Saturday, March 21, 2009

Looking Back...City Needs Independent Study of Amblulance Service

Please see my comments that follow the article.

Peoria Journal Star

January 10, 2004


City needs independent study of ambulance service

Peoria's new city manager, Randy Oliver, is organizing a commission to study emergency medical services (EMS) in Peoria. The editorial board of the Journal Star pleads for a fiscally responsible decision regarding these services. Local physicians need to insist that both fiscally and medically responsible choices are made for pre-hospital patients.

The EMS services in Peoria are provided by two agencies. Advanced Medical Transport (AMT) provides the only advanced life support service and transport of patients. This company is supported by Peoria's three hospitals and governing boards. AMT grosses over $7 million per year and desires a 10-year contract to remain the only paramedic and transport agency in Peoria.

The second agency is the Peoria Fire Department. Firefighters arrive quickly at the scene, but can provide only basic life support and are not permitted to transport patients.

The Peoria Medical Society needs to consider the following questions: Who will compile and interpret the statistics regarding local EMS care? What EMS issues will be analyzed? What is the response time for the Peoria Fire Department versus AMT to an emergency? How much time elapses from the 911 dispatch call until the electrical shock is administered to a patient in full cardiac arrest?

When AMT arrives at the scene and begins its advanced life support, have the patients waited longer than necessary? What percentage of Peorians survive and walk out of the hospital after suffering a cardiac arrest? Are Peoria's trauma patients transported quickly and efficiently with the "scoop and treat" philosophy? How does Peoria compare to other cities in the U.S. and Canada that have state-of-the-art EMS? Might it not be responsible and medically important to allow Peoria firefighters to advance their skills (such as improved airway control and IV medication administration) to improve patient outcome?

The most important question is: Can Peoria's EMS system be studied in an independent and unbiased fashion? The same doctors, administrators and boards of directors that made questionable decisions 10 years ago are still in absolute control today.

Thus, the Peoria Medical Society needs to do exactly what the first sentence of its mission statement professes: To promote the health and general welfare of the Peoria public.

Peoria's pre-hospital patients have never been in a more perilous situation.

Encourage Oliver's study to ask the correct questions and answer them using scientific rigor. Then and only then will fiscal and medically appropriate decisions be made regarding EMS in Peoria.

Dr. John Carroll

My comments today, March 22, 2009:

1. This Forum article was written 5 years ago. Since I submitted this article, the Peoria Fire Department paramedics have been allowed by OSF to give advanced life support drugs and can intubate the patient at the scene of an emergency. And two fire stations in Peoria have become paramedic. OSF EMS leaders were critical of my attempts to inform the public, but then the same doctors made the needed changes. More about this later.

2. The Matrix Consulting firm came to Peoria in September, 2004, six months after this Forum article, and documented that the Peoria Fire Department responded to life threatening emergencies almost two minutes faster than Advanced Medical Transport. (When I called the Peoria Area EMS office, I was told by the director that no statistics existed regarding how Peoria pre hospital patients were doing in Peoria's EMS.)

3. I did write the President of the Peoria Medical Society, Richard Anderson, M.D., during these years and he assured me that all was fine with Peoria's EMS. He also told me not to publish the contents of his letter.

4. In March, 2005, EMS Director Rick Miller, would write the Journal Star criticizing me. However, a couple of months later in 2005, a man would die in a Peoria restaurant, and Dr. Miller would change the policy. His policy change would allow the PFD paramedics to intubate the patient at the scene.

5. Even now in 2009, the Peoria Fire Department cannot transport patients. AMT still has this monopolized. I will report the summary of a study that states that quick transport in trauma patients can be life saving. Peoria is not there yet....

No comments: