limitations and sending the car or ambulance based on proximity to the call could be doing good to meet response times but may not be the best decision for the system. I think another car and another ambulance could provide excellent coverage in this area, but that will cost money, one thing that all emergency services are hurting for.
The car model should be evaluated by rural areas or any volunteer ambulance or squad running Paramedic Fire Resources. You can get a medic in the door and make the determination as to how the ambulance should respond, instead of so many persons put at risk running lights and sirens to what will likely turn out to be a non-emergency.
I’ll be learning more about the Pathways triage and redirection system tomorrow and hope to learn hoe this system can triage callers away from 999 and to the appropriate persons in the healthcare system.
But I know what I want out of this, what do you want? Im over here as your eyes and ears and this is your chance to learn about Mark and this system just as much as me, only you dont have to sufferthe jet lag and 5 AM starts (9pm my body keeps telling me)
So I ask you to email me what you want to know while Im here. What are you dying to ask someone over here but never get the chance? The chance is here, take it.
Weve gotten requests on Twitter to have a look around the rapid response car in a video update, thats coming up.
Ive also been asked by some of my fire service readers to bring up the high pressure low volume tactics emloyed here. Believe me that will be a big part of my discussions on Wednesday with Swalwell Station Manager Moodie who will be giving me a tour of the fire resources in the area.
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I would like to know how how they handle transports from Physician's offices and clinics there. Here in my community (Metro Atlanta, Ga) we often respond to physician's offices to find non-emergent patients being transferred to the ED by request of the physician. How do they handle those request?
I would like to know how how they handle transports from Physician's offices and clinics there. Here in my community (Metro Atlanta, Ga) we often respond to physician's offices to find non-emergent patients being transferred to the ED by request of the physician. How do they handle those request?
Gamedic, I may be able to answer that one. In our trust, and I'd guess it's the same in Mark's, a call to a doctor's consulting rooms is treated the same as all others. The patient's condition will determine whether or not the call is categorised A, B or C. Cat A calls should be met within 8 minutes, Cat B within 20 and Cat C when we get around to it! (Actually, 2 hours.)
In many cases, Cat C will be asked (told) to make their own way to hospital if possible by the doctor. They probably don't really need an ambulance.
We also have “Doctors' Urgents” where the doctor has arranged admission for the patient. With these, the time is negotiated but our crews are supposed to turn up within so many minutes of the arranged time. Some go by emergency ambulance if one is available, but the rest are often conveyed by the Patient Transport Section, which means that highly trained paramedics and technicians are not used for “taxi” jobs.
It's decided on the level of care needed.
Justin – I'm a CFR (a volunteer) – get Mark to explain if you don't know what one is. Do you have similar people in the USA, or are all volunteers trained to a higher level?
We have to transport regaurdless of severity. Once we are on the scene we cannot leave even if a Cardiac Arrest is dispatched and we are the closest unit. I have a Blog dedicated to the topic – Did you call 911 for this? It talks about the non-emergency use of 911 and the consequences. http://gamedicbc.blogspot.com/ Please take a look at it. I would like to hear your comments.
Justin- I think telling your American firefighter colleagues about the kind of accountability and tracking system British firefighters use could be telling. Mentioning their LODD stats versus ours might drive the point home (if in fact you determine that the two are connected).
On the EMS side, maybe you could talk about some other things that British EMS doesn't transport- like cardiac arrests. Or what their criteria are for requesting HEMS, and the limits under which they will lift off?
And last but not least, the educational requirements to not only attain Paramedic certification under the British system, but what it takes beyond that, if anything, to be an independent first-response practitioner like Mark.
I don't mean Mark personally, but in General, what's the average pay for a newer paramedic? How does it compare to Nurses in the NHS?
GA medic, that blog title sounds familiar…Your blog is now in the Mutual Aid Board.
Brendan – Asked and Answered!
I spoke to “Smudge' the equivelent of an engineer here and he told me about the elaborate air management timers they use on the fireground. another aspect of safety here is the complete lack of the “macho tough guy” attitude in the firefighters. everyone here sees a job that needs to be done and does it safely. Strangely their folks aren't dying like ours, but they also have far fewer fires.
Mark's pay, certification times and HEMS are long answers that each deserve their own post so watch http://999medic.com for more on that.
Transporting codes? Only if they're viable. their protocols there are the same as mine.
Asked and kinda Answered!
Mark will discuss pay in a seperate post, watch http://999medic.com for that soon.
Thanks for placing my Blog on the Mutual Aid Board. I have just started reading Blogs so i have not found another with that title. I am sure a Blog with that title would normally speak of ridiculous calls that we get. Mine does not mention a list of ridicuous calls but rather the dangers these calls pose, with units responding lights and siren to a call that turns out to be non-emergent. It also talks about the strain these call place on the system and possible re-education of the public to understand what constitutes a true emergency. I tried to cover much more than 'hey you won't belive what he called for'. I believe what you are learning from Mark and the system they use could benefit us greatly.
Thanks for placing my Blog on the Mutual Aid Board. I have just started reading Blogs so i have not found another with that title. I am sure a Blog with that title would normally speak of ridiculous calls that we get. Mine does not mention a list of ridicuous calls but rather the dangers these calls pose, with units responding lights and siren to a call that turns out to be non-emergent. It also talks about the strain these call place on the system and possible re-education of the public to understand what constitutes a true emergency. I tried to cover much more than 'hey you won't belive what he called for'. I believe what you are learning from Mark and the system they use could benefit us greatly.
I was just looking through the tabs on your page. I was reading the Bio under the “Who is HM?” tab when I saw the familiar You called 911…For this? I did not see that prior to 5 minutes ago. I had no intention of using a title already out there. But as you know that is a common thought medics have all over this country and I am sure around the world. I see why the title looks familiar now!
“Transporting codes? Only if they're viable. their protocols there are the same as mine.”
Good for you guys. I still have to work anything that isn't purple or rigored. And keep working it, all the way in.
Could you go through the “kit” they carry on the Ambos? Maybe even a short video tour of the ambulance. Also how about a piece on spinal immobilization protocols?
Could you go through the “kit” they carry on the Ambos? Maybe even a short video tour of the ambulance. Also how about a piece on spinal immobilization protocols?
Could you go through the “kit” they carry on the Ambos? Maybe even a short video tour of the ambulance. Also how about a piece on spinal immobilization protocols?