A Country EMS in The Big City

Last night I was fortunate enough to have been given the opportunity by Baltimore City FD to ride-along with one of their EMS crews as part of the EMS Today 2012 conference.† My desire was to learn some of the many differences between their service and the more rural EMS service back home.† While there clearly were definite differences, the thing that struck me more than anything else was actually how similar we all are, not how different.

I anticipated the promise that each tone held to expose me to some uniquely urban situation.† And while the individuals I met were clearly unique, the choreography between us all was mostly a repeat.† This is exactly how we are trained in EMS.† We take whatever situation is given to us and we bring a defined order to the chaos.† We seek sameness in purpose and outcome.† The empathy I felt for the apparently homeless patient with the self-induced alteration in LOC and the young woman facing a possible miscarriage was no different here than anywhere.† I simply wanted to help.† The public attitude toward EMS leading to abuse of the system and the painful inefficiencies it causes was also no surprise.† We face the same issues everywhere even if the proportions change.

It was witnessing the banter between calls that told me I wasnít back home.† The teams and even the sports were different, the union issues too.† But then then there was the discussion of changes in protocols, the latest findings in medicine, the issues faced in home life.† Maybe I am not so far from home after all.

At this conference I have already met medics from truly rural areas as far apart as Georgia and Alaska.† Iíve met some who work for private agencies and others who come from city or county services.† It is a commonality that brings us together and that allows us to discuss and learn from each other about our unique situations and approaches.† The pre-conference session I attended yesterday has also helped me think about operational questions I had never considered before.† Personally, I am definitely ready to start this conference today with a proper perspective.

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Comments
Roger Thayne
Static v. Dynamic: A Continuum of Cost
Totally agree. I would add that response and transport need to be understood. Within busy urban areas an ambulance can be both the response and transport vehicle. In rural areas response can be achieved efficiently by a Community Paramedic in a car within 8 minutes supported by an ambulance within 20 to 30 minutes i.e.…
2014-08-10 10:28:37
daleloberger
About
Jodi, it took a while, but we have begun putting this sort of information together in book form. Our first attempt is "Dynamic Deployment: A Primer for EMS" (http://www.amazon.com/Dynamic-Deployment-A-Primer-EMS/dp/1500428574/ref=sr_1_1?ie=UTF8&qid=1407501551&sr=8-1&keywords=dynamic+deployment). We are already in the process of building its sequel that we hope to be a broader compendium of cases, authors, and opinions regarding the measurement…
2014-08-08 07:44:52
Alex
Could Busier be Better?
Since medical calls are now the focus of fire service. Maybe it's time for a rebranding if you will to new terms like "EMS Based Fire Service". Paramedics are constantly upgrading thier knowledge and skills and get thier butts kicked daily but don't enjoy the same pay or benifits that firefighters do. Something is wrong…
2014-08-05 03:55:31
Lauren
Could Busier be Better?
This article is more about understanding evidence based research then applying it rather then replying on personal experience and tradition. Even if you don't like what research says.
2014-07-19 20:30:03
Paul
Could Busier be Better?
High quality comes from seeing multiples of truley sick patients with strong training and support from an experienced partner, not just from being a busy transport vehicle.
2014-07-19 08:26:57

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