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ALS personnel may best benefit rural communities

A rural Nebraska city recently welcomed a graduating class of six paramedics who took their coursework off campus. Editorial Advisor Art Hsieh says that for rural communities, placing education initiatives within community could offset the difficulty in providing advanced life support services.

I've mentioned in the past how difficult it is to deliver EMS in rural regions of the country. Sparsely populated areas generally cannot support paid services — there is too small of a tax base and not enough insured patients. At the same time, and for the same reasons, hospital and medical professional services are also in short supply. The result is that in areas where advanced life support personnel might be of the greatest benefit to the health of the community, the ability to train and retain them is minimal. So, I applaud this initiative to place these resources within the community.

Recent data has been slamming the ALS side of the profession. It seems like every study out there shows that ALS interventions doesn't help patient outcomes. On the other hand, most of these studies are conducted in urban and suburban areas, where call volume is high enough to support such research. There's a dearth of information about how rural systems benefit from ALS providers. My personal opinion is if there is any area that ALS might make a difference, it will be in locations where access to primary care is minimal.

Training as a paramedic is not easy. Ask any paramedic — the time and cost is much more than meets the eye. Long hours in the classroom and in clinicals, followed by even more time studying, preparing reports, and taking exams — it's a significant investment. On the other side of the classroom, running a paramedic program is also costly, in terms of time and resources. I'm sure that even with the university's support behind them, the folks involved at the ground level really had to sacrifice a lot to ensure the success of the program.

Here's hoping that whatever the funding sources involved with this program, they stay available and allow for more opportunities for rural communities to place ALS personnel in their EMS systems. It sounds like a good way to bring an essential resource to an area where it's needed the most.

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