Today another woman died and not on a foreign field and not with a rifle strapped to her back, and not with a large defense of tanks rumbling and rolling behind her.
She died without CNN, & Fox covering her war.
She died without talk of intelligent bombs and strategic targets
The target was simply her face, her back her pregnant belly.
The target was her precious flesh that was once composed like music in her mother’s body and sung in the anthem of birth.
The target was this life
that had lived its own dear wildness, had been loved and not loved, had danced and not danced.
A life like yours or mine
that had stumbled up
from a beginning
and had learned to walk
and had learned to read.
and had learned to sing.
Another woman died today.
not far from where you live;
Just there, next door where the tall light falls across the pavement.
Just there, a few steps away
where you’ve often heard shouting,
Another woman died today.
She was the same girl
her mother used to kiss;
the same child you dreamed
beside in school.
The same baby her parents
walked in the night with
and listened and listened and listened For her cries even while they slept.
And someone has confused his rage with this woman’s only life.
Anatomy of Domestic Abuse Include:
Name-calling or putdowns
Keeping a partner from contacting their family or friends
Stopping a partner from getting or keeping a job
Actual or threatened physical harm
ANYONE CAN BE A VICTIM!
Victims can be of any age, sex, race, culture, religion, education, employment or marital status. Although both men and women can be abused, most victims are women. Children in homes where there is domestic violence are more likely to be abused and/or neglected. Most children in these homes know about the violence. Even if a child is not physically harmed, they may have emotional and behavior problems.
COMMON MYTHS AND
WHY THEY ARE WRONG
Domestic violence is not a problem in my community
Domestic violence only happens to poor women and women of color.
Some people deserve to be hit
Alcohol, drug abuse, stress, and mental illness cause domestic violence.
Domestic violence is a personal problem between a husband and a wife.
If it were that bad, she would just leave.
Guidelines for the Role of EMS Personnel in Domestic Violence
Domestic Violenceis also known as partner abuse, spouse abuse and battering. It is part of a larger spectrum of family violence, which also includes sexual assault, child and elder abuse and neglect. It is estimated that 8-12 million women in the United States are at risk for abuse from a current or former partner. The FBI estimates that a woman is battered every 5-15 seconds. Prehospital providers encounter the victims of Domestic Assaults and must be aware of the unique problems inherent to this abuse. Initial and continuing education programs for emergency medical services (EMS) personnel must incorporate information about domestic violence, including identification of victims, special aspects of care, scene safety and documentation requirements. EMS Personnel must also be aware that in 95% of domestic assaults the perpetrator is a man. However, it should be remembered that men can also be victims of domestic violence.
SIGNS OF ABUSE:Domestic violence crosses all boundaries, including those of age, race, education, socioeconomic class and sexual orientation. Frequently the victim will not admit to being abused, and this seems to be more true of middle class homes. Abuse should be suspected when the injuries sustained do not fit the history, and when patients seem ashamed or embarrassed about their injuries. Accidental injuries tend to involve the extremities and periphery of the body, whereas injuries from domestic violence tend to involve contusions and lacerations of the face, head, neck, breast and abdomen. The perpetrator is often unwilling to allow the victim to give a history or allow the victim to be alone with the EMS personnel. Excessive delays between injury and seeking treatment, repeated use of EMS services, injuries during pregnancy, substance abuse, and frequent suicide gestures are also hallmarks of domestic violence. Any of these conditions should lead EMS personnel to suspect abuse and respond accordingly.
Treating The Victim:Physical injuries need to be cared for according to standard practice protocols. However, special attention should be directed toward the emotional needs of the victim. Domestic Violence tends to follow a cycle of three phases. Phase one is comprised of arguing and verbal abuse, phase two progresses to physical and sexual abuse, and phase three consists of denial and apologies. The last phase is often referred to as a "honeymoon phase". Intervention is best accomplished in phase two or three. Without intervention the cycle repeats itself, usually increasing in frequency and severity. EMS personnel must understand this cycle of violence in order to adequately assess the situation and care for the victim. They must understand that victims of abuse feel ashamed, humiliated and responsible for the violence. EMS personnel need to see that by treating a victim in a respectful, sensitive and sympathetic manner, by confirming that the victim is not at fault and does not deserve to be abused, and by ensuring the victim safety, they will become agents of change in helping to give the support needed to eventually leave the abusive environment. If the patient elects not to be transported to an emergency department, prehospital providers should have a written list of community resources, including shelters and hot-line numbers, which can be left with the victim.
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.
EMS AND VICTIMS NEED TO SUPPORT AND PUSH FOR MORE LEGISLATIONS.
