theearlyyears

Have Changes in EMS been Positive?
Yes
No
Long way to Go Yet
Not Sure
Maybe

McCoy Miller was the Builder for ALL of Mercy Ambulance Services Fleet. McCoy Miller Builds beyond industry Standards and there rigs last and in this photo the workman ship protected the Medics involved in this accident. This Unit was responding to a medical, traveling at 70 mph the unit was struck broadsided by a drunk driver, after impact the rig became airborne landing on it's side. Two of my Fellow Co-Workers received minor injuries and were released later that evening. Scott Brady then CEO of Mercy Ambulance and a former medic himself, along with its staff were surprised how well the vehicle performed. The interior cabinets remained intact and equipment that had been secured protected the crew from their medical equipment from becoming deadly missiles. (McCoy Miller purchased this unit and used it as an expo display.)

THANK YOU McCoy MILLER FOR BUILDING EXCELLENCE

EQUIPMENT CARRIED In: Today's Ambulances

Airway & Suction

Airway Bag

Oral Airway (assorted sizes)

Nasal Airway (assorted sizes)

Ventilator

Monitors

Physio-Control Life Pak 11 monitor/defibrillator w/pacing and 12 lead ECG

Pro-Pak 102 ECG/Pulse/Blood Pressure

LSP 3000 Portable Ventilator

Monitors

Thermometer

Combo-Tube

Blood Pressure Cuff

Stethoscope

Suction

Ohmeda Portable Suction

Nellcor Pulse Oximeter

Portable Oxygen Tank/Regulator/Wrench

Oxygen Mask (Adult/Pediatric)

Nasal Cannula

Nebulizer

Bag-Valve-Mask (Adult)

Laryngoscope Handle

Laryngoscope Blades (Miller and MacIntosh 1 -3) Disposable

Endotracheal Tubes (size 3 -8)

Stylet

Magil Forceps

Oral Airway (assorted sizes)

Nasal Airway (assorted sizes)

Combo-Tube

SCHOOL VIOLENCE

"Mommy"

Johnny brought a gun to school,

He told his friends that it was cool,

And when he pulled the trigger back,

It shot with a great crack.

Mommy, I was a good girl,

I did what I was told,

I went to school,

I got straight A's and B's,

I even got the gold!

But Mommy, when I went to school that day,

I never said good-bye,

I'm sorry Mommy, I had to go,

But Mommy, please don't cry.

When Johnny shot the gun,

He hit me and another,

And all because Johnny,

Got the gun from his older brother.

Mommy, please tell Daddy;

That I love him very much,

And please tell Zack; my boyfriend;

That it wasn't just a crush.

And tell my little sister;

That she is the only now,

And tell my dear sweet Grandmother;

I'll be waiting for her now,

And tell my wonderful friends;

That they always were the best,

Mommy, I'm not the first,

I'm no better then the rest.

Mommy, tell my teachers;

I won't show up for class,

And never to forget this,

And please don't let this pass.

Mommy, why'd it have to be me?

No one deserves this,

Mommy, warn the others,

Mommy, I left without a first kiss.

And Mommy, tell the doctors;

I know they really did try,

I think I even saw the Doctor,

Trying not to cry.

Mommy, I'm slowly dying,

With a bullet in my chest,

But Mommy, please remember,

I'm in heaven with the rest.

Mommy, I ran as fast as I could,

When I heard that crack,

Mommy, listen to me if you would,

I'm not coming back.

I wanted to go to college,

I wanted to try things that were new,

I guess I'm not going with Daddy; On that trip to the new zoo. I wanted to get married, I wanted to have a kid, I wanted to be a singer, Mommy, I wanted to live. But Mommy, I must go now, The time is getting late, Mommy tell my boyfriend, I'm sorry, I had to cancel the date. I love you Mommy, I always have, I know; you know it's true, And Mommy all I wanted to say is, "Mommy, I love you"

JUST ANOTHER DAY IN EMS

I delivered a baby on the ambulance stretcher

I baptized a newborn whose life ended before it began.

I hugged a frightened child.

I was kissed by an intoxicated old man.

I held the hand of a teenage girl while she delivered a 3 pound baby.

I listened to the mournful squeak of a stretcher being wheeled to the morgue.

I gently stroked the fragile hand of a 102 year old woman.

I hesitated at the outreached hand of a 300 pound prisoner in handcuffs.

I trudged for ten hours in my boots.

I had a teenager vomit on those same boots.

I rubbed the feverish body of a 14-year-old cancer patient.

I cradled the ice-cold hand of a child hit by a car.

I was referred to as "an angel of mercy".

I was called every four-letter word in the book.

I always see fear in people's eyes.

I never see joy or relief.

I listened to a tormented voice pleading for the preservation of life.

