Replacing An Ambulance With A Station Wagon by Eric Whitney
NPR - September 5, 2014
When a fire department gets a call for medical help, most of them scramble both an ambulance and a fully staffed fire truck. But that's way more than most people need, according to Rick Lewis, chief of emergency medical services at South Metro Fire Rescue Authority in the Denver suburbs....
I'm not sure I understand this idea. In the first place, Oak Park certainly doesn't send a fire truck every time it gets an ambulance call. A fire (or potential fire in the case of an auto accident) is one thing, a medical emergency is another. Second, if somebody needs stitches, I'm not clear why it is all that advantageous to do the stitches in the ambulance rather than taking the patient a few blocks to the ER. Especially since this system calls for the municipality to hire a nurse practitioner who wouldn't otherwise be needed.
It's never explained, but I get the impression that maybe this agency is somehow responsible for providing health care -- perhaps acting as an extension of the county hospital -- not just providing ambulance services. But that's not a common arrangement.
Bill, the article mentions several things that the station wagon can do that ambulances do not. I believe stitches is one of them. Dispensing meds is another, hence the need for a NP. It is much less expensive for the patient (often less than their deductible), and it's home care vs an unsettling ride to the ER.
What I can't understand is why someone would call an ambulance if they didn't expect to go to the hospital. If they wanted home health care instead, wouldn't they call something like the health department? To put it another way, I can see a service like this being offered by Cook County Hospital but not by the Oak Park Fire Department.
I did some in home day care when mine were little. I used to laugh at the *fact* that my little's poop didn't smell, whereas my neighbor's little's did. Later, when I was training as a nurse's aid, I wondered how my patients' would seem to me. First full night on shift, I was relieved to find that they were all my babies and it didn't bother me at all. . . .
Bill, poor folks and elderly folks are known to call an ambulance or the fire department for help of all sorts. My Dad used to call the fire department to help him when he fell out of bed. They were right next door and so kind about it.
Have to agree, listener: a huge percentage of calls to 911 here, are from people who have fallen. What we have is a first responder system, where an EMT goes directly to the house rather than to the station to pick up the ambulance. Saves a lot of time if the ambulance is needed. And a trip to any hospital here is an hour away, so they are needed!
I think there is a big difference between a hospital an hour away and one 5 minutes away. But my main point is that I would trust a health services agency to operate something of this sort. I'm not sure I would trust the fire department to do something that is basically not its job.
puddle, my mom followed up on the link you posted on Facebook about ordering a cake. Long story short, we can't have one delivered, but Daughter will have a little birthday celebration, with cake, at a bakery near college.
Penny had a close call today. She didn't quite make it home from her shopping trip before the thunderstorm hit. As I was sitting at home I heard a tremendous crack of thunder. The lightning hit about half a block from where Penny was walking home from the "L" station!
Bill, often enough a layperson doesn't know whether they need a hospital or not. There are health agencies, such as the Visiting Nurses Association, for routine things, but the emergent ones are NOT their territory. Moreover the Home Health Aides are not trained in discerning initial concerns, just doing follow-up after a concern has been diagnosed and prescribed for.
Fire Departments do everything from putting out blazes to getting cats out of trees, and most of them are skilled EMTs as well.
Here, as at puddle's, we have First Responders who go straight to the scene and do triage, and vital first things until the ambulance can arrive. So a First Responder may well call and say the ambulance needn't come. But having a nurse practitioner in the mix greatly increases what can be done without having to make a trip to a hospital or possibly even a doctor (at least for a day or two). That would greatly cut down on health care costs.
First Responders are, of course, quite different from the on-call home health services we're talking about. They seem as though they might make sense in rural areas. But not in a built-up suburban area like Oak Park or Denver's Metro South. With a fire station within a mile of any Oak Park home, the ambulance can get here quicker than anything else.
You've mentioned that the station wagon can do things an ambulance can't, but the reverse is also true: the station wagon does not have the heavy-duty life support equipment you find in an ambulance. Essentially, you have to know which is needed before you send one out. And anything that calls for the station wagon is obviously not a life-threatening emergency. So even if somebody initially calls the fire department, there is time to relay the call to the proper agency.
The Dr. is First!