DOCUMENTATION:Domestic violence is a crime. Therefore, the scene must be treated as a crime scene, and standard precautions regarding preservation of evidence should be exercised. Training in these techniques by law enforcement personnel is beneficial. Documentation should be both comprehensive and exact. History obtained from the victim, alleged perpetrator and witnesses should be documented in written reports. The victims own words should be used. recording of injuries should be made, including type, number, size, location and explanations given a reported mechanism. Use the body diagrams on the EMS Report. Document the behavior of your victim and the "alleged perpetrator," do not accuse in your report remember that it may be used in court, it is a legal document, all of this is necessary should the case go to court. Document the names of law enforcement officers present should also be noted on the prehospital report.
REPORTING: Many States do not have mandatory reporting requirements for domestic violence. In fact it is not clear if mandatory reporting ensures or diminishes the safety of adult victims. However, it is important for EMS personnel to inform the receiving hospital of suspicions and observations. Such information should also be carefully documented in the EMS Run Form. EMS personnel must be familiarized with thier State Domestic Abuse reporting requirements. Keep in mind Child abuse and suspected Child Abuse MUST Documented and REPORTED.
DomesticViolencehas 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.
National Domestic ViolenceHotline (USA)
Are you or someone you know, being emotionally or physically abused? Advocates at the National Domestic Violence Hotline urge you to call, day or night. Toll free, above.
You Can Help.
Domestic violence is found in every community. As an EMS provider you probably have already responded to a call that involved domestic violence. It's important for you to know how to keep yourself safe. It's also important to know that there are many reasons a victim cannot leave a dangerous situation. But when the victim does decide to leave, he or she needs to know there is a well-defined support system ready to help. You can be part of this support system and can help victims who are ready for help, find the support they need.
EMS SAFETY AT SCENES OF DOMESTIC VIOLENCE
Enroute to Call
1.) Have police been dispatched? How far away are they?
2.) Have there been comparable calls to this residence in the past?
3.) Are both you and your partner prepared and equipped for this call?
Preparation includes not only equipment, but also mental and emotional preparedness. Have you and your partner practiced
what to do in potentially dangerous scenes? Approach of the scene with extreme caution.
Approaching the Scene
1. Approach with your sirens and lights off. Stop your vehicle a half mile from the
scene to gather additional clues before stepping from your rig.
2. What clues are evident before stepping out of your rig:
a. Are there items in the yard or driveway that indicate children might be present?
b. Are there any indications that firearms may be present at this residence (e.g.,
c. gun rack or bumper stickers on a vehicle)?
d. If at night, what lights are on in the house?
3. Is your vehicle parked so that an escape route is available if needed?
4. What is the level of noise at the residence? Is there yelling, screaming, or sounds of
Entry into the residence
1. Don’t stand in front of the open door. As you enter a room, turn on the lights. Leave lights on in every room if possible.
2. Are there indications of alcohol or drug use at this residence?
3 Visually frisk everyone for possible weapons when you enter.
4.Identify how many people are in the residence and where they are located. Are there
neighbors that could be asked to leave. The less people, the better. Never walk
down a hallway with someone behind you. Let them lead.
5. If at all possible, do not work on people in kitchens or bedrooms:
a. Kitchens have numerous and a variety of weapons, including knives,
heavy cooking pots, boiling water, glassware.
b. Bedrooms usually do not have an exit or escape route. Many people
keep concealed, loaded handguns in the bedroom. Finally, if the
perpetrator has jealous nature, the bedroom may be viewed as an
intimate and therefore; threatening place.
6. Do not assume that just because the offender has been arrested at the scene, that the
situation is under control. The victim or members of the family, even children, have
been known to assault police and EMS personnel. Always stay alert!
7. Keep your partner in sight at all times.
8. Maintain link with your dispatch or communication system.
9. Determine location and condition of victim, and separate suspect and perpetrator, if
still at scene. Interview victim and any witnesses separately, especially if both are
10. Keep your exit path open at all times.
HHS GUIDANCE ON PATIENT'S PRIVACY PROTECTIONS:
PROTECTING THE PRIVACY OF PATIENTS' HEALTH INFORMATION
Overview:The first-ever federal privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers took effect on April 14, 2003. Developed by the Department of Health and Human Services (HHS), these new standards provide patients with access to their medical records and more control over how their personal health information is used and disclosed. They represent a uniform, federal floor of privacy protections for consumers across the country. State laws providing additional protections to consumers are not affected by this new rule.
Congress called on HHS to issue patient privacy protections as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA included provisions designed to encourage electronic transactions and also required new safeguards to protect the security and confidentiality of health information. The final regulation covers health plans, health care clearinghouses, and those health care providers who conduct certain financial and administrative transactions (e.g., