HJBR May/Jun 2022

HEALTHCARE JOURNAL OF BATON ROUGE I  MAY / JUN 2022 11 Editor You now have the ear of Baton Rouge’s healthcare industry. What would you like them to know about EMS and pre-hospital emergency care? Godbee I think most people outside of the emergency department in the healthcare community — docs, nurses, the ancillary staff, people like that — don’t know that much about EMS to begin with, and particu- larly what paramedics are capable of doing, howmuch they can do, and how good they are at it. We have emergency residents, family medicine residents, and medical students rotate with our service fairly regularly, and one of the things that they will consistently say is, “I had no idea how much you guys could do in the back of an ambulance.” That’s what I would like to get across to people — the incredible capabilities and the very high proficiency of EMS medics. Editor What is Emergency Triage, Treat and Transport versus treat in place? Godbee Well, they’re two different things, ET3 and TIP. I’ll start with treat in place (TIP). Treat in place is a program where we can use telemedicine. Our medics go to people’s homes and realize this person really does not need to go to the emergency department, so we can take care of what they’ve got right here in their home. It’s a great program by the federal government to help lessen the load on emergency depart- ments by not transporting people who don’t need emergency care. It uses telemedicine where the medic can call straight to a doc- tor and get pretty much what they need with a telemedicine consult, the paramedic on- scene literally being the hands and eyes and ears of that doctor who’s on the computer talking to them via telemedicine hookup. The other one, Emergency Triage, Treat, and Transport (ET3) is a program of the same nature, again sponsored by the gov- ernment, that allows the medic to do part of that with treat in place, but it also allows us in the EMS world to take a patient some- where other than the emergency depart- ment. I have to give you a little background here — the way the federal government wrote the laws previously, the only way an ambulance service could bill for their services, meaning the only way we could actually get paid, was to take a patient to the emergency department. So, there was only one outcome that was of any benefit to us as a service — go to the patient, pick them up, take them to the emergency room. A lot of people who call 911 don’t really need to go to an emergency room. They need some form of care but not necessarily emergency care in an emergency room. The old school way was if you pick them up, you take them to emergency room. That’s the only way you’re going to get paid. If any- thing else, we did a lot of good medical care, but we didn’t get paid for it by not taking the patient to an emergency department. With Emergency Triage, Treat, and Transport, you can triage them, meaning you can make a decision on what they need, howmuch they need. And then treatment is “treat in place”— you can treat them right there in the house and be done with it. Or, you can transport them, if they really do need transport, to the emergency department. Here’s the kicker on the new version ... there is what’s called an “alternative location,”meaning we can take someone directly to a different location — an urgent care, an after-hours clinic, any one of the psych facilities — because they don’t need to go to an emergency room, but they do need something. Editor How much does the patient dictate on the decision to transport and what hospital they go to? Godbee Great question. The answer is 100%, and this is what I really hope the Baton Rouge and East Baton Rouge medical com- munity gets out of this interview. I know it sounds a little flippant, but I’ll explain what I mean when I say that we’re not allowed to kidnap people, meaning it is illegal to take somebody somewhere they don’t want to “I often want to try to help educate local emergency providers and explain to them that you don't need to ask the paramedic why we brought the patient to your hospital. You need to go ask the patient, ‘Why did you choose to come to this hospital?’ We brought them there because they asked to go there.”