Selects: How Paramedics Work | STUFF YOU SHOULD KNOW

hi everybody Chuck here uh I just. realized I have almost cut my finger off. while I was playing with a pocket knife. just now and it's bleeding quite a bit. so I'm going to call 911 and in the. meantime I'm going to listen to this. episode from April 12 2018 how. paramedics work oh thank. God welcome to stuff you should know a. production of ihart.

[Music]. radio hey and welcome to the podcast I'm. Josh Clark with Charles W Chuck Bryant. and there's Jerry Jerome Roland and this. is Stu you should know the. emergency we should have a new podcast. called Sirens around the world yeah it's.

the most annoying show ever it would be. pretty annoying but there'd be some. subset of people who like just really. despise themselves that' be popular. among so we would love it uh we don't. hate ourselves do we tell me I need to. know no I guess it depends on the day I. didn't want to hate myself sometimes I. want to punch myself does that count no. I know exactly what you mean man. sometimes I'm just like I am so sick of. myself is that is that what you're.

talking about uh that was a good song. remember that song No Sick of myself no. that was Matthew. Sweet oh yeah wow that's weird that this. is going on right now because Matthew. Sweet just popped up like randomly in. the last couple days in like an article. I was reading I was like I forgot about. him haven't heard about him in 20 years. and then bam bmine Hoff here he is again. well he's still around he's an Atlanta. guy you know I didn't know that yeah.

well that's cool yeah no I think I I. think that's like the way it goes just. because you had one hit and the world. came and like listened to you and then. moved on doesn't mean like you're like. okay well I guess I'll go bury myself. alive now in my own backyard usually. usually the artist like keeps going yeah. you know yeah he had two hits though I. know girlfriend and then the other one. you was talking about yeah girlfriend. that's a great song yeah it's a good. song uh okay so obviously what we're. talking about today are.

paramedics paramedicine really is what. we're we're talking about yeah which is. um it's actually a pretty interesting. topic because you you kind of look into. it you're like oh these these people. save lives that's great um here's some. of the life-saving techniques that they. do fantastic but there's like actually. so much more to it it's got a really. interesting history it's got a a a a. it's one of those things where it's way. worse off than it should be as far as.

like funding and and and like um. Logistics and stuff like that goes I. just find it interesting it's it's. interesting to to kind of poke into a. topic and then find that oh this is even. more interesting than I thought and have. it poke back yep with forceps so uh I. guess we should say right off the bat. that the word paramedic par means. alongside uh so. alongside medicine I guess which I'm not.

quite sure what that. means so what I think it means is as. follows Charles. okay these people. paramedics they are not doctors correct. but they work with and alongside and. really honestly um as an extension of a. a doctor okay an MD I buy that so that's. what I think it means because it's not. like what they're doing is a different. type of wacky medicine like they're. actually doing.

the same type of medicine that an ER. doctor an ER nurse would be doing in an. ER they're they're just doing it out in. the field could you imagine how. disconcerting it would be to be like on. the ground and have a paramedic come up. and like blow green dust in your face or. you're like what are the chicken bones. for man oh man blow green dust in your. face I don't know it would depend on. what the effect of the green dust was. that's true so um I think that's what. paramedic means right okay we can go we.

can go further back actually and and. describe what ambulance means we know. that one for certain yes uh that came. around in 15th century MH Spain during. the Inquisition they clearly had a lot. of Need for medical work yeah uh and. they actually had field hospitals that. were called. ambulancias right it was just basically. like a a mash unit out in the field MH. um and then eventually the um the French.

shortly after I think under Napoleon. they innovated on the ambulance and said. well that's great that's neat that we. have these things out in the field but. there's some guys way over there who are. injured and and they probably wouldn't. die if we could get them to these. ambulances these field hospitals right. correct so they came up with basically. mobile. ambulances um which is the this idea of. a flying or a moving ambulance which is.

like a little medical facility that they. would put the people into and move them. away from Battle to go patch them up. rather than waiting for the battle to. end well yeah and before that even. during the Crusades when they also had a. great need for medical care uhhuh uh. there were the Knights. hospitaler. hospitaler I think. hospitaler oh whoa is there an extra I. might be putting an extra syllable in.

there well that's all right I'm known to. do. that uh kns hospitaler that's what I'm. going to say of the order of St John of. Jerusalem and they were the first kind. of the first people to practice. emergency medicine on the battlefield. and they even invented the uh what we. now call the stretcher although it's. still called a litter in some circles. yeah it's pretty intuitive thing but. it's it it it works someone had to think.

