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     The EMTs Prayer
  Grant me the wisdom so that I may treat those of your children that lay at my feet.

Let my hands be gentle, sure and swift to impart to them your sacred gift.  Let me see only a patient's need not their color, race or creed.
Help me always to be my best
even when it's on my hours rest.

Grant me the insight to understand why patients of mine are going to die.  Let me remember that when they do there is a wonderful life in Heaven with You.

Lord, if in the time of duty I should fall help my family to hold their heads tall.  For it was You who decided that I should be one of your chosen few,
an EMT.
     Heaven's Angels
One September Morning
There was evil on our shores
In the hills and heartlands
It chilled us to our core

We watched it on our TVs
In a state of disbelief
So many have been taken
We all can feel the grief

Families lost loved ones
They feel so all alone
Their contrymen support them
A foundation made of stone

Nothing can we do
Nothing can we say
There's nothing in our power
To take their pain away

And from this moment on
We'll all rise and unite
With our brothers and our
sisters From the darkness,
there'll be light

And on this tragic day
When so many fell
They slipped the bonds
of earth Into heaven where they dwell
Lights flash, Sirens blare Into the deep, dark air. EOA, AED, life saving equipment against death, Even for the guy that OD'd on meth.

Saving lives is what we do, Our hearts are in their place, our care is true.  Some live, some die, Most are afraid to ask why.

Sometimes we try, Sometimes they die, families find it hard to say goodbye.  Our hearts try to be strong through jokes and cold hearts.

Then reality hits and life, death parts.  We feel we must do what we can, In those hospitals, in those big vans.  Who are we you ask?

Saving lives is our job, it is our task.  Never giving more than any less, We are a team, we are E.M.S.
Because you have risen in the middle of the night, You understand what means to be needed is.
Because you have been stained with the blood of others, You understand the precious meaning of life.
Because you have delivered the newborn child You understand the need to go on.  Because you have held the dying in your arms, You understand the meaning of human limitations.  And, because of these understandings, You know why you try so hard.



It never entered my mind when I began my career as a Paramedic, that my career would be shortened after becoming the victim of violence. But in fact my career was in fact shortened because I was assaulted by a patient who had overdosed on illegal narcotics and became violent. Scene safety was never discussed in the emergency medical education program. Today emergency medical services personnel wear bulletproof vests because of the increased violence against EMS workers.

A study conducted in 1999 concluded that during 12-years in EMS, those paramedics received an average of 9 assaults per paramedic. Assault injuries resulted in 170 cases of blunt trauma, 73 lacerations, 2 gun shot wounds, 10 stabbings, 1 burn, 8 fractures, 9 dislocations, 1 choking, and 56 cases of miscellaneous body injuries.” Emergency medical services personnel continue to face many dangers in the course of their profession and in the line of duty. The dangers faced begin upon receiving a call from their dispatcher for response to a medical or traumatic call. The emergency run poses a greater risk of becoming involved in an automobile accident causing injury or death then the chances of an EMT accidentally sustaining a needle stick and contracting HIV.

Once on the scene of a call the emergency medical technicians chances of becoming the victim of an act of aggression and violence.  Danger can threaten EMS providers at any time and anywhere. There is no such thing as a "safe" neighborhood or a "safe" area of town. Emergency medical services personnel have been killed and or injured, in the line of duty.  The causes and acts are becoming more and more random. They include injury and or fatal injuries resulting from motorists who have failed to yield the right away to the EMS vehicles equipped that are equipped with state of the art flashers, sirens, and intersection lights. Drivers do not pay attention to Emergency Vehicles, and are distracted by blasting stereos, driving while intoxicated, and talking on cell phones just to name a few.

Once on the scene, emergency medical personnel often are faced with hysterical family members, sometime including verbal and physical assaults from bystanders. Additional risks faced by the EMS personnel include being struck by cars while treating patients at accident scenes that have resulted in both critical injuries and deaths. Motorist fails to slow down, or operate their cars dangerously and aggressively in accident zones. Over the years, paramedics have seen in an increase in responses to more dangerous situations that have resulted from both foreign and domestic terrorism.

EMS personnel have been targets during the Columbine school shootings, the bombing of the Oklahoma Federal building, the 1993 World Trade Center Attack, release of gas in the New York subways, and the most recent attacks on September 11, 2001 of the World Trade Center, and the Pentagon. Emergency medical services personnel who are trained to save lives and operate under the EMT Oath taken to preserve life, EMS Personnel now face the uncertainty that Police officers and Firefighters that there is no guarantee of returning home to their families at the end of their shift. Paramedics and Firefighters do not carry a firearm their only means of safety is a Law Enforcement presence and that's still not a safety guarantee. 

Legislation is lacking in many states that provides strong legal consequences for causing injuries and or death of these dedicated men and women in Emergency Medical Services. As stated earlier the cost of a bullet proof vests is approximately $500.00 per vest, many private agencies as well as volunteer organizations do not provide these needed safety devices because of the cost, leaving the choice and expense of the EMT. Recently in my county a new policy was adopted by the Medical Control Director that states that EMS Personnel and Firefighters responding to violent and suicide calls must "stage," [park several blocks away from the scene until police units have arrived and secured the scene] although this protects the responding medical personnel it does create the danger of delaying rapid treatment for the patient.  EMS Personnel should incorporate the following criteria in their response to Dangerous calls.

1.) Dispatchers need to obtain as much Information as possible, i.e. is there a violent situation for patient? Is this an attempted suicide and by what means, if this is a shooting and or stabbing is the perpetrator still on the scene?  Is the patient in possession of any type of weapon? 

2.) The responding EMS crew and Fire personnel must be given detailed dispatch information, including frequent updates regarding Law Enforcement's response as well as their estimated time of arrival. In addition, dispatch should update the crews as additional information becomes available.

3.) Upon EMS arrival, the EMS crew should overview the scene. i.e. is there any immediate danger, is law enforcement on the scene, and are there any visible dangers to the crew. Identify areas for a safe retreat.

4.) When on scene of a motor vehicle accident, survey the area before getting out of the rig is the scene secure.  Are there any electrical lines down on or around the vehicle or vehicles, is there a vehicle fire, are there any vehicles involved there is transporting hazardous waste or chemicals?  Is traffic congestion causing additional hazards?  Place your Unit in a safe position that will protect you, the patients, and the scene.

5.) Do not put yourself in harm's way; Always have open communications with your dispatcher. If the scene becomes dangerous remove yourself and your partner from the scene until security is reestablished by law enforcement.

The potential for scene violence & violent patients exists for all types of EMS responses, do not become complacent you must always remain vigilant.  Since the attack on September 11, 2001 police officers, firefighters, and EMS personnel have had the publics renewed appreciation for the work that we do and the a unselfish sacrifices we make.

After a football game between Ohio State and the University of Michigan, Police Officers, Firefighters, and Paramedics were attacked by a large group of party revelers celebrating the game that had been played earlier that day. As a result of the violence that broke out, several Police Officers called in to restore order were attacked by individuals throwing bottles, rocks, and were subjected to physical attacks.  Firefighters who also responded because of fires that had been started, found themselves attacked in the same way. Paramedics were also called to help the injured and became the targets of rioters who began throwing rocks and bottles. This is a strong example for us in the Emergency Profession to remain vigilant and safety conscious
More EMS providers die on the job than anyone suspected, making the occupation nearly as dangerous as police officer or firefighter, according to the first-ever national study of EMS fatalities. The study, "Occupational Fatalities in Emergency Medical Services: A Hidden Crisis," is detailed in the December issue of Annals of Emergency Medicine, the peer-reviewed journal of the American College of Emergency Physicians.

