Modern Day EMS

I’m tired. I’m tired of an ambulance service being seen as a “transport service”. Perhaps 30 years ago, that connotation had merit. Today, it does not.

I’m tired of an EMS service having its vehicles called “ambulances”. According to Merriman-Webster’s Dictionary, “the term ambulance comes from the Latin word "ambulare" as meaning "to walk or move about" which is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements.” EMS services now meet the definition in the last sentence: While they do not follow armies, ambulances are moving hospitals with trained staff (EMT’s, Advanced EMT’s and Paramedics) capable of providing pre-hospital care. EMS staffs can provide essential fluids, drugs, interpret EKG’s, deliver defibrillation and consult in real-time with physicians and other providers on treatment of patients. McGregor personnel are trained in providing compassionate care to those patients experiencing what may be the greatest crisis in their lives.

Perhaps the average person doesn’t know the amount of training required to attain the various levels. To become an EMT requires CPR/AED certification and certain vaccinations all prior to taking a 110-hour course involving all aspects of emergency care – including 10 hours of observation time with an EMS service. Successful completion requires passing extensive written and practical exams. After course completion, candidates must sit for an exhaustive National Registry of EMT written exam. Successful passing of this exam allows the candidate to take the practical exam where multiple stations are set up and the candidate must perform critical skills to pass.

Advanced EMT certification requires all of the above prior to taking the 120-hour course that refreshes the basic skills and introduces skills such as IV administration, application of 4 and 12-lead EKG’s and advanced diagnostic skills. A 30-hour in hospital training is also required where students administer IV’s to patients, assist hospital staff with skills and acquire a real sense of pre-hospital care.

Paramedic training is, at present, the highest level of training for EMS personnel in New Hampshire and most other states. Attaining this level involves certified programs usually provided through a community college where the student also receives an Associate’s Degree in Paramedicine. Extensive hospital time working in concert with hospital staff is required. Many paramedics work in Emergency Departments and are capable of administering drugs, medications, EKG’s and writing patient charts. Delivering medications to a patient requires extensive knowledge in diagnosis, drug interactions, patient history, allergies and dosages. EKG interpretations are a vital component in ensuring a patient receives accurate and effective pre-hospital care. EKG’s are transmitted to the receiving hospital for concurrence on treatment. Certain cardiac conditions require rapid intervention and a patient is often taken directly to a cardiac catheterization laboratory for treatment. Patients receiving paramedic levels of care should feel comfortable knowing they are receiving a high level of care and treatment.

McGregor Memorial EMS provides all these levels of care and paramedic services are available 24/7/365. Regardless of their levels of training, each member constantly trains and practices skills – some they may never use – all done to provide the highest level of care. Every McGregor member has to provide this care in accordance with New Hampshire EMS Protocols that are developed by a panel of health care providers and regularly updated as data and patient outcomes warrant. While safe “transport” of patients is crucial, it is but one skill of hundreds required in providing successful patient outcomes.

So, to solve my “tiredness”, perhaps we should rename “ambulances” to “mobile emergency rooms”- a designation justly deserved.