Let’s contemplate changing the name from Emergency Medical Service to Mobile Health Care. The skill levels of providers from Basic EMT to Advanced EMT to Paramedic are always improving and practice protocols are being expanded to meet these skills. Providers are capable of performing routine assessments for cardiac and/or respiratory issues, stroke, mental health, fever, malaise and pain to name but a few.
While an integral component in the entire health care system EMS, despite the level of training and field experience of its personnel, is still often considered only a safe means of transport for a patient. Perhaps the general public and maybe even health care providers are not cognizant of the services that are delivered in the field. IV and medication administration, blood drawn for lab analysis, vital signs taken, cardiac monitoring and interpretation of EKG’s, advanced airway management provided via specific equipment and neurological and orthopedic treatment are all practiced on a fairly frequent basis. A patient enters the health care system the minute a trained and licensed EMS person makes contact and provides care and continues for whatever length of time until that patient is discharged from care – be it a hospital, nursing home or another health care provider or facility.
In the 1970’s, when EMT training was first made available, no EMT could provide advanced treatment. IV administration, pain control, specialized airways and advanced orthopedic care were the purview of physicians. EMT’s, in those days, essentially provided comfort and a rudimentary level of treatment. Frequently, it was a “mad dash” to the Emergency Department. Over the years, more and more advanced skills and treatments were passed down to the EMS system as health care, in general, realized the benefits of immediate care and treatment of the sick and injured.
So, here we are in a new century where EMT’s and Paramedics are delivering vey sophisticated treatments in the field, stabilizing and frequently improving a patient’s condition and transporting them safely to a health care facility (often with the flow of traffic with no warning lights or siren). The next logical step in this progression is having EMT’s and Paramedics follow-up on patients in their service area to assess their safety and stability, their nutrition habits and their medication administration. One may argue that this service is being provided typically by the VNA or similar organizations. This certainly may be the case and dialog must take place with these agencies to define duties and responsibilities I envision EMS’s role as a short-term engagement at the point a patient returns home. They assist the patient with their basic needs as the patient re-acclimates to his/her normal living environment. They make the house safe for the patient, they assure nourishment is present and may reach out to family members to coordinate care. The VNA or similar agencies can then address the longer-term needs.
This is the continuum of care that can only improve patient outcomes as well as enhancing the quality of life. McGregor’s mission of “Commitment to Compassionate Care” must extend much further than the doors of the ambulance.