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I AM THE PARAMEDIC
I am the PARAMEDIC, First to arrive at the scene, I respond to the cry for help of the sick and injured.  Trained and Skilled in the Healing Arts. 
I fight to buy time for suffering humanity.

My duty takes me to varied places, and challenges me in various ways.  I function anywhere at any time, even in small dark places, cannot deter me from rendering aid to those in need of my skill.

I try to ease pain of the injured, and with gentle hands I've known the thrill of bringing  a new life into the world.  On Return to base, I relinquish to others those whom I have salvaged from death, praying that the skills taught to another will be enough to complete the Rescue I began.

I am the PARAMEDIC!  The gift of love for my fellow man is what I give back to my Community.  With Brain and Heart and with skillful hands entrusted to me by God, I serve to help others to Live!
  I AM THE PARAMEDIC
Learn CPR

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!
Welcome to My Web Site, that’s devoted to EMS professionals. Professionals who are too often referred as "ambulance drivers,” Professionals tired of not receiving the respect they’ve earned in the Medical Community.  Professionals tired of being continually ignored as a critical part of the team that makes up the Emergency Services field.  It's time that we step out into the light and proudly announce to the world who we are and what we do                                                                                          WE'VE EARNED IT !
Copyright © 2001-2014 DAVE’S EMS HEADQUARTERS All Rights Reserved
The Last Call
I stood staring out the station bay window, staring onto the
black rain soaked street.

The station is quiet, the rig is silent, the faint sound of sirens past echo in my ears.

The smell of diesel hangs in the air like a vivid dream.

It's 3 a.m., I still see the pain.  I still see the fear. I still hear the sorrow.
I cannot sleep.

The silence is pierced by the emergency tone, my heart begins to beat fast, a
thousand thoughts rush my
mind in an instant, what kind of terror has shattered the night?

As the bay door opens, the
rig awakens with mighty
vengeance.
The doctor tells the parents their baby is now in God's hands, his ever loving embrace.

I walk what seems like a thousand miles, I stand outside of the hospital in the cold rain as the tears stream down my flushed cheeks.

I replay over and over the baby's lifeless thousand mile stare, this time the angels
beat us to the call.

I feel empty. I feel cheated.

I feel angry.

It's 5 a.m., I stare blankly out the station bay window. I am numb. The sounds of painful
cries echo in my ears, the smell of diesel is intoxicating.

The rain gently falls.

The night is silent.

By Ben Deacon,
EMT
The above Poem was written by Ben Deacon.  Ben's poem was published in his department's news letter last year.  I have been given the honor by Mr. Deacon to publish this wonderful poem.  If you would like permission to use Ben's Poem please e-mail me and I will put Ben in touch with you, so you may obtain his permission to use.
The dispatcher tells of a baby who will not wake up.

The dark silent street suddenly comes to life, red pulses of light disturb the night, sirens shatter the eerie silence.

My heart feels like it will explode, I must cage my fear, my sorrow , my pain.

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 her 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.
May I have the Number Please?
If someone is our hero, it is because that person does what you would like to see Accomplished.
DAVES EMS HEADQUARTERS
Heroes stand for what is Right.
THE EMS FIELD
SITES STATE OF    MICHIGAN PAGE
THE EMS PRAYER
Tell a friend about this page
"Never forget what has happened. If you forget, it will happen again."
SEPTEMBER 11, 2001
      SEPTEMBER 11, 2012                      11 YEARS LATER
NAVIGATION MENU
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.
EMS RESPONSE
People's lives often depend on the quick reaction and competent care of emergency medical technicians (EMT’s) and paramedics, EMT’s with additional advanced training to perform more difficult pre-hospital medical procedures. Incidents as varied as automobile accidents, heart attacks, drowning, childbirth, and gunshot wounds all require immediate medical attention. EMT’s and paramedics provide this vital attention as they care for and transport the sick or injured to a medical facility.

Depending on the nature of the emergency, EMT’s and paramedics typically are dispatched to the scene by a 911 operator and often work with police and fire department personnel. Once they arrive, they determine the nature and extent of the patient's condition while trying to ascertain whether the patient has preexisting medical problems.

Following strict rules and guidelines, they give appropriate emergency care and, when necessary, transport the patient. Some paramedics are trained to treat patients with minor injuries on the scene of an accident or at their home without transporting them to a medical facility. Emergency treatments for more complicated problems are carried out under the direction of medical doctors by radio preceding or during transport.

EMT’s and paramedics may use special equipment such as backboards to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. Usually, one EMT or paramedic drives while the other monitors the patient's vital signs and gives additional care as needed. 

At the medical facility, EMT’s and paramedics help transfer patients to the emergency department, report their observations and actions to staff, and may provide additional emergency treatment. After each run, EMT’s and paramedics replace used supplies and check equipment. If a transported patient had a contagious disease, EMT’s and paramedics decontaminate the interior of the ambulance and report cases to the proper authorities.

Beyond these general duties, the specific responsibilities of EMT’s and paramedics depend on their level of qualification and training. To determine this, the National Registry of Emergency Medical Technicians (NREMT) registers emergency medical service (EMS) providers at four levels: First Responder, EMT-Basic, EMT-Intermediate, and EMT-Paramedic. Some States, however, do their own certification and use numeric ratings from 1 to 4 to distinguish levels of proficiency.

The lowest level—First Responders—are trained to provide basic emergency medical care because they tend to be the first persons to arrive at the scene of an incident. Many firefighters, police officers, and other emergency workers have this level of training. The EMT-Basic, also known as EMT-1, represents the first component of the emergency medical technician system. An EMT-1 is trained to care for patients on accident scenes and on transport by ambulance to the hospital under medical direction. The EMT-1 has the emergency skills to assess a patient's condition and manage respiratory, cardiac, and trauma emergencies.

The EMT-Intermediate (EMT-2 and EMT-3) has more advanced training that allows administration of intravenous fluids, use of manual defibrillators to give lifesaving shocks to a stopped heart, and use of advanced airway techniques and equipment to assist patients experiencing respiratory emergencies. EMT-Paramedics (EMT-4) provide the most extensive pre-hospital care. In addition to the procedures already described, paramedics may administer drugs orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations, and use monitors and other complex equipment.

EMT’s 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,

EMT’s 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.

EMT’s 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, EMT’s and paramedics have irregular working hours that add to job stress.
                             Facts On CPR
Sudden cardiac arrest is the leading cause of death in adults. Most arrests occur in persons with underlying heart disease.

CPR doubles a person's chance of survival from sudden cardiac arrest.

75% of all cardiac arrests happen in people's homes.

The typical victim of cardiac arrest is a man in his early 60's and a woman in her late 60's.

Cardiac arrest occurs twice as frequently in men compared to women.

CPR was invented in 1960

There has never been a case of HIV transmitted by mouth-to-mouth CPR.
In sudden cardiac arrest the heart goes from a normal heartbeat to a quivering rhythm called ventricular fibrillation (VF). This happens in approximately 2/3rds of all cardiac arrests. VF is fatal unless an electric shock, called defibrillation, can be given. CPR does not stop VF but CPR extends the window of time in which defibrillation can be effective.

CPR provides a trickle of oxygenated blood to the brain and heart and keeps these organs alive until defibrillation can shock the heart into a normal rhythm.

