In the news…

First in the news this week, an EMT in New York City quits after posting to twitter. Oh, yes he is the son of the FDNY fire commissioner. no real big deal, other than a PR black eye on the service, right? Wrong. The commissioner’s son was only working EMS so he could get on the fire side. This is the type of person who works for a service just to get on the fire engine. Read the article, he is biding his time and doing time until he can transfer to the fire side. If you want quality people, you need to have a service that is not just a stepping stone to a fire engine.

Winnipeg EMS is going to start a Community Paramedic Program, to be in operation by spring.

Two articles about the University of Pittsburgh Medical Center starting a Community Paramedic program. One from Pittsburgh Businesstimes and one from the University of Pittsburgh, who says that this will be one of the largest community paramedic programs in the country. It’s nice to read how the community paramedic program is slowly being recognized in this country as an option.

EMS director for the County of Frontenac in Canada says that staffing a community paramedic in a clinic could help cut down on 911 calls.

Just a few bits of news you might have missed. Be safe.

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NREMT Transition

While compiling my NREMT re-certification paperwork today, I found a few interesting items.

First, and most important, Kentucky Board of Emergency Medical Services (KBEMS)  has opened the transition web course applications for paramedics who will re-certify NREMT in March 2013. You can follow this link for the details.

Also, from a blog post on the Courier-Journal website, Baptist Health had a press conference on March 1, 2013 where they stated that EMTs in Kentucky will be allowed to perform 12 lead ECGs in the field. I think this is a great idea, especially given that there are many BLS only services in the state. I wonder why KBEMS has not informed the EMTs or Paramedics about this change? The link to the blog post is below, I will continue to search for more details and try to keep you informed.

Team efforts will improve heart attack care in Kentucky

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One parapgraph

My literature assignment this week was to write a paragraph in the style William Faulkner’s “Barn Burning”. Specifically to copy the style of the first paragraph, which you can read here. I offer you my one paragraph in this style. Thank you and enjoy.

The floor of the ambulance was caked with mud and snow. The man, laying on the aluminum wheeled bed, yellow and black in color, cold from the night air, and more: the floor littered with discarded  equipment previously sealed to keep implements sterile, a snake like hissing from the oxygen regulator full open, brushed steel instruments once clean now blood tinged lay about the counter space directly to the right, reminding them of the twice missed opportunity to secure an airway, failing to change the blue pallor back to pink, warm and dry- this, the laryngoscope with its light still on mocking them, turning their hope to grief, leaving one last solution, a vain attempt at respiration turning frustration to fear, fear that they will not be able to save this one. The medic could not see the fourth passenger, patiently sitting on the far end of the bench seat against the wall, but knew he was watching, the medic’s enemy  (our enemy, he thought with familiar melancholy: mine! My patient’s! He’s my patient!) , the Angel of Death sat waiting to gather what belonged now to him.

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EMT required for paramedic?

Yesterday I was listening to the EMS Educast episode on Mike Ward’s article EMT not needed for paramedic certification on

I use to have very strong opinions regarding prerequisites for a paramedic program. I thought that an EMT certification plus one year experience should be required.

Now I have to wonder why would we require paramedics to be EMTs prior to being paramedics? Do nursing programs require a LPN certification before becoming an RN (Yes, actually there are some nursing programs out there that make you sit for your LPN before moving on to the RN)? Are doctors or physician assistants required to be paramedics, nurses or medical assistants before enrolling in medical school or a PA program? Not that I know of, you can have no experience in medicine and still get in to med school, so why are EMS educational programs sticking with the antiquated EMT before paramedic path?

I believe that the right paramedic program can take someone with no medical experience and turn out paramedics. That is the catch, the right program. Most paramedic programs around me assume that the potential students are all EMTs and they take the knowledge that the EMTs are suppose to have for granted, although not every EMT has maintained their knowledge base to make it practical. The instructors spend time reviewing information that the EMT should know, so what was the purpose of requiring EMT certification for entry to the paramedic program?

Some EMTs want to become paramedics, but not all. We need to rethink how we educate the providers, paramedics are doing more and we need to be able to educate them to be able to provide out of hospital care in to the future.

