Is This the Future of EMS?


This picture was taken in Boston by a friend of mine. He thought I’d get a kick out of it, and he was right. If you look at the left side you’ll see something that looks like a Star of Life. It IS a Star of Life and if you can’t make out what the wording is it’s “Cardiac Defibrillation Unit”. I don’t think that cabs in Boston have defibrillators, so my guess is that this was an old police car and no one removed the sticker when the car started it’s new life as a taxi cab.

Although this is humorous, it’s a good symbol for what some people think EMS is or should be. All too many of those people work for organizations that drive big red trucks to medical scenes, stand around giving the “stare of life” and waiting for EMS to show up. To hear their version of events, it’s they that are the true EMS providers and the ambulance crews are little more than horizontal cab drivers.

What utter crap that is. As a general rule, and I know that there are some excellent exceptions, fire service EMS is lowest common denominator medicine at it’s worse. DC Fire/EMS is one of the latest examples, but there are stories from other cities as well.

The there is this story from Tulsa, State Investigating Tulsa Fire Department. I know that refresher training can be deathly boring, but it’s part of the job. I’ve gone to at least fifteen refresher courses and countless in server training sessions over the years, I know how tiresome it can be. However, it’s part of the job and no one should be claiming credit for classes they never attended.

What would happen at your agency if you were caught doing this? My guess is it wouldn’t be pretty. What will happen at Tulsa FD? For some reason I think nothing serious will happen, but that’s just me.

How widespread is the problem? I doubt that any statistics exist, but it’s serious enough that in 2004 Fire Chief magazine published an article entitled Protect Yourself from Medic Cons

The demand for paramedics on every piece of equipment creates similar problems. Service providers must persuade firefighters to attend paramedic classes, even when they have no enthusiasm for the field. This often results in mediocre paramedics and average patient care. The system tolerates this and allows for further deterioration of the level of care by not supporting those paramedics through teambuilding and skills improvement.

Which raises a couple of questions I’ve asked before. Why is a paramedic needed on every piece of equipment? We certainly don’t need a paramedic on every ambulance, although many systems persist in maintaining that type of staffing.

Unfortunately, when it comes to Fire Service EMS the rationale seems to come down to, as Vice President Joe Biden once said “A three letter word, J-O-B-S.”

It will be interesting to see what happens in Tulsa, in light of the fire departments quest to displace EMSA as the ambulance provider.

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After a long career as a field EMS provider, I'm now doing all that back office stuff I used to laugh at. Life is full of ironies, isn't it? I still live in the Northeast corner of the United States, although I hope to change that to another part of the country more in tune with my values and beliefs. I still write about EMS, but I'm adding more and more non EMS subject matter. Thanks for visiting.