Between 1992 and 1997, the study finds 114 EMTs and paramedics were killed on the job, more than half of them in ambulance crashes. That's an estimated 12.7 fatalities per 100,000 EMS workers, making it close to the death rates for police (14.2) and firefighters (16.5) in the same time period, the study says. And it's more than twice the national average for all workers (5.0).  "The profession is much more dangerous than most people realized," says Brian Maguire, MSA, EMT-P, chief researcher and study author. "I don't think people know this is almost as dangerous as firefighting or police work." He says even EMTs and paramedics who respond to emergencies every day don't realize the toll their job  take's.
Click on Pictures to Enlarge
Anatomy of Ambulance Accident Sequence
       Is Heaven in the Yellow Pages?
Daddy went to Heaven, but I need him here today, My tummy hurts and I fell down, I need him right away.

Operator can you tell me how to find him in this book?  Is heaven in the yellow part, I don't know where to look.  I think my mommy needs him too, at night I hear him cry.  I hear her call his name sometimes, but I really don't know why.

Maybe if I call him, he will hurry home to me. Is Heaven very far away, is it across the sea? he's been gone a long, long time he needs to come home now!  I really need to reach him, but I simply don't know how.

Help me find the number please, is it listed under "Heaven"?  I can't read these big big words, I am only seven.

I'm sorry operator; I didn't mean to make you cry, Is your tummy hurting too, or is there something in your eye?

If I call my church maybe they will know.
Daddy said when we need help that's where we should go.

I found the number to my church tacked up on the wall.  Thank you operator, I'll give them a call.
                                            Study Finds EMS is a Risky Occupation
Little has been known about the occupational risks for emergency medical services (EMS) personnel, but a new study finds it is
a far more hazardous profession than previously believed. Only four previous studies have evaluated EMS injuries, but most provided limited data. (Occupational Fatalities in Emergency Medical Services: A Hidden Crisis, p. 625)  In the most comprehensive study to date, the EMS occupational fatality rate from 1992 to 1997 was estimated at 12.7 fatalities per 100,000 EMS workers, more than twice the national average for workers and comparable with rates for police (14.2) and firefighters (16.5) during the same period.  Ambulance crashes appear to be the most likely cause of death for EMS workers. 
The study’s authors examined three independent databases, including the Census of Fatal Occupational Injuries (CFOI), the Fatality Analysis Reporting System (FARS), and the National Emergency Medical Services Memorial Service (NEMSMS), to help develop the most comprehensive picture to date of the occupational hazards for EMS workers.  According to the study, EMS personnel, which include emergency medical technicians and paramedics, are exposed to a wide variety of occupational hazards, including ambulance crashes, assaults, infectious disease, hearing loss, lower back injury, hazardous materials exposure, stress, extended work hours, and exposure to extreme temperature.
Bullet Proof Vests usually worn by police Officers, are fast becoming standard issue for EMS Peronnel due to the violence being encountered out in the field.
The Emergency Run Today Poses One Of The Greatest Hazards in Emergency Medical Services Today.  In fact Emergency Medical Service Personnel are more likely to be killed, injured and disabled during the course of an Emergency Run, than contracting AIDS during direct patient care.
  EMS Working Conditions:
EMTs and paramedics work both indoors and outdoors, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers risk noise-induced hearing loss from sirens and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to diseases such as Hepatitis-B and AIDS, as well as violence from drug overdose victims or mentally unstable patients. The work is not only physically strenuous, but also stressful, involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others.

EMTs and paramedics employed by fire departments work about 50 hours a week. Those employed by hospitals frequently work between 45 and 60 hours a week, and those in private ambulance services, between 45 and 50 hours. Some of these workers, especially those in police and fire departments, are on call for extended periods. Because emergency services function 24 hours a day, EMTs and paramedics have irregular working hours that add to job stress.
Violence toward EMS providers is a concept that, on the surface, seems absurd. After all, EMS is there to help. It doesn't judge, doesn't condemn (or at least it shouldn't), and is certainly not the police, there to lock somebody up or put an end to their good times. All EMS wants to do is assist those in need, to help the hurt. Who could object, much less respond violently, to a person doing that? Yet some do, and probably more than most people realize.
Almost everyone experiences acute back pain at some time in their adult life. Back-related complaints are second only to the common cold as a reason for office visits to primary care physicians. How can EMS providers avoid becoming part of this staggering statistic? By reviewing the anatomy of the back and descriptions of specific injuries, you will understand the complexity of an injury. The end result is to share with you how to avoid the harmful effects of an acute back episode-a situation that can change the direction of your life.
             Principles of Lifting
Prepare for the lift mentally. Visualize how the lift will occur and what         the end result will be.
Plant your feet firmly with a wide base of support.
Bend your knees.
Grasp the load firmly, keeping it close to the center of your body.
Keep the spine upright.
Lift with your legs.
Don't twist with your body. While lifting, shift your feet.
EMS providers must quickly assess threats and restrain patients in a manner that will prevent injury to the Medic, the Patient, and bystanders.
Employment of Emergency Medical Technicians & Paramedics is expected to grow faster than the average for all occupations through 2010. Population growth and urbanization will increase the demand for full-time paid EMTs and paramedics rather than for volunteers. In addition, a large segment of the population—the aging baby boomers—will further spur demand for EMT services, as they become more likely to have medical emergencies. There will still be demand for part-time, volunteer EMTs and paramedics in rural areas and smaller metropolitan areas. In addition to job growth, openings will occur because of replacement needs; some workers leave because of stressful working conditions, limited advancement potential, and the modest pay and benefits in the private sector.

Most opportunities for EMTs and Paramedics are expected to arise in hospitals and private ambulance services. Competition will be greater for jobs in local government, including fire, police, and independent third service rescue squad departments, where salaries and benefits tend to be slightly better. Opportunities will be best for those who have advanced certifications, such as EMT-Intermediate and EMT-Paramedic, as clients and patients demand higher levels of care before arriving at the hospital.
The income of EMT's & Paramedics depend on the employment setting and geographic location as well as the individual's training and experience. Median annual earnings of EMTs and Paramedics were $22,460 in 2000. The middle 50 percent earned between $17,930 and $29,270. The lowest 10 percent earned less than $14,660, and the highest 10 percent earned more than $37,760. Median annual earnings in the industries employing the largest numbers of EMTs and paramedics in 2000 were:
                                                      Local Government $24,800
                                               Hospitals $23,590
                                                                  Local and Suburban Transportation $20,950
                                                                  Additional information can be found at Daves Site Page "EMS Issues"
While the causes of such Attacks on EMS Personnel have not been comprehensively studied, some evidence points to a few common factors, whether the attacker is a patient or a bystander. A major contributor to EMS assaults is intoxication.

Patients, in almost every studied case, were found to be under the influence of some type of substance. In addition the EMS uniforms can resemble those of police officers, in most cases both have badges, patches, even similar color schemes.  This has
led to EMS personnel being mistaken for police officers and thereby having received misdirected violence.

Another cause towards assaults on EMS Personnel is mental illness. Any Medical or Trauma event that causes an altered level
of consciousness, including head trauma and diabetes, may lead to a violent patient. EMS personnel have also been assaulted from a domestic violence that is still taking place when EMS arrives on scene while emotions are still at a boil.
Weak laws and PunishmentsContinue to contribute to the increased violence against Emergency Medical Personnel.  Violent attacks have caused injuries, disabilities, and death to Emergency Medical Technicians and Paramedics.  It’s long past time for Federal, State, and Local lawmakers to create and strengthen laws to help stop the violence that EMT’s and Paramedics are facing daily. Elected officials must protect EMS Personnel with new laws and legislation that will make it a felony to assault EMS Personnel.  Once stronger laws are passed and implemented prosecutors must not plea bargain down the charges.  Judges must hand down firm decisions as they dispense stern sentencing, and not handing out a community service sentence. Both EMT’s and Paramedics must be protected from assaults that cause injury, disabilities and death.  It is time to send a message that attacks against EMS Personnel will not be tolerated!!
Risk Factors which contibute to Back Injuries
Lifting with your back bowed out.
Bending and reaching with your back bowed out.
Slouched sitting
Jerking or twisted.
Lack of proper rest
Loss of strength and flexibility
Stressful living and working habits
Poor nutrition.
Proper posture and body mechanics can help to protect your body, especially your back, from pain and injury. Back pain is usually the result of a number of contributory factors.  Poor posture and faulty body mechanics are generally involved.
    Is Heaven in the Yellow Pages?
Mommy went to Heaven, but I need her here today, My tummy hurts and I fell down, I need her right away.