of it couple of sticks with some canvas. stretch between them throw a person on. there you can pick them up two people. can pick them up and get him off of the. battlefield licky split hooray so yeah. so this is the idea of emergency. medicine grew basically exclusively out. of warfare over the centuries well yeah. but what's remarkable to me is that from. that time I have the right idea let's. get these people out of here quickly it. took about 130 years all the way until.

the mid to late 1960s uhhuh until they. said hey wait a. minute if we actually put trained. medical people in these things and. weren't simply driving people to a. hospital we might have even more luck. yeah that was the late 60s is't that. amazing it is and at the time it was so. a lot of medicine was practiced through. house calls right oh yeah including. mercies like if there was an emergency.

and you could get a hold of a doctor the. doctor was expected to go out to that. emergency and do what they could but. more often than not either the cops um. or local morticians were tasked with. basically was called like a scooping. scoop and run or scooping carry where. you just basically get the person out of. that car wreck or um from the bottom of. that ladder or whatever just happened to. him throw them in the back of a car a. cop car or a hearse yeah I looked it up.

the uh Ecto one the Ghostbusters uhuh um. ambulance is a modified Cadillac hearse. oh yeah so um they would that was a. sinking feeling it really was for a. mortician to show up in a hearse and be. like I'm going to take you to the. hospital depending on what happens you. may be back in the same car yeah and. talk about a conflict of interest you. know what I mean oh that's a good point. hopefully not but yeah on paper yeah. right or they just you know casually put.

their hand on the person's nose and. mouth in the back seat Drive ter the. thing is though is whether the mortician. or the cops were were getting you to the. uh Hospital even when you got to the. hospital it's not like there was such a. thing as an ER room ERS didn't come. about really until like the mid 70s. where you could find them in in Fair. abundance around the United States like. er just didn't exist it was here you go. doc I know you just delivered a baby and.

you um treated somebody else for Angina. but now you've got to put this person's. head back together wow yeah and it was. all just medicine at the time so yeah. the idea of getting somebody to a. hospital and having a medical person a. professional in the car that's. transporting them it came out of Ireland. I think right yeah big shout out 1967 to. Dr J Frank pantridge of Belfast he had a. study he published a study that said hey.

you know what we have more success. saving people's lives when our mobile. units have a physician or a nurse inside. right and everyone went huh never really. thought about that but there it is. there's a study yeah pretty cool so he. he definitely um set the stage for this. and then the year before there was a. report I think it was a year earlier. right the one from uh Congress and. America uh a couple years 65 or I think.

it was like the National Academy of. Sciences or somebody basically got. together with another group and said. let's let's study accidents and what. they came up with was this idea that. there was like this um. overlooked disaster that happened like. accidents were huge major leading cause. of injury and death in the United States. and this this inquiry determined that we. weren't doing much about it and. specifically a lot of people died who.

otherwise wouldn't have if there had. been something like an emergency medical. service to attend to them at the. accident scene and on the way to the. hospital and then having the hospital. actually know what they were doing as. far as emergency medicine goes yeah it's. just it's just staggering to me it seems. so intuitive and I can't believe it took. that long for this to happen mhm you. know uh and in fact the emergency. medical uh systems Act was signed in.

1973 which basically said we need a a. standardized system here like Nationwide. that was after that paper came out in. 1966 yeah many years later I mean that's. a speed of government I guess sure uh. and then in 1977 the publication of the. first very first National Standard. curriculum for EMTs and paramedics 77 Y. and then so alongside this perah this um.

they they there were people like around. the country at universities around the. country and around the world who um were. kind of all recognizing all of this at. the same time that there were there's a. lot more that could be done for people. who were injured in in accidents um and. so you had the people at uh pit. University of Pittsburgh taking up the. cause go Panthers yeah they started um. is it the Panthers yeah huh they started. um creating some of the first uh.

curriculum for paramedics some of the. earliest tests for paramedics uh the. University of Cincinnati came up with uh. the first curriculum for training. physicians in ER medicine uh I think the. University of California was an early uh. entrant into the world of of um teaching. paramedicine and I think they were the. first one to be accredited in 1980 like. they had their operation going for years. but they were the first one to say hey. somebody take a look at this and make.