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Community Paramedicine News

Community Paramedicine is slowly creeping in to the national discussion about health care, and it’s about time.  Until now, most of the community paramedicine talk and focus has been around rural health care. There are few urban agencies that have turned towards CP to ease the stress on the health care systems in larger cities.

Los Angeles County EMS, one of the largest multijurisdictional EMS agencies in the country, is officially looking in to the possibility of Community Paramedicine. The article is from California Healthline, and well worth the read. This will be a very interesting process to follow, and I encourage everyone with a vested interest in EMS to keep track of this initiative. IF L.A. County EMS moves towards community paramedicine it could set the national model for urban community paramedicine, and it’s about time.

Congratulations, California, for again being the leader in EMS.

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Time to walk

As EMS week continues, more bloggers are talking about the problems in EMS. The direction we are going (or not going), the educational standards, and the salary we are paid.   Rescuing Providence posted “EMS Week, ‘Take it, It’s There‘”, and the venerable Skip K., replied with his standard mantra of “you have to invest first before reaping the rewards”, and he is correct.

Too Old To Work (TOTWTYTR), replied in his blog post “The Other EMS Week Post“.

I agree with Skip. As long as EMS continually accepts the lowest standard, and caters to the lowest common denominator, we will never grow as a profession. My question to the EMS chiefs in the U.S. is, When will we stop the rhetoric and take action? 

We settle for the lowest educational standards, but we don’t have to settle. We cannot individually change the educational standards for your local licensing authority, and there NEEDS to be a place for entry level paramedics and EMTs. We CAN make promotional positions require more education. IF you have a paramilitary style organization (with ranks) you, as EMS chief, can say that the minimum requirement for becoming a sergeant is an Associate Degree. Captains and/or Lieutenant have to have a Bachelor degree. No ranking system in your agency? Do you have FTOs (you should), then make them a different pay scale and require them to have an Associate Degree. EMS Chiefs have the ability to enforce higher educational standards. Why aren’t they?

The time to blog endlessly about the woes of the EMS system, and how great it could be is over. The time to take action and make a change had started. Walk the Talk.

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National EMS week 2012

It’s that time of year again, where everyone thanks EMS professionals for the service they provide. The one week a year you get when not every nurse greets you with a scowl. Not all is well in EMS though, some people believe that we need to actually make improvements in the system, improvements in reimbursment, and improvements in professionalism.

The Fossil Medic has two excellent posts about his thoughts, Is EMS Really a Calling? , and How EMS physicians Became Recognized and Rewarded. Go read them both, especially Skip Kirkwood’s comment on ‘Is EMS really a calling?’

Bob Sullivan over at The EMS Patient Perspective also had some thoughts in his post, EMS: Calling, Job, or Prison Sentence?

I’ll get my opinion out of the way, regrading these “National Week” type events. I understand that it is suppose to raise awareness and appreciation for the EMS professionals (wouldn’t it be easier if I could just say paramedics?). I don’t buy in to the hype. Emergency Service workers should always be appreciated, not just once a year. It is the same way with fire fighters, (yes I mentioned fire fighters in an EMS post). During the Sept. 11 memorials, they are revered. The next day they are just in the way, or harrassing the public with their inspections (I have been told that by business owners in the past). Appreciate the people who choose to risk their lives for yours every day, not just when you need them.

Professionalism. Skip Kirkwood continuously brings up this topic, and rightly so, about advancing EMS. Some people like to lay partial blame on EMS volunteers, saying that they are keeping our pay scales low. There are far more volunteer firefighters in the U.S. than paid firefighters. I don’t see firefighter salaries as low as EMS salaries. I seriously doubt the problem is with volunteers.

If you are looking to point the finger for all the woes of EMS, turn the finger around and point it at yourself.  What are you doing to advance the image of EMS? What actions are you taking? How’s you attitude lately? How is your partner’s attitude? Do you dress like a professional, or insist on wearing a tee shirt on duty? Do you attend as many EMS conferences as you can? Are you working towards a degree? Are you doing anything to improve your medical knowledge and patient care?

Stop trying to place the blame on everyone else. You want to celebrate EMS week this year, start by BEING the person who people will call a professional. Attitudes are infectious, having a positive one will raise the people around you.

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