Operator can you tell me how to find him in this book?  Is heaven in the yellow part, I don't know where to look. I think my Daddy needs her too, at night I hear him cry.  I hear him call her name sometimes, but I really don't know why.

Maybe if I call her, she will hurry home to me.  Is Heaven very far away, is it across the sea?  She's been gone a long, long time she needs to come home now!  I really need to reach her, but I simply don't know how.

Help me find the number please, is it listed under "Heaven"?  I can't read these big big words, I am only seven.

I'm sorry operator; I didn't mean to make you cry, Is your tummy hurting too, or is there something in your eye?

If I call my church maybe they will know.  Mommy said when we need help that's where we should go.

I found the number to my church tacked up on the wall.  Thank you operator, I'll give them a call.
                                                         JOB STRESS       
Job stress is common among EMT's and Paramedic's due to the hours they work, low pay and the number of life-and-death situations they face each shift they work.
Paramedic Killed
Paramedic Shot
On February 23, 2004A female Paramedic was shot by a sniper, according to Metropolitan Ambulance Services Trust, spokesman Eric Dooley. The paramedic's name has not been released, but Dooley stated she has been with MAST for more than 15 years.  Her injuries were classified as serious, but she was reported to be in stable condition after undergoing surgery at a hospital. The paramedic was with police, fire and other ambulance personnel who came under gun fire, striking the paramedic after  they arrived to fight the blaze, said Capt. Ron Fletcher, a spokesman for the Kansas City Police Department. Only the paramedic, a 15-year veteran of the Metropolitan Ambulance Service Trust was shot.
On a Friday afternoon, the 13th of February 2004, Lt. Brenda Cowan, a 12 year veteran of the Division of Fire & Emergency Services, was slain on duty. Lt. Cowan was hit by gunfire while responding to an emergency medical assistance call on Adams Lane in rural Fayette County. Lt. Cowan's promotion was just celebrated at the Fire Training Center Tuesday, the 10th of February 2004. This was her first duty day following the promotion ceremony. Her years of service with the Division of Fire have been marked by her kindness, her ready smile and cheerful demeanor, and her eagerness to help her fellow man. She has consistently set an example of the high standards of service expected of - and delivered by - her peers. Lt. Cowan is sorely missed.
People’s lives often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and Paramedics—EMTs with additional advanced training to perform more difficult prehospital medical procedures. Incidents as varied as automobile accidents, heart attacks, drownings, childbirth, and gunshot wounds all require immediate medical attention. EMTs and Paramedics provide this vital attention as they care for and transport the sick or injured to a medical facility.  Care cannot be provided when the EMT--Paramedics become victims.
Dangerous EMS Working Conditions:
EMTs and Paramedics work both indoors and outdoors, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers risk noise-induced hearing loss from sirens and back injuries from lifting patients. 

In addition, EMTs and paramedics may be exposed to diseases such as hepatitis-B and AIDS, as well as violence
from drug overdose victims or mentally unstable patients. The work is not only physically strenuous, but also stressful, involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others.
                         EMS STAGE'S FOR VIOLENT SCENES
Many EMS Agencies have established “staging” policies. Which in essence, when an Ambulance is dispatched to a violent-crime scene involving any form of assault need to stage away from the incident until the police have secured the scene.  Remember the difference between “police being on the scene” and “securing the scene” are two different things. It is possible to have the police on the scene and the situation is still voiltale.  Remember that
a secure scene means the assailant is gone or has been arrested and Law Enforcement gives the okay to enter the perimeter.
                     Guidelines for the Role of EMS Personnel in Domestic Violence
SCENE SAFETY: Police officers state that scenes of domestic violence are one of the most dangerous calls to which they respond. This is no less true for EMS personnel. If it is known from dispatch information that the scene is one of domestic violence, law enforcement should be summoned and EMS personnel should not enter the scene until it has been "secured" by
the police.  If domestic violence is not suspected until after arrival, the victim should be removed from the scene as quickly as possible. The victim and the perpetrator should be treated in a neutral and non-judgmental manner.  No questions regarding possible violence, and no display of sympathy should be made until after the victim is in the ambulance and away from the perpetrator. Violence may be directed toward the EMS personnel, particularly if the perpetrator perceives that too much empathy is being directed toward the victim. It should be remembered that there is no safety in numbers, that no scene is ever "secure", and that removal of the victim is the surest way to provide safety for all.  Training is essential for EMS Personnel and
is needed in  dealing with aspects of domestic violence, These educational programs should include scene assessment, management of violence, management of the scene and self-defense techniques for the EMS Personnel.  The Federal Goverment and Several States have and continue to enact "PROTECTIVE," Legislation establishing harsher penalties for any assault on a Emergency Medical Technician.
                                        THE PUBLIC NEEDS TO SUPPORT AND PUSH FOR MORE TOUGHER LAWS.
Domestic violence has reached epidemic proportions and EMS personnel will be called upon to evaluate and manage victims. EMS personnel must be educated in the cycle of domestic violence, special aspects of care, scene and medic safety as well as documentation requirements. This should be part of initial and continuing educational programs.
Attacks on Paramedics in the U.S. have risen four fold in the past three years according to ambulance stats.

The number of assaults on Emergency Medical Personnel that have been reported to the NHTSA Administration shows that assaults against EMT/Paramedics have dramatically risen from April to October each year since 2001. 
In the past two months there have been several aggressive attacks against Emergency Medical personnel while
on duty. 

This include three Paramedics gunned down, also in this time frame EMT’s/Paramedics have been attacked by patients, and families armed with knitting needles, another was threatened with a knife after challenging a man who was searching his ambulance, and a medic whose vehicle was stoned as he traveled to an emergency call.

Some EMS Service’s are now providing training to train EMS Personnel in dealing with dangerous situations.

Several times a month EMS Personnel must deal with both verbal as well as physical assaults. Even with defensive training with various techniques to defuse dangerous situations and the use of staging, physical attacks against EMS Personnel remain unpredictable, as well as unexpected and come from unlikely situations.
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As I perform my duty Lord
Whatever be the call
Help to guide and keep me safe
From dangers big and small
I want to serve and do my best
No matter what the scene
I pledge to keep my skills refined
My judgment quick and keen
This calling to give of myself
Most do not understand
But I stand ready all the time
To help my fellow man
To have the chance to help a child
Restore his laugh with glee
A word of thanks I might not hear
But knowing is enough for me
The praise of men is fine for some
But I feel truly blessed
That you oh Lord have chosen me
To serve in EMS!!
GOD ... Grant me the ability to give emergency care.

With skillful hands, knowledgeable mind, and tender loving care.

Help me deal with everything, when lives are on the line.

To see the worst, administer aid, and ease a worried mind.

So help me as I go today, accept what fate may be.

Touch these hands, use this mind, and help this E.M.T.
                     This Site Page is Dedicated to all who Serve in EMS
Professional status as an Emergency Medical Technician and Emergency Medical Technician-Paramedic is maintained and enriched by the willingness of the individual practitioner to accept and fulfill obligations to society, other medical professionals, and the profession of Emergency Medical Technician. As an Emergency Medical Technician-Paramedic, I solemnly pledge myself to the following code of professional ethics:

A fundamental responsibility of the Emergency Medical Technician is to conserve life, to alleviate suffering, to promote health, to do no harm, and to encourage the quality and equal availability of emergency medical care.

The Emergency Medical Technician provides services based on human need, with respect for human dignity, unrestricted by consideration of nationality, race creed, color, or status.

