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Home > EMS Products > Ambulances
February 20, 2009
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The Ambulance Driver's Perspective
by Kelly Grayson

Top Ten Predictions for the Future of EMS

By Kelly Grayson

December brought a flurry of retrospective musings about the most significant EMS events of 2008. And as surely as day follows night — or poop follows the Valsalva maneuver for your SVT patients taking stool softeners — the first months of 2009 bring predictions for the coming months. It’s simply the natural order of things.

The editorial board here at EMS1 suggested I might consider writing a Top Ten list of predictions for EMS. So, when enough time had passed that I was no longer writing “2008” on my patient care reports, I turned down the lights here at the ambulance station, lit some incense and candles, and tried to get my Nostradamus on.

And soon enough, the vision came. A ghostly white apparition appeared with predictions of the future. Unfortunately, the apparition turned out to be a white-shirted supervisor with predictions of unemployment unless I put out the incense and candles and answered my radio traffic, tout de suite.

So, I waited till my day off to seek a more suitable venue for prognostication. In the comfort of my living room — safely ensconced in my bean bag chair and fortified with Cheetos and beer, my DVD of "Mother, Jugs and Speed" playing softly in the background to set the mood — I was able to successfully channel Miss Cleo for my vision into the future of EMS:

Spurred by encouraging outcomes with prehospital CPAP and studies that cast doubt on paramedics’ ability to intubate, EMS systems nationwide place a moratorium on paramedic field intubations. Within months, the intubation success rate for emergency medicine residents in those cities plummets. No one can figure out why.

Congress enacts sweeping legislation to provide free health care to all citizens, and President Obama immediately passes national health care into law. Within six months, fibromyalgia and dental abscesses rise to the top two most common emergency department triage diagnoses, and patient volume doubles. After a few well-publicized incidents of cardiac patients dying in ED waiting rooms, Congress promises swift action. In its best “the beatings will continue until morale improves” management style, CMS threatens to cut reimbursement to underperforming EDs until they shape up. 

The American Heart Association hires Adam Sandler as its new national spokesman. Henceforth, every AHA training video will feature the Waterboy saying, “N-n-now that’s hiiiigh quality CPR! M-m-momma said artificial ventilation is the debbil!”

Medtronic/Physio-Control debuts the LifePak 15, Eddie Bauer Edition. In addition to all the standard bells and whistles, this one comes equipped with a Bose sound system, an ETOH sensor integrated into the nasal capnograph line, automatic deodorant misters for those patients with Toxic Sock Syndrome, and an automatic TiVo interface that will record the rest of your shows when you get called out in the middle of "CSI: Punxatawney."

Following the lead of the banking, insurance and auto industries, the American Ambulance Association, on behalf of its members, asks Congress for a bailout. After several days of testimony, Congress feels our pain… and decides to cut Medicare reimbursement by 30 percent.

A district chief for DC Fire and EMS sees an image of Johnny and Roy in a plate of scrambled eggs and hash browns. Word of the vision spreads like wildfire on the Internet, and EMS whackers from around the country make the pilgrimage to see it. The vision is later revealed to be a hoax, part of a scheme to boost recruitment and bring DC Fire and EMS a little good press for a change.

Summer 2009 sees a return of the fuel crisis, and the cost of diesel fuel skyrockets to $6 a gallon. In response, EMS systems around the country convert their fleets to Sprinter ambulances. When diesel rises to $8 a gallon, Bound Tree Medical responds to the crisis by introducing the EMS Rickshaw. SSM systems nationwide buy them in the thousands.

Following in the footsteps of David Lee Roth, Chuck Norris enrolls in EMT school and volunteers for his local volunteer EMS corps. Within months, the cardiac arrest survival rate skyrockets because people are literally too afraid to die when Chuck is on duty. And Chuck is always on duty, folks. Chuck Norris doesn’t sleep. He waits.

The Discovery Channel cancels its popular hit, "The Most Dangerous Catch," and replaces it in the fall lineup with a documentary series highlighting America’s newest and most dangerous profession: flight medic. The debut season of "The Most Dangerous Flight" ends prematurely after one of its helicopters crashes transporting a patient with a broken pinky finger to the trauma center in the middle of a thunderstorm. Industry insiders blame Bryan Bledsoe for the show’s demise.

And the number one prediction for the future of EMS:

A leading public safety distributor takes a public relations hit when it is discovered that most of its products are made in Singapore sweatshops. Tales of 8-year-old girls forced to work 16 hours a day in brutal working conditions for roughly $8 a day garner shocked reactions from the media and labor unions. Meanwhile, EMT whackers across America say, “Wait a minute…they make eight bucks a day and they get discounts on gear? Dude, are they taking applications?”


Write these predictions down, folks. They’re every bit as sound as the U.S. dollar. I guarantee it.

About the author


Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (www.facebook.com/theambulancedriverfiles), or email him at kelly.grayson@ems1.com.

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