[fenwayfrankee]

I understand that since Emerson Hospital shut down its paramedic intercept service Professional Ambulance taken over. Anybody have any info on this? Are they are they in ambulances or are they doing non-transport? Would love to hear about it.

[TedEMTP]

fenwayfrankee, on 05 March 2010 - 12:56 PM, said:

I understand that since Emerson Hospital shut down its paramedic intercept service Professional Ambulance taken over. Anybody have any info on this? Are they are they in ambulances or are they doing non-transport? Would love to hear about it.

Emerson Hospital decided it could no longer support its ALS program, because hospitals don't like to pay for things that don't make them money (when I started at Emerson in 2002 there were something like 13 hospital-based regional ALS services out there -- Lawrence General, Saints Memorial and UMassMemorial are now the only exceptions, although UMass covers only Worcester and Shrewsbury, so they're not technically a regional system) and have no use for Paramedics or EMS.

SO, thanks to the new CEO, Emerson embarked on a two-year process of finding a way to offer regional ALS to the area without having to pay for it or employ Paramedics themselves.

In the end, the hospital, in conjunction with a consortium of local fire chiefs, decided to hand over the 30-year-old system to ProEMS of Cambridge.

I don't think the FDs or local nursing homes will see much of a difference, but there are a few important changes.

On average, the Pro staff is much less experienced than the medics they replaced, and their pay scale stinks ($16.50 an hour base with $0.25 an hour per year experience). With the demise of Emerson ALS-1 the local RSI program is gone, too, so a valuable airway management tool is not available to the residents of the district. And the owner of Pro, a pretty shrewd and successful businessman, has pledged to increase the service's call volume and double the revenue extracted from the system, so overall local residents and/or their insurance companies are going to ultimately pay more for the same service.

There are some definite improvements, though. For one, from the guys I talk to who are working with the Pro medics, Pro has spared no expense in equipping its people, and its medics have tools at their disposal -- like the Lucas II CPR device -- that Emerson never would have invested in. I also understand that Pro is going to be offering extensive training to the local FDs and will attempt to drag area dispatch systems into the 21st century.

I don't know how things will work out there in the long run for Pro. My guess is this system is just a bridge to something else, but what that is I have no idea.

This post has been edited by TedEMTP: 07 March 2010 - 04:33 PM

[fenwayfrankee]

What a shame. Regionalized ALS is the way to go. A small core group of paramedics that are highly trained and experienced is proven to show the best results. I hope PRO will be able to offer comparable care. I have doublts that a for-profit company will have the same expections of care.

I work in 2 different system that use MAI/RSI. Its a great tool. Its too bad that the population the Emerson served will no longer have access to it.

[TedEMTP]

fenwayfrankee, on 07 March 2010 - 07:00 PM, said:

What a shame. Regionalized ALS is the way to go. A small core group of paramedics that are highly trained and experienced is proven to show the best results. I hope PRO will be able to offer comparable care. I have doublts that a for-profit company will have the same expections of care.

I work in 2 different system that use MAI/RSI. Its a great tool. Its too bad that the population the Emerson served will no longer have access to it.

I agree on all points my friend. I'm still sad to see the place close down.

[kiltedjake702]

When did Emerson Medics stop or cease? I have been on Rt-2 within the past 2 weeks and I have seen the Emerson Medic SUV...Is Pro-EMS using the Emerson SUV or are they using one of the own vehicles?

[TedEMTP]

kiltedjake702, on 08 March 2010 - 02:02 AM, said:

When did Emerson Medics stop or cease? I have been on Rt-2 within the past 2 weeks and I have seen the Emerson Medic SUV...Is Pro-EMS using the Emerson SUV or are they using one of the own vehicles?

Yeah, part of the deal is that Pro received the two Emerson Expeditions (the hospital had two almost-brand-new trucks at the time they shut down) painted in the Emerson colors. The last concession the Emerson medics got out of Pro was that the designation "ALS-1," which Emerson had used for 30 years, would be retired when the service shut down. I think Pro calls their truck "ALS-4" or something like that. The service shut down on Feb. 14.

[TedEMTP]

fenwayfrankee, on 07 March 2010 - 07:00 PM, said:

What a shame. Regionalized ALS is the way to go. A small core group of paramedics that are highly trained and experienced is proven to show the best results. I hope PRO will be able to offer comparable care. I have doublts that a for-profit company will have the same expections of care.

I work in 2 different system that use MAI/RSI. Its a great tool. Its too bad that the population the Emerson served will no longer have access to it.

I think Pro would claim that they're still running a regional ALS service, but the call volume was barely there for skill retention when Emerson had a single truck covering 14 towns. Pro has added a SECOND truck, which means there are even fewer critical calls available for a Paramedic pool that's twice as big as before. I don't know when, but someday people are going to realize that MORE medics = POORER outcomes.

When it comes to optimal, successful ALS that actually benefits patients, FEWER PARAMEDICS IS BETTER.....

But I think that battle has been lost in Massachusetts, although other states seem to get it.

[Future Fireman]

I remember hearing a story about Emerson's medics that if anaestesiologists (so I spelled it wrong ) in Emerson were unavailable, they'd go up and intubate patients in house.

Mike

[PCC]

Ted,

I enjoy reading your postings as always. The debate over "fewer paramedics equals better outcomes, greater skill retention" etc. is an interesting one. It is ironic because Massachusetts ascribed to this philosophy for many years with the hospital run "QRVs" that covered rather large geographic areas. I have relatives in Medway so I am very familiar with the unit from Milford Hospital which I understand no longer exits (replaced by AMR or "Events"?).

However it seems like in recent years Massachusetts has gone in the complete opposite direction with the large number of FDs in the smaller suburban and rural towns providing their own ALS transport. I'm sure eventually these agencies will be like it is here in Florida where "everybody's a medic" and it will not only be an ALS rescue/ambulance but the suppression rigs as well.

Where I live in Central Florida Lake-Sumter EMS is the exclusive transport provider and has served in this capacity (in various incarnations) for nearly 30 years. When I started doing this back in the mid 80s they were also the sole ALS provider and the usual staffing pattern was one medic and one EMT-B on an ALS ambulance. What this meant was that on a cardiac arrest, severe trauma, etc. you had one medic and 3 or 4 EMT-Bs (1 off of the transport unit and another 2 or 3 from the first responder agency). The single medic was responsible for tube, IV, meds, monitor/defib, etc., of course the EMT-Bs assisted with the ALS skills to the extent that they were allowed. Although this seemed overwhelming at the time, the medics from this era gained a lot of experience very quickly both on scene and during the often long transport times in from the more remote areas.
Over the years the local FDs have begun providing ALS first response although none transport. Also not uncommon to have two medics on a transport unit, especially in the case of a new employee or intern. Although all these guys (and gals) go through the same course and a rigorous "provisional" period before they can function independently as a paramedic, many are very young and have not been in the field for long. Furthermore our county FD here serves some rural, low density communities with low call volumes. Those seasoned, decorated medics from the 80s and 90s either have moved up into the administrative ranks, left the field for greener pastures, or retired prematurely due to injuries or health problems. Sadly, one who was a colleague and friend of mine recently passed away.

I think we are getting to a point where paramedic is becoming the new EMT-B and EMT-B is the new first responder, if we aren't there already!

Phil