sure we're kosher and then we can say. we're an. accredited uh training facility for. paramedics amazing it is it is pretty. amazing and then the the the problem is. this so the federal government got into. the act in. 1973 with the Emergency Medical Services. act yeah but by. 1981 there was an Omnibus budget that. said we're out we're done we're not. funding Emergency Services anymore and. then from that point forward the.

emergency service system in the United. States whatever had been developed to. that point broke into patchworks of. State local County programs yeah. sometimes multiple ones within a single. County I think there's a county in. Michigan that has like 18 different. Emergency Services um and that has kind. of created this where we are now which. is people doing the absolute best they. can in what what amounts to a broken. system in a lot of ways should we take a.

break sure all right when we come back. we will put the broken system behind us. momentarily talk about EMTs and. paramedics. [Music]. [Music].

[Music]. all right so if you want to ride in an. ambulance or drive an ambulance and get. on the scene and help someone out who's. in need there are a couple of ways you. can do it uh you can be an EMT emergency. medical technician and this is the uh. this is the person who has has undergone. about.

uh between about 120 and 150 hours of. cours work they are they are well. trained in all kinds of life-saving. procedures if you need CPR if you need U. oxygen administered if you were having. some bad allergic reaction that your. life is in Jeopardy but uh there are. limits to what they are allowed to do so. one thing they cannot do even in the. case of giving shots is they can't break. the skin right which is super. interesting I never knew that no I.

didn't know that either but you can. consider an EMT like a an entrylevel. paramedicine professional right that's. where you would start and in fact I. think you have to start as an EMT to go. on to the next level which would be. paramedic right for sure yeah so if. you're paramedic you have about 10 times. the amount of coursework and schooling. under your belt by the time you're a. paramedic and I think you do have to. have about 6 months at least of Prior. immediately EMT experience to start um.

becoming a paramedic as well which I I'm. sure is the way most people go is you. start out as an EMT and then you you. know move on to the next level which is. paramedic yeah which like you said 10. times so that's about anywhere from. 1,200 to 18800 hours depending on your. state or your municipality to get. certified and this is where the real. action can happen um you can give an IV. you can if someone's having a heart. attack you can deal with that you can. operate a defibrillator fibrillator.

fibrillator fibrillator it's fun to say. once you master it they should have just. called it the the clear. machine yeah. the uh but it's a it's a lot of work and. a lot of hours and one of the people. that uh they interviewed in this article. said that you know it's really grueling. and when you're in paramedic training in. school and doing your coursework. basically for a year or two you can just. say goodbye to your friends and family.

yeah I saw that too yeah that's tough. stuff so um the paramedic is actually. they operate under the license not just. like like under the direction but under. the license of a physician in their. local right there's a couple of ways. that you can do it and and as you'll. start to see like I saw a quote that um. it said if you've seen one emergency. medical system you've seen one emergency. medical system they're all just so. different. the whole is patchwor but um there is a.

naal standard which I think is the. national uh emergency medical. technician registry exam that's like the. national exam and then you may have to. pass like a state Andor local exam too. depending on where you live but there is. like a national accreditation and. National coursework but then how the. system functions and runs is what's the. P the patchwork part of it yeah and. it'll cost you I mean it depends on. where it is of course and what program.

but the the example they used in our. article is the UCLA Center for. prehospital care uh and they quoted. about 10 grand for just the tuition and. then of course like any college uh or. coursework you're going to have to pay. for books and equipment and uniforms and. stuff like that that's exactly where. they get you the Plaid skirt uh and then. after that though the good news is is. that you have a really good chance of. getting work I get the impression that. if you have gone through all of your.

paramedic training you're not sitting. around like there's usually a job. waiting for you somewhere yeah I saw. that as well and actually um it doesn't. necessarily pay super well no people so. if you ever see a paramedic be extra. nice to them for sure because not only. are they running around saving people's. lives they're not getting rich off of it. at all um they're doing it because it's. something they care about yeah um but. there despite that despite the the. mediocre pay um it's I saw it's going to.

be one of the most in demand jobs over. the next like 10 to 15 years I really. wish I could remember the statistic. exactly but I think they're like. expecting another like. 53,000 EMT jobs or paramedic jobs to be. added to the the American economy over. the next like decade maybe so it's. definitely a growing growing um career. for sure growing profession yeah and you. mentioned the pay if you uh if you go to. the US Bureau of Labor statistic ICS to. kind of find a mean salary or something.