The Emergency Medical Technician does not use professional knowledge and skills in any enterprise detrimental to the public well being.

The Emergency Medical Technician respects and holds in confidence all information of a confidential nature obtained in the course of professional work unless required by law to divulge such information.

The Emergency Medical Technician, as a citizen, understands and upholds the law and performs the duties of citizenship; as a professional, the Emergency Medical Technician has the never-ending responsibility to work with concerned citizens and other health care professionals in promoting a high standard of emergency medical care to all people.

The Emergency Medical Technician shall maintain professional competence and demonstrate concern for the competence of other members of the Emergency Medical Services health care team.

An Emergency Medical Technician assumes responsibility in defining and upholding standards of professional practice and education.

The Emergency Medical Technician assumes responsibility for individual professional actions and judgment, both in dependent and independent emergency functions, and knows and upholds the laws which affect the practice of the Emergency Medical Technician.

An Emergency Medical Technician has the responsibility to be aware of and participate in matters of legislation affecting the Emergency Medical Service System.

The Emergency Medical Technician, or groups of Emergency Medical Technicians, who advertise professional service, do so in conformity with the dignity of the profession.

The Emergency Medical Technician has an obligation to protect the public by not delegating to a person less qualified, any service which requires the professional competence of an Emergency Medical Technician

The Emergency Medical Technician will work harmoniously with and sustain confidence in Emergency Medical Technician associates, the nurses, the physicians, and other members of the Emergency Medical Services health care team.

The Emergency Medical Technician refuses to participate in unethical procedures, and assumes the responsibility to expose incompetence or unethical conduct of others to the appropriate authority in a proper and professional manner.
   Written by: Charles Gillespie M.D.  Adopted by: The National Association of Emergency Medical Technicians, 1978
The brave fearless 'Fighters' that step out into the night, working under extreme conditions, for which we have no insight.Their continued schooling is never ending, for to them, your life is only just beginning.  Crawling through pieces of what used to be a car, to find a person lying there in need of CPR.

They are called Paramedics, a link between life and death, all give a priceless gift, the gift of breath.  The equipment they must carry, you may not understand, but one kneels beside you, as another takes your hand.  They feel the Angel standing there, but refuse to let you go, searching their deepest thoughts of knowledge that they know. 

Until such time their job complete, and you return to them, only then will they place you in a physician's hand.  They no sooner leave the hospital, another call comes through, lights flashing, sirens screaming, fighting traffic to get to you. 

A child this time in need of help, unsure of what went wrong,they begin their protocol of survey, soon realize this one is gone. On bended knee, heads hung low, a tear slips down their cheek, always asking questions, looking for answers that they seek.

The shift will be a long one, twenty four hours to be exact, a proud profession that they chose, without even looking back.  And the next life that they save, to bring a loved one home, perhaps it will be your life, or it could be their own family.
Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever honors I enter,
I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.

I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.

While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot. So help me God.
Emergency Medical Workers have an occupational fatality rate of 9.6 per 100,000 workers per year in transportation-related incidents, compared with 6.3 for police, 4.5 for fire fighters and 2 for average citizens.
$$INCOME: $$
Deciding to become apart of an EMS workforce is a life challenging decision. You must take into consideration many factors that will hamper your efforts and ability to perform your duties both professionally and correctly.  Violence against emergency personnel continues to rise at an alarming rate.  Over the past several years EMT's and Paramedics have become targets in both urban and rural areas. EMS personnel frequently enter inner city war zones daily and face many various kinds of dangers such as assaults, shootings, and stabbings.

Gangs frequently associated with large cities, have today branched out into suburbs and small towns, selling weapons and illicit drugs.  These drugs cause overdoses and altered mental status.  EMS personnel are dispatched, respond, and arrive to the overdose call many times without police back-up and find a patient mentally altered, possibly armed, and faced with physical assault from a patient or bystander without any provocation.

Recently EMS personnel have been ambushed or have come under fire after arriving on scene.  EMS personnel are finding themselves in the middle of scenes the rapidly turn violent and find themselves in the middle of physical danger. EMT’s and Paramedics have found themselves in a quagmire as they are unarmed, and God forbid that a medic should attempt to defend themselves from being attacked.  

EMS Agencies have disciplined suspended and fired EMT’s and Paramedics because they have defending themselves.  Patients, who have attacked EMS personnel, have turned around and filed suit or have sworn out criminal complaints because a medic choose to protect themselves from injury or death.  Liability Attorneys attempt to line their pockets with money after medics have been forced to protect themselves.

Food for thought an EMT or Paramedic make between $10.00 to $14.95 per hour (based on national EMS income surveys) where a medics training and actions save lives, EMS personnel salaries compared to the salaries of an EMS regional director (in most cases is someone who have never been in an ambulance) for an EMS company or a factory worker who separately make two to three times the wage that of a EMT or Paramedic.
Paramedic Shot While Responding To House Fire

Paramedic Hit by Gunfire

Medics Rush to aid Injured in Boston Terror Attack

Attacks on Paramedics Continue to Soar

Man takes Five First Responders Hostage

Medic Defends Self--"Charged with Assault"
Deciding to become apart of an EMS workforce is a life changing decision. One must take into consideration many factors that may hamper one's effort to perform the job correctly.

Violence against emergency workers continues to emerge in recent years; EMT's and EMS personnel have become targets in urban areas. EMS personnel enter urban war zones daily and face many man made dangers. One peril an EMT may face is the continuing growth of gangs. Gangs have branched out from big cities into smaller towns frequently; EMS personnel are attacked without provocation. In most cases, the EMS personnel are responding to a call when they are ambushed by a variety of things. Fire bombings on EMS personnel and their vehicles have increased in at least ten major U.S. cities

In addition, EMT's and EMS personnel are faced with the dangers of driving into already volatile situations. After the Rodney King verdict, cities such as Los Angeles, California and Atlanta Georgia erupted into massive riots. EMS personnel were thrust into physical danger. Both cities were set afire and gangs of people rushed to loot local stores EMT's and other EMS personnel put their lives in direct jeopardy to perform their jobs. Besides rioting and gang violence, EMS personnel are often faced with other more maniacal acts of violence, such as domestic terrorism.

The most gruesome example of this is the case of the bombing of the Federal Building in Oklahoma City, Oklahoma. The direct targets for this disaster were the civil servants that worked in the building. EMS workers suffered emotional trauma from the shear devastation of the building. News reports depicted the various branches of the EMS workforce as relentless in their search for survivors. EMS responders appeared to be exhausted, but yet somehow were able to continue their tasks in victim recovery. Lastly, the weather conditions or the climate the rescue is being performed can be a natural danger to EMS personnel

What can EMS personnel do to protect themselves? 1) 360 degree view of the scene at all times. 2) Watch your partner's back and have them watch yours. 3) Carry more than one source of artificial light. 4) Cooperate and communicate with the policing officials. 5) In cases of crime, do your best to preserve any potential evidence. 6) Keep accurate records and know your administration's policies.

List of don'ts include: 1) never extricate a victim from a crowd without the assistance of ample security. 2) Never stand in front of doors when knocking them down. 3) Never stay in a situation where cannot see impending danger. 4) Only use the maximum amount of force necessary when defending your self. 5) Don't forget plan ahead-always have a way out

Besides facing natural and man made emergencies, EMT’s and EMS first responders are at the risk of suffering emotional stress this stress can be caused by a number of ways. Initially, an EMT may encounter feelings of the immediate despair and destruction of the scene. The scene itself may be so gruesome and confusing that the EMT would go into auto pilot. Additionally, the surrounding scene may cause a flight or fight reaction.