ReplyDeleteAnd I think he would approve of this idea:
Replacing An Ambulance With A Station Wagon
by Eric Whitney
NPR - September 5, 2014
When a fire department gets a call for medical help, most of them scramble both an ambulance and a fully staffed fire truck. But that's way more than most people need, according to Rick Lewis, chief of emergency medical services at South Metro Fire Rescue Authority in the Denver suburbs....
http://www.npr.org/blogs/health/2014/09/05/345256876/replacing-an-ambulance-with-a-station-wagon?sc=17&f=1001
I'm not sure I understand this idea. In the first place, Oak Park certainly doesn't send a fire truck every time it gets an ambulance call. A fire (or potential fire in the case of an auto accident) is one thing, a medical emergency is another. Second, if somebody needs stitches, I'm not clear why it is all that advantageous to do the stitches in the ambulance rather than taking the patient a few blocks to the ER. Especially since this system calls for the municipality to hire a nurse practitioner who wouldn't otherwise be needed.
ReplyDeleteIt's never explained, but I get the impression that maybe this agency is somehow responsible for providing health care -- perhaps acting as an extension of the county hospital -- not just providing ambulance services. But that's not a common arrangement.
Bill, the article mentions several things that the station wagon can do that ambulances do not. I believe stitches is one of them. Dispensing meds is another, hence the need for a NP.
DeleteIt is much less expensive for the patient (often less than their deductible), and it's home care vs an unsettling ride to the ER.
What I can't understand is why someone would call an ambulance if they didn't expect to go to the hospital. If they wanted home health care instead, wouldn't they call something like the health department? To put it another way, I can see a service like this being offered by Cook County Hospital but not by the Oak Park Fire Department.
DeleteSusan, you'll love this:
ReplyDeleteI was feeling a little sad about washing away Grandson's sweet little fingerprints. Then I found a used diaper under the guest room bed. Cured! :-)
I did some in home day care when mine were little. I used to laugh at the *fact* that my little's poop didn't smell, whereas my neighbor's little's did. Later, when I was training as a nurse's aid, I wondered how my patients' would seem to me. First full night on shift, I was relieved to find that they were all my babies and it didn't bother me at all. . . .
DeleteWell, see, they were here 5 days ago. Heh.
DeleteBill, poor folks and elderly folks are known to call an ambulance or the fire department for help of all sorts. My Dad used to call the fire department to help him when he fell out of bed. They were right next door and so kind about it.
ReplyDeleteHave to agree, listener: a huge percentage of calls to 911 here, are from people who have fallen. What we have is a first responder system, where an EMT goes directly to the house rather than to the station to pick up the ambulance. Saves a lot of time if the ambulance is needed. And a trip to any hospital here is an hour away, so they are needed!
ReplyDeleteI think there is a big difference between a hospital an hour away and one 5 minutes away. But my main point is that I would trust a health services agency to operate something of this sort. I'm not sure I would trust the fire department to do something that is basically not its job.
Deletepuddle, my mom followed up on the link you posted on Facebook about ordering a cake. Long story short, we can't have one delivered, but Daughter will have a little birthday celebration, with cake, at a bakery near college.
ReplyDeleteGlad that helped! I know you can have cheesecakes delivered, lol! And a happy birthday to your little!
DeletePenny had a close call today. She didn't quite make it home from her shopping trip before the thunderstorm hit. As I was sitting at home I heard a tremendous crack of thunder. The lightning hit about half a block from where Penny was walking home from the "L" station!
ReplyDelete{{{ YIKES! }}} So glad Penny was okay!!
ReplyDeleteBill, often enough a layperson doesn't know whether they need a hospital or not. There are health agencies, such as the Visiting Nurses Association, for routine things, but the emergent ones are NOT their territory. Moreover the Home Health Aides are not trained in discerning initial concerns, just doing follow-up after a concern has been diagnosed and prescribed for.
ReplyDeleteFire Departments do everything from putting out blazes to getting cats out of trees, and most of them are skilled EMTs as well.
Here, as at puddle's, we have First Responders who go straight to the scene and do triage, and vital first things until the ambulance can arrive. So a First Responder may well call and say the ambulance needn't come. But having a nurse practitioner in the mix greatly increases what can be done without having to make a trip to a hospital or possibly even a doctor (at least for a day or two). That would greatly cut down on health care costs.
First Responders are, of course, quite different from the on-call home health services we're talking about. They seem as though they might make sense in rural areas. But not in a built-up suburban area like Oak Park or Denver's Metro South. With a fire station within a mile of any Oak Park home, the ambulance can get here quicker than anything else.
DeleteYou've mentioned that the station wagon can do things an ambulance can't, but the reverse is also true: the station wagon does not have the heavy-duty life support equipment you find in an ambulance. Essentially, you have to know which is needed before you send one out. And anything that calls for the station wagon is obviously not a life-threatening emergency. So even if somebody initially calls the fire department, there is time to relay the call to the proper agency.