Who's Who in US emergency aid
Text and photo: Glib Bityukov, instructor Patriot Defence
Patriot Defence instructors are being trained as EMTs (Emergency Medical Technician) in a program in Boston, USA. This is the next step that Patriot Defence has taken to further quality education and international standards of medicine in Ukraine.
Gleb Bityukov recently reflected on the system of emergency care training in the United States and talked about certain characteristics of the medical sector for a Ukrainian audience.
Workers involved in pre-hospital emergency care in the United States are divided into the following levels:
- EMR (Emergency Medical Rescuer)
- EMT - B (Emergency Medial Technician) - Basic
- EMT - I (Emergency Medial Technician) - Intermediate
- EMT - P (Emergency Medial Technician) - Paramedic
Requirements and standards of care vary from state to state, but the whole system is governed by the NHTSA - National Highway Traffic Safety Administration.
The difference between the levels of emergency care personnel is based on permitted procedures and duration of the training.
For example, in order to become an EMT - B, a medical technician basic level, you have one type of training, which usually consists of 160-180 hours of study of theoretical and practical training.
Training lasts for 3-4 months depending on the college or other educational institution that is running the training.
Theoretically any institution can become one that is capable of training. In order to become a training institution, a certification must be obtained, which process is also regulated medical administration department of each state separately.
To obtain a license EMT-P, paramedics are recommended to have previous EMT-B education and experience in the ambulance or fire service.
The course lasts 1.5 years and consists of 900-1500 hours of study.
After education, paramedics can work in the emergency medical response service and in rescue or fire services (requiring some additional education).
By population and area, Massachusetts is similar to Kyiv, but the difference is that the vast majority of the population lives in the country.
The largest city - the capital of Boston, has a population of about 600 000 inhabitants. In general, there are more than 6 million citizens in the state.
There are both public and private ambulance services. Accordingly, each company may have different requirements for their employees.
The approximate salary of EMT-B employees is 30-50 dollars an hour.
Shifts last 12 or 24 hours. At the end of the shift, a quick return home should not be expected. Paramedics need to clean / wash the vehicle and do the necessary paperwork, which can take an additional 1-2 hours.
Fast travel is responsible both for responding to 911 calls and for transporting patients from one hospital to another hospital or home, which also passes through a common dispatch system.
The work is often complicated by many characteristics, which in our country are practically nonexistent.
For example, there are certain legal niceties when the victim has previously written a refusal of resuscitation, or when a patient can sue the employee for damaged clothing.
There are also complications associated with many nationalities and different working environments. For example, calls to the top stories of buildings (30-40) where the fire alarms were pulled and the elevators are out of order and the weight of some patients may be such that their extraction from buildings requires cranes.
In Boston, as of today, there are 17 substations of state aid and 51 ambulance brigades, located in the same place as the police departments.
Overall the state has 319 distinct business, government, and emergency services and overall this involves about 2,000 teams.
After responding to a victim’s emergency call, he or she are taken to trauma centers, of which there are 17 in 7 areas of Boston (remember, the population is about 600 000 inhabitants), which are divided into 3 levels.
The lowest level - the third, is when the center of injury can provide critical patient stabilization and provide surgical care and, if necessary, to transfer the injured to a higher level trauma center.
Top tier trauma centers are open 24 hours a day and provide all the necessary assistance. Typically, these centers are found near universities and at the same time they conduct research and other scientific processes.
The average length of stay of the patient in hospital is 4.5 days.
Treatment is expensive enough and, for example, a stay in the hospital involving surgery will cost about $20,000 for the entire period. Other medical procedures will cost around $8,000 and a neonatal hospital stay costs around $4,000 - 5,000.
Usually citizens pay health insurance that covers these costs. The amount of payment varies depending on many factors such as solvency, the selected insurance program, or the insurance company and can vary from $180 to several thousand dollars per month.
A woman whom we met in Providence said that while working as a teacher in her early career, she paid $2,000 a month for insurance, but then switched to a less expensive plan.
Now she is senior citizen, or pensioner, and pays 20% of the cost of medications, and the remaining 80% is covered by the insurance company. Currently, the cost of health insurance for her is about $80 per month.
At the same time there is a state program that covers medical expenses for those who can not afford health insurance. To participate in this program is not easy as there are many different categories people may fall into, but about 40-50% of clinical applications are still covered by these funds.
(The original article appeared in Ukrainian as a post on Glib's Facebook page: https://www.facebook.com/belgow)