Yes, it is. It’s a comparison analogy. And it’s false. You said “Modern properly equipped paramedic units are equipped the same way as a hospital.” That’s simply not true. As I said, ER’s and hospitals have treatment adjuncts and drugs that paramedics in the back of an ambulance don’t have. And if you think that just because you take the same ACLS classes that ERMD’s take, that your knowledge and skills and experience are on par with theirs...then that’s just as big of a crock as is your assertion that the back of an ambulance “is equipped the same way as a hospital” is. Again, not knockin’ EMS...I’ve been very involved with it for well over 30 years...but paramedics ain’t ER doctors, and the back of an ambulance ain’t an ER.
I ever keel over from a heart attack or serious trauma I’d rather have a king county medic working on me to start then an er doc every time. Of course I would still want to end up in an er but the medic units here have hundreds of medications on them, their life pack is no different then the ones in the er, ive seen them perform in field operations and I’ve been in tons of situations where doctors happened to be on scene and it was a cluster. To be fair there have been a couple times when drs were on scene of something and did a fantastic job, just the far less common example. I also think that not all medics are created equal in general but certainly in different parts of the country. Far different levels of training and equipment available. I would love to hear what airway interventions an er can do for a code that a medic unit here can’t.
We (L.A. County) were in a cricothyrotomy study for a year or so. We didn't do enough to even come to a conclusion and the 2-3 that did happen were bloody messes so we never got it a added to our field protocols. Same with peds intubation, not enough data. So hospitals here do crikes but medics do not. The conclusion was that in almost all cases we are within 20 minutes of a paramedic receiving hospital and we were just supposed to do the best we could until we could transfer care.
We were required to get a docs ID if he insisted on getting involved and usually got them to back off if their license number was going to be on record. Even when we went to their offices they backed away. A podiatrist or kidney specialist isn't always going to help if they want to be in charge. We met a young doctor on a 3 victim TC that volunteered to be an extra set of hands. He was really cool surfer doc, and thought what we were doing was really cool and decided to come hang out with us for a couple shifts and eventually switched over to emergency medicine at our trauma center.
