National Standard for EMS response..

[Smokeshowing]

Does anyone know where to find the national standard for response in a metro city, the only thing I can find is, Paramedics need to arrive at life threating emegercies within 8 minutes 90% of the time.

What I'm looking for is number of ambulances needed to handle a certain number of calls within a certain size metro city. Is there a formula avaiable.

Thanks

[croaker260]

I think you may have hit on a very important, and deliberately overlooked question...

The simple answer is THERE IS NO SCIENTIFICALLY PROVEN STANDARD.

The long answer...

First, the 8 minute response time was not to life threatenting emergencies, it is to cardiac arrest (and its 8 min, 59 seconds according to some...). there are no other standards for other "life threatening emergencies" or non life threatening emergencies, or even what defines life threatening and non lifethreatening for responses (the MPDS is the closest comprehensive effort...)

Second..parts of the UK use a 15 minute response standard I believe in metro areas and longer in rural areas.

Third, there is a legitimate thought process that fewer paramedics for a metro area is better. USA today compared cities and arrest survival rates and paramedics per 100 thousand...I will have to find the results of this..while not scientific, it is very point blank and period on a subject the fire service would rather everyone ignore.

Fourth, I really am not trying to bash the fire service specifically on this, as any service that wants to put a paramedic on every street corner is wasting resources and adversely effecting patient care via paramedic over saturation and skill degradation....its just the fire service is the worst offender of this concept with their paramedic engine company model and because they are the ones with the resources to waste on this, and the will to do so.

Most knowledgeable people ion the EMS industry will admit its more important to get competent EMTs with AEDs to the scene in 4 minutes or less, than it is to get paramedics in 8 minutes or less...and just as pertinent to this discussion..getting a paramedic to the scene in the first 4 minutes of arrest doesn't do any good what so ever and may make things worse by taking the emphasis off of good CPR.

Its just hard to sell anyone on this as americans often believes more is better....

If I was you, I would look at your EMD/MPDS stats, and make sure you had enough medics to handle your peak Charlie and Delta and Echo responses, enough BLS/ILS transport units to handle alpha through charlie responses at peak (plus a comfortable safety margin) and enough BLS/ILS first responders units to handle all responses at peak.

Then I would consider titrating up and down for effect from there...

But this is my planet we are talking on here, and the weather is often different here than in the real world.

[wakehead]

Most knowledgeable people ion the EMS industry will admit its more important to get competent EMTs with AEDs to the scene in 4 minutes or less, than it is to get paramedics in 8 minutes or less...and just as pertinent to this discussion..getting a paramedic to the scene in the first 4 minutes of arrest doesn't do any good what so ever and may make things worse by taking the emphasis off of good CPR.

I dont know how it is in B*&^*, name withheld to protect the innocent, but everywhere else it should be BLS before ALS...even by a Paramedic and yes I have seen IVs performed without CPR by a skill seeking Medic but that is just wrong, so wouldnt a 4 minute response by a Paramedic on a Engine be better for the customer? because the bus is coming from the ER or a transfer.....

just adding my 2 cents here! and yes Croaker you know I am a Fire-Medic!

Dam we are off the subject again!!!!

[deputychief1441]

Sorry, another Fire-Medic comment, we have always ran rapid response EMS, EMT and Medics(engine Co.) We now received the authority from our county to start ambulances out of our FD. We for years have had medics on engines in rural settings. We have made drammatic differences with 4-6 minute ALS as compared to the 25-30 minute ambulance reponse. I am not saying there are medics who set and need to move. Maybe your are around the wrong medics

[croaker260]

Sorry, another Fire-Medic comment, we have always ran rapid response EMS, EMT and Medics(engine Co.) We now received the authority from our county to start ambulances out of our FD. We for years have had medics on engines in rural settings. We have made drammatic differences with 4-6 minute ALS as compared to the 25-30 minute ambulance reponse. I am not saying there are medics who set and need to move. Maybe your are around the wrong medics

Not around the wrong medics, just around the wrong FDs who want to do EMS for the wrong reasons....

[lexfd5]

You mean our chief who has just created 26 medic in our last recruit class and the new hiring class they are also going to make medics is wrong?????? ;)

We are going to end up with all the "senior" medics on apparatus and have three year medics in charge of trucks with a "probie" medic (who will have to drive all the time) and a "student" medic. Just hope I don't get hurt on the job, might have to take care of myself....

In our department I can see some ALS companies. Covering our rural areas where an ambulance is going to be delayed. And also in our technical rescue team where patient care might happen in a confined space, trench, collapse or other high hazard area. But we are heading down the medic on every corner...

For those that think everything should be ALS I am on an ALS company. Usually by the time the "Buggy" shows up we have done high quality BLS, gotten all the patient information and completed the primary exam.

[River]

All information I have been able to come across has been specific for each state or each EMS Region or within the contract of each municipality itself. As far as a national standard this won't come into play until we are all under the same National Standards. This is what the NAEMSE is attempting to do regarding protocols and education. If this is accomplished all other rules and regulations regarding EMS will become standardized and we will all be on the same page. Will make things easier an expeciable. This concept is called "The Blue print of the Future". The program will be accredited and therefore hold more water under the lable of Professional.