If CPR is started within 4 minutes of collapse and defibrillation provided within 10 minutes a person has a 40% chance of survival.
What it is and   Who we are
                             EMERGENCY MEDICAL SERVICES CODE OF ETHICS

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.
                                                            EMT OATH
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.
Written By: Dave D.
Written By: Dave D.
NOVEMBER IS CPR AWARENESS MONTH
Before you can fully understand this webpage and all of the issues facing the EMS you need to understand the rich and complex history of ambulances and the Emergency Medical Service. It doesn't matter if you know everything about EMS, or nothing at all this information will prove enlightening to everyone. As I researched this material for my website I learned quite a bit about the history of EMS and I think you will too.

The History of the ambulance service (a precursor to the modern Emergency Medical Service) was born as a result of numerous milestones throughout history. The ambulance service can be traced all the way back to the middle ages. During the Crusades of the 11th Century, the Knights of Saint John received instruction in first-aid treatment from Arab and Greek doctors. The Knights of Saint John then acted as the first emergency workers, treating soldiers on both sides of the war on the battlefield and bringing in the wounded to nearby tents for further medical treatment. During this time it had become common practice for small rewards to be paid to soldiers who treated and carried the wounded bodies of other soldiers in for medical treatment.

In the year 1487 during the siege of Malaga in Spain, the next recorded use of an ambulance (horse drawn cart with attendant) was used by the military. They were used to help remove wounded solders and civilians from the fields of battle.  However the first big leap in EMS came during the late 1700s. Napoleon Bonaparte appointed Baron Dominique-Jean Larrey to develop the first medical patient care system for the French army. One of his findings was that leaving wounded soldiers on the battlefield for several days increased the complications and suffering. This delay in treatment resulted in needless deaths. "  The remoteness of our ambulances deprived the wounded of the requisite attention," he wrote. In 1797. Larrey then developed a method to send trained medical personnel into the field to provide medical care to the wounded soldiers and to provide medical care en route to the field hospital. This action increased their chances of survival and benefited Napoleon's conquest efforts. He designed a special carriage staffed with medical personnel to access all parts of the battlefield. The carriage became known as the ambulance volante, or flying ambulance.

Baron Larrey developed all of the precepts of emergency medical care that are used today by all modern EMS systems:

1) Rapid access to the patient by trained personnel.

2) Field treatment and stabilization.

3) Rapid transportation back to the medical facility, while providing medical care en route.

Although removal of the wounded and dead from the battlefields has existed in some form since early Greek and Roman times, Larrey can still be considered the "father of emergency medical services."

At the beginning of the 1860s the United States created the first field ambulance and attendant. The first recorded use of a field ambulance and attendant was during the Civil War. During the U.S. Civil War, both sides attempted to emulate the medical practices of the Napoleonic wars with little success. Lack of funding, government support, and dedicated personnel initially prevented the development of an effective ambulance system. During the Second Battle of Bull Run in August of 1862, on the Union side alone over 3000 wounded solders lay in the field for 3 days and 600 wounded solders lay in the fields for over a week. James Brady and Walt Whitman reported that emergency medical facilities were primitive and many wounded solders died in agony. At that time the ambulance service was being run by the QuartermasterCorps. It was transferred to surgeon general Jonathan Letterman, MD, to organize and he reinstated all of Larrey's concepts greatly increasing the survival rate of the wounded.

At the Geneva Convention of 1864 an agreement was developed among the European countries to recognize the neutrality of hospitals, the sick and wounded, all persons involved in medical care, and ambulances. It provided safe passage across battle lines for all medical and injured personnel. On August 22, 1864, the organization adopted  for its logo the reverse of the Swiss flag. The logo was a red cross on a white background. The name that they adopted was the International Red Cross.

By late 1865 the first civilian ambulance service in the nation was being run by The Commercial Hospital of Cincinnati. Other ambulance services followed at Grady Hospital in Atlanta, and Charity Hospital in New Orleans.

In 1867 Major General Rucker won the "best of kind" for an ambulance that was adopted as the regulation ambulance. It had extra springs on the floor, more elasticity to the stretchers, and improved ventilation.

By the late 1860s there was a major proliferation of ambulances throughout the United States. In late 1869 the first New York City hospital-based ambulance service was established at Bellevue Hospital by Dr. Edward L. Dalton. In December of 1869 the  first month of operation of the ambulance service of the Free Hospital of New York (Bellevue) they ran a total of 74 calls. In 1870 1466 calls were run. The Bellevue dispatch system was different from the dispatch used today. A hospital worker rang a bell, which triggered a weight to fall, lighting the gas lamp to wake the physician and the driver. It also caused the harness, saddle, and collar to drop on the horse and opened the stable doors. However, this improved response and care was mostly limited to the larger cities in America.

During World War I and especially during World War II, the military medical corps proved their worth in field assessment and early management of injured personnel. Although the military system of emergency care became well developed, the development of a civilian system lagged far behind. In the mid 1950s, J.D. "Deke" Farrington, MD, FACS (the Father of modern EMS), and others, questioned why the lessons learned by the military medical corps during World War II and the Korean   War could not be brought into the civilian community to improve the standard of  civilian care. At that time, emergency medicine and EMS were not what we know today. In San Francisco, New York, New Orleans, and other American cities, interns were assigned to ambulances to provide care for the victims of trauma and other conditions outside of the hospital. Most hospitals did not have a place to manage emergencies. Some hospitals had set up an unstaffed "emergency room" at the back of the hospital. The "ambulance driver" had to ring the doorbell beside the emergency room door so that the nurse could come down from the ward to unlock the door. The nurse then checked the patient and called a physician from home if she thought that the patient was really sick. (Did you ever wonder why modern emergency departments are in the rear of the hospital and not out front? Tradition.) All the physicians on staff had to take turns "covering the Emergency Room." A patient involved in a major wreck with multiple fractures, and perhaps a ruptured spleen or a head injury, might be seen by an ophthalmologist or a dermatologist. Many physicians knew that they were ill prepared to handle trauma or a major myocardial infarction, but there was no alternative at the time.

Until the concept arose that  non physicians could be trained to provide this kind of emergency care, the majority of the pre-hospital care was merely transportation provided by the local mortuary. The victim was driven to the hospital in a hearse with no one in the "patient compartment" except the patient and perhaps a family member. Many people began to question the efficacy and even ethics of this transportation. When the paper titled "Accidental Death and Disability: The Neglected Disease of Modern Society" was written by the National Academy of Sciences and the National Research Council in 1966, it became apparent that much improvement could be made by changing the emergency vehicles themselves and improving the training of EMTs, communications, record keeping, and the care provided upon arrival to the facility.

At the Airlie House conference (May 1969) sponsored by the Committee on Trauma, American College of Surgeons and Committee on Injuries, American Academy of Orthopedic Surgeons, "Recommendations for an Approach to an Urgent National Problem" was written. This conference indicated that immediate attention and control were needed in the areas of transportation and communication. Developing standards for ambulance design and equipment was recognized as "painfully slow." Dr. Farrington and Dr. Sam Banks developed a trauma training school for the Chicago Fire Department that served as the prototype of what later became the first EMT-Ambulance (EMT-A) training program. The task force involved in the design of the program for the United States Department of Transportation (USDOT) included Deke Farrington, Rocco Morando, Oscar Hampton, Walter Hoyt, Walter Hunt, Robert Oswald, Peter Safar, and Joseph Territo.

