dr-exmedic.com

 The shotgun is loaded, so I have done it:  uploaded a response to the video “Fire Service-Based EMS:  The Right Response.”  You are welcome to view it on YouTube (in two parts), or download it directly for your repeated viewing pleasure.  (478MB mpeg or 230MB avi, right-click and “Save Target As”)  All websites referred to in the video are available as links below, along with a little bit of rationale.

Links referred to in the video (in order)
Part One (if you’re watching YouTube, not downloading)

• A documentary on Freedom House ambulance
• IAFF legislative issues page
• CFSI current legislation page
• NVFC legislative issues page
• IAFC legislative issues page
• NFPA doesn’t seem to have a separate legislation page at all
• I didn’t actually provide links to back up my statement about patient handovers, but even a quick internet search will give you a handful of articles about people wringing their hands over physician-to-physician transfers (examples here and here)…so one agency to a different agency isn’t the problem, it’s one person to another–despite having the same employer and level of education.
• US Fire Administration response times study
• Review of studies showing lack of evidence of ALS benefit in several situations

Part Two

• USA Today EMS series
• JAMA study
• Oklahoma City EMSA authorities recall the bombing
• Acadian and Katrina
• American Medical Response and Katrina

A friend and I were discussing the original video, and we both agreed that the most egregious misrepresentation in the video is the assertion that I spent the most time debunking:  that people served by cross-trained providers have documented higher cardiac arrest save rates.  The most charitable way that I can describe that statement is that there is no conclusive proof that such is the case; in fact, there are hints of evidence that it is not true.  For those who wish to accuse me of cherry-picking information, you are welcome to provide other reliable data with the same criteria that I used:  it must be one source, less than 10 years old, comparing several localities over the same time frame using any internally consistent method.  I will happily consider non-Utstein data, although I certainly prefer the standardized type.

Filed under: EMS