I heard the threatening words of one bent on self destruction.

I spoke with a girl who was hoping she had the flu, not a pregnancy.

I see innocent people hurt by a drunk driver, and the drunk driver is never hurt.

I marveled at the genius of a cardiologist.

I saw a 12-year-old boy who shot himself in the head, and the gun was still loaded at his feet.

I talked in circles with a schizophrenic person.

I was horrified at the battered body of a child whose parents were incapable of love.

I gazed at a horribly burned body.

I shuddered at a cold water drowning.

I see women beaten up by their spouses, but they never press charges.

I walk into houses and do CPR with family watching over my shoulder in tears.

I arrive at serious auto accidents, and the first words I hear are, "Am I going to die?"

I find out hours later they did die.

I listen to the repeated question "Why?” from a family devastated by death.

I search my soul for the answers to their question.

This is just another day in EMS.

Depending on the nature of the emergency, EMTs and paramedics typically are dispatched to the scene by a 911 operator and often work with police and fire department personnel. Once they arrive, they determine the nature and extent of the patient’s condition while trying to ascertain whether the patient has preexisting medical problems. Following strict procedures, they give appropriate emergency care and transport the patient. Some conditions can be handled following general rules and guidelines, while more complicated problems are carried out under the direction of medical doctors by radio.

The specific responsibilities of EMTs and paramedics depend on their level of qualification and training.

To determine this, the National Registry of Emergency Medical Technicians (NREMT) registers Emergency Medical Service (EMS) Providers at four levels: First Responder, EMT-Basic, EMT-Intermediate, and EMT-Paramedic. Some States, however, do their own certification and use numeric ratings from 1 to 4 to distinguish levels of proficiency.

Is Heaven in the Yellow Pages?

Mommy went to Heaven, but I need her here today, My tummy hurts and I fell down, I need her right away.

Operator can you tell me how to find her in this book? Is heaven in the yellow part, I don't know where to look. I think my daddy needs her too, at night I hear him cry.

I hear him call her name sometimes, but I really don't know why.

Maybe if I call her, she will hurry home to me. Is Heaven very far away, is it across the sea?

She's been gone a long, long time she needs to come home now! I really need to reach her, but I simply don't know how.

Help me find the number please, is it listed under "Heaven"? I can't read these big big words, I am only seven.

I'm sorry operator; I didn't mean to make you cry, Is your tummy hurting too, or is there something in your eye?

If I call my church maybe they will know. Mommy said when we need help that's where we should go.

I found the number to my church tacked up on the wall. Thank you operator, I'll give them a call.

Modern EMS systems developed following the 1966 publication of National Academy of Sciences paper entitled Accidental Death and Disability: The Neglected Disease of Modern Society and the work of J.F. Pantridge extending emergency cardiac care to the prehospital setting in the United Kingdom. Dr. Pantridge’s program in Northern Ireland inspired the pioneering efforts of physicians such as Eugene Nagel in Miami and Leonard Cobb in Seattle to extend emergency cardiac care to the patient’s home.

Medicine is primarily concerned with preventing and curing disease and relieving suffering. The Emergency Medical Service (EMS) is an important part of the health care system, especially for people who suffer sudden and unexpected emergencies. In most communities, EMS is regarded as a public good. There are myriad approaches to offering EMS: it may be provided by the fire department, by another agency within the local government, by private entities that provide care within a local geographic area, by volunteer organizations, or by any number of other configurations.

Emergency medical service is often regarded as including the full spectrum of emergency care from recognition of the emergency condition, requesting emergency medical aid, provision of prehospital care, through definitive care in the hospital. It may also include medical response to disasters, planning for and providing medical coverage at mass gatherings, and interfacility transfer of patients. However, for the purposes of this document, the examination of EMS is limited to the more traditional, colloquial definition: prehospital emergency care from the time of the request for medical aid until arrival at and transfer of care to the hospital.

EMS care is provided by a variety of personnel, both paid and volunteer, who are trained at various levels of sophistication including first responders, EMT-Basic, EMT-Intermediate, and EMT-Paramedic. Basic level providers, trained in as little as 110 hours, provide services such as first aid, cardiopulmonary resuscitation, and patient stabilization. At the other end of the training spectrum, paramedics, who have acquired up to thousands of hours of training, bring highly sophisticated medical interventions that require critical thinking, such as endotracheal intubation and intravenous medication administration, to patients in the prehospital setting. EMS agencies often employ physicians with the expertise to evaluate new treatments and with the ability to develop and improve protocols based on scientific findings.

EMS treats and transports approximately 25 to 30 million patients per year. As an important point of entry into the healthcare system, EMS is in a unique position to impact those patients. It is logical to assume that prehospital intervention positively affects patient outcome, but this influence is difficult to quantify. For example, early defibrillation to victims of sudden cardiac arrest, administration of nitroglycerin to patients with chest pain, and prehospital administration of fibrinolytic therapy to patients with myocardial infarction measurably saves lives. On the other hand, seemingly logical interventions such as the pneumatic anti-shock garment and endotracheal intubation in children in just over the past few years have begun studies and research that study if in fact harm is caused to the pediatric patient. More research is necessary to provide the evidence upon which EMS practices in pediatrics treatment can be based.

Misperceptions about EMS on the part of the public abound. In one study, fifteen percent of the patients in a hospital emergency department thought that paramedics were physicians. The entertainment media routinely depict cardiopulmonary resuscitation as resulting in good patient outcome, likely leading to unrealistic expectations among the lay public. Most members of the public believe that the use of warning lights and sirens saves clinically significant time in ambulance response and transport to the hospital, although several studies have suggested otherwise, and the debate continues today regarding rapid transport.

EMS Systems are expensive to operate. The true economic burden of EMS is widely distributed and therefore well hidden from view. In the Medicare program alone, more than $2.5 billion is spent for patient transportation. It is estimated that $5 billion is spent on EMS in the United States each year. More detail on the costs of the EMS system is available in the document describing the Negotiated Rule Making process on EMS reimbursement sponsored by the Health Care Financing Administration on the Internet at: ww.hcfa.gov/medicare/comstate.html

The incremental costs and benefits of different levels of EMS care are poorly quantified and remain the subjects of ongoing studies.

The Star of Life (SOL) was designed by a Leo R. Schwartz, EMS Branch Chief at the National Highway Traffic Safety Administration ( NHTSA ) United States of America. The star of life was created in 1973 as a common symbol to be used by US emergency medical services (EMS) and medical goods pertaining to EMS, after complaints from the American National Red Cross objecting to the use and imitation of the red cross symbol by ambulance services throughout America

However the use of the red cross symbol can still be seen on military vehicles, hospital tents and buildings to protect wounded civilian and military personnel as per the Geneva Convention in times of war.

The snake and staff in the symbol portray the staff of Aesculapius, son of Apollo, the staff represents medicine and healing. The Star of Life symbol can be seen as a means of identification on ambulances and ambulance equipment worldwide. It`s use on EMS patches in the US and other countries signifies the wearer has been trained to meet National or State Training Standards.

In order to become a paramedic you must first complete basic Emergency Medical Technician (EMT) training. Basic EMT training is conducted by many Community Colleges in Michigan.

Your first step is to enroll in EMT training. EMT requirements are as follows:

1. It must be a state approved EMT program.

2. You must have a high school diploma or GED and be 18 yrs of age.

3. You must be able to pass a physical examination and be signed off by a physician as having sufficient health to do the responsibilities of an EMT.

4. Be free of Felony, drug, or DUI convictions.

5. Pass the schools prescribed EMT course with usually an average of 80%

After meeting those requirements, an applicant will need to enroll in a Paramedic training course given by many institutions (Community Colleges) for admission to the Paramedic program.

The first ambulance service in the United States was created in Cincinnati in 1865 at Cincinnati General Hospital.

This service still operated in the fire department.

Other services followed at Grady Hospital in Atlanta, Charity Hospital in New Orleans, and several hospitals in New York City and other major cities.

In December of 1869 the first month of operation of the ambulance service of the Free Hospital of New York (Bellevue) ran 74 calls. A total of 1466 calls were run in 1870.

In the mid 1950's, J.D. "Deke" Farrington, MD, FACS (known as the Father of modern EMS), and others, questioned why the lessons learned by the military medical corps during World War II and the Korean War could not be brought into the civilian community to improve the standard of civilian care.

At that time, emergency medicine and EMS were not what we it know as today. In San Francisco, New York, New Orleans, and other U.S. cities, interns were assigned to ambulances to provide care for the victims of trauma and other conditions outside hospital's. Most of U.S. hospitals did not have a place to manage emergencies. Some hospitals had set up so called "emergency room" that were unstaffed at the back of the hospital.

The "ambulance driver" would have to ring the doorbell beside the emergency room door so that the nursing staff could come down from the ward to unlock the door. The nurse then checked the patient and called a physician from home if she thought that the patient was really sick. Today's modern emergency departments are still primarily in the rear of the hospital and not out front is this tradition?

Physicians that were on staff had to take turns "covering the emergency room." In the 1950's a patient involved in a major wreck with multiple fractures, and perhaps a ruptured spleen or a head injury, might be seen by an ophthalmologist or a dermatologist.

Many physicians were ill prepared to handle trauma or a major myocardial infarction, (Heart Attack) but there was no alternative.