FeedEMS Advice
January 2, 2007 in Local
There are different levels of life support that can be provided and the terminology can be confusing. First Responders, Basic, Intermediate, and Advanced (Paramedic) offer different degrees of medical care for the pre-hospital patient. Skills and medication improve and become more comprehensive as the level of the provider advances to Paramedic.
Each community offers their own type of EMS. Some is volunteer, some is provided by paid municipal fire departments, and some EMS is provided by private ambulance companies. Many communities offer combinations of the above.
Decisions regarding EMS policy are made by local physicians and city leaders.
I would like to offer my services for the people of the Peoria community to answer any questions you may have regarding the level of care you or your family member received at the time of an emergency. With your permission, I will review the run sheets of
I will attempt to answer any medical questions you may have regarding the pre-hospital care provided.
My objective is to offer a better understanding, in very clear language, of what occurs after 911 is called.
There will be no charge for this service.
John A. Carroll. M.D.
drjohn@mtco.com
www.peoriasmedicalmafia.com
January 3rd, 2007 at 10:57 am
Fine, question 1, why do you hate AMT so much
January 4th, 2007 at 11:36 am
DR. JOHN: I HOPE THIS WILL NOT BE TOO HARD FOR YOU-UNFORTUNATELY I PASSED OUT RECENTLY IN A PUBLIC BUILDING-I HVE A HEART CONDITION AND THOSE PRESENT WERE PARTICULARLY CONCERNED BECAUSE OF THAT FACT, THEY CALLED 911 AND IN EXACTLY THREE MINUTES EMS AND FIREFIGHTERS ARRIVED AND TOOK GREAT CARE OF ME , TAKING ME TO THE HOSPITAL. DOES THIS MEET WITH YOUR STANDARD OF CARE?
January 4th, 2007 at 1:33 pm
Roman, I think only if you donated money at the time you were having a problem that you met his “standard of care.”
January 4th, 2007 at 7:46 pm
Dear Opus,
As I have documented on http://www.peoriasmedicalmafia.com, the paramedic notes and their observations were very important for patient management in the Emergency Room. I relied on them enormously.
The AMT paramedics are obviously not the problem. The problem is that the Peoria Fire Department Intermediates and Paramedics could not offer their skills at the scene of a 911 call. It seems the rule is changed now, and if AMT asks for their help at the scene, the PFD Intermediates and Paramedics can help the patient. This still seems very inadequate for Peoria’s EMS, but does reflect the political situation in Peoria.
When PFD paramedics can moonlight for AMT in their sparetime, but need to wait for AMT to ask for their paramedic help when working for the PFD, something seems quite fishy.
If I am wrong with the above assumptions regarding care at the scene, please let me know.
John
Roman, your question/statement doesn’t make total sense. You don’t understand the confusing EMS vernacular, so I have no idea how to answer your question. But I am glad you did well.
January 5th, 2007 at 9:14 am
John you know that it isn’t just a PAEMS rule that says you can only act at the level to which your agency is certified (i.e. an EMT-I employed by PFD can only act as an EMT-B when representing the PFD). You know that it is an IDPH rule. Why are you intentionally misleading your audience by playing it off as Peoria politics?
January 5th, 2007 at 9:57 am
That is an unfortunate rule isn’t it? I know there are several volunteer EMT-B’s in the Tri-County area that are RN’s or paramedics but can only function at the B level when they are on a call.
I’m not really sure why it’s set up that way though. If I had to guess, I would say that once your agency is licensed at a higher level, you are required to provide that level of care all the time to be fair to everyone. Volunteer departments have a hard enough time getting people to help at the B level.
January 6th, 2007 at 9:41 pm
You are exactly right in your guess Mandy. To be certified at a certain level you have to guarantee that you will provide that level of care on all responses. Most volunteer agencies cannot attract people above a First Responder or EMT-B level. The other thing to consider is that EMT-B level agencies can now carry the common field drugs, and the number of drugs and other equipment increases as the levels get higher. You wouldn’t want a person to utilize a tool or med that they are not fully trained to use.
January 6th, 2007 at 10:16 pm
Mandy,
Tony knows that the Peoria Fire Department Paramedics can intubate at the scene which is above the Basic level training of the Peoria Fire Department. That negates his argument above.
And understand his last sentence when he writes, “You wouldn’t want a person to utilize a tool or med that they are not fully trained to use.” I think we know this, don’t we? Tony responded to me that he did not think that the Peoria Fire Department Paramedics should be able to use their skills at the scene if AMT is not present. I bet he would if he were the one on the ground in pulseless ventricular tachycardia.
John
January 6th, 2007 at 11:04 pm
I don’t know of a rule that allows PFD firefighters who happen to be Paramedics to intubate a patient, unless that is they are asked to by AMT (which is a Paramedic agency). Mixing the truth again are we?
I don’t think they should because that would go against what IDPH says and what the leaders of the PFD want. Two good reasons. If one of them weren’t the case you might have an argument.
January 6th, 2007 at 11:14 pm
And besides, what was my argument above? I answered Mandy’s question, rather I confirmed her guess, in complete truth using the rules as they are stated. Do you really not know the difference between fact and fiction?
January 6th, 2007 at 11:20 pm
Yes, Anonymous Tony, you are mixing the truth.
Many other EMS agencies in the state knows how this plays in Peoria and they understand the Peoria politics quite well. And I am sure you do too.
January 6th, 2007 at 11:28 pm
Goofball John, Why don’t you explain it to us then.
January 6th, 2007 at 11:34 pm
T.V,
Read http://www.peoriasmedicalmafia.com for full explanation.
John
January 7th, 2007 at 8:25 am
It’s obvious this is just a swipe at AMT. the rule is in place so that a system will put forth the financial committment to be an ALS provider. If the city wants to do it, then fine. It is not good care to let the PFD come in, do stuff and then leave to let the AMT guys transport.
January 7th, 2007 at 9:10 am
Rebel Yell,
Since the PFD can’t transport, someone needs to. So let the PFD Paramedics and Intermediates function at the scene for the patient, and AMT can transport and then bill the patient.
Everyone would be happy including the patient.
It is not that difficult.
John
January 7th, 2007 at 8:37 pm
John,
I have never said there are no politics in Peoria. Having been in on a couple meetings to decide the Peoria County FDs response to the incident with Dunlap FD last year, I know quite well how things work sometimes. I have stated before that I have had both good and bad experiences with the PAEMS system.
The full truth continues to escape you.
Regarding your comments to Rebel Yell: Exactly. You have, using logic, proven how AMT has nothing to lose if the PFD was an ILS or ALS agency. Continue the thought process… Why isn’t the PFD at a higher level?
To answer that you could either ask their leaders (I have) or ask the PAEMS office (another reader did and posted her finding).
The answer is that they aren’t ready to make that step, and they haven’t applied to do so, respectively.
You are right John, it ISN’T that difficult.