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  While the issue of Electronic Medical Records and physicians seems a little off base for an EMS blog, the reality is that their use and adoption is occuring throughout all levels of healthcare.   This includes the prehospital arena and intrafacility transport systems.  Insurance information capture is now stressed with most ambulance systems, both […]

Creating and Maintaining Drug Addictions in the EMS/ED Setting

Some background:   I have a very good friend who is a nurse who recenty admitted to me that the reason s/he "dropped off the face of the Earth," was s/he had an addiction problem.   This person is on the road to recovery and offerred to write about what occurred.  Interestingly, over the years, […]

A Tale of Two, Two Tiers

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Disclaimer:  I appologize for the format of the text as this is one of my first blog entires with this interface, and for some reason it and Word didn't want to play nicely.  I tried to fix it up best I can.  Future posts will not have this problem. It’s interesting that Dr. Barnett picked a […]

New Jersey’s Two Tier ALS System. Time to Advance?

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I had missed dinner and was heading in for my first of three night shifts. I made excellent time on the highway, and pulled into a local strip mall just several blocks from the hospital to grab a bite to eat before tackling my shift. Off along the curb a quarter mile back along the […]

Hiding In The Nursing Lounge

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“They aren’t learning to be fry cooks – they will be responsible for peoples lives!” I explained to my nurses that the observation time provided to these students to see what the Emergency Department staff actually does is crucial.

EMS System in NJ

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What really blows my mind is that the system we currently operate in does not mandate any minimum standards for providers (mainly BLS, as ALS is in my opinion OVER regulated), does not require an ambulance to be licensed by the Department of Health nor meet any minimum standards, nor mandate minimum response times. Better yet, EMS in New Jersey isn’t even considered an essential service like police, fire, and municipal services are. It’s simply, sickening.

Time for Intelligence in Implementing EMS

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During the recent snowstorm, the governor of New Jersey declared a state of Emergency closing all roads to nonemergency vehicles. As luck would have it, I was on shift at one of the hospitals where I work.

Christmas Eve in the ER

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As my thirteen year old daughter would put it, “it bites” being stuck working on Christmas Eve in the Emergency Department. Considering how busy we normally are on a typical work day, the fact that I am able to sit here with the nurses at the computer typing this entry I find thoroughly amazing. Since 2:00 pm today, my staff and I have been keeping a tally of what pathology has shown up so far.

The Free Taxi Ride

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Years ago I was working with New York City as an EMT out of Queens General Hospital. I remember being in shock after picking up an otherwise non-ill appearing man who gave a complaint that I currently cannot recall. We took him in a city ambulance to the local hospital. The part that shocked me was that he never entered the hospital. He thanked us and proceeded to go across the street to do his shopping. He never was sick and never intended to enter the ED doors. We served as free transportation for him.

The Perception of Care Versus Quality of Care

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Emergency services selects for a unique “customer” base. This customer base is comprised of the truly ill and the desperate, those who have no where else to turn for care, as well as those with poor coping skills and a naiveté regarding emergency care realities and, on occasion, those with secondary gain interests. What is being measured is the perception of quality in care and not quality of care. The survey industry has duped the hospital administrators who are trying to promote their “businesses”. Kind, considerate, thoughtful care, with a focus on the patient is absolutely paramount. Inappropriate prescribing of antibiotics and addictive narcotics, exposure to potentially harmful unnecessary studies, especially in developing children, as well as further straining an already economically burdened health care system are just some of the products of blinding following these surveys. The survey industry has duped hospital administration into believing that the same system used to evaluate customer service at my auto dealership translates to all niches of hospital care. Obviously, it doesn’t. Blind focusing on these surveys without true reflection on their source and meaning will lead to many patients becoming victims.

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Jordan Barnett

Jordan Barnett, MD, is an Emergency Medicine Physician in the Philadelphia Suburban Region.  He has previously worked as a volunteer firefighter, was a member of New York City EMS, and provides Medical Command for several ALS Ambulance Services. Dr Barnett provides EMS consultation services. Additionally, he is actively involved with EMS education.
July 2014
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