they do it it's not really they should. separate it out but they lump in EMTs. and paramedics when uh of course EMTs. don't make the kind of money their. paramedic would but they had a mean. annual wage of about. $31,000 a few years ago uh and if you're. in the top 10% it's about. 54,000 mhm and apparently the state of. Washington is one on the higher side. they you can can get as high as 71 Grand.

in uh the state of Washington right but. I mean you know that's that's a good. living and a decent living but it's not. like like you said they don't go into. this because like oh man you know that. 31 Grand a year it's sort of like being. a school teacher it's a I feel like it's. a calling in a lot of cases for sure for. sure um as I was saying about the uh the. license that they operate under right so. if you're a a certified paramedic. when you are um it depending on the.

state you're in you may be operating. under the license of the State medical. director like that's where you have your. license yeah or you could also be. operating under the license of a local. physician like that Physician's license. covers you covers the physician's. assistant basically everything working. for everyone working for him or her so. you might be operating under that. Physician's license or I didn't know. this man during an ambulance ride so. remember how just adding like a trained. Medical Professional to the ride from an.

accident scene to the hospital and. proves outcomes and we've done that. since 1966 at least they figured out. that if you can communicate with a. doctor a pH an ER physician on Route you. could also improve outcomes even more so. during these um this transportation from. an accident to the hospital the. paramedic is probably in touch with an. ER doctor interes who is instructing um. and Advising and Consulting with the.

paramedic to figure out the best course. of action the best course of treatment. and then how to carry that out and from. what I understand at that time the. paramedic is operating under that. Physician's license in that state would. that make you feel better or worse what. that the paramedic was getting. instruction from a physician yeah like. if you're he hear this going on I don't. know I I would say pardon me is like. better because it's doctor telling you. that but the other part of me is like.

don't you know right and you would hate. to hear like the doctor say well get the. something something and for the. paramedic to say the. what right I don't know what that is. I've never seen this before ever have. you ever had to take an ambulance ride. for yourself no no thank goodness I. didn't think I had either but then I did. remember um when I was 13 or 14 my. brother was 16 or 17 we were in a car. wreck there were eight people. in a jeep my in my brother's jeep that.

was once my Dad's Jeep and that was. definitely not safe to do to begin with. but we were going to a movie after. church on a Sunday night bunch of kids. in youth group raised in Hell piled in. my brother's Jeep wasted no just kidding. um completely sober wasted on the. Lord we were and it was raining really. hard and uh you know at at Pont uh Pont. to Leon Avenue new here in Atlanta. everyone that doesn't live in Atlanta.

probably laughs that we pronounce it. that way instead of. p uh but on PS where it kind of um if. you're leaving from Atlanta it's that. big curve where you go over that large. Stone Archway yes kind of headed toward. into decar uhhuh we were coming down. that way nowhere near North Lake Mall. where we were supposed to be headed uh. we were lost and my brother uh we. hydroplaned hit a curb and turned the. Jeep over on its side and I ripped.

through the canvas ceiling or whatever. it's made of oh man you got thrown oh. yeah we were scattered all over the. street you are lucky I know it's the. only time I think that I've been knocked. unconscious and I just remember waking. up you know what would have been. probably seconds later in the pouring. rain and looking around and seeing my. friends like scattered within like 20. feet of each other in various places wow. man that is scary stuff dude it was. scary so uh in the and the good news is.

no one had like I think the worst injury. was like a broken collar bone I broke my. finger there were little cuts and. scrapes but nobody was hurt bad uh but I. do remember this hope my brother doesn't. listen to this one in the ambulance on. the way my brother was just sort of. catatonic and they said they were trying. to get information and they asked what. his name was and he said a-hole. what he said a-hole he said the reward.

felt so bad yeah I think he was just. sort of out of it and felt terrible poor. Scott and he didn't curse at all at the. time and still doesn't even curse much. but that's weird that that is what. stands out of my mind I wonder if he. remembers that actually well that's a. big one especially if he didn't curse. you know so funny man that's a that's. you are a great Storyteller was that a. good story yeah I was like I was. seriously where you kept like going off. on tangents I'm like no we got to get. back to the story what happened to the.

