January 2009 Archives

Steve Volk published this interesting article on the state of EMS in the country. For those of us who have been monitoring the EMS challenges of Recruitment, Retention, Reimbursement and Recognition (known in PA as the 4 R’s), the article is a welcome spotlight on concerns that have been around for a long time. The effect of low wages on recruiting and lack of recognition as a third essential service are the two most prominent issues mentioned in the article. I think Mr. Volk also handled the challenges associated with merging EMS with Fire fairly well. My take away from his analysis was that EMS and Fire mergers can work well if the two roles are embraced equally. Unfortunately it appears that in many cases, EMS becomes a necessary evil to supplement the decreasing number of fire-related responses.

For those of you who have been talking to your local politicos for years about these issues, send them an email with a link to the article. For those of you who have not been talking about these issues, START TALKING!

Dan

PS Many thanks to BJ Pino from Citizen’s Ambulance in Indiana County PA for passing along the article, and for never losing his voice when it comes to talking to legislators.

This recent article in Time discusses a California Supreme Court’s decision that a woman who pulled another woman from a car after a crash would not be protected by California’s Good Samaritan Laws. In this case, the victim is now a paraplegic, claiming that the injuries are a result of the extrication, and not just the accident itself. According to the article, the court ruled that “the state statute immunizing rescuers from liability applies only if the individual is performing medical care in an emergency situation.”

I don’t think I would be alone in arguing that extrication is certainly considered part of emergency medical care. The process of extrication is inextricably linked to C-spine immobilization, airway management, and all the other procedures a trained responder would have considered while treating this particular victim. This untrained bystander may have unintentionally caused injury by not taking C-spine precautions, but in my mind that’s part of the reason these laws were created. Having bystanders stand idly by, not acting out of fear of retaliation will cause many more preventable deaths than it will avoid.

On the other hand, I do wonder whether some measure of protection should be given to the victims/patients who suffer from some well-meaning but misguided attempt to help. Should there be a “prudent rescuer” definition that establishes a definition or process to determine what the majority of people would have done in the same circumstance? After all, you don’t know how many people will think that they can perform surgery on the street because they stayed at a Holiday-Inn Express the night before.

Please comment with your thoughts. And, please don’t sue me for sharing my opinions.