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EMS In The News

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Lots of EMS news stories lately, but they don’t seem very positive.

BOY DIES AS 999 CREW ON BREAK

It’s a short story, but full of fail. I’ve always believed that if you work in EMS there are some trade offs. One of those is that you don’t get guaranteed breaks, especially in smaller, rural systems. There may be hours of down time between calls, but that’s not a “break” in the work sense of the word. Like everyone else in EMS (in the US) I’ve had meals disrupted by calls. It’s just one of the things that you learn to deal with. Apparently not in formerly Great Britain, though. EMS is struggling to be regarded and respected as an emergency service along side police and fire agencies. I don’t think that those two services get defined breaks, at least not in the US. That’s in general, I’m sure there are some exceptions, but I don’t think that you can be an emergency service and expect to have scheduled breaks which can’t be disturbed. That’s just me speaking though, you might think differently.

Former Trinity worker fined in EMT-training scheme

LOWELL — Named the central architect in a statewide EMT-training scheme, a former Trinity Ambulance paramedic has been slapped with fines totaling $16,000.

Leo Nault, 51, of Concord, N.H., pleaded guilty in Suffolk Superior Court to 16 charges of emergency services violations and three indictments charging conspiracy. Nault was accused of creating fraudulent training records for more than 200 EMT workers across the state who never completed required courses.

Thanks Leo for making the life of every EMT and paramedic in MA (and some in NH) just that much harder. I hope you don’t like to do any shooting Leo, because for evermore you are what the federal government considers a “prohibited person”, barred from possessing firearms or ammunition.  I think in general you can kiss any job that involves trust of some sort good bye. And I don’t have even a shred of sympathy for you.
The continuing joke known as DC Fire and EMS or FEMS if you must, provides us with more news,

D.C.’s ambulance fleet depleted by repairs

Nearly a third of the District’s basic life support ambulances are out of service for repairs, a situation that couldn’t come at a worse time, union officials said.

The shortage of transport units comes as a heat advisory has been issued and the fire department is reporting an unusually high number of calls

Once again summer seems to have sneaked up on the management of DC FEMS. Again a short article, again full of fail,

Smith said the city got into this problem when it stopped buying new units several years ago.

“Now we’re playing catch-up,” Smith said.

According to department’s budget, the District has ordered 10 new ambulances, with plans to buy 20 more over the next two years.

Stopped buying ambulances several years ago? WTF? How long do they expect vehicles that are running almost 24 hours a day every day to last? No matter how good the maintenance, and I’m guessing it’s not that good, vehicles wear out over time. That’s why competent managers figure on replacing some part of their fleet every year. Oh wait, I said competent managers. Never mind.
For the record having no air conditioning, especially in the patient compartment is a completely acceptable reason to take an ambulance out of service. AC is not a luxury, it’s a necessity. Nothing can make an ill person more ill than taking them out of a somewhat stuffy apartment and putting them into a metal box that approaches the temperature conditions of a pizza oven. Again, that’s one of the things that competent managers know and take into account.
That’s enough cheerful news for one day.

 

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I'm a retired paramedic who formerly worked in a largish city in the Northeast corner of the U.S. In my post EMS life I provide Quality Improvement instruction and consulting under contract. I haven't really retired, I just don't work nights, holidays, or weekends.  I escaped the Northeast a couple of years ago and now live in Texas.  I'm more than just a little opinionated, but that comes with having been around the block more than once. You can email me at EMSArtifact@gmail.com After living most of my life (so far) in the northeast my lovely wife and I have moved to central Texas because we weren't comfortable in the northeast any longer. Life is full of twists and turns.

6 COMMENTS

  1. Of course the stories of how thousands of EMTs, poilce officers, and fire fighters do their job properly and help millions of people every day is a “dog bites man” story that the media has no interest in. Of course when things go right, it’s just not newsworthy.

  2. I can only really comment on the story from the UK. The rules are different depending on which part of the UK is involved, but in general, over the past 2-3 years rules were introduced that crews were to be given mandatory breaks – normally 30 minutes in every 12 hour shift within a certain break window. Thankfully, things such as 24-48 hour shifts don’t exist here…
    Whilst on these breaks a crew is uninterruptable. That is to say that they won’t even know the call exists. So blaming a crew is not only unfortunate, but wrong. I can’t imagine a single ambulance crew who, if told that there is a 3-year-old in cardiac arrest a mile down the road, wouldn’t drop whatever they were doing, including eating their meal, and run to the call.
    In London, where I work, chances are that we are not given these breaks. We usually start a shift on station and then see that station again only at shift end. When that happens, the theory is that we are compensated for our meal break by being allowed to end our shift 30 mins early.
    That too rarely happens.
    In a city where almost every shift is busy from start to finish, I believe crews are entitled to a break, as a rested and well fed medic is more likely to be at the top of their game. The onus should be on the overall management to ensure the cover is available. That too, is sometimes a problem in itself.
    It’s a balancing act – and one that often fails. More often than not, however, it fails the crews and not the patients. You could argue either way which would be the right way round.

    • I didn’t mean to blame the crew at all. Or the dispatchers for that matter. I have no doubt that if the crew knew there was a call ten minutes away, they would have responded. The dispatcher was following policy and protocol, so he can’t be blamed either. This seems to be more than an occasional systemic problem with the UK ambulance system. There are complex rules about this sort of thing in the US, controlled by both state and federal laws. The problem is that at least here, we run into problems with the definitions of emergency service and public safety. I know of one smallish municipal EMS system not very far from where I am where union members argued that they should be allowed to form their own union because the union that they were represented by didn’t adequately represent their needs. They lost because the arbitrator looked at their job and looked at the job of the public works and street departments and decided that they all essentially drove trucks and moved heavy objects. You can argue that the EMS workers had poor representation by their lawyer, but that’s beside the point. They failed to convince the arbitrator that what they did was either public safety or emergency work. That despite the fact that they responded to the same calls (fires, vehicle collisions, assaults, and so on) that the other services did. Oh, and they still didn’t get regular breaks after that either.

      While in principal I agree that we should get breaks, the reality is that I don’t know of any major EMS system in the US, whether private, fire, or 3rd service based, where crews are guaranteed breaks. You can get Ambulance Driver to rant for hours about System Status Management and how that abuses EMS crews, just asking about breaks. Oh, some managers like to contend that down time between calls constitutes break time, but that’s BS.

  3. First – I didn’t mean that it sounded like you were blaming the crews – but that’s always how it comes across in the media here when a story like this happens.
    As for downtime – I agree. Grabbing a cup of coffee at the hospital doesn’t count as a break – and, again, in London – that’s often all the downtime we get on a shift. It’s not nearly enough…

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