I had the pleasure of finally figuring out how the emergency medical system works in this country. I made a contact online (I've never done that before) with a person who works for one of the more modernized/Americanized EMS systems in Buenos Aires, located in the province of San Martín. Paramedics don't really exist in Argentina, and they don't really exist in the rest of the world. When you call for an ambulance (and that means you call either the nation-wide recognized public medical emergency number of 107 -- 911 is for police and 100 for fire -- which gets you the public ambulance, or your private healthcare provider's 8 digit emergency number to get their ambulance) you will get a non-medically trained driver and a doctor. To tell you the truth, I am not sure what doctor ("medico") means here. As far as I can tell it involves an approximately 7 year undergraduate career and a few years of residency, but that is it. I don't know if I can say that doctors in the US are more highly trained when they start working by themselves, but that might be the case. Obviously there are very good doctors here, but I'm not sure what the qualifications of anyone working alone as a "doctor" are.
Anyway, I got to ride on the public ambulance of San Martín. Don't let "public" ambulance make you think that it is bad. In fact, quite the opposite. The ambulance service is pretty modernized. They work with Nextels and modern dispatch systems. They don't use radios. The ambulances, just like many ambulances outside of the US are simply boxes with a bed, three bags, drug kit, a suction unit and a manual Argentine-made defibrillator. No cabinets full of tons of supplies. Also no sheets! That was a surprise.
Riding in the ambulance was one thing, but walking into the public hospital was a shocker. The ER was a cement walled room with a bunch of metal tables cordoned off with curtains. In the middle of the ER stood a cement-walled-off trauma room with another metal table and next to the door a table full of fluids, meds, a large record book, and a yellow defibrillator that looked like it was made in 1960.
Here, when an ambulance brings a patient in, you don't just drop the patient off with a nurse or doctor (transfer to a higher level of care) and put your rig back into service. Here, you stay with the patient until all of his necessary tests are done. That means that you need to bring your own patient to get his own CT, x-ray, bloodwork, etc. if necessary and the whole time an ambulance is out of service. However, putting all the unbelievable part of this system aside, there are still a few very important points: it works, and it is all free. It might take people months to see the right doctor, and three hours for a semi-urgent patient to get images taken with really old equipment in a run-down building, but it is still free.
The next day I had the pleasure of volunteering with the Red Cross (Cruz Roja Argentina) at a concert in Luna Park, one of the more well-known venues in Buenos Aires. The concert was relatively small and not much exciting happened, but it was interesting to see how they work. There is no real incident command structure. They talked to each other with their own VHF radios and had teams of two throughout the theater, but you just write down the name and ID# of any patients you have, let them go if they don't need treatment, and report it all to the person in charge after the concert is over. Aka no refusals. Basic life support in a relatively non-litigious society. Why does everyone in the US always have to sue everyone else for things that aren't their fault!
Anyway, Dad is on a plane right now coming to BsAs. I am very exited. Also, 1 month left. I hope to make the best of it.
Me and the rig (móvil)
Inside of the móvil
Yes, the defibrillator. I am told it works.
¡Hola!
A quick comment on these thoughts. I forgot to mention something about the uniforms. In the US, the Emergency Medical System was born out of the fire departments. Doctors realized that firemen already had some of the rescue training that would make them ideal candidates to start practicing basic medical procedures out in the field. Somewhere in the mix of EMS being part of the fire department and a blend of associations between EMS, Fire, and Police as "emergency service workers," EMTs in the US now wear uniforms that look a lot like police uniforms. Here in Buenos Aires, everyone who works on an ambulance wears scrubs. It makes sense. Doctors on ambulances are not police officers or firemen, they are doctors. Yes, they work in the field, but they are healthcare providers. So now you know why I am wearing those green scrubs in the pictures, and why I am beginning to doubt why we look like police officers when working as EMTs.
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