The purpose of the EMT and EMS personnel is to provide optimal, acute health care. Each day presents many physical and mental challenges. To be effective as an EMT, occasionally you must reflect on your past performances. You can step back and say to yourself, I've been hurt too much by what I've done and seen and I cannot do my job anymore. Conversely, you can put those feelings aside, re-dedicate yourself to your profession and begin each day anew.
EMS is an inherently risky job. There are violent crime scenes, abusive patients, driving emergent, exposure to infectious diseases, highway scenes with inattentive drivers that fail to notice EMS personnel, and deterioration of one’s health, that   also includes heart attacks.

Emergency Medical Service has been statistically proven to be equally as dangerous as Law Enforcement and Fire fighters in the public safety profession. Today there are organizations that provide help and assistance for the families of EMS professionals who are killed in the line of duty.   One such  foundation, that you can contact by either writing to the EMS Command Memorial Foundation, at P.O. Box 2650, New York, NY 10108-2650.
  EMS Field is a Life Changing Decision
On September 11, 2001, the day that America came under attack by terrorists who had hijacked four planes, turning them into missiles aimed at the World Trade Center, and the Pentagon. Rescuers made up of police officers, firefighters, emergency medical technicians and paramedics entered two 110 story buildings known as the world trade center. For over 90 minutes these rescuers feverishly work to evacuate more than 25,000 individuals. Emergency medical services personnel which is made up of both Emergency Medical Technicians and Paramedics were in the two towers providing treatment to the civilians suffering from smoke inhalation, medical problems including chest pains, burn patients and a host of other injuries and ailments.

In addition Emergency Medical Technicians and Paramedics we’re also rendering aid to firemen, and law enforcement officers who were suffering from exhaustion, as emergency medical personnel continued rendering aid the unthinkable happened the first tower collapsed trapping civilians, firefighters, police officers, Emergency Medical Technicians, and Paramedics. Minutes later the second tower collapsed also trapping Emergency Medical Technicians, Paramedics, police officers, firefighters, and civilians.   As time went on throughout the day and next day it became obvious that everyone who remained in the building were lost forever.

On this historically tragic day all the major news network’s which included the following ABC, CBS, CNN, FOX news agencies transfixed the airwaves with images showing the utter destruction, and continually providing updated figures as to the number of police officers and firefighters who had given their lives unselfishly. As the days, months and now years have passed the media which includes newspaper organizations continue to omit the role played by member of emergency services known as Emergency Medical Services, who on this fateful day lost ten Emergency Medical Technicians and Paramedics who were also in the towers at the time the buildings collapsed. Ten Emergency Medical Technicians and Paramedics lost their lives and another 116 other Emergency Medical Technicians and Paramedics were injured.

Why? Have these news agencies failed time after time to include or acknowledge the heroic actions of the Emergency Medical Technicians and Paramedics who lost their lives in the performance of the duties in addition to the 116 EMT’s and Paramedic who were injured many who continued to aid the critically injured from the falling towers.  We also know from those who made it out of the buildings that many individuals who were working in the world trade center at the time of the attacks were also part time EMS Personnel and many other EMT’s and Paramedics who were members of many Volunteer EMS Services who stayed behind to treat patients in the two towers, subsequently loosing their lives when they could have chosen to leave the buildings to find safety.

The media must correct their critical error in fairness to the omitted professional organization of emergency medical services who served with the highest degree of professionalism.  The media recognize that two of the ten EMS Personnel who perished on September 11, 2001 were members of the New York City Fire departments EMS Division, and additionally recognize the eight other EMT’s and Paramedics who perished worked for several private Emergency Medical Services Agencies.

Emergency Medical Service's is a critical part of the Emergency Services System, and it is time that this horrific and disgraceful omission is rectified. Emergency Medical Technicians and Paramedics are the highest train prehospital care provider’s whose actions and skills saved many individuals who were injured, suffered cardiac symptoms and suffered respiratory emergencies as a result of  smoke, falling debris, and trauma.

The names of the ten Emergency Medical Technicians and Paramedics who lost their lives in the Line of Duty September 11, 2001.

Mitch Wallace, EMT, Bayside Volunteer Ambulance                             

Richard Pearlman, EMT, Forest Hills VAC                                                                        

Mark Schwartz, EMT, Hunter Ambulance

Marc Sullins, Cabrini Medical Center

Mario Santoro, EMT-P New York Presbyterian Hospital

Keith Fairben, EMT-P New York Presbyterian Hospital 

David P. Lemagne, EMT-P, Port Authority of NY & NJ Police

Carlos Lillo, EMT-P FDNY EMS

Ricardo Quinn, EMT-P FDNY EMS

Yamel Merino, EMT-P Metrocare/Montefiore Medical Center

This Letter was mailed to ABC, CBS, CNN, FOX, and MSNBC in addition to the Washington Post, USA Today, and the Detroit Free Press just to name a few
Somewhere in the realm of society, located just between the security of sanity and the neurosis which precedes psychosis, we find a group of individuals who cling to life and death by a slender thread.

                                               These people are those who make up what is known as E.M.S.

You may find that these people located in various positions within the city in an effort to be prepared for the next possible disaster which could occur, hindered only by the natural obstacles of daily traffic.

No other group of humanity can carry so many items in their pockets which are strategically located in optimal positions of the body.  Perhaps you’ll find scissors, band aids, tape, chap stick, combs or essential lifesaving sustaining items, but one thing that is certain, the last paycheck has long since met its demise and will not be found here.

With an overwhelming desire to sustain the flame of life from the last flicker of a spark which is near spent, these people cope on a daily basis with variables which few people can tolerate.

When things go right the public loves them, the newspapers ignore them and life goes on.

Then the earth shaking bill arrives, which automatically turns everyone against them and publicity now surrounds them.

These individuals come from all walks of life With few standing on common ground until they meet in the surrounding of the insanity of the streets, then all seems to pull together with each needing the others to lean on
For support and occasionally share the stories which create a flurry of mixed emotions.

                                                                        What kind of people are they?

They are the people to whom for moments at a time you may need to trust with a life of yourself or loved ones.

These people who crawl into a twisted steel cage which once was a fine automobile, to search for signs of life amongst its occupants.

The calm voice on the other end of the telephone when it seems as though your world is crashing around you.

These people are the last to win the respect of the public and the first to be brought to court for actions which were made on the spur of the moment in the environment of absolute chaos.

It makes you wonder what kind of dedication it must take to shoulder the task which has been placed in front of these individuals.

                                      These are the Men and Women of E.M.S.
What we do and     Who we are
EMT’s and Paramedics respond to emergencies every day, however the profession is becoming more dangerous than the general public realizes.  EMS employers down play the increased dangers facing EMT’s and Paramedics which has caused increased frustrations for the “Street Medic’s.”

Among the many dangers faced by EMT’s and Paramedics today include ambulance accidents, bodily assaults, blunt trauma, shootings, stabbings, hazardous materials exposure, infectious diseases, blunt trauma, spinal cord injuries, low back injuries, hearing loss, stress related illnesses, heat exposure, such as hyperthermia and hypothermia caused by prolonged patient extrications, and terrorist attacks.
Total number of Emergency Medical Service injuries at the World Trade Center:                                       116 Total Injured
                      FDNY-EMS injured: 65
       Total voluntary EMS and private ambulance workers Injured: 51  
       The number of Emergency Medical Service workers who Died 42                              Total for FDNY- EMS: 2

              Total Voluntary EMS & Other: 30

                    Total Private ambulance workers: 2

                                       Total EMS Deaths Post 9-11-2001:  11
  Attacks on EMT's & Paramedics Continue to Rise
An Open Letter to the Media:
Act 300 of 1949
257.653a Stationary emergency vehicle giving visual signal; duty of approaching vehicle to exhibit due care and caution; violation; penalty.
                                                                     Sec. 653a. States the following:
(1) Upon approaching and passing a stationary authorized emergency vehicle that is giving a visual signal by means of “Flashing, Rotating, or Oscillating Red, Blue, or White Lights” as permitted by section 698, the driver of an approaching vehicle shall exhibit due care and caution, as required under the following:

(1a) On any public roadway with at least 2 adjacent lanes proceeding in the same direction of the stationary authorized emergency vehicle, the driver of the approaching vehicle shall proceed with caution and yield the right-of-way by moving into a lane at least 1 moving lane or 2 vehicle widths apart from the stationary authorized emergency vehicle, unless directed otherwise by a Police Officer. If movement to an adjacent lane or 2 vehicle widths apart is not possible due to weather, road conditions, or the immediate presence of vehicular or pedestrian traffic in parallel moving lanes, the driver of the approaching vehicle shall proceed as required in subdivision.

