Can an EMS service deliver more than just emergency care and transport? Can an EMS service be proactive? Can an EMS service be a change agent? Yes on all counts!
The rapidly changing health care and EMS environments require McGregor to remain abreast of changes in protocols, treatment, equipment and finances. Recently, after substantial medical research, the NH Bureau of EMS announced a change in its protocols regarding spinal immobilization. The practice of placing any patient who underwent a mechanism of injury that could involve the head, neck or spine onto a long backboard has been changed. Now, after a full physical and cognitive assessment and weighed against the mechanism of injury, EMS providers can determine whether to immobilize a patient with a long backboard. This is especially important for a patient who cannot tolerate being placed flat on their back nor without experiencing substantial pain if they are. To implement the protocol, each McGregor member has to review an online video, take a brief exam and receive a certificate. The response by our members has been remarkable with many coming to the station to take the program. We will be implementing the protocol by the time you read this.
Can we be proactive? On many fronts – we already are. Our CPR Safe program through the McGregor Institute of EMS has over 300 instructors and over 5400 students were taught last year! There have been documented “saves” due to our training and the immediate availability of Automatic External Defibrillators (AED’s). McGregor has received grant money in the past to provide bicycle helmets for a nominal fee. We contact social service agencies when living conditions of patients warrant. We attend conferences, make presentations, conduct community education and provide information on our websites for consumers to utilize. Yet can we go even further? Over the next ten years, I envision primary medical care being provided by EMS services. Consider this: an ambulance staffed by EMS providers and health care practitioners (physicians, PA’s, APRN’s, Paramedics, etc.) makes house calls to conduct routine follow-up visits, conduct non-emergency assessments including EKG’s, conduct laboratory tests, prescribe medications, educate the patient, and perhaps even deliver medications from the pharmacy! As technology improves, the ability to conduct more advanced testing and on-site analysis will allow the patient to remain in place and will, undoubtedly, improve quality of life and medical outcomes.
McGregor’s model is one to be envied. While high quality compassionate EMS services is our foremost priority, a culture of learning, of collaboration, of mentoring and of constant improvement exists. In a previous Windshield View article, I mentioned the volunteer component of McGregor and the incredible amount of time and devotion our volunteers give. This model is highly cost-effective and fluid and drives change through the talent we are privileged to have. I’d venture to guess that few volunteer agencies see their members devoting the time and energy that ours do.
“The Times They Are a-Changin” – Bob Dylan