Jeep I know you looked a little nervous. yeah so. um wow okay should we take a break oh. yeah and also I forgot to mention the. one guy that was tragically. killed right you're like but did I. mention I also broke my finger no nobody. nobody was hurt everybody's too bad. everybody was good everybody's good I. think my brother broke his foot man yeah. it was just stuff like that heck of a. story Chuck heck of a story thank you uh. yeah let's take a break and regroup. shall we yeah let's do okay.

[Music]. [Music]. [Music]. okay we're back I'm not reeling quite as.

much as I was but that was a good story. again I feel like we should mention even. though it's uh kind of silly that. emergency TV show oh yeah for sure from. the 70s because it seems like it. definitely like actually played a part. in ramping up uh ambulance. services yeah so this is I think 1971 or. 72 when it premiered and um remember the. Emergency Medical Services act wasn't. passed until 1973 that white paper had.

come out in 1966 so this idea of like. this new type of medicine and this new. type of like healthc care worker was. really on America's mind but one of the. ways it got there was from that TV show. emergency in part because it was shot. like documentary style people played. themselves on it like there were real. dispatchers on the show acting as. dispatchers um it just captured. America's imagination yeah I remember. watching it do I I don't think I ever. saw an episode of it yeah it was.

emergency with an exclamation point it. ran until 77 and uh it was mainly two. dudes uh two firefighter characters is. with the story centered on and one of. them was a young Kevin uh TIG or Teague. he was uh did you ever see roadh house. yeah he was the owner he's a character. actor he's been in he owned the double. Deuce yeah he's great yeah I can't. remember what else I've seen I've seen. him young before I wonder if it was.

emergency now that you mention it maybe. huh maybe I have cuz I'm a runs it for. sure it did but I'm a Jack Webb fan and. I think he produced or created it you're. a Big Jack Webb. guy are you not I don't know uh he's the. dude from dragna Sergeant Friday yeah I. guess I need to think about that yeah. he's awesome I'll let you know man if. you go back and watch like old episodes. of draget oh my God yeah that was a good. show yes it was and I think emergency.

maybe Adam 12 is like the direct. spin-off of Dragnet maybe that's what. I'm thinking of but I swear I know. exactly what you're talking about with. um the Teague fella from Roadhouse and. then wasn't uh Dragnet uh Colonel Potter. yes Harry Morgan right we had a emilina. had a long conversation about mash the. other day and how that was I was a mash. nut yeah and how that show was one of. the few to survive like major cast.

changes oh yeah like three of them yeah. I they certainly didn't like like big. stars like co-stars I think one of the. few people who made it through was alen. Alder right he was there the whole time. yeah and like hot lips I think was the. same um and a few others but they had. like radar and Clinger yeah they Al They. coexisted I think but eventually radar. left and Clinger took his job they. Potter took over for what's his face the. original guy uh I don't remember but he.

wore the fishing hat yeah he was oh man. the saddest ending ever for that one. what when he left yeah remember he got. his papers to go home and everyone's all. excited and then he was killed in a. helicopter crash or a plane crash I. don't remember that on his way out wow. uh and then of course Frank Burns left. and was replaced by Winchester mhm and. then Trapper left and was replaced by. Honeycut right but it just it was still. great well got it wasn't as great at the.

very. end I don't know man goodbye farewell. and amen was one of the all-time best. last episodes ever no true for sure um. but you're saying they pulled it. together at the at the in the last. episode I think I remember the last like. couple of Seasons it was a little bit. like you know this maybe it did run its. course huh but I was a very Discerning. 12-year-old viewer yeah I guess so yeah. like they've really gone to the the. hooch Jin joke too many times this. episode it is funny though that like.

little 12-year-old me thought like the. funniest thing in the world was war. surgeons drunk War surgeons right drunk. philandering War. surgeons all right we really got off. track there yeah maybe we should take a. third break no I don't think so I don't. think we should either so we're talking. about paramedics today believe it or not. and um one of the things we talked about. was the idea that that paramedics well. let's talk a little bit more about their. job right okay one of the things that.

paramedics are sometimes criticized for. is um that they don't run to the scene. of an emergency I've never thought about. that once you haven't I I really hadn't. either but then I started thinking about. I'm like yeah I could totally see that. um apparently for some people who are at. an emergency scene and see the. paramedics kind of walk up they appear a. little too casual and they want to know. what are you doing why aren't you. rushing to this scene and paramedics I. think we saw a question answered on Kora.

