dr-exmedic.com

If, after my next post, you don’t hear from me, know that someone has figured out where I live–for I am wading into that swamp which is the debate over fire-based EMS.  I didn’t really want to, but since comments have been disabled on this video, I can’t correct a few factual inaccuracies there.  I’m actually working on a response video to be posted to Youtube.

In theory, I have nothing against fire-based EMS, and will happily hold Seattle’s fire-run program as a model as good as any in the country (while simultaneously noting that it won’t necessarily work everywhere).  In real life, however, much of my experience has been in Northeast Ohio, where (to quote Thom Dick) a paramedic is pretty much “just an entry-level firefighter.”  It is a place where bad things happen, like a particularly galling event just miles from where I graduated high school (and my parents still live):  a medic failed to defibrillate a patient in pulseless VT, and the chief’s response is that his providers aren’t incompetent, they just wrote the wrong thing on the tripsheet.  Please note the bit about not feeling the need for a QA/QI program until after the reporters started nosing around.  (That link is to the follow-up story; apparently they hadn’t started archiving video when the original story was posted.)

I have no doubt that a fire-based EMS system that truly embraces the EMS mission can provide care equal to that of any EMS-only provider.  My doubts are about the ability of those systems to treat EMS duties as anything but a chore to be left to the people without enough seniority to bid into an engine or ladder slot.  Needless to say, this frequently leaves the least experienced medics on the ambulance–a situation I once referred to as “the unwilling, led by the untrained.”

After I click “Publish,” I’m going to load the shotgun.  Wish me well.

Update same day, 2 hours later:  I didn’t notice how you got to become a member of the group that put out the video.  There are no dues to pay, you merely have to write them a letter (no emails apparently) that says you agree with their mission…and you have to write the mission statement down.  Weird.