Posted on 03/22/2009 9:19:28 PM PDT by buccaneer81
Columbus questions whether it needs paramedics City panel suggests returning to cheaper basic emergency medical care Sunday, March 22, 2009 8:43 PM By Suzanne Hoholik THE COLUMBUS DISPATCH
A committee charged with finding ways for Columbus to save money has recommended that the city return to a basic emergency medical system.
The last time the Columbus Division of Fire provided only basic-level care was in 1968.
Since then, Columbus has provided advanced life support to anyone who calls 911 for medical attention, whether a patient needs it or not.
Basic care mostly involves stabilizing injuries before a patient is transported. Paramedics trained in advanced support can administer lifesaving drugs and treat heart attacks on the way to a hospital.
The economic advisory committee, appointed by Mayor Michael B. Coleman and City Council President Michael C. Mentel, suggested comparing costs and benefits of the current system with basic life support.
The group cited a 2005 study published in the Journal of Prehospital and Disaster Medicine that found that patients fared about the same. The study examined 22 previous studies, 18 of them more than a decade old.
"The (2005) study would lead you to the conclusion that whether you have advanced life support or basic life support, you really don't have much difference in the outcome," said Robert F. Howarth, a lawyer who led the committee.
"If there's no positive result or effect, and basic life support is cheaper, then in fact the Fire Division could reallocate those assets and use them elsewhere."
Basic life support is provided by emergency medical technicians who, for example, can stabilize broken bones or use an automatic external defibrillator on cardiac-arrest patients.
With advanced life support, highly trained paramedics can administer lifesaving drugs, create airways in patients who can't breathe, and shock patients who have had heart attacks.
"A paramedic is vital in saving lives; there is a huge difference," said Battalion Chief Doug Smith, spokesman for the Columbus Division of Fire. "I think (Howarth) is wrong."
Dr. David Keseg, the Fire Division's medical director, said the study did not take into account the benefits of drugs that paramedics administer. "This paper in and of itself is not a good defense of trying to promote" an all-basic emergency medical system, he said.
More than a decade ago, Columbus leaders moved from a two-tiered system to an advanced-only system in which every medic unit is made up of paramedics trained to use lifesaving equipment and drugs.
Many new firefighters are required to become paramedics. Of the city's 1,520 firefighters, about 640 are paramedics and are paid at a higher rate than firefighters.
Fire officials say the system works. For example, the national survival rate for cardiac arrest is 6.4 percent. In Columbus, it's 12 percent.
"I can't see the citizens of our community changing from an (advanced) system to a (basic) system in order to save 3 percent of the budget," said Jack Reall, president of the Columbus Fire Fighters Union.
He questioned whether the committee considered the money the city could lose in switching. Columbus bills government and private insurers at a higher rate for advanced emergency transports to hospitals than for basic care.
Last year, the city collected $12.4 million for emergency medical runs.
"If that's their recommendation, you have to wonder what the rest of the report has in it," Reall said.
Fire leaders have discussed returning to a tiered system so paramedics wouldn't respond to basic calls.
Howarth said the committee did not recommend studying a two-level system.
shoholik@dispatch.com
Columbus ping!
Politicians always threaten to cut off essential services when they do not get support for tax hikes. These people have to be voted out.
Ohio right? This is sad.
Yes, Ohio. I have paramedic friends. These guys are the best. There was a story I read from the National Institutes of Health several years ago that said the two "best" places to have a heart attack in America were Seattle and Columbus.
I am donning my asbestos suit here, but, if the outcomes are the same whether it is advanced life support or basic life support, why send advanced life support?
The first response of most liberals to anyone in distress is to “Call 911!” (as opposed to performing a heimlick, or doing CPR themselves, for instance. I do speak from experience on this).
Having highly qualified parameds show up has almost become a legend in urban culture, since it was first depicted in its early form in that 1970’s show, “Emergency”.
Sad to say that will not be the case without quality pre-hospital care.
This question on outcomes could be applied to our entire medical system, as well as fire-rescue.
It can be a slippery slope going down this path. I would figure that once you start rolling a vehicle, the difference between a $14 a hour BLS team and $19 an hour ALS team wouldn’t make much difference in the long run. I think the vehicle costs about 50 grand (more?) and the other fixed costs are about the same.
I get your point but give them an inch...
I hear both of you. If the taxpayers in the community think it is worth it to pay the difference, I have no problem with it. I just hope it helps.
Fire officials say the system works. For example, the national survival rate for cardiac arrest is 6.4 percent. In Columbus, it's 12 percent.
Hey, if it saves a buck here and there, let ‘em die.
12 percent as opposed to 6.4 percent is pretty impressive, especially if you or one of your loved ones is part of that 5.6 percent difference.
LOL
IF you live in Wasilla Ak, you call 911 and maybe the ambulance shows up in 15 to 30 Min.
All volunter FD don’t cha know..... (well, they have small (3) paid staff)
Type of Fire Department: Mostly Volunteer
Department Run By: Local
Number of Fire Stations: 6
Number of Career Firefighters: 3
Even worse the further you get from urban centers.
I guess that private (pay for play) ambulance services could fill the difference - but no insurance would mean no ride....
No heart attack here in nearby Columbus, but, when I hit a tree after sliding my 1 ton truck off a bridge, I told the Officer my chest hurt a bit (hell, I'd just got impaled by the steering wheel.) He called the EMT guys.
Despite my protestations that I was only bruised and not in arrest, I had a complete and exhaustive, roadside cardiac exam.
“I think the vehicle costs about 50 grand (more?) “
We’re getting a new ambulance in a few weeks. They’re well over $100,000 now.
But there’s going to be a tax levy on the May ballot for Metroparks funding, despite the fact that there are millions of dollars already sitting in that fund?
Ugh.
I thought so. It just seemed hard to believe as I was writing it.
Personally, I’d prefer that a rolling ER/Intensive Care Suite be staffed by those who knew how to use it’s capabilities to the fullest. The ride I took was easy, but had there been complications I was GLAD that the guy in the back with me was a full Paramed, at ease and clearly on top of his game.
I seem to vagely recall something about France’s more BLS/transport only system playing a role in the death of Princess Di.
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