Kora or something like that and um a. paramedic explains there's actually a. number of really good reasons why. paramedics why you don't see them. running to the scene first of all. they're going to park as close as they. can sure so that running is only going. to shave a couple seconds off but really. the number one reason or one of the top. reasons is that they are supposed to be. they're supposed to bring with them to. this scene of catastroph catastrophic. Panic basically MH calm and and. professionalism and being in.

control yeah I get that like I think it. would be a little disconcerting if I was. injured and I saw a paramedic burst into. the room like breathing heavy God what's. going on what's going on is everybody. okay yeah plus they might get hurt. running that's another one and they're. usually you know or not usually but I. would say probably a lot of times it's. not like they're walking through a you. know a perfectly laid pathway like they. could be running upstairs or through a a.

house of hoarders or you know through. the woods like you don't know what's. going on you got to be careful on your. way there yeah and you have to be going. slow enough that you can assess what the. the risks you're walking into are as. you're walking into him rather than. running into it and being like Oh the. guy who shot you still here waiting for. me you know now that I've run into the. scene I know that but it's terrible um. it's also uh kind of hard to run from. place to place depending on the. equipment that they're carrying with.

them those stretchers get heavy um the. EKG machines get heavy the. defibrillators get heavy all that stuff. gets heavy so there's a number of. reasons why you won't see a paramedic. rushing to the scene you will see him. rushing to the scene in the ambulance. though and from what I understand the. driving in the ambulance or riding in. the ambulance is the most dangerous part. of the entire job yeah and uh here's. another tip aside from being nice to. your EMT or paramedic is don't call them.

ambulance drivers yeah because that's. part of their job uh and it's a weird. thing too that there it's not like they. hire a driver who's super skilled at. that and then they have other people in. there that do the work like they do. double duty they have to learn to drive. like that and I mean while their EMTs. are paramedics yeah and so you know if. if you've ever seen an ambulance going. through an intersection they're going to. slow and and maybe even stop and then. proceed they still get broadsided very.

frequently by people going through the. intersection because they're they have a. green light and they're not paying. attention they'll they'll hit an. ambulance like T-bone an ambulance and. the driver's probably okay or I should. say the paramedic driving is is probably. okay but the paramedics in the back they. probably aren't um lashed down in any. way shape or form because they're. working on the patient and so they're. getting thrown around and can get. injured killed themselves that way so. that's the the most dangerous aspect of.

the job from what I I've seen yeah. another interesting thing that I saw. from that list you sent was that if. you're in a big city a lot of times they. even have divided up uh between EMT and. paramedic for different cases so like if. if there's a scene of trauma going on. like a car accident then you're more. likely to get an EMT whereas if you're. at home and you're like my husband's. having a heart attack or my child's.

having a seizure then you're more likely. to get a paramedic yeah which is. interesting yeah and um if in cities as. well if you're a paramedic you probably. once you get into your ambulance you're. basically stationed at the ambulance for. the rest of your 12-hour shift um you're. you don't go back to like the firehouse. or to the ambulance Clubhouse or. anything like. that you're you're like on a designated. street corner parked waiting for your. next call yeah um probably killing time.

somehow but uh you you there's there's. not very much downtime on like in a in a. city especially the opposite is true for. more rural um EMTs and paramedics and. that there's a lot of downtime so much. so that this guy who was actually one of. the Consultants on that show emergency. years back uh he became a minister of. Health I think in Nova Scotia yeah and. he um he created this program for.

Rural EMS workers um to use their down. time in much the same way that like a. country doctor would have made house. calls yeah so like wasn't the idea that. they would go to places and sort of help. train like uh regular citizens on how to. avoid getting hurt and stuff to begin. with right yeah like like doing out. preventative medicine like making sure. that people are taking their medicines. correctly teaching CPR. classes um teaching leading exercise.

classes for like seniors at a senior. center like doing all this stuff to. reduce the number of calls that they. have to go on anyway so it cuts down on. their downtime which I think is actually. very much appreciated by paramedics. because there's really nothing more. boring than sitting around constantly. and then they're actually doing. something and and also um making their. Community a healthier Place yeah I. thought it was funny when they were. talking to some real on the ground. paramedics about the downtime they're.

like well HBO Go's kind of awesome right. yeah like oh well I guess you got to. pass the time it's better than uh. Nicholas Cage and bringing out the dead. what did he do CU I remember that movie. but I don't remember all the details of. it he well it wasn't that great um I. liked it he did tons of drugs oh okay. that's why a speed freak or something I. gotta yeah yeah he kept begging to be. fired right uh I don't remember it very. well at all actually I think he did like.

