In this week’s episode of Inside EMS, it’s all about the Benjamins.
Co-host Chris Cebollero and I discuss Rural Metro’s decision to close most of its Indiana operations, laying off 361 EMTs in the process, a Virginia county’s program to cover ambulance co-pays for its residents, and a Missouri petition to halt outsourcing of ambulance billing.
In our Clinical Issue, we discuss something else that has everything to do with money, and negatively impacts safety: the ubiquity of 24-hour (or longer) shifts in EMS.
Constantly running ambulance calls for 24 hours increases provider fatigue, which in turn increases medical errors, crew burnout, and the likelihood of ambulance accidents. The only time it is acceptable is in low-volume, rural systems where crews can get at least eight hours of uninterrupted sleep per shift. Even then, agencies should have fatigue-mitigation policies for those instances where crews are required to drive long stretches without rest.
Of course, that doesn’t stop a lot of busy EMS agencies from running crews into the ground on 24-hour shifts, or stop a lot of EMTs from willingly working them, convinced that they are the exception to human physiology.