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PMD 1996 or “…of course I can find data…I’m a consultant…”

Gather data??? No problem…that’s what I do…and I’m pretty good at it. …or at least I thought I was. But I didn’t really know the EMS market – especially for a pediatric product…and I was soon to find out no one else did either.

I started with what I thought was a pretty good list of some very basic questions:

I.   General Market Insights:The PedREST story2

  1. Overview of stretcher market
    • Key players / competitors
    • Listing of stretcher models
      • Which stretchers are unique (independently manufactured)
      • Which are market leaders
    • Market share
    • Distribution channels
      • % VARS / Direct / Wholesale
      • Means of communication (Internet, catalogue, sales personnel, etc.)
  2. Overview of US emergency medical transport (e.g. ambulance) market
    • Ambulance company data:
      • company size (public, private & govt.) by region (if available)
        • # small (<20 ambulances)
        • # medium (21-50 ambulances)
        • # large 50+
        • how has this changed over past 5 years
      • average number of sites per company (small/medium/large)
      • average number of ambulances per site (small/medium/large)
    • Purchases (last 5 years) ambulances and stretchers

II. Pediatric “Emergencies” (1994+)

  1. Infant/pediatric ambulance (ground and air) transports
    • age distribution
    • geographic distribution (if significant)
  2. Volume of infant/pediatric transports as % of total transports conducted by various services
  3. Breakdown of call “codes” (as initially called/diagnosed)
    • % code 3: stable transport
    • % code 2: unstable or potentially unstable – not usually life threatening
    • % code 1: medical emergency – life threatening
    • Frequency of code escalation (eg. How often code 3 or 2 becomes code 1)
  4. % of infant/pediatric transports requiring “medication” administration en-route

Truth be told there were more questions on my list, but you get the idea. It seemed like this would be a good place to start. So armed with my questionnaire I started my research. Unfortunately at this point the internet was still in its infancy. While today you could type in “ambulance crash child transport” and get tens of thousands of references, back then the results barely registered.

My luck didn’t get any better by phone…I tried the American Ambulance Association and was referred to a nurse at the Walter Reed Hospital who referred me to an editor at JEMS magazine (an EMS trade publication) who referred me …and referred me…and so on. The list was endless…and no matter who I contacted no-one had the information I was looking for. What amazed me was the difficulty I was having even finding “the basics” – i.e. the number of ambulances in the US…and the number of crashes they had – forget trying to locate anything pediatric specific.

It wasn’t that the people I encountered weren’t helpful. The basic fact was the information was not available because it wasn’t being gathered. No-one was tracking the number of ambulance crashes taking place in the US primarily because no-one was reporting them. And why would they??? The only crashes required to be reported were the ones that resulted in a fatality. It would not in fact be until late 1999, with the creation of an internet site called EMS Network News that we would finally see how “big of a deal” the issue of ambulance crashes truly was. In the meantime, I was beyond frustrated – feeling like I had failed before I’d even begun. Still I had made a promise that I wasn’t quite willing to let go of… so I made a decision – a leap of faith so to speak, that this was (or would be) something that really mattered once people finally knew about it.   I hoped for the best …and jumped.       …thanks for listening…

Air Travel Safety for Kids

The Yapta Blog is an online site for comments and ideas concerning travel-related situations for the travel industry. In an article on air travel and child safety dated May 28, 2010, Jeff Pecor wrote that the National Transportation Safety Board (NTSB) was recommending that infants and young children flying on airplanes, be strapped into their own safety seat to protect them in case of air turbulence or a survivable crash.

Air Travel SafetyThough not enforceable, and just a suggestion for now, the NTSB is hoping that at some time in the future, steps would be taken to make it a requirement that anyone traveling with a young child would have to purchase a seat for that child and secure him/her in a safety harness. If they are successful in their mission, no longer would anyone be allowed to fly while holding a child in their lap. If turbulence causes the plane to suddenly lose altitude, that child could become a projectile and be seriously injured. It could be that and worse if the plane is involved in a crash and the unrestrained child is thrown a distance from the crash site. It appears to me, that a very important part of providing protection for our youngest citizens has virtually been ignored for a long time.

I appreciate the fact that Mr. Pecor has brought the information from the NTSB to our attention, and by doing so, has shown a spotlight on the inadequacy of the airline industry to make available to young children, the same protection from injury accorded to that child’s parents.

It’s a very small leap that brings my mind to another industry with a similar deficit in its ability to protect the young children in its care. I’m referring to a vocation where the saving of lives can be, and often is, an everyday occurrence. Emergency Medical Services (EMS) is far behind in being able to offer the safe transport of children with equipment that is specifically designed and sized for pediatric patients. And even though the equipment is available, no state or federal agency has stepped up to the plate to do whatever it takes to support it, test it, and make it available. It’s very scary when you consider the number of children being transported unprotected in the passenger compartment of a speeding ambulance, flying through intersections on a daily basis. I am left questioning why the NTSB has, to my knowledge, neither lobbied for, nor put pressure on Congress to enact laws that specifically regulate how care is administered to infants and young children in the rear compartment of an ambulance.

I believe that both situations call out for the correction of a serious deficit in the way children are transported; one, as a passenger on a plane, two, as a passenger in an ambulance or other rescue vehicle.

Both situations require immediate action and new regulations. There are children’s lives at stake.

The law of averages

On Tuesday April 7, 2009, a Hermosa Beach ambulance carrying a 3-year-old child to the hospital collided with a pickup truck in a Torrance intersection. The crash happened at 190th Street and Entradero Avenue and occurred about 5:45 p.m. The paramedics immediately called for help and another Hermosa Beach ambulance quickly took the child, who had suffered seizures, to the hospital. Fortunately, the child did not appear to suffer any “physical injuries” from the crash. http://www.dailybreeze.com/latestnews/ci_12095260
On Monday April 13th, 2009 a car struck an ambulance transporting a child to Children’s Mercy Hospital in Kansas City, MO. Another ambulance rushed to complete the transport. Luckily in this case, there were no injuries. http://www.kctv5.com/news/19166283/detail.html
People have often asked me why I have stayed with this “cause” for so long. Fourteen years ago there was very little data available for me to document what was really happening. Today, there is so much more information available…and yet so many who have the power to help change things know nothing about this.
A wise person reminded me today of the law of averages or in simple terms from Wikipedia: a belief that outcomes of a random event shall “even out” within a small sample. If that is the case, then I guess my best answer would be to say that I have stayed with this cause so long because I have seen what happens when there isn’t a happy ending. And my goal – my determination – is to find a way to ensure our kids are safe before mother nature, the law of averages – or anything else gets a chance to “balance out the scales”.

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