(1b) On any public roadway that does not have at least 2 adjacent lanes proceeding in the same direction as the stationary Authorized Emergency Vehicle, or if the movement by the driver of the vehicle into an adjacent lane or 2 vehicle widths apart is not possible as described in subdivision (a), the approaching vehicle shall reduce and maintain a safe speed for weather, road conditions, and vehicular or pedestrian traffic and proceed with due care and caution, or as directed by a Police Officer.

(2) Except as provided in subsections (3) and (4), a person who violates this section is guilty of a "Misdemeanor" punishable by a fine of not more than $500.00 or imprisonment for not more than 90 days, or both.

(3) A person who violates this section and causes injury to a Police Officer, Firefighter, EMT, Paramedic, or other Emergency Response Personnel in the immediate area of the stationary authorized Emergency Vehicle is guilty of a “Felony” which is punishable by a fine of not more than $1,000.00 or imprisonment for not more than 2 years, or both.

(4) A person who violates this section and causes the death to a Police Officer, EMT, Paramedic, Firefighter, or other Emergency Response Personnel in the immediate area of the stationary authorized Emergency Vehicle is guilty of a "Felony" punishable by a fine of not more than $7,500.00 or by imprisonment for not more than 15 years, or both.
Copyright © 2001-2016 DAVE’S EMS HEADQUARTERS All Rights Reserved
  Written by: Charles B. Gillespie, M.D.    Albany, Georgia  1978
Click--For List of EMS Killed---->
Updated on 01-15-2014
Always be aware of your surroundings and your location on the scene. Take a second and look around and try to notice as many details as possible. Then, be sure that it is safe to approach and continue.

Be aware of your partner and their presence at all times. You need to look out for yourself and your partner’s safety equally. They will be doing the same.

Always be aware of the location of the best egress routes to safety and to extricate yourself and others from the scene.

Make sure that others know your location and your activities so that they will know both where to go should you need help and assistance from public safety entities.

Make sure to have communication with dispatch and let them know your most current status so that they will be able to get in touch with you and send help if needed.

Trust no one, patients, family members, staff, bystanders, etc. They can and will turn on you or be deceitful at any time.

If there is a Law Enforcement presence with you have them search the patient and be active participants in helping to be sure that the scene remains safe and secure while you treat your patient.

In the course of your assessment, and Physical Exam, be cognizant and alert for the presence and potential for concealed weapons or sharp objects.

Wear body armor to work, and do your best to look out for your partner and patient while doing all of the aforementioned

Always control your patient’s access to their belongings and others after you have initiated care, you never know what might happen.
Statistical Information
   Dangers Faced by Emergency Medical Personnel
Click on Pictures to Enlarge
In a study of a large urban EMS system a staggering 92% of responding paramedics had been assaulted at some point while performing their duties, and that in the course of a 12-year career, each averaged more than nine assaults.  Another Large city studied found that 45% of surveyed EMS providers there had been subject to violence on the job, and, perhaps even more disturbing, 30% had bought a weapon for self-defense.
Research Collected and Published by Brian J. Maguire

Should EMT & Paramedics Be Armed?
Not Sure
Need more facts
Only in high risk situations
EMT's and Paramedics should at least be armed with Tasers

In the darkest of times, true heroism and sacrifice shines a bright light for us all to live by. We will for a very long time to come mourn the tragic loss of our brothers and sisters who gave of themselves without hesitation or second thought. They have shown us the very best of emergency service -- EMS, Fire, and Police. They will be missed and this great loss will be felt not only by their friends and families, but also by the larger, global family we are all members of.

The stories of their heroism, of how they climbed the stairs while others were rushing down them, will be told for many years to come. Dave’s EMS Headquarters joins with all of the Paramedics, Firefighters, and Police Officers around the world in saluting these brave individuals. We have and will continue to shed tears beside all of you, and not just for our brothers, but for those many thousands of others who lost their lives in this senseless and horrible tragedy.

EMS Personnel are all heroes. Who give of themselves to protect, serve, and provide aid to those placed in their charge, no matter how small or how seemingly insignificant the acts that they perform on a daily basis. Out of this perhaps we can all reclaim, or reinforce, to the public the pride taken in the work that we do.
                                   A TRIBUTE FOR EMS PERSONNEL
    September 11, 2001

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    New Dangers to EMS Personnel from Meth Labs
First Responders, EMT's, and Paramedics are faced with new dangers responding to residences, car accidents, etc, with the economy still in in deep dive Meth labs are popping up in all fifty states.  Labs are being set up in inner city neighborhoods, suburbs, rural areas.  In addition meth makers are even creating "rolling meth labs" in vehicles trying to stay ahead of Law Enforcement efforts of finding and shutting these Meth Labs. 

Meth labs utilize chemicals that create bio-hazardous situations for not only the individual (s) but for family members living in the home as well as their neighbors.  EMS Personnel are becoming exposed responding to medical emergencies at locations that such labs are set-up.  The lab may be big or small yet the hazards to Medics remain the same.

As a result Dave's EMS Headquarters has asked local law enforcement officials to assist me in exposing this critical and lethal new danger for those who respond to such a scene.  More to follow regarding this "Critical Danger" that is worsening with meth labs being placed in vehicles "rolling meth Labs."
EMS Personnel Should be Immunized for Anthrax
Emergency responders arrived at Sen. Tom Daschle’s Capitol Hill office on Oct. 15, 2001 suited in personal protective equipment (PPE). One of Daschle’s staffers had opened an anthrax-laced letter, yet another in a string of bioterrorist attacks that tormented the U.S. psyche in the immediate aftermath of 9/11. Nasal swabs taken of those first responders as they exited the building revealed that some had been exposed to anthrax, despite their PPEs and the miniscule amount of spores contained in that letter.

Thus, the question was raised: How can first responders provide necessary medical treatment following an anthrax attack while preserving their own health and safety?

At the annual 2010 EMS Today Conference in Baltimore, Dr. Thomas Waytes added to the continuing discussion, addressing an audience of EMS personnel on what specific medical countermeasures are available for protecting emergency responders against anthrax bioterrorism. Waytes is a vice president at Emergent BioSolutions, manufacturer of BioThrax, the only currently licensed anthrax vaccine in the U.S.  “In a lot of circles, anthrax is called the poor man’s nuclear bomb,” says Waytes. According to Waytes, merely 6.5 kilograms of anthrax spores, if appropriately distributed, would have the kill potential of a small nuclear bomb, a sobering reality for EMS personnel and first responders to confront, especially considering the relatively easy availability of anthrax.

Because it’s a “naturally-occurring disease,” says Waytes, anthrax can be found from natural sources throughout the world; indeed, areas of Africa and the Middle East have outbreaks of anthrax on a regular basis. Anthrax spores are easy to grow, cheap to produce, well suited for aerosol delivery, completely tasteless and colorless, and resistant to the environment, which means they can last for decades. According to Congress’s bipartisan Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism, the U.S. now has a gap in its anthrax preparedness, compounded by the fact that anthrax can be genetically modified to be antibiotic-resistant.  “You can’t absolutely count on the fact that anthrax is going to be susceptible to the common antibiotics,” says Waytes.

Of greatest concern to EMS personnel and the general American public is inhalational anthrax, caused by breathing in anthrax spores. According to Waytes, even with aggressive medical treatment, the mortality range can reach upwards of 90 percent. In the 2001 attacks, of the 22 cases of anthrax confirmed, 11 were inhalational, with five of those cases being fatal.