At the same time that the EMT-A training program was evolving, Eugene Nagle in Miami; Ron Stewart and Jim Page in Los Angeles; John Waters in Jacksonville, Florida; Costas Lambrew in New York; Mark Vasu in Grand Rapids, Michigan; Jim Warren in Columbus, Ohio; and others began to provide "paramedic care." Originally designed for cardiac patients, all types of patients soon received the type of pre-hospital cardiac care developed by Pantridge and Geddes in Belfast, Ireland. Small communities, such as Newton, Kansas, under the direction of Jim Werries, had developed a cardiac care EMS service by the early 1970s, but these were isolated situations. Kansas was like many of the states during the period that worked in isolation to develop a method of providing pre-hospital care for its citizens. It was not until 1974 to 1975 that Kansas had the statewide program going at the basic level and partially evolved at the EMT-Paramedic (EMT-P) level.

The initial training program was called the Advanced Training Program of EMT. The USDOT organized a subcommittee on ambulance services, which developed the standards on which this course was based. Many of those leaders who have been identified were active in the development of this curriculum. Nancy Caroline and her team at the University of Pittsburgh was awarded the contract from the USDOT to write the National Standard Curriculum for the EMT-P. This modular training program included sections that then became the basis for the EMT-Intermediate (EMT-I). Up until the late 1970s, most of the federal involvement came through the USDOT under the leadership of Leo Schwartz and Robert Motley. A new EMS act was passed in 1976 that gave money and responsibility to the U.S. Department of Health, Education, and Welfare. Chicago trauma surgeon David Boyd led this enactment, which resulted in the development of state and local EMS regions throughout the United States.

The National Registry of EMTs (NREMT) was created shortly after the Airlie Conference. This organization was responsible for registering and reregistering EMTs based on completion of the USDOT standard EMT-A curriculum (and later the EMT-I and EMT-P training). The NREMT developed written and practical examinations based on the objectives of these courses to examine and register those who satisfactorily completed the examination process. Most states use the NREMT's process in whole or in part as the basis for licenser. The "Star of Life" is a logo patented by the American Medical Association in 1967. It represents the three rivers of life and the staff of Aesculapius. It was given to the NREMT as the EMT logo. When Dawson Mills of the USDOT asked the American Red Cross to use the red cross as the EMS logo for ambulances and was refused, he asked "Deke" Farrington if the USDOT could use the Star of Life on all ambulances in the United States, and Farrington approved it. The six points of the star were named by Leo Schwartz.

The National Association of EMTs (NAEMT), founded in 1975, was developed to represent EMTs at all levels. The state EMS directors formed the National Association of State EMS Directors (NASEMSD) to share ideas and develop strategies for EMS development across state lines. Another organization, the National Council of EMS Training Coordinators (NASEMSTC), is also charged with sharing educational ideas across state lines. The National Association of EMS Physicians (NAEMSP) was formed to provide leadership in medical direction of EMS services. This association is the focus of activities, discussion, and meetings for physicians involved either full-or part-time in EMS.

This very brief overview can only mention a few of the highlights in the development of EMS in the United States. However, even this history underscores how far EMS has evolved from its roots in European battlefields. Below is a table of some of the important events in the history of EMS.

                                                   Year / Event
1865 America's first ambulance service is instituted by the U.S. Army.
1865 The first civilian ambulance service in the nation was being run by The Commercial Hospital of Cincinnati.

1869 America's first city ambulance service (utilizing horse drawn carriages) is instituted in New York City by Bellevue Hospital.

1870 Prussian siege of Paris used hot air balloons to transported wounded soldiers. This was the first documented case of aeromedical transportation.

1899 First motorized ambulance operated out of the Michael Reese Hospital in Chicago; reached a speed of 16 miles per hour

1901 President McKinley shot in Buffalo and transported in a motorized ambulance

1910 First known air ambulance aircraft was built in North Carolina and tested in Florida. The aircraft failed after flying only 400 yards and crashing.

1922 Committee on Treatment of Fractures formed
1926 Phoenix Fire Department begins "inhalator" calls.
1928 Julien Stanley Wise implemented the first rescue squad (Roanoke Life Saving Crew) in the nation in Roanoke, VA.

1931 Outline of Treatment of Injuries
1939 Committee on Fractures and Other Injures formed

1940 Prior to World War II, hospitals provided ambulance service in many large cities. With the severe manpower shortages imposed by the war effort, it became difficult for many hospitals to maintain their ambulance operations. City governments in many cases turned ambulance service over to the police or fire department. No laws required minimal training for ambulance personnel and no training programs existed beyond basic first aid existed. In many fire departments, assignment to ambulance duty became an unofficial form of punishment.

1951 Helicopters began to be used for medical evacuations during the Korea war.
1954 Survey of EMS systems performed by ACS/COT chairman Alan Dimick, MD; 64 cities, 5 years of data (1/4 excellent, 1/3 unacceptable)
1955 Saturday Evening Post article, "Let Those Crash Victims Lie-Ambulance Attendants are Trained to Handle Them," published
1956 Dr. Elan & Dr. Safar developed mouth-to-mouth resuscitation.
1957 Chicago Fire Department training program developed by "Deke" Farrington, MD
1959 Symposium on Medical Aspects of Traffic Safety formed
1959 Researchers at John's Hopkins Hospital in Baltimore, MD developed the first portable defibrillator as well as perfected CPR.

1960 "Management of Fractures and Soft Tissue" published by Committee on Trauma, American College of Surgeons
1960 Cardiopulmonary resuscitation (CPR) successful (Kouwenhoven)
1960 "CPR"-Journal of the American Medical Association article published by Jude
1960 Martin McMahon experimented with various types of artificial respiration by paralyzing Baltimore City firefighters and seeing which method worked best.
1962 AMBU bag developed
1962 "Thumper," developed by Michigan Instruments
1962 "Resusci-Anne," developed by Laerdal
1965 Life Pack 33 developed
1966 "Accidental Death and Disability-The Neglected Disease of Modern Society" published by NRC-NAS
1966 Presidents Commission on Highway Safety formed
1966 Highway Safety Act enacted
1966 Dr. Pantridge in Belfast, Ireland, started to deliver pre-hospital coronary care using ambulances. His research showed that his program significantly improved patient survivability in out-of-hospital cardiac events.
1966 In Pittsburgh, citizens demand an ambulance service to transport minority citizens. Freedom House Enterprises took 44 unemployed 18-60 year old men and gave then 3,000 hours of medical training. The program was deemed a success.
1967 "Death in a Ditch" published by "Deke" Farrington, MD
1967 Mobile Coronary Care Units developed by Pantridge
1967 Traction splint developed by Glenn Hare
1967 "Star of Life" patented by American Medical Association
1967 Jaws of Life developed by George Hurst
1968 On January 12, 1968 AT&T announces their designation of 911 as a universal emergency number at a press conference in the Washington (DC) office of Indiana Rep. Ed Roush, who had championed for Congressional support for "one number." AT&T's plan affected only the Bell companies, and not any of the independent telephone companies. Up to this point, the number "911" wasn't mentioned in any literature, and apparently wasn't identified until the press conference. In fact, a Wall Street Journal article written the day before the press conference didn't mention "911" as the number that AT&T selected.
1969 Ohio Heart mobile developed
1969 Arlie House Conference formed
1969 American Medical Association Commission on EMS formed
1969 Helicopter used for civilian medical transportation
1969 EMT-A published by Dunlap and Associates
1969 The Miami FL Fire Department started the nation's first paramedic program under Dr. Eugene Nagel. The very first out-of-hospital defibrillation occurred shortly thereafter (the patient survived and left the hospital neurologically intact). In Seattle, Dr. Leonard Cobb at Harbor View Medical Center teams up with the Seattle Fire Department and creates Medic I. Medic I is a Winnebago, (called "Mobi Pig" by the firefighters manning it), based at the hospital and is dispatched only on cardiac related calls.

