Note: This site is for discussion purposes, toward inspiring youth to become health professionals.
Who are the Hurry Kings?
The Hurry Kings are a (proposed) Society of Paramedics and EMRs (Emergency Medical Responders) who specialize in early intervention and life safety within office or residential high rises up to one city block in size.
What is their purpose or specialty?
The Hurry Kings aim to be alongside patients within 3 to 4 minutes of an alert. Facilities that rely on vehicular EMS (ambulance and fire trucks) have been shown to average more than 13 minutes for responders.
So they are attempting to reduce responses by a full 10 minutes?
Yes. The Hurry Kings utilize an end-to-end protocol that connects the onset of symptoms in a patient with an onsite responder being alongside without delay. There are many reasons why early intervention is critical. For example, an AED must be used within 4 minutes for optimal effect on a patient experiencing sudden cardiac arrest (SCA), with its effectiveness declining by an estimated 10% every minute thereafter. So a fireman or ambulance attendant arriving after 13 minutes, even with a $25,000 monitor/defibrillator, has very little chance of success, and may be reviving someone who has already incurred severe brain or organ damage.
How do the Hurry Kings receive these alerts?
They rely on a life safety cellular network, answering either a Blackberry Classic that they carry, or alerts forwarded from a fixed-cellular phone and medical emergency number provided to the building workers and residents. This device (LifePad™) is a Blackberry™ Passport phone mounted in an enclosure, in a secure location.
Why is the cellphone mounted in an enclosure?
The LifePad device is the facility’s or city block’s emergency phone, has a fixed IP address, and cannot be portable or allowed to go missing. It contains the contacts of every registered occupant being protected. When an EMR comes on shift, incoming calls are forwarded to their BB Classic phone, and to 911.
The 911 dispatcher gets the call too?
Yes, because patients may have the understanding that they are calling EMS, and that action cannot be diverted. So the call is expanded to a conference call between the patient, the EMR, and the dispatcher. The EMR keeps the dispatcher updated over the next few minutes as the suite is accessed, and this allows the dispatcher to estimate how serious the incident is, and what resources to muster for it.
So the EMR is filtering the calls to EMS?
This call-sharing separates acute emergencies that might require the immediate dispatch of an ACLS ambulance, from those that can be resolved locally by the EMR, as a medical attendant or as liaison within the community health network. One compelling advantage is that the EMR, being onsite, means the fire department does not have to attend as a first and sole responder, promising huge savings for municipalities reliant on fire fighting vehicles.
What happens if the patient can’t talk or is in great distress?
The EMR’s daily routine is to visit the suites in the complex, and try to register every worker (office tower) or resident (condos, apartments) as a contact, along with any medical information they wish to volunteer (or enter themselves into a confidential website registry). The EMR provides an app for the occupant’s cellphone (iPhone, Android, BB) that displays a big red ‘panic button’ icon. When this is pressed, both the emergency number and 9-1-1 are called, and a prepared text is sent to the EMR with the volunteered details for that occupant. An estimated 85% of SCAs are not witnessed, so this icon allows these victims one last chance at life, if it’s monitored onsite.
Can 911 read texts?
Some PSAPs can, and some cannot (yet). But the LifePad and the EMR’s cellphone can receive advanced MMS texts, so the EMR can tell the dispatcher something like “She reported that she is diabetic and on pain killers for arthritis in her knees.” This suggests looking for symptoms of a diabetic complication or possibly an opioid overdose.
This sounds like a pretty advanced level of care…
The Hurry Kings are comprised of licensed EMRs being supervised by veteran paramedics, who are passing on their invaluable experience as another career option. Paramedics can start IV’s and deliver a number of treatments under medical direction, right up to leading edge trials of new approaches such as NA-1 stroke intervention. Paramedics work daytime supervisory and instructional shifts with EMRs, and their reports will be a key source of outcomes data termed medical surveillance.
What is medical surveillance?
The LifePad and BB Classic devices used by the Hurry Kings are on a cloud network (SDN) that administers their daily functions as phones, but also safeguards and backs up all their data and related website registries. Together this data, over hundreds of large facilities, will hold great value for medical studies and trials. Population health experts, including the American Heart Association recognize the Hurry Kings surveillance model, and its promise for studies from early intervention treatments – an unheard of and optimal opportunity.
So the Hurry Kings feed a large medical surveillance network?
Yes, the Society and its cloud network is intended to become a working laboratory for early intervention, resuscitation and epidemiology studies. Having EMRs onsite and online allows medical direction to be given live by an on-call emergency physician.
The EMRs can also participate in new community health technologies such as RPM (Remote Patient Monitoring) and digital imaging. their rescues can themselves be recorded in progress by the network. Together these functions may earn the EMRs sufficient extra revenue to consider remaining as community health workers as their full time career.
How many suites or people can one EMR protect?
The delivery of lifesaving procedures such as AED defibrillation or the naloxone antidote for overdose demands a response within about 4 minutes, so the EMRs have that ‘time radius’ to work with.
Because the life safety protocol is so direct, the EMR can reach most people within one city block within 4 minutes. There might be 1000 people registered on the network for that block, within cities. This is a community health model that complements ambulance service, providing a human endpoint.
Who will pay for these EMRs?
The Hurry Kings’ aggregate cost will be about $15/individual per month, e.g. as an all-inclusive contract. This assessment would be based on a minimum of 1000 people in a city block containing high rises, individually specified by the municipality.
The salary and premises overhead (about $15K/month at union wages for 3 EMRs) is funded jointly by federal, regional and municipal health authorities, and by the property owners. The savings in lives protected, organ damage prevented, and ambulance/ED/hospital resources will more than cover the $15K putative monthly cost, for an integral city block of high rises.
Every person in the city block is covered 7am to midnight (after that with conventional EMS), so health equity is assured, and the service will be financially transparent to all occupants and visitors.
This model can be adopted as a small business opportunity for experienced paramedics, to implement as an contracting member of the Society, and in this fashion small business helps deliver community health efficiently and to scale, relieving taxpayers. If organized as a Society, the Hurry Kings can adopt very high standards, trusted by medical authorities, that will satisfy the medical direction typical of paramedics in any municipality.
The Society can evolve customized curricula that teach less high speed ambulance driving, e.g. and more about community health structures and social welfare. Paramedics supporting this broader range of wellness will constitute a new breed of health professional.
What other benefits do onsite paramedics offer?
Community health and life safety are emerging as priorities in everybody’s awareness, and seek expression in our growing cities. Will LEED recognize humans as part of the environment in green buildings?
The public does not yet understand how dangerous high rise buildings really are. The dismal success rate for AEDs, and the absence of naloxone for overdoses means that these definitive treatments just aren’t there when we need them most.
If someone is onsite with a single AED and one dose of naloxone – we can leverage our new cellular technology and bring these protective factors into play.
Field Stations An EMR in these complexes will be the focal point of community health; its eyes and ears, whether it be comforting an abused child, senior or woman after a domestic dispute, counselling an addicted ‘frequent flyer’ about alternative options besides 911. In times of need, looking in on the infirm, or advising social services of want and distress – these options are missing otherwise. The working apartments are field stations with secure medical communications that can enable telemedicine.
EMRs are onsite practitioners of community paramedicine, the ‘last mile’ in the EMS safety network, especially for ambulance services. If an EMR, as a student can ‘learn and earn’ as a Hurry King, then any youth can be inspired to join them, and begin building a career as a health care professional.
Hopefully the Hurry Kings can become a teaching Society, mentored by the real pros of health care – our veteran paramedics.
Here is a Sample Pilot Program for your municipality.