that was his shtick he be he begged to. be fired huh um so one of the things. about those that downtime uh the. community community preventative. medicine initiatives have kind of spread. from Nova Scotia out through around the. country um when you see a paramedic. doing that they're they're not being. paid or at the very least their unit or. their County or their city is not being. paid for that. which is a huge problem yeah this is.

where I got a little confused the way I. was reading this. was Medicaid and Medicare and stuff and. insurance companies will. reimburse only if they have transported. someone to a hospital yes so in other. words if you go as an ambulance in a. paramedic or EMT to a place and you. actually can just help and treat someone. there and they don't need to go to the. hospital then that's a freebie yeah. yes or did they send a bill to the.

people as from what I understand it's a. freebie I don't I it it probably since. it is such a patchwork of systems all. around the country I'm sure that you. could live somewhere where you the. person would get a bill for that uh I. think as a matter of fact you do no. matter where you live but um Medicaid. and Medicare won't pay for it um so. there is there is a substan reason to. say keep working chest compressions on a.

person who is obviously Dead all the way. to the hospital interesting so that you. can like build Medicaid for that. transport or getting somebody to go to. the hospital even though they don't need. to so that you can Bill Medicaid for. that that as well and the the problem is. that that leads to other problems as. well like Hospital ERS are very much. overcrowded and understaffed and. overworked right yeah so when you show. up with another person that's one more.

person they have to deal with and. apparently it creates a bit of a. um conflict yeah there's a cultural. conflict between the people the. paramedics and the EMTs bringing people. to the ER and the people who staff the. ER and are accepting these people so. much so that there's it's become kind of. common for ER rooms to um to issue uh. ambulance diversions right saying don't. bring anybody to our e ER go somewhere. else and on a really bad night in a.

really populated city you might find. every single uh ER room like with that. diversion alert on and you got to take. somebody out to like a country hospital. that doesn't know anything about trauma. and it takes 45 minutes to get there um. and they're not going to get the care. they could receive at a good Trauma. Center in the city um so that's a real. problem yeah and isn't uh too in terms. of pay and we need to hear from people. on the ground because this it's.

surprisingly confusing when you research. this on how it all works uh and maybe. that's the point but um it seems like. it's also a fixed rate there's no. difference between I treated a kid for. an allergic beasting reaction to I. brought a guy back from the dead who had. had a heart attack or heart failure yeah. is that right yeah so long as you. transport both of them to the hospital. that you're going to get I think I saw. his low is 25 bucks from Medicaid in. some places I don't understand this the.

numbers just do not add up I don't get. it at all I know that some places some. counties and cities fold their EMT or. EMS workers under their fire departments. so that they they fall under the fire. departments funding which I think fire. departments tend to be way better funded. than any kind of EMS service so I think. that's how that's one way that it. happens but I I just I don't I don't get. get how this how this actually works.

MoneyWise cuz it it doesn't add up it. doesn't make sense yeah I mean it's not. often that we're a little styed um so. we're going to follow up for sure with. some emails but I think it's also going. to vary from place to place right. because the other thing that I got. really confused about was Private uh the. privatization of ambulance services yeah. uh and as best that as I can tell is in. the 70s and 80s there were a lot of. small private ambulance companies but.

then they merged into more Regional. things and that these days there's just. a few like big multinational companies. that are the most dominant in the. industry right but I don't get how that. works like if they're private are they. like working with only private hospitals. or can they go go to a state hospital I. think that they can get a contract from. the state they can be they can have a. license operate within a state or County. or wherever um and I think they go.

wherever they're called to I know that. there can be like competition among them. so like multiple ambulances will show up. at a scene sometimes uh it's just it's. it's it's kind of a a bit of a cluster. um as far as competing with the local. EMS services and I think it's on the. decline from what I've seen yeah but. when you call. 911 do you have a choice so what you can. do I think it's kind of like uber where.

like they the the 911 dispatcher has a. log of companies or services like public. funded or private services that that it. can be issued to and they send out the. alarm and whoever takes the call goes. and gets it interesting so the problem. is is I saw a Las Vegas Review Journal. article about this Las Vegas was. debating whether to just totally. privatize their EMS Services their EMS. just like went berserk they're like no. like this is this doesn't work um the.

