Status Check! is a new series that explores the history of pre-hospital emergency medicine, common misconceptions, misunderstanding, hot topics in EMS and public perception.
BY TODD BOWMAN
Over the years in EMS we all have had the opportunity to work with great partners, mediocre partners and partners you can’t remember their names. Being in close quarters with this person, whether it be in the ambulance or the station for 12 to 24 hours, you get to know them…their likes, dislikes, favorite foods, movies and finally, ticks. You learn that thing that changes a smile upside down. It might be an address that you get dispatched to, their favorite sports team losing the game or someone forgetting to put toilet paper in the bathroom. Nevertheless, when you hear that deep sigh from the next room, you know.
Picture it, this isn’t a Golden Girls rerun and Sophia isn’t making a guest appearance. You and your partner are dispatched to an address that you frequent regularly. You hear the sigh. Smiling on the inside with self-gratification that you could predict the future.
A common theme heard around stations is the perceived misuse of the 911 systems, specifically unnecessary ambulance transports. EMS providers working long shifts are transporting the same patient two to three times with complaints that clog up waiting rooms and treatment areas at local hospitals. Additionally, it ties up an ambulance that could be handling an actual emergency call and physicians that could be focusing on critically ill patients.
As the calls for ambulance continues to rise locally and nationally, managers have been trying to find solutions to this problem for decades.
The Journal of Emergency Medical Service published EMS System Abuse, The mystery of the frequent flyer in January of 2011.
The article cites several studies including a New Mexico study that found repeated ambulance use by patients (five or more transports during the two-year study period) was most often associated with alcohol-related disorders, seizures and respiratory illness. The study concluded that although this group of patient accounted for 4.3% of all patients, it accounted for 28.4% of all transports.
A second study from sunny San Francisco showed that patient’s greater than 65 years of age, “male in gender, black ethnicity, homelessness and a variety of types of medical problems were associated with increased use of EMS resources,” with the single best indicator being homelessness.
Johns Hopkins Hospital, known locally, nationally and internationally for the care they provide. Beginning in the early to mid 1900’s the original “Accident Room,” a two bed facility that treated the sick and injured…free of charge.
The patient’s were transported via police patrol wagon, because ambulance services were not widely available, according to their website.
Physicians at Hopkins were instrumental in developing the specialty of emergency medicine.
In the 1950s, Hopkins originated the Emergency Squad Doctor Plan so that a physician on call could be taken to the scene of an accident to administer on-the-spot treatment. This idea evolved into the Department of Emergency Medicine, which continues the tradition of innovation, service and excellence.
The Johns Hopkins Department of Emergency Medicine, as it evolves remains true to its original mission: excellence in teaching and research and quality care for all patients, regardless of their ability to pay, according to their website.
If these founding doctors could be brought to the present day, what would their reactions be about the current state of the misuse of the 911 system? What recommendation could they offer from the incubation period of EMS to its transformation today?
The bottom line is public education, which is vital in any system. EMS departments and hospitals should take additional steps to try and educate the public on what types of emergencies warrant an ambulance, compared to visiting their primary care office or urgent care.
Todd Bowman is a senior writer for Shock-Advised.com and can be followed on Twitter @todd_bowman87. For live and up-to-the-minute coverage follow @ShockAdviseNEWS on Twitter and Facebook @ShockAdviseNews.