1970 National Registry of EMTs (NREMT) founded
1970 "Emergency!" with Johnny and Roy airs on TV
1972 The Department of Transportation and Department of Defense team up to form a helicopter evacuation service. In Seattle, Medic II is instituted. Medic II is a program to train 100,000 citizens in CPR. Harbor View Medical Center starts up the nation's most intensive training program for paramedics. The course is 5,000 hours long, compared to 3,600 hours a medical student endures to become a doctor.
1973 Emergency Medical Services Act enacted
1975 National Association of EMTs (NAEMT) founded
1975 ACLS developed by American Heart Association
1978 ATLS pilot course developed in Auburn, Nebraska
1979 ATLS approved by ACS/COT
1979 Joint Review Committee for EMT-Paramedic accreditation formed

1981 Pre-hospital Trauma Life Support (PHTLS) approved by NAEMT and ACS/COT
1981 BTLS developed by Alabama Chapter of ACEP
1983 PHTLS pilot courses run in Iowa, Connecticut, and Louisiana
EMS grew exponentially after the early 1980s. So many people contributed so much that an attempt to list all of these contributions would leave out many of the major players. This does not detract from all of the work done by each of them. It only points out the growth of EMS in the United States and the world. A small example is all of those who made possible the spread of PHTLS to 25 countries and greater than 300,000 providers trained by the year 2000 and a similar spread of BTLS by its contributors.
1986 The Comprehensive Omnibus Budget Reconciliation Act (COBRA) is passed by Congress. This affected transfers of patients from ED to ED and prevented "dumping" (financially motivated transfers of patients).

1992 A public opinion survey conducted for the American College of Emergency Physicians found that nearly half of adult Americans could not identify 9-1-1 as the emergency number, or confused it with 4-1-1, the directory assistance number.
1995 Los Angeles City Fire Department institutes EMT Assessment & Paramedic Engine companies.
1996 New York City EMS is absorbed by FDNY.
1997 San Francisco and Chicago institute paramedic engine companies.
1999 President Clinton signs Senate Bill 800, which designates 911 as the nationwide emergency telephone number.

09-11-01 Terrorist attacks on the World Trade Center, and Pentagon result in the largest peacetime EMS response in history. Over 3000 people are killed in the attacks.
EMS AND IT'S LONG HISTORY
Author & Source: fdnyemswebsite  used with Permission copyrighted data
In 1966 President Lyndon Johnson created a commission to address a study regarding the growing issues of accidental death and disabilities.  This commission was responsible for the formation of what is known as Emergency Medical Services.  The commission’s report determined adequate ambulance services are as much a municipal responsibility as firefighting police services are. 

The commission’s report one on the state if the community does not provide ambulance services directly the quality of the services should be controlled by licensing procedures and by adequate surveillance of both volunteer and commercial ambulance companies.

This led to the formation of states Emergency Medical Services Divisions and charged State Governments to create legislation and to track compliance.  The commissions recommendations further lead to a more extensive growth of both volunteer EMS Agencies.  This lead to creating a higher level of care thereby reducing deaths and disabilities from traumatic injuries and a reduction of highway deaths, and charged the National Highway Transportation and Safety Administration with the oversight
of  Emergency Medical Services as a whole.
    Arlie House Conference
Crisis in Emergency Medical Services
With the cuts in Medicaid and Medicare reimbursements, EMS Providers have been forced to write off legitimate fees for services rendered, and accept reimbursement for Advanced Medical Support (ALS) which is set between $64.00 to 74.00.  Today a large portion of the population in the United States do not have Medical Insurance and millions more either have low end health insurance polices that do not provide major medical coverage, many individuals are unaware that ambulance services are not covered.

Look at it this way if your wife, husband, mother, father, son or daughter suffers a medical emergency, you call 911 for an ambulance.  An ambulance is dispatched to your home an ambulance that cost between $50,000 to $100,000, inside the ambulance their is thousands of dollars of the most current and advanced medical equipment such as an defibrillator, advanced airway equipment, and many other pieces of equipment that is necessary to sustaining life.  In addition the most high tech communications system is installed which provides the crew with the ability to communicate with emergency room physicians.  An Ambulance is most often staffed with a minimum of at least one (1) Paramedic and a one (1) Emergency Medical Technician. (Many times the second medic is also a Paramedic State of Michigan requires that Ambulances maintain two (2) Paramedics.)  Medics are highly trained professionals who have gone through the most extensive training program and are required to pass their course with a minimum of an 85% average, then are required to write and take a practical state exam passing successfully passing the state exam allows the medic to provide pre-hospital care, however the medic must maintain continuing education in order to recertify every three (3) years.  EMS Agencies most often maintain these ambulances that meet both federal and state requirements in addition EMS agencies maintain dispatch/communications unit which is staffed twenty-four seven.  Other cost includes fleet insurance, malpractice insurance coverage, license plates, annual state vehicle licensing, operations expenditures, and many other miscellaneous fees.

Look at it this way if your wife, husband, mother, father, son or daughter suffers a medical emergency, you call 911 for an ambulance.  Once an ambulance arrives treats the patient, depending on the emergency may have to start an Intravenous access (IV), if the patient is in cardiac or respiratory distress the medics may push various medications to stabile the patient, if the patient goes into cardiac arrest the medics will defibrillate the patient insert an endotracheal tube (ET) to secure the patients airway and provide oxygen to maintain organs and prevent brain damage or death.  The patient is stabilized and transported sometimes by emergency transport lights and sirens other time by non emergency transportation (No light or siren) to the hospital.  Once the patient reaches the hospital his or her care is transferred to the emergency room doctor.  The medics who handle the call fill out a medical incident report which documents the care given including medications, supplies and equipment used.  The medic must also fill out a company billing form that is turned into the companies billing office and eventually a bill is mailed out to the patient or guardian.  An ambulance bill is determined by several factors many variables are calculated a low bill may range from $250.00 to $300.00 and for a full Advanced Life Support call such as a cardiac arrest bill may run from $700.00 to $800.00. (as of 04-2006)

If you have medical insurance which includes ambulance services you may pay a minimal deductible bill however if you have no insurance or your insurance does not provide coverage for ambulance services than you are responsible for the bill.  Many EMS Providers billing coordinators will work with you for example setting up payment schedules until the bill is paid in full, however many people who are struck with sudden onset of medical issues also receive emergency room bills and if the are admitted to the hospital they are billed also for the time spent in the hospital as well as procedures and surgeries.  Emergency Room and Hospital fees can run into thousands of dollars of debt if an individual is underinsured or have no insurance what so ever.

The economy has forced many businesses to cut their work force laying off personnel and terminating executives, with unemployment rising and larger companies outsourcing work to other countries individual are finding themselves either unemployed or under-employed.  People are finding themselves in the situations described above, and since EMS Agencies do not receive any state or federal dollars and EMS Provider can only continue to operate by collecting in full bills for services provided, many times for services that saved their life.  This leads agencies to use collection agencies and even court proceedings in an attempt to collect the debt.  Unfortunately it’s the medics who find themselves faced at times with hostile patients because they have called for an ambulance again and fear the large bill, medics have been assaulted, spit on and cursed the very medics who were once again called to help and are only there to help.  Medics do not set the fee schedule and as shown below EMS Personnel are the lowest paid group in Emergency Services compared to their counterparts Police Officer’s and Firefighters.