For EMS on the scene, PPEs aren’t always enough to prevent inhalation. And while anthrax itself isn’t contagious, spores residing on clothing or skin can be passed to EMS workers who come into physical contact with carriers.  “The most effective way to protect people against anthrax is to immunize people pre-exposure,” says Waytes.

The military has been immunizing service men and women since 1998, and the Department of Health and Human Services (HHS) has a biodefense strategy predicated on the possibility of two major metropolitan areas getting hit with anthrax. They estimate that up to 25 million people would be exposed to anthrax; their goal, then, is to build up a national stockpile of 75 million doses of anthrax vaccine (three per person). But HHS has not distributed the vaccine widely to emergency responders, says Waytes.  But with unused doses of already purchased anthrax vaccine sitting in the Strategic National Stockpile and reaching their expiry date (the vaccine has a four-year shelf life), Waytes thinks the time is right to take some of these expiring doses and make them available free to EMS personnel.

“You shouldn’t routinely say that all emergency responders should be immunized, but there are groups that may find themselves at increased risk of exposure,” says Waytes. “These are the people that should be identified. Give them the benefit of pre-exposure immunization.”
Such people include environmental sampling and hazmat teams, as well as EMS and fire rescue personnel. At Michigan State University, members of their campus security that have to respond to white powders are immunized with the vaccine. According to Waytes, it’s the first university that has pre-protected emergency personnel on their university police team.  Ultimately, for Waytes, the key to providing effective emergency response to an anthrax attack while keeping EMS personnel safe is to anticipate another attack.

“We need to understand that certain people in certain occupations may be at increased risk for exposure,” says Waytes. “Identify those people at higher risk and offer them pre-exposure immunization.”

Author:  Dr. Thomas Waytes
EMS Personnel face Heat & Cold Weather Dangers
Heat illness is divided into two major categories: heat exhaustion and heat stroke. Both illnesses arise when the body is unable to dissipate heat generated on its own and gained from the environment. When the regulatory system is moderately impaired, heat exhaustion occurs. If this is not corrected promptly and the system shuts down, the patient will go on to develop heat stroke.

The two most important ways the body transfers heat away are by radiation of heat and evaporation of perspiration. If there is a temperature difference between the body and the air, then a large percentage of heat is dissipated through radiation. When the air temperature exceeds 95 degrees, the body can no longer lose heat in this way. Evaporation then becomes the only means of heat loss. But when the humidity reaches 100 percent, evaporation of sweat is no longer possible and the body loses its ability to dissipate heat.

As the body tries to correct the rising temperature and cool itself, it shunts more blood to the skin and away from vital organs, causing a kind of shock -- heat exhaustion. If not recognized and treated, this will progress to heat stroke in which the temperature can rise so high that brain damage and even death can occur.

Signals of heat exhaustion include cool, moist, pale, flushed or even red skin; heavy sweating; headache; nausea or vomiting; dizziness. Body temperature will be near normal.

Heat stroke is characterized by hot, red and dry skin (but cessation of sweating can be a very late sign); changes in consciousness; rapid, weak pulse; and rapid, shallow breathing. Body temperature can be as high as 107 F.

In one of these emergencies, act quickly. Call 911. Get the person to a cooler place if possible, loosen tight clothing, apply cool, wet cloths and fan the victim. Ice packs can be applied to the neck, armpits and groin areas. Airway, breathing and circulation may need to be supported with basic CPR measures. Your quick response may prevent irreversible damage or even save a life.

All heat-related illnesses are preventable. Wear lightweight, light-colored clothing. Hats or umbrellas can be used to protect from direct sunlight. Drink water even if not thirsty. Avoid alcohol and caffeine. Eat small meals. Slow down. If you must engage in strenuous activity, do it during the cooler part of the day (usually early morning). Check on the elderly and those without air conditioning. Never lock children in the car and always lock your car when not in use.
New Ambulance Safety Features for medics treating patients in patient compartmentSafety CabinsCentered Captains ChairCrew Safety BeltingSafety cushionsEquipment and Patient access
New Ambulance Patient Compartment SafetyFeatures are being added to new Units
                                       Continue on Page-2 "EMS DANGERS & HAZARDS"
                                                                     EMS Dangers Page-2
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When it comes to EMS safety, worker perception may reflect reality, Pitt study finds
Public release date: 17-Nov-2011
Contact: Wendy Zellner
University of Pittsburgh Schools of the Health Sciences
Poor perceptions about workplace safety culture among emergency medical services (EMS) workers is associated with negative patient and provider safety outcomes -- the first time such a link has been shown in the pre-hospital setting, according to a study by University of Pittsburgh researchers that now appears online in Prehospital Emergency Care and is scheduled to be published in the January-March print edition.

"There are sometimes drastic differences in how workers perceive their workplace safety from one EMS agency to the next," said senior author P. Daniel Patterson, Ph.D., EMT-B, assistant professor of emergency medicine at the University of Pittsburgh School of Medicine. "What we have found is that perceptions about safety may be reality."
Prior studies of the in-hospital setting and of high-risk occupations outside of health care have linked safety culture scores to such outcomes as injuries and accidents, but this is the first time that such a connection has been found in the EMS setting, noted Dr. Patterson.

The investigators measured EMS safety culture by surveying emergency medical technicians and paramedics at 21 EMS agencies across the U.S. They used a scientifically validated survey that collects EMS worker opinions regarding six key areas: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition and job satisfaction. Safety outcomes were measured through a survey designed by EMS physician medical directors and investigators to identify provider injuries, patient care errors and safety-compromising behavior.

The analysis of 412 surveys showed that individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. Notably, the researchers found that 16 percent of all respondents reported experiencing an injury in the past three months; four of every 10 reported an error or adverse event; and 89 percent reported safety-compromising behavior. Respondents reporting injury scored lower on five of the six areas of safety culture, while those reporting an error or adverse event scored lower for four of six, and those reporting safety-compromising behavior had lower scores for five of the six domains.

"Measuring safety outcomes such as errors or adverse events is particularly difficult in the EMS setting. The EMS Safety Attitudes Questionnaire is helpful because it is fairly easy to administer and linked to safety outcomes, as shown in our study. This should provide EMS administrators or medical directors confidence in using this tool to evaluate safety conditions in their agencies," said Dr. Patterson.

In addition to Dr. Patterson, authors of the study include Matthew D. Weaver, M.P.H., also of the University of Pittsburgh; Henry E. Wang, M.D., University of Alabama at Birmingham; and Rollin J. Fairbanks, M.D., National Center for Human Factors Engineering in Healthcare, Washington, D.C.

The study was supported by an award from the National Center for Research Resources. Additional support was provided by the North Central EMS Institute and Pittsburgh Emergency Medicine Foundation.
The Material below has been authorized for use by Dave's EMS Headquarters
This Material is the property of David G. Nadeau
Safety Specialist
Website:  Click E-mail
                                                                  Safety Commitment Letter Somewhere Prominent
                                                 Commitment to Roadway Safety Pledge = Safe Emergency Scene’s
                                  The commitment Guide’s below are when operating in or near roadway incident scenes.

A. I will position first-arriving fire apparatus to protect the scene, patient(s), and emergency personnel.

B.I will provide a work area protected from approaching traffic in at least one direction

C.I will angle emergency vehicles in a fending-off position to create a physical barrier between the scene and approaching traffic.

D. I will establish an initial block of the lane(s) occupied by the incident plus one additional traffic lane, or close the roadway to the flow of traffic to provide appropriate safety.

E. I will consider cab ingress/egress, pump operator and panel positions, equipment access, and roadway configuration when positioning vehicles.

F. I will turn the front wheels of any parked emergency vehicle away from the incident.
G. I will have the ambulance positioned within the shadow/protected area, in a manner that positions the rear patient loading doors away from the nearest lanes of moving traffic. Note: Be sure to leave room for other inbound apparatus to perform fire, police, tow truck additional rescue procedures.