private companies are late I think they. were late like 10,000 plus times in one. year in in Las Vegas um their response. time tends to be less than the actual. fire department or emss um it's just not. as it it's just not as preferable and. the reason why ambulance private. ambulance services came about or be. became widespread is this this idea that. you should just privatize everything and. then that competition will keep. everything going and that hasn't. necessarily panned out to be the case.

and from what I see New York is actually. scaling back on theirs right yeah I. think Giuliani is one of the people that. really tried and of course you know no. surprise given his politics trying to. privatize the. industry uh but apparently a lot of. those had gone out of gone bankrupt. basically yeah and and the during the um. during the housing boom the financial. collapse strange ly or maybe not. strangely because I don't understand it. a lot of private Equity firms started.

buying up ambulance services yeah that's. there you go there's the downfall it's. just so interesting I know that this is. one of those where someone's going to. knock our socks off with a great email. yeah I think also um one more thing. about the uh private ambulance services. it's not like they're just a bad idea. all around sure in it's in a local that. is underserved if a company wants to. come and set up ambulance services that. would be great for that area because. they have a far you know they have they.

can get places faster in an ambulance. than they could have before in a place. where you've got your EMS overstretched. and the Count's like no we're not hiring. a single additional EMS worker a company. that sets up shop can actually take up. the slack like there are good aspects to. it like it's not just like some terrible. idea but in practice it hasn't worked. out as well as as one would hope from. what I understand yeah. yeah EMS workers like email us like.

explain this because I really like you I. do not get who's footing the bill it has. to be insurance companies and if you. don't have insurance it has to be just. the the person the individual yeah and I. think we have we waited into the Waters. of doing a 911 podcast once and didn't. isn't that correct because it was I me. we'll do it at some point but I remember. thinking oh that's a good easyish one. and it ended up like being super. convoluted yeah I think I think we. should do that we should also do um just.

ERS in general too. yeah so that's a a bit about paramedics. sounds like there's way more to it right. yeah uh but uh you got anything else for. now no sir okay well since Chuck said no. sir it's time for listen to. mail all right I'm going to call this we. helped the dude win something oh yeah I. love this one hey guys been listening to. your show for about 4 years and always. wanted to write in but now I have a. great reason a local store was doing a. giveaway a few days ago and they posted.

that the first people to show up and. answer correctly would win a prize the. question was bacon and eggs was not. always a breakfast food and what year. did it become so and who was the man. behind the marketing idea so this guy. sounded super excited because he knew. the answer immediately I thought of your. Show and The Uncanny ability of Mr. Edward Bernay to pop up in seemingly. strange histories I remembered your PR. episode and knew it was sometime in the. 20s so I hopped in my car took off for. the business uh when I got there I told.

them to answer uh with a startle look. they told me I'd want a huge case of. [Laughter]. meat and not just junky stuff either. this place sells to restaurants and. businesses all across the country I love. that I was super stoked good meat he's. like I won meat and not just like. terrible meat like good stuff. too uh when they asked if I had to look. it up I told them no that I listen to. stuff you should know and they I. retained it in the back of my mind they. asked for the name of the show uh and.

they said they were going to play it for. all the workers there during the day so. now they can get more difficult and. random questions that's awesome and he. said it doesn't in there I went back. later in the week and the same girl I'd. spoken to recognize me so they had two. other people come in that had known the. answer from stuff you should know as. well all right even though we live in. super rural uh Utah you apparently have. a large following and that is from John. robas. thanks John Robison I hope you have a. healthy uh EMS service out there to come.

find you after you eat that box of meat. yeah and you know what let's hear from. Salt Lake City cuz we have debated a. live show there and just didn't know if. we had the support so I want to I want. to hear it okay we want to hear we want. to hear from. utahan and EMS workers yeah if we get 10. people that email us and say to come to. Salt Lake City we'll come I I think we. should set the bar High than that oh. okay okay uh well if you want to let us.

know that you're from Utah and you want. us to come or you're an EMS worker and. you got some good stories for us you can. send us an email it's probably easiest. to stuff podcast howstuffworks.com as. always join us at our home on the web. stuff you should know.com. stuff you should know is a production of. iHeart radio for more podcasts my heart. radio visit the iHeart Radio app Apple. podcasts or wherever you listen to your. favorite shows. [Music].