EMT’s and Paramedics today are being forced to leave the pre-hospital care profession because the wages that are offered cannot support them, let alone a family.  An average yearly income for Emergency Medical Technicians is between 21,000 to $23,000.00, and Paramedics have an average yearly income of $27,000 up to $29,000. (as of 04-2006) Medics make slightly more the fast food workers, and enormously less than a factory worker, health benefits are generally low end policies.  The number of assaults and attacks against EMT’s and Paramedics continually rises, if medics were protective vests (bullet proof) they do so at their own cost. (A bullet proof vest cost more than 500.00)  The number of medics killed in the line of duty has also been rising; however their pay scale remains always the last to be raised.

The EMS crisis now being faced and threatened with the increased costs of fuel, with crude oil currently priced at $74.00 a barrel and with the speculation and even expectation that crude oil cost will continue to rise as summer draws closer the future for EMS providers that are in the thorns of financial distress could be pushed further towards closure endangering the public.  The increase in gasoline prices is not maybe but will force both private and public EMS Providers to increase fees for pre-hospital care and transportation.      

EMS like Law Enforcement is a mobile fleet unlike Fire Departments whose vehicles sit idle between calls, and according to the American Fire Agency study shows a 5 year decline in the number of “fire,” calls, whereas ambulance calls continually and dramatically increasing.  EMS providers utilize the computer aided dispatch system which in short keeps records of calls allowing dispatchers to shift it’s fleet of ambulance’s and there crew’s to various geographical locations throughout the day which  maintain both adequate coverage while continuing to maintain national response times. 

EMS Providers already faced with the cuts from Medicaid and Medicare reimbursements, are now faced with the increased costs of fuel, and facing the loss of experienced medics to higher paying jobs outside the EMS field and replacing them with lesser experienced medics, which further places the public in jeopardy. 

American Medical Response opted out of Emergency Medical Services in 2005, selling out to Onex another Canadian Company after facing major financial loses, litigation and a decline in contracts. Acadian EMS is still recovering from Hurricane Katrina and the loss of medics who relocated after the storms. 

Management for larger EMS Providers is mostly made up of executives who have never worked as either an EMT or Paramedic who work behind a desk continuing to look for ways to lower cost and increase profit margins. Unlike the Emergency Medical Technicians and Paramedics whose focus is saving lives and pray they make it home to their families at the end of their shift uninjured and alive.

Management are worried about profit as profit is the bottom line in especially when run by corporations and when profit is threatened companies look for ways to reduce costs this is a another reason why Emergency Medical Services are facing a crisis and that crisis endangers both the patients as well as the EMT’s and Paramedics.

Emergency Medical Services is as critical as Police services and Fire Suppression Departments, Police and Fire services are operated by a city and its tax base.  Emergency Medical Services should have been and needs to be run the same way as Cities provide Police and Fire Services, EMS should not and cannot be operated effectively as a joint operation with fire or law enforcement, why? For the very reason firefighters complain about their role as first responders each group has there specific role and specific training and is various situations their resources need to work extremely cohesively with each other and communicate especially in mass casualty situations.  Providing Emergency Medical Services as a city service under public safety would create the ability to provide sufficient salaries that will retain senior medics, provide better health care, and provide in services with police and fire that will continue to ensure safer working conditions, which would allow for extended training, provide ongoing safe driving skills by training and providing skills assessments.

The current make up of having two to three different EMS providers in the same city hurt the purpose of EMS, which is meant to get to a patient in a timely manner, stabilize the patient and transport the patient to a hospital for continued treatment.  With multiple services in a city incoming 911 calls are funneled to the company that services that district instead of utilizing the closest ambulance. This proposal can work and in the post 9-11 world eliminates the confusion that was pointed out in the 9-11 commission report as well as the McKinnely Report.

                                                                        Benefits of a Municipal EMS Services:

1.  Municipal run Emergency Medical Services are abundant as State and Federal dollars could be allocated directly to the betterment of services.   
2.  Increased wages and benefits for both EMT’s and Paramedics thus retaining experienced Medics thus providing better services for the public.
3.  Better coordination between Police, Fire and EMS in the handling of mass casualty incidents (MCI) such as dedicated frequencies and allocating other frequencies for joint operations such as terrorist attacks, domestic terrorism, school violence
4.  Base fee for EMS that could offset Tax money
5.  Ability to purchase safer Ambulances
6.  Ability to provide onsite Continuing Education
7.  Accessibility to Ambulance Service for all regardless of income or insurance
8.  Access to Strategic Fuel Reserves to ease Gas Price Burden for Emergency Services such as Police, Fire, and EMS especially in disaster management

Municipal Run Emergency Medical Services, is the next major step that EMS must take to maintain consistent response times, equal service and protections to the public, and providing critical services to the public by providing the inclusion of Emergency Medical Services along with Police and Fire Services that are already provided.

Written by:  Dave D. Owner/Webmaster "Dave’s EMS Headquarters" April 2006  ©
Written by: Charles B. Gillespie, M.D.                                                                                                                        Albany, Georgia  1978
                 WHY AM I CALLED AN AMBULANCE DRIVER??
                                             “Editorial
You may have heard about me either in your local newspaper or evening news, and yes sometimes I have been mentioned on both network and cable news programs.  My position in your community is serving as a “Paramedic,” to reach me for help if you are having a heart attack, and you need help from EMS trained personnel, can be found on the inside cover of your phone book under “Public Safety,” Police Department, Fire Department, and Emergency Medical Services which is also known as “EMS.”.

When you call 911 for help a dispatcher will generally answer the phone stating 9-1-1 what is your Emergency?   You may indicate that you need the “Police because your car has been stolen, or that you need the “Fire Dept,” because you smell smoke and believe your home is burning, or you need an “Ambulance,” because a family member has stopped breathing.  Some times you may need all three services Police, Fire and EMS because a family returning from their vacation has been involved in an accident which has resulted in blocking traffic, entrapment of the occupants in the twisted steel once called a “car,” requiring the need of the “jaws of life,” in order to gain access to the members of the family who may have sustained critical life threatening injuries.

I had already, had attended another university obtaining a bachelor’s degree in criminal justice, initially all I wanted to do this be a police officer, however the department I work for operated a police emergency unit program which consisted of crossed trained police officers/ paramedics. The department utilized specially outfitted Suburbans that served as non transport advanced life support units. I decided that I two wanted to be part of this Division. This required the necessity to return to a university to obtain the Training required to become a paramedic.

In order to be an “Ambulance Driver,” I applied and was accepted at a major university for the sole purpose of becoming a paramedic, to work in the field of emergency medical services. Nowhere on the curriculum was a classification or term “ambulance driver.”  Under health sciences I found a choice between a two year associates degree and a four year bachelor’s degree in the field of emergency medical services.

In order to become a paramedic, you were required to take and pass the other two levels leading up to paramedic. Level one was obtaining the necessary credits in order to become what is commonly referred to as a EMT, or Basic EMT, after successfully studying, training, and the practical training, I was allowed to progress to level two of the emergency medical services program most commonly called EMT-Intermediate, again after taking the required credit hours necessary to pass level two, I was now eligible to take the paramedic portion towards the degree.

Now like every collegiate program there are prerequisites that must be taken and this is the case for a degree in Emergency Medical Services.  Such prerequisites for EMS include: two years of English and Math others include basic and advanced anatomy
public speech, pharmacology just to name a few.  In addition to obtain a associate or bachelors degree you must also participate in an internship program.  Depending on what type of collegiate program you enter to obtain a certificate, associate, or bachelor’s degree, in Emergency Medical Services.  Graduating from school as a Paramedic with a Bachelors degree in EMS Business Management in my case was not the ending of my requirements in order to work in the field of Emergency Medical Services as a Paramedic.

