Abuse of Medical Services

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Running head: ABUSE OF THE EMERGENCY MEDICAL SYSTEM

Abuse of the Emergency Medical System

4/8/2010
Running head: ABUSE OF THE EMERGENCY MEDICAL SYSTEM

Abuse of the Emergency Medical System

The system of emergency medicine is often abused. From 911 calls, to visits at an emergency room (ER) we are experiencing an overload of non-emergency patients, causing the systems to become backed up and consuming money and time from all people involved. This abuse largely stems from the general public not being properly educated with the true functions of the system. Thus, seeking alternate systems would be beneficial in several ways. An emergency medical service (EMS) has a limited number of ambulances available, based on the number of runs usually required per time of day, and considering the population it serves. At times all ambulance units are out on runs (i.e. service calls) and a true emergency 911 call comes in with no ambulance units available to respond until a unit clears its scene. The alternatives that are taken to avoid this event are, employees on stand-by call; a supervisor in a chase car (non-patient transport vehicle), and/or mutual aid agreements with adjacent counties EMS service. Employees on stand-by call are the most widely used solution to solve moments when all units are tied up on a scene. The downfall is you are dependant on employees signing up for the call and/or the distance the individual lives from the station he/she is reporting to. More times then not, by the time the employee reaches the station the need for them is over. EMS services are timed in minutes. Sometimes those minutes are critical in the timeline of a patient suffering from a heart attack, or stroke, or respiratory distress. A supervisor or medic in a chase car lessens the need for advanced life support (ALS) units so an agency can employee more basic life support (BLS) units. This will allow an emergency medical service room in their budget for more units on shift at a time or the accessibility to purchase needed equipment, or upgrades, or for better training exercises. The hindrance is a finite number of medics in a chase car able to respond with a BLS unit. They too are a limited resource that is not always available. A mutual aid agreement between counties can be an EMS’s savior. In 2007 there was a fully occupied charted bus that drove head-on into a bridge column on I-65 near the town of Bowling Green, Kentucky. Medical Center EMS handled the accident and had 5 units on shift spread over two counties available to respond. Three other ambulance services were contacted to respond through a mutual aid agreement among Barren County, Edmonson County, and Simpson County. In total 13 ambulances, and 5 helicopters, and a fixed-wing medical aircraft on the ground at the local airport responded to that particular event. While this was happening and with all units tied up on a life threatening run, a patient suffering from a nosebleed called 911 and all that was available to respond to the call was a fire truck. Because none of these solutions are failsafe, there can occur a time that a true emergency is put on hold with the 911 staff because an ambulance has been dispatched to the scene of a panic attack, or someone with a minor injury, or someone just calling because he/she is lonely and wants the company of the medical staff. The reasons for non-emergency 911 calls are countless. Due to liability issues if a person calls for an ambulance and says they want to be transported to the ER they must be transported. A common misconception is that if one is taken to the hospital in an ambulance one is then immediately seen by a doctor. This is untrue as the patient will be screened by a triage person just like everyone else. If their situation is deemed non-life threatening then they are sent to the waiting room to join everyone else. The national average wait time from the ER door to doctor visit is 222...
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