I’ve written before that Western New York is
heading into, if not already in, a public safety crisis. There are too few fire
and emergency medical services (EMS) volunteers and those that are good enough
to give of themselves are spread too thin. Understaffed fire and ambulance
crews find it difficult to address emergencies in a timely and effective
fashion – and sometimes even at all.
The solution, especially in rural areas which do
not have paid services, is to encourage volunteerism rather than discourage
volunteerism. Unfortunately, the organization that oversees EMS in Western New
York is heading down the latter path.
The Western Regional Emergency Medical Advisory
Council (WREMAC) is a committee of physicians and first responders from the
eight-county region who are empowered by law to develop policies and
procedures, and triage, treatment, and transportation protocols to be followed
by EMS personnel in the territory.
Since at least 2013, WREMAC has pondered eliminating
the position of emergency medical technicians at the critical care level
(EMT-CC). It is something that the organization has talked much about in recent
meetings and plans to address again this month.
EMT-CC is the highest level of EMT coverage
afforded in the state. EMT-CCs are fully classified as advanced life support
(ALS) providers and are trained in advanced airway management, intubation, IV
fluid administration, cardiac monitoring, cardiac pacing, cardioversion, and
medication usage/administration. Their skills are comparable to having a MASH
unit on wheels.
But, WREMAC doesn’t think that’s enough. EMT-CCs
are one level below paramedics and that’s what WREMAC would like to see
utilized as a means to take some of the burden off of emergency room doctors.
What they fail to see, though, is that doing away
with EMT-CCs and what EMTs can and cannot do will place an even greater
workload on physicians – most folks in the EMS field will choose to become the
next lowest level of EMT, which is the advanced EMT (AEMT) rather than taking
the path of paramedic. That means ER doctors will see significantly more trauma
that was unattended too – and, in such cases, the minutes lost due to the
inability to provide critical care will be the difference between health and
debilitation or life and death.
Why wouldn’t an EMT-CC want to become a paramedic?
There’s not enough time and money.
It’s a huge investment of time to become an EMT-CC,
let alone a paramedic. To become a basic EMT, the volunteer has to take 200
hours of training. To become an AEMT, another 200 hours is required. To achieve
EMT-CC rank, there is another 600 hours to be taken. That’s 1,000 total hours.
To become a paramedic, an EMT-CC would have to take
another 1,300 hours of classroom, technical, and field training; they would
have to spend more time in training to go up just one level as they’ve put into
their entire EMS career to date. The paramedic course takes 14 months and there
is talk of adding more classes to it which would take it to 18 months.
If EMT-CCs do chose to go up in the ranks, those
tiring 1,300 hours would take them away from actually doing what volunteers
want to do – that is, being out in the field saving lives -- and it will keep them
from family, hobbies, and sometimes work for more than a year.
As if that’s not enough, the typical cost for
paramedic training is more than $2,000. That’s a lot of money to ask of someone
who’s already giving their time.
If WREMAC moves ahead with their plan rural
counties will be hardest hit. In Allegany County there are 24 EMT-CCs and only
10 paramedics. Of those 10, only 5 of them actively practice and/or work in the
county. There’s no way that 5 paramedics can handle the needs of 50,000
residents spread across 1,000 square miles.
Eliminating EMT-CCs won’t do a thing to improve
emergency medical care in WNY…it will only magnify the problems were are faced
with. People will become crippled, or worse yet, dead when the already hard-hit
and understaffed fire and EMS crews are not allowed by law to perform medical
tasks to the best of their abilities and knowledge.
From the 12 September 2016 Greater Niagara Newspapers
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