Depending on which state you wish to work in you must then prepare to take the State’s Licensesure program consisting of both a written as well as practical exam. And must pass both exams with a minimum average of 85% on both test failure to achieve passing grades in both categories is failure and the entire process must be re-taken again.  Unlike the bar for attorneys, or Encaps for medical students who continue to retake the exam until passing this is not the case foe and EMT, EMT-Intermediate, or Paramedic, if you fail the state’s exam a second time you are required to take a refresher course prior to taking the exam a third time.

Once you have passed the exam you seek out an agency to apply for a job at your level of training. First a potential employer must in the State of Michigan run a criminal background and driver history thru the Secretary of States Office.  In Michigan you do not qualify to test for State licensure if:

Registration of individuals convicted of certain crimes present an unreasonable risk to public health and safety. Thus, applications for certification by individuals convicted of the following crimes will be denied in all cases.

1.Felonies involving sexual misconduct where the victim’s failure to affirmatively consent is an element of the crime, such as forcible rape.

2.Felonies involving the sexual or physical abuse of children, the elderly or the infirm, such as sexual misconduct with a child, making or distributing child pornography or using a child in a sexual display, incest involving a child, assault on an elderly or infirm person.

3.Any crime in which the victim is an out-of-hospital patient or a patient or resident of a health care facility including abuse, neglect, theft from, or financial exploitation of a person entrusted to the care or protection of the applicant. 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:

After meeting the requirements for an EMS Program, passing and gaining your licensure for EMT-Basic, EMT-Intermediate, or Paramedic.   You must recertify with a minimum of 45 continuing education credits every three years.  This must be done as long as you work in the field of Emergency Medical Services.  In Michigan you are also required to take the National Registry Exam.

At the Paramedic Level you must also hold and renew certifications separate of your State certification which include the following:  

My certifications included Basic CPR, Basic Trauma Life Support (BTLS), Advanced Cardiac Life Support (ACLS), Pediatric Trauma and cardiac Life Support (PALS).  In addition I took programs for certifications in Defensive Driving Conditions and Situations Automatic Electronic Defibrillation (AED)

In addition I took the following programs for and passed the necessary Certifications and State Licensure as a:  Paramedic Instructor-Coordinator and OSHA Instructor.

As I mentioned at the beginning I began my career as a crossed trained Police Officer/Paramedic.  However, I eventually choose to work solely as a Paramedic, and therefore I once again was subjected to both a criminal background and driving record check for the private agency I was going to work with.

Back in 1980, the cost of my education exceeded $20,000.00, which even today almost equaled a year’s salary here in the State of Michigan working for a private EMS Agency with an average Paramedic Salary of 26,000 to 31,000 a year.

Many EMS Agencies in Michigan only hire Paramedics, which means both partners are State Licensed Paramedics. Yet with all the education required to become a Paramedic, a profession which is part of your communities “Public Safety,” we are frequently labeled as “Ambulance Drivers,” by the media supposedly made up of professionals. 

How professional is it to degrade individuals who work in the Field of Emergency Medical Services as EMT’s, EMT Intermediates, and Paramedics?  When Police Fire and EMS Personnel respond to multi-car accidents and a Police Office or the Fire Unit enroute to the scene are involved in an accident or are involved in a news item the media does not present a headline which starts with a headline such as; “Police Car Driver Accident or Fire Truck Driver injured.

Last year a national campaign was began airing public service commercials that defined EMS Personnel as “Medics,” this was done as too include Medical First Responders, which is a new certification level that falls under Emergency Medical Services (EMS) which is made up of very minimally trained firefighters and police officers to allow the MFR to apply an Automatic defibrillator, (AED) to a patient in “cardiac arrest,” more rapidly. 

Despite the campaign the media cannot retrain itself to acknowledge the men and women in EMS as Professionals.  Since 2001, more than 170 EMT’s Paramedics, Flight Nurses (many States require Flight Nurse to license as a Paramedic) have lost their lives, “In the Line of Duty,” these medics have lost their lives from accident enroute to and from accident scenes, on scene killed by inattentive drivers, increase assaults on medics that have led to loss of life. Over the same time frame 6 medics have been killed on scene victims of shootings.  The number of medics injured is rarely tracked or tracked in inappropriate categories, on September 11, 2001, alone 116 Medics where injured in New York alone. 

EMS has been and is a dangerous profession made up of men and women who are the lowest paid of the “Public Safety Services,” and the most disrespected by the various news organizations charged with providing fair, respectful, accurate and credible reporting.

Below is research utilized through manual and on-line resources:

Webster’s Dictionary defines an “Ambulance;” as “a vehicle equipped for transporting the injured or sick.”

Webster’s further defines a “Driver;” as one that drives: as a: coachman b: the operator of a motor vehicle c: an implement (as a hammer) for driving d: a mechanical piece for imparting motion to another piece

Webster’s On-Line Dictionary respond with the following when the offensive word “Ambulance driver;” The word you've entered isn't in the dictionary. Click on a spelling suggestion below or try again using the search bar above.

Webster’s On-Line Dictionary respond with the following when the offensive word “Police driver;” The word you've entered isn't in the dictionary. Click on a spelling suggestion below or try again using the search bar above.

Webster’s On-Line Dictionary respond with the following when the offensive word “Fire truck driver;” The word you've entered isn't in the dictionary. Click on a spelling suggestion below or try again using the search bar above.

Many EMS Personnel who leave EMS do so to follow through in careers as either Physicians, or Physicians Assistants (P.A.), demonstrating that EMS Personnel are high educational achievers. 

Yet with the education required to work in EMS are roles are reduced to “Ambulance Driver.”  News agencies such as the Detroit Free Press, CNN, CBS, NBC Fox News and the list can go on and on with reportedly high regard and professionalism are shamefully responsible for the dissemination of inaccurate and degrading references to EMS Personnel.

Yes in my area Ambulances which are built under specific federal Governmental specifications as defined by the National Traffic Highway Safety Administration
(NTHSA), are staffed by two medics both who hold valid State of Michigan License that define the Paramedic on their certification card as “Advanced Emergency Medical Technician.  I have looked at all my previous license renewals all the way back to 1979 through the time of this article and nowhere on the certification is the non existent term “Ambulance Driver.”

I am called an “Ambulance Driver,” there is no such word, I am a “EMT, EMT Intermediate or a Paramedic.  We answer your call when you have suffered illness or injury.  We are called when a Police Officer has been shot or injured, or fall ill.  We respond to the scene of a house fire rendering aid to a firefighter has suffered burns, falls from height, or suffer exposure to the heat, cold, or chemical.

As Medics and not “Ambulance Drivers,” we have responded with Police, and Fire personnel to incidents such as; the United Flight 232 crash, the bombing of the Federal building in Oklahoma, Columbine High School Shootings, Terrorists Attacks at the WTC in 1993, and the Terror Attacks on September 11, 2001.  We continue to respond to mass causality events, as well as delivering a new born in a home, shopping center or in the back of an Ambulance.  We as Medics treat wives, husbands, fathers, mother, brothers and sisters involved in automobile accidents, or suffering from a diabetic emergency. 

Please do not confuse the fact that we arrive in an ambulance which is comparable to a Mobile Trauma Unit, which carries medications to stabilize a cardiac patient, a defibillilator which returns a still heart to a beating heart, medical equipment that prevents neck and back fractures from permanent disabilities, that we are anything less than Professionals who are skilled EMT’s and Paramedics. 

