ACEP report card: America gets a D+ in emergency medical care

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ACEP report card: America gets a D+ in emergency medical care

The national grade dropped from a C- in 2009 — where does your state stand?


Sorry, America: Support for emergency care patients barely receives a passing grade and needs extra help, according to a new report.

The American College of Emergency Physicians, a national medical specialty society, issued a "report card" assessing the country's emergency medical services. As a whole, the United States got a measly D-plus.

"This report card is saying: The nation's policies are failing to support emergency patients," Alexander Rosenau, president of the American College of Emergency Physicians, said Thursday.

Read full storySupport for nation's emergency medical care gets D-plus

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Danielle Little Danielle Little Sunday, January 19, 2014 8:46:38 PM No idea what my country rating is but find this fascinating as comments made by myself and others from NZ are routinely slammed by American paramedics. We have a great degree of autonomy in our practice so we often think quote differently maybe this will remove some of the "we are better th a n you mentality" and encourage healthy respectful debate over different clinical procedures. No offence meant
Arnie Higgins Arnie Higgins Sunday, January 19, 2014 9:06:31 PM Goo Biiiig REEEEED
Andy Wisheart Andy Wisheart Sunday, January 19, 2014 10:04:16 PM Interesting that you think you have greater autonomy than other countries paramedics. St. John still works to guidelines just the same as everyone else. What makes NZ paramedics more autonomous? I often heard this when I worked for St John in relation to my practice in the UK. Never managed to work out where NZ was more autonomous? Anyone care to explain it to me?
Aron Sperling Aron Sperling Sunday, January 19, 2014 10:06:59 PM the courses need to be standardized from s state to state and have Federal Oversight for liceincing across the border. and all steted
Danielle Little Danielle Little Sunday, January 19, 2014 11:21:01 PM Andy as you know they are guidelines and not protocols I make a clinical decision independent of a conversation then and there with a doctor and can apply and work to a certain extent outside of them if I have good clinical rationale. All of which you already know from your time as a paramedic in auckland. Since you have left there have been some significant changes
Phil Cuchetti Phil Cuchetti Monday, January 20, 2014 12:19:25 AM Maybe if the wages where more than minimum wage we might see more and better care.
Pat R Lanier Pat R Lanier Monday, January 20, 2014 2:44:08 AM I couldn't get the article to come up so I didn't read it, but maybe if people didn't use the ER like a doctor's office people could get better care. You can go to just about any ER after regular doctor's office hours and they are full of non-emergency type people. One Hispanic woman sitting next to me at about 6PM on a Friday night had her toddler in her arms. She said the child had been running fever of between 101 and 103 all week. I asked her why she didn't take the child to the doctor sooner and she said cause she would have had to pay, and by coming to the ER on Friday night they will giver her enough meds for at least the weekend and not just tell her to go to the doctor in the morning. I suspect she was illegal.
Crystal Smith Crystal Smith Monday, January 20, 2014 6:49:43 AM How about not using the ambulance as a taxi service, or abusing the ED? RATE US ON QUALITY of care for REAL emergency and not just included in the average. I know I work with amazing crew and though the ED IN ED in my home town is not rated #1 we get the job done and fly out what can't be treated there .
Elizabeth Miller Elizabeth Miller Monday, January 20, 2014 8:48:54 AM Emergency departments got a C because they couldn't cure somebody's asymptomatic hyperglycemia or administer a routine mammogram on a Saturday? I'm shocked.
Mark Torrence Mark Torrence Tuesday, January 21, 2014 4:54:01 PM Interesting and as usual AMBULANCE services do not seem to be even considered in this article much less Paramedics. No mention of ambulance services at all. We're the bastard child as usual. And here sits the American public cheering a bunch of over paid prima dona criminal athletes getting ready to play another game for way too much money! Gee what could possibly be wrong with this picture?
Alan Yates Alan Yates Tuesday, January 21, 2014 10:52:54 PM The only problem I encountered in my emergency visit last year lay with the physicians who were lackadaisical and uninterested in my condition. I have CHF and presented to the ER with dyspnea. I spent 16.5 hours in the, (non-busy), ER "under observation" and largely being ignored until I tired of it and signed myself out. I went to my ZPCP who sent me directly to another hospital across town where I was evaluated, admitted within 2 hours and spent 5 days in CCU. The encounters I had with paramedics and firefighter/EMTs have always been productive and professionally done. Doctors? Not at all.
Steve Weaver Steve Weaver Tuesday, January 21, 2014 11:50:56 PM Why are you harping on about American Paramedics? This report card is about Hospital ERs and the physicians that staff them. You may also want to note that it is an American only survey and report. It in no way tries to compare the US with any other country's quality of care. One thing that I am impressed with is that The American College of Emergency Physicians is willing to grade itself and apparently be objective about it. As to comments by American Paramedics "slamming" your posts. All I can say is that there are a fair number of incompetent paramedics in the US just as there are in EVERY service in every country worldwide. Your scope of practice may be ,and probably is, much larger than many US services but I would be willing to bet not all. Unless you are allowed to do elective surgery in the field I can not see how your scope would be larger than the service I worked for. And No, I didn't have to have "a conversation then and there with a doctor".
Danielle Little Danielle Little Wednesday, January 22, 2014 12:30:17 AM Steve elective surgery had been done in the field by paramedics on several occasions recently during a pretty significant earthquake with a non orthopedic trained doctor several amputations of legs admittedly under extra ordinary circumstances, we will soon be able to do ring blocks independently among other skills, rsi already in place no doctor required. It wayour defensive comment to be fair supports what I said. Rather than getting in a knot over my comment I would be more concerned with having a conversation on how to improve what appears to be appalling statistics. Perhaps looming at other services medical facilities trauma systems emergency preparedness of other countries rather than making negative comments might improve what are apalling grades
Steve Weaver Steve Weaver Wednesday, January 22, 2014 1:43:43 AM Danielle Little. I think we may be at odds as to what constitutes"elective surgery" here. Disaster response is a whole other can of worms. I may have come across more terse than I intended by the way. My intended point was that this report was about hospitals and the ER physicians, not about the pre-hospital arm of EMS, which is what you appeared to be commenting on. Are there problems in in US pre-hospital EMS? Hell yes! I have argued within the system for years that the standards are not set high enough when it comes to allowing people to practice as ALS/MICU paramedics. I was also just trying to point out that this "black cat" argument about who has the larger scope of practice is just that, a black cat argument. I too could utilise RSI without needing to ask "permission" by the way. Although not a skill I was trained in, a colleague of mine was permitted to perform cardiocentesis in the field, without having to get permission. If NZ is in fact taking the same route as the UK in establishing a Paramedic practitioner program then I wholeheartedly support this idea. I believe the US could benefit from such a program but it will not happen until the MD's that restrict/protect their "holy" realm allow it. ( which means never in my opinion) In closing I would say that I hope you are as good a service as you believe on account of my brother and his family are residents of Auckland and I have a nephew who lives in Christchurch. That was not meant to sound sarcastic by the way.
Steve Weaver Steve Weaver Wednesday, January 22, 2014 1:49:13 AM On the flip side of the "black cat" argument. I am now living in Sweden. All ALS personnel here are RN's. A good friend of mine is an RN-anesthetist on the ambulance service but is not allowed to RSI outside the Operating Room.
Pam Donaldson Pam Donaldson Wednesday, January 22, 2014 8:13:30 AM Mark, I saw on the news this morning that AMR put the only bid in for Multnomah County and the bid was denied
Leonard Misner Leonard Misner Wednesday, January 22, 2014 5:16:56 PM What country has an A?