Re: [at-l] fees

[tom@netword.com]

At 04:18 PM 1/11/00 -0500, Bpwildness@aol.com wrote:
>In Maryland, if you are in a car accident, and ambulance is automatically 
>dispatched to the scene once the police are called. (A fender bender creates 
>an ambulance call.) Once at the scene, and they observe a head injury, they 
>immediately call the air ambulance. If you are climbing and fall down a 
>cliff, and the air ambulance has to transport you, it is at the expense of 
>the tax payers, just as an auto accident. If you are at a Maryland race 
>track, and have an accident producing head injuries, an air ambulance is 
>called at tax payer expense.
Actually it's not that simple.  In Maryland if there's a car wreck (they
usually aren't 'accidents', they are usually 'inevitables') if the person
calling 911 either says there are injuries or doesn't know if there are
infuries they will send an ambulance, or if (when a police officer arrives)
one of the people involved requests and ambulance, they have to send one.

Depending on the 'mechanism of injury' (how badly is the car beat up, what
kind of injuries there are, etc), the first emergency response people
arriving on the scene are required to call for ALS (them's the paramedics).
 If they are more than 20 minutes by ground from an open trauma center (or
burn center, etc depending on injuries), then they have the option to call
for a helicopter.   

Head injuries are tricky things.  What looks like a minor booboo (I hope
I'm not getting too techinical ^_^) can indicate that the person has severe
internal bleading in their noggin.  Also a bruise on your forehead might
indicate your head smacked the dash (for example).  Which might mean there
could be significant hidden cervical spine injury.  There could also be
significant internal injuries from incorrectly worn seat belts.  These
sorts of injuries might not become apparent until the patient starts to 'go
south' on you later.

Many injuries are undiagnosable in the field, so EMT's are trained to have
a 'high index of  suspicion'.  It may seem like 'wasting tax payer money'
but what would you say if that was your son, daughter, mother, father, in
that car?  

having said all that, in Maryland anyway I think the charges are indeed
past on to the patient's insurance company.

Can you tell I'm getting ready to teach my EMT class tonight?

Tom


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