Medic’s are paid the least, in the Public Safety Field, are exposed to many of the same dangers as our partners in Law Enforcement and Fire Suppression and feel pain and hurt when a patient is lost.

Medics working in EMS today receive little thanks and acknowledgement, you rarely here about who we are, or what we do, unless there is a scandal attached.  Scandal is rare but like any profession it is made up of men and women who are not infallible. 

Also Like so many Fire Departments which are operated by Volunteers, there is an equal number of EMS Services that are provided by an all volunteer staff.  They raise funds utilizing “pancake breakfast,” in order to purchase equipment and other fund raiser in order to remain available to your community.   

We do work under a “Code of Ethics,” and an “EMS Oath” as outlined on my site page located at: http://www.davesems.com/EMS1.html

Any Medic who breaks the Code of Ethics,” and or the “EMS Oath,” faces disciplinary action and in cases which warrant the necessity to cause the revocation of licensure, as would a Police Officer or Fire Fighter.

The morale of this article is there is no such individual in the United States today.  Pre-Hospital care is provided by Medics who serve your community as highly trained, extremely skilled and carefully screened Professionals at the ready 24 hours a day 365 day a year.

Written by: David D
Owner of Dave’s EMS Headquarters
Sources:  Dave’s EMS Headquarters http://www.davesems.com
         Webster’s Dictionary (manual & online)
         Emergency Medical Services Code of Ethics by: Dr. Charles B. Gillespie, M.D.
         EMT Oath by:  Dr. Charles B. Gillespie, M.D
                Posted © 03-12-2007
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Medics are First to respond to the Health and Safety Needs of America’s Communities, however the are NOT “First Responders” they are Paramedics and EMT’s who serve the Community as Emergency Medical Services.

Medics are employed by various types of services including private (for-profit and non-profit), hospital-based, volunteer, government-owned and fire department-based organizations. Over two-thirds of the nation's largest 200 cities are served by non-fire-based emergency ambulance services.

The Emergency Medical Services (EMS) system assures a timely and medically appropriate response to each request for out-of-hospital care and medical transportation including emergency responses resulting from 9-1-1 calls and inter-facility transports.

Emergency Medical Technicians are trained to deliver basic life support (BLS) services and provide first aid, oxygen application of splints, bandages and CPR. Paramedics are trained to deliver advanced life support (ALS) services and provide intravenous therapy, airway management, cardiac monitoring and defibrillation, medications and other advanced emergency care.

The EMS role over the course of a natural disaster, Public Health Emergency, Accidents, Mass Casualty incidents, and Medical Emergencies, includes patient triage, on scene decontamination, Pre-Hospital treatment, transportation or the staffing of on-scene disaster shelters and it's staffing.

                                                                                                 Key Trends
Many communities are served by high-performance emergency ambulance service providers with proven track records in simultaneously delivering clinical excellence, response-time reliability, economic efficiency and customer satisfaction.
As their key role was demonstrated during the 9/11/01 attacks, ambulance providers are operating at a heightened state of readiness and are working to build the necessary capacity to respond to new homeland security threats such as bio-terrorism attacks.

Ambulance providers face unique financial challenges due to inadequate Medicare payments and barriers to receiving federal homeland security funds.
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Crisis in Emergency Medical Services EMS1.html

Events of 9-11-2001 Still Killing   Hero2.html

Dave's EMS Headquarters editorial regarding the USA-Today Article Featured on May 21, 2006, "Fewer Paramedics Saves Lives"  EMSHQ.html

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Are Medicare lowered reimbursmenrts Hurting your Local EMS Service?
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Professionals working in the field often risk their own safety to help others. EMS Medics work tirelessly to provide for the community. It is important to thank them not only during the designated EMS Week, but every week of every year.

Annual Emergency Medical Services (EMS) Week is held throughout the Nation always over the third week of May.  The purpose is a celebration of EMS and honor’s the men and women who work in the field of EMS.  Local organizations will conduct events to promote health awareness and recognize the EMS professionals dedicated to protecting the safety of their communities.

EMS Week is a nationwide celebration of the everyday heroes who work in emergency services. Dispatchers, Emergency Medical Technicians (EMT), Paramedics, and Registered Nurses (RN) work 24 hours a day, 365 days a week to serve the families in their local communities. Vehicle Supply Technicians (VST), fleet mechanics, and administrative personnel dedicate their time and energy to ensure smooth operations throughout the system. EMS Week recognizes the efforts and sacrifice of these EMS professionals.

Emergency medicine, as we know it today, began four decades ago in response to increasing numbers of accidental injury and death. Congress took the lead in implementing organizations to define the standards for EMS systems throughout the country in the 1960’s. First responders were given more comprehensive curricula and medical advances increased the demand for EMS. The profession soon became an extension of in-hospital medical care. As EMS responsibilities grew, the typically reactive industry became more proactive. Emergency medical providers have focused on community-based prevention programs more and more in recent years. Today, EMS is as much a promoter of public health and safety as it is a provider of emergency medical response.
EMS WEEK INFORMATION AND HISTORY
This Page was Last Updated: June 24, 2014
Despite similar triage urgency and admission rates, homeless people who arrive at emergency departments are more likely than non-homeless people to be uninsured and arrive by ambulance, according to a study in the August issue of the Journal of Health Care for the Poor and Underserved.

Gary Oates, M.D., of West Virginia University in Morgantown, and colleagues analyzed data from the 2005 National Hospital Ambulatory Medical Care Survey in order to determine national use of emergency departments by homeless individuals. Homeless individuals were identified by self-report.

The researchers report that, during 2005, 472,922 of the 115 million visits to emergency departments in the United States were made by homeless patients. The majority of these patients were male (approximately 75 percent) and Caucasian (65 percent). A total of 55 percent of the homeless population was uninsured, and homeless individuals were found to be significantly more likely than the non-homeless population to be uninsured and to utilize an ambulance to arrive at the emergency department. The authors further note that, although there was no difference in triage urgency or hospital admission rate between the two populations, homeless individuals were more likely to undergo more diagnostic tests.

"Interventions and solutions for improving access to both primary care and urgent care for the non-emergent health problems of homeless people must be further investigated so they will not have to rely on emergency departments as the only venue for health care," Oates and colleagues concluded.
Ambulance Transports More Frequent Among the Homeless
                  EMT & Paramedic's our Quiet Unsung Hero's, May God Bless Them
Code_of_Ethics.txt
Code_of_Ethics.txt
                                                                                                                      
   Number of Ambulance Services in the U.S. 12,254
Number of Ground Ambulance Vehicles in the U.S. 23,575
   Number of EMS Personnel in the U.S. 840,669
Written by: Charles B. Gillespie, M.D.  Albany, Georgia  1978
Medics are First to Respond
EMS ARTICLES & LOCATIONS
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                    Emergency Medical Services
                              Author:  David D.
                    Dave’s EMS Headquarters
                         www.davesems.com
Emergency Medical Services known as “EMS,” which as a profession provides pre-hospital care for medical and trauma emergencies.  EMS is part of the Emergency Services of Police, Fire, and EMS services provided by County, Cities, and townships throughout the country.

EMS Services is provided in most locations by privately owned EMS companies, volunteer based provider.  Several states provide EMS Services through counties/parishes funded through taxpayer dollars, and millages.  Several large cities provide EMS Services by combining Fire and EMS services yet running them independently from one another. 