H. I will stage unneeded emergency vehicles off the roadway and return these units to service as soon as possible.

I. I will at intersections, or where the incident may be near the middle lane of the roadway, two or more sides of the incident will need to be protected. The sequential blocking of the work area must be prioritized, from the most critical or highest-volume of inbound traffic flow to the least critical direction. (Request law enforcement assistance to expand the initial work area for traffic approaching from all directions)

J. I will if possible, during nighttime operations or inclement weather, turn off white flashing lights and headlamps (unless headlamps are providing scene lighting). Raise floodlights and angle them such that they point downward. Turn on apparatus ground lights and compartment lights.

K. I will place traffic cones along the incident location for both daytime and nighttime operations.

L. I will place traffic cones to establish a taper whenever possible, when it is safe to do so.

M.I will place flares in conjunction with cones during nighttime operations, or during inclement weather.  (Flares next to cones but not to close will illuminate the cones)

N. I will for all tapers, personnel shall deploy cones and flares from the outside edge inward (e.g. from the base to the end of the taper, in that order). Removal shall be in the opposite order (starting from the end of the taper).

O. I will when possible only deploy and remove cones and flares while facing oncoming traffic.

P. I will don high-visibility reflective personal protective equipment prior to exiting an emergency vehicle or as soon as possible after arrival on scene.

Q. I will when arriving in fire apparatus that allow ingress/egress from either side of the apparatus should exit and enter the apparatus from the protected downstream side, away from moving traffic.

C. I will look before opening doors and stepping out of emergency vehicle into any moving traffic areas. And I will maintain an acute awareness of the hazards associated with working in or near moving traffic.

                                               Name __________________________________                  Position or Title: _________________________
                                               Department _____________________________                  Date: ______________________
                                                    WHAT IS AN EMT & PARAMEDIC?










For a copy to Post (Copyrighted material proberty of David G. Nadeau)  E-mail

We use checklist and visual reminders to remind us of things we need to do, we have an oil change sticker in the windshield to remind us when we need to change our oil.
The same concept can work in other areas like saving lives of emergency service personal that respond every day to emergencies on our roadways throughout this great country of ours. Visual reminders help us to remember and focus on what we need to do.
We all use visual reminders every day on the roadway’s like signs buckle up click it or ticket it; give them a brake high way construction workers.  How many of us use (post it) notes in the office and even in our vehicles to remind us to do something for that day, month, and year. How many of us have the car notepad with the suction cup stuck to our windshield, how about a visual reminder in real-time for real time situations. You write on the wall calendar to remind you of meetings, birthdays and other events every day we need to be reminded of something.
Now days with have cell phones, I-pads and other electronic devices to remind us of things we need to do with those catchy ring tones. We have vehicles that talk to us, that can almost park themselves. Too bad we can’t program our electronic devices to go off as we approach an emergency scene telling us what we need to do safely to get past the emergency scene. I can hear it now a ring tone just for approaching an emergency scene, (stop what you’re doing and listen to me), but I am not a song writer or an electronic wizard. But they have radar detectors that warn us as you come within a certain distance of speed traps, construction zones, even accidents ahead why not have one that can alert us what to do when approaching an emergency scene. The new radar detector’s can alert us to: accident black spots, safety cameras and mobile laser guns; with an audible, visual and voice alerts. In the UK most fixed cameras are installed at accident 'black spots' where four or more fatal or serious road collisions have occurred over the previous three years.  The Tom-Toms out now will reroute you around an accident scene why not program it to tell us how to be safe if we are approaching an emergency scene.
With the amount of things we have to remember in any given day, the things that go through our minds as we drive down the roadway are staggering.  When you want to remember something, the very best thing to do is write it down. Then, when you need to recall it, it will be there for you in an instant. When you have a visual reminder you want to keep them in one consistent place.
Why not have a visual reminder that can save your life and lives of emergency personal that are trying to save a life on a roadway accident scene. When our eye catches an object we quickly recognize it and it could be just a brief change, how many times at stop light we look at our oil change sticker each and every day.
Every time I see a picture of the three firefighters that are raising the flag September 11, 2001 at ground zero is a visual reminder of the loss of life that terrible day.

I came up with a Life Critical Visual Reminder (LCVR) for Fire apparatus vehicles, Police, EMS, Fire or EMS services that use their own vehicle to respond and POV’s. I have been a firefighter for 18 years and a lieutenant for the last five years on a paid on call department in Monroe Michigan with a call volume of around 1500 a year.  I have been a safety specialist for a large construction company for 12 years and I am always trying to coming up with ways for our employee’s and firefighters to stay safe. We have visual reminders all over our construction sites and at our fire stations.
I have come up with a visual reminder windshield safety sticker for emergency services and POV’s that I think should be consider for  all new vehicles’ as they come off the assembly line including all fire apparatus assembly lines. This sticker should be given to every teenage driver after they completed their driver’s education class. There is no training in the driver education class about roadway safety when approaching an emergency scene, no test questions either. In all Secretary of State offices when we renew your driver’s license you should get a LCVR sticker, there should be posters of emergency scene safety. You have the people all over the country that get specialized license plates why not one for emergency scene safety.  The specialized plate could have either the name or picture or the badge of the emergency service group.
Fire-Police-EMS  Approach Safely                          Helmet of a Firefighter-Police –Ems on the license plate                                                                                                                                    


                                                                                                        Approach Safety
I would love to see Ford, GM and Chrysler do an advertisement about how each and every day we have emergency service personal pay the ultimate sacrifice due to being hit on the roadways.
Ford – Have you driven a Ford lately- Built for the Road Ahead (Slow-Down/Move Over)
General Motors – People in Motion (Slow Down/Move Over)
Chrysler – Life Best Driven, Imported From Detroit (Slow Down/Move Over)
United Auto Workers – United Together in Saving a Precious Resource. “Fire, Police, EMS all Emergency Services”

How about our auto makers having a slogan for trying to save the lives of our emergency service personal that drive their vehicle to and from then emergency scenes. They have the crash test dummies hitting a wall testing the safety of their vehicle. There commercials out there of brake companies showing how there brakes saved the life of an animal, squirrels doing the high five because they did not get hit by an out of control vehicle. Why not have a commercial showing a vehicle hitting a firefighter, police officer or EMS worker at an accident scene then showing a funeral of a firefighter.
Have a small clip of a terrible accident scene and the firefighters, police officers and EMS doing everything they can to save a life, with the proper protection in place and a civilian driving by doing the right things as they pass the emergency scene slowing down and moving over.
Have scene of a football huddle with all the protected gear helmets, should pads emphasizing the protect gear with the goal post in site and the quarter back giving the play, telling all the players to block.  After the play is given they all put their hands together and yell break. Then show the play where the blocker’s is protecting the runner, just before the touchdown you show a perfect block and how they make it to the touch down safely.
Then show the firefighters, police officers, EMS and tow truck drivers with the Incident Commander in a huddle up stream of an accident scene. The IC is giving the play by play of how to protect the scene after they get their assignments they put their hands together and yell break. You could show how a block fire apparatus does it job when blocking correctly and when what happens if not blocking correctly. Then show the scene being cleared the correct way and the car being towed away by the towing company. Then a shot of all the emergency services doing the high five and they all break away, at the same have a shot of some of the emergency services going home hugging one of their family members.   Then emergency service personal look into the camera and say thank you for letting me come home to my family, please slow down, move over at all emergency roadway accident scene’s.

                             Privately Own Vehicle (POV) Clear Windshield sticker, Dash Board or Visor Sticker.   Place in Area for an Unobstructed View of the Road.
Powerful Visual Reminder That Can Save Firefighters, Police, Ems, Civilians and Other Emergency Services Lives
This Material is Copyrighted and the property of: David G. Nadeau
Safety Specialist
Website:        E-mail
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Updated on 01-15-2014