Rural EMS

[Dale]

Hi,

Anybody else in a rural area? How far do you have to travel to a hospital? How fast can you get an intercept?

dale

[easi822]

Oh man, we have some areas that can take 35-45 minutes to get to a patient and then another hour to get to a hospital. We are the only ambulance service in our county. We are ALS and do carry narcotics so we can relieve chest pain and pain from fractures, but it can be a long ride out of the woods to the ED. Fortunately, Air-Evac (www.lifeteam.net) has a base right next to our hospital and can fly most of our bad patients to a trauma center or to a real hospital instead of our little baind-aid station that we call a hospital.

[Edward]

The thought of being 30-45 minutes away from a hospital gives me the willies. I think that EMS services need to be at least 10 minutes away tops. I mean, if I can't get to the hospital in the 'Golden Hour' I might be 'toast'. I mean, I was listening to Jamie talk about how you need CPR started in 2 minutes after an MI, etc. Well how can I have CPR in 2 minutes when the closest ambulance is 30 minutes away.

Not to mention, Fire and Poilce services. They are of equal importance. If I am not close to a Fire/EMS/Police station and am about 40-60 minutes out from one, I would demand to my state and local government that one be built and someone in the 10-20 minute vicinity AT LEAST!

Thank God the police are about 1 minute away and the Fire/EMS are about 2 minutes away where I live.

[Dale]

Hi,

Out here in the boonies, everything can be a long way away. Helicopters can be a God Send for critical patients. If the weather is good enough to fly. My service is just BLS, but we do what we can.

The thing is Edward, out here, and in many rural places, we are getting fewer and farther between. Many small towns are dropping Fire and EMS, and even Law Enforcement because there isn't enough money to fund those services. And for Fire and EMS, just getting people to volunteer help provide those services is getting harder every year.

Sadly and frankly, if you have that M.I. out here and you are out in the country, you will most like die before we can get there. We don't get many saves.

[Dean Harris]

This is why small towns would benefit from having more people having at least some basic medical knowledge. CPR, Heimlich, ABC's, etc.

I don't know, what am I saying?

[Tyler Smith]

We too are about 30-40 minutes from the nearest hosp. We dont have a hospital in one of the counties that I work and we dont have many first responders so when we have a bad patient it usually takes two of our 3 ambulances out of service. Since we are so far away we have more freedom in our protocols. You also get to see the effects of the medications that you give.

[Jamie Davis, the Podmedic]

Thanks for all of those comments, gang. For my region, we have one of the longest transport times at 20 to 25 minutes to the local community hospital and 45 minutes to an hour to the specialty centers (trauma, burn, peds). I think that's way too long so my hat is off to you guys who routinely have even longer transport times.
Good discussion, keep it up!
--
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[Medic 1]

Hi Dale

New to the forum, so Hi.
Here in West Australia we operate a country service as well as a metro service. There are large grey area's that are meant to be Metro but are 45-60 minutes to a trauma hospital or less to a Hospital that you can't really call a trauma hospital. We have one chopper that we can call up, if it is not in use elsewhere in the State. It sure does get the mind working at 2am driving to a suspected trauma as to when to get the bird up and minimise flight/ back up time!

Jerry

[Dale]

Hi,

I've had another thought about rural EMS. How do some of you Medics get enough calls to remain proficient? I do perhaps 50 to 60 calls a year between 2 different volunteer services. So maybe one a week.

We practice as much as we can. But injured dummies ain't real. Sometimes it takes a moment or two to just remember were something is in the rig because we don't use it everyday.

And what about average age of your service? Mine is about 40-50 years old. Why so old? Well, there just aren't that many younger people around here anymore. Makes one wonder what is to become of EMS/Fire out here in 15 to 20 years.


dalee

[James]

Sometimes our turn around call would be around an hour or so depending on road conditions out on the reservation which was scary. Occasionally we'd run EMT-B only rigs, and when you're heading to the middle of nowhere for a reported hypoglycemic patient it definitely got ya worried. We routinely has to call in Classic Lifeguard or Guardian to transport via helicopter. With limited additional resources and extremely long patient transports you definitely learn a thing or two about patient care.

[Medic 1]

OK guys, I now work on a remote mine site. The nearest hospital is 50 minutes away, and that is on non-tarmac track.......the closest trauma hospital is like 200kms away or we need to call in a fixed wing support in the form of the Royal Flying Doctor Service. I guess that CPR will be futile, we do carry advanced kit with us..........but we do realise that there is only so much we can do! Talk about the goldern hour eh?