2009: A Year of Paramedicine

Our service went to electronic run forms late in 2008. I was able to go through the data bank for the full year 2009 and select out my calls to get some quantitative idea of what I do as a paramedic in a one year period. I am sure there are more sophisticated ways to data mine, here is what I did. Ran total number of calls. Ran calls where IV was listed as intervention, which I than called ALS calls. Ran total number of calls where medication was given. I then reviewed each medication call and tallied the meds I gave. The results below represent meds per unique patient. I may have given a patient three squirts of Nitro, but I tallied it as 1. As tallied below I gave Nitro to 27 different patients. I did not count oxygen or saline as drugs.

Every medic’s experience is going to be different based on the type of service they operate in, their medical control, the hours they work and the population served.

I work in a one-medic system in a urban/suburban town (bordering the city) 26 square miles with a resident population of 20,000 according to the 2000 census. 54% African-American, 40% white, 6% other. 1 out of five people are over 65. (A few years ago when we were only inputting demographic and dispatch time information into a computer, I ran a query that showed the average age of our patients was 69). There are five convalescent homes, several retirement communities, many doctor’s offices, and good amount of industry, ranging from insurance companies to a helicopter plant. The population is a mix of lower middle class and middle class, although there are a few upper middle class and wealthy neighborhoods. I worked 40 hours a week Sunday 6-18, Monday 6-18, Tuesday, 6-22 (sometimes Saturday 6-22 instead of Tuesday). Week days are much busier than weekends. I worked no overtime. No transfers (although many of the calls I did we call “emergi-fers” calls from nursing homes going to the ED for non-life-threatening reasons where 911 was called) .

466 Calls
312 ALS Calls
9 “workable” cardiac arrests (all medical)
3 ROSC
0 Survivors to Hospital Discharge
8 intubations
2 LMAs
2 Defibrillations

Drugs
Zofran – 41
Morphine – 37
ASA – 36
NTG – 27
D50 – 19
Duoneb – 11
Albuterol – 10
Atropine – 11
Epi 1: 10,000 – 9
Solumedrol – 7
Benadryl – 4
Ativan – 3
Cardizem – 3
Adenosine – 2
Amiodarone – 2
Epi 1:1000 – 1
Narcan – 1
Torodol – 1
Sodium Bicarb – 1
Dopamine – 1

Did not use: Calcium, Magnesium, Metoprolol, Tetracaine, Haldol, Versed, Vasopressin, Lidocaine, Lasix

Some drugs are very situation dependent. We can’t give amiodarone unless we have a patient with V-fib or VT. Others are more a matter of choice. Morphine for instance. (I hope to soon sort out the morphine calls and breakdown what I gave the drug for such as hip fractures, abdominal pain, etc.).

I have at home copies of paper run forms from my first three years (1995, 1996, 1997) as a full-time medic (although working mostly in the city with some suburban response). I am going through them now, and will soon post the comparison results, which so far are very telling in how paramedicine and my practice has changed over the years.

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