Unlike Police and Fire Services, patients are billed by the EMS Provider for responding and transporting patients who suffered a medical emergency, or a traumatic injury.  Billing for EMS transportation and treatment based on the level of care provided by EMT’s/Paramedics are categorized as “basic life support procedures,” or “advanced life support procedures,” and patient transfers.  Additionally patients are also charged a based fee, along with mileage fees.  An EMS Provider bill for a patient transport can range from $500.00 for a “bls transport” to as much as $1,200.00 for an “als transport.”  (Fee’s vary by geographical locations) 

EMS Providers most frequently bill a patient’s health insurance provider for services provided, insurance payments are based on their coverage plan.  Patients are often shocked to learn that EMS Services may not be included in their insurance coverage plan and learn that they are fully responsible for the entire fee of pre-hospital care and transport.  Due to the economy patients find that they are under insured or have no insurance due to premiums cost.  Seniors Citizens and the disabled who have Medicare in most cases will have co-pays.  Medicare utilizes a set fee schedule for EMS Providers, Medicare payments are based on a fee schedule, which are so low that its financially hurting EMS Providers.

State based Medicaid programs also utilize a “fee schedule.”  States regulate their Medicaid payments for Ambulance Services; Providers receive as little as $50.00 regardless of the type of care and transportation provided by EMS Providers.  Sadly some Medicaid patients abuse both Medicaid and the EMS System, for unnecessary transportation.

EMS providers today are faced with financial crisis, due to low Medicare and Medicaid payment schedules, low collection rates, and rising fee in providing pre-hospital care.  Several EMS Providers been forced to close due to low revenue over the past few years. Providers and Volunteer Organization closures have increased over 2009 and 2010.  EMS Volunteer Agencies are facing more closures in 2011, because of mounting debt, and the decreased number of volunteers available.  U.S. Fire Department’s calls for service are approximately 70% EMS calls and 30% Fire/other type calls.  Fire Department’s who also provide EMS is facing the same billing issue/costs as the Private and EMS Providers.

EMT’s and Paramedics are highly trained after attending EMS programs, and most often pay for their training themselves.  EMT’s and Paramedics are the lowest paid professionals, compared to Firefighters and Police Officers.  Also over 2010 thirty-nine (39) medics have lost their lives, “In the line of duty.”

By:  Dave D.
Dave's EMS Headquarters
03-2011
What it is and   Who we are
EMS
DAVE'S EMS HEADQUARTERS HELPS PORTLAND MEDICS
EMS Emergency Response policy implemented by AMR challenged over Medics unfair discipline, Union files Grievance, Attorney asks site owner for help..

Dave,

I do want to thank you PROFUSELY for all of the work you put towards our project, both I and the paramedics here are exceedingly grateful. You put me on some knowledgeable paths -- paths I would not have discovered on my own, to be sure.

The hearing was Monday and Tuesday of this week, and it went very well. The arbitrator tipped his hand towards the end of the hearing and stated, "Unless more evidence is put on, it is clear to me that this rule is extraordinarily unwise and unreasonable, if not plain stupid." He went on to say, "that is not to say that management is under any duty to create intelligent rules," and he narrowed the issues for our brief-writing -- essentially to "does the punishment fit the crime." knock on wood, I think we've won it. To what extent, I don't know -- but I'm so happy that it's over and that it went well.

The most beautiful moment in the hearing was after AMR put on some VIP Safety and Risk Manager, who is in charge of 18 states on the west coast. He went on and on with some rather irrelevant (in my mind) speeches, and when I was cross-examining him, the grievant scratched a note out to me to ask him how many years he had driven an ambulance. I thought I was just humoring the grievant, but I asked the SRM man, and he responded, "I haven't driven an ambulance." "You've NEVER driven an ambulance??" "No. Well, I've driven one, but just to see what it's like." "But not in an emergency situation?" "No." "No further questions." What is with these people who drive desks making up the policies without any input from the field??

We won't get a decision turned around until probably October, but if it turns out well, is it something that you might want to put a little blurb on your website about? I'm thinking that since I found you by searching the web, maybe other labor advocates will find you while searching for info on this topic, as well.

I will write to you when the decision is rendered so that you can spread the word.

Thanks again, Dave. And please thank all of your comrades and associates who have helped with this project. We here in Portland are indebted to you.

Laura
Union ATU 757 Attorney

Updated: The arbitrator's decision has been received the grievance was won, AMR's policy was found to be a "risk to employees" and the employees no longer face discipline or forfeitures of their job as a medic's

                                                                                           BEFORE HALLOWEEN:

Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent           tripping, entanglement or contact with flame.
Consider adding reflective tape or striping to costumes and trick-or-treat bags for greater visibility.
Secure emergency identification (name, address, phone number) discreetly within Halloween attire or on a bracelet.
Because a mask can limit or block eyesight, consider non-toxic and hypoallergenic makeup or a decorative hat as a safe               alternative.
When shopping for costumes, wigs and accessories purchase only those with a label indicating they are flame resistant.
Think twice before using simulated knives, guns or swords. If such props must be used, be certain they do not appear                   authentic and are soft and flexible to prevent injury.
Obtain flashlights with fresh batteries for all children and their escorts.
Plan ahead to use only battery powered lanterns or chemical light sticks in place of candles in decorations & costumes.
This is also a great time to buy fresh batteries for your home Smoke Alarms.
Teach children their home phone number and to how call 9-1-1 (or their local emergency number) if they have an                         emergency or become lost. Remind them that 9-1-1 can be dialed free from any phone.
Review with your children the principle of "Stop-Drop-Roll", should their clothes catch on fire.
Openly discuss appropriate and inappropriate behavior at Halloween time.
Consider purchasing individually packaged healthy food alternatives (or safe non-food treats) for those who visit your                  home.
Take extra effort to eliminate tripping hazards on your porch and walkway. Check around your property for flower pots,              low tree limbs, support wires or garden hoses that may prove hazardous to young children rushing from house to house.
Learn or review CPR skills to aid someone who is choking or having a heart attack.
Consider safe party guidelines when hosting an Adult or Office Party.


                                              WHEN TRICK-OR-TREATING  

A Parent or responsible Adult should always accompany young children on their neighborhood rounds.
Remind Trick-or-Treaters:
By using a flashlight, they can see and be seen by others.
Stay in a group, walk slowly and communicate where you are going.
Only trick-or-treat in well known neighborhoods at homes that have a porch light on.
Remain on well-lit streets and always use the sidewalk.
If no sidewalk is available, walk at the farthest edge of the roadway facing traffic.
Never cut across yards or use alleys.
Never enter a stranger's home or car for a treat.
Obey all traffic and pedestrian regulations.
Always walk. Never run across a street.
Only cross the street as a group in established crosswalks (as recognized by local custom).
Remove any mask or item that will limit eyesight before crossing a street, driveway or alley.
Don't assume the right of way. Motorists may have trouble seeing Trick-or-Treaters.  Just because one car stops, doesn't             mean others will.
Never consume unwrapped food items or open beverages that may be offered.
No treats are to be eaten until they are thoroughly checked by an Adult at home.
Law Enforcement authorities should be notified immediately of any suspicious or unlawful activity.


                                  AFTER TRICK-OR-TREATING:    

Wait until children are home to sort and check treats. Though tampering is rare, a responsible Adult should closely examine all treats and throw                 away any spoiled, unwrapped or suspicious items.
Try to apportion treats for the days following Halloween.
Although sharing is encouraged, make sure items that can cause choking (such as hard candies), are given only to those of an appropriate age.

HALLOWEEN SAFETY:
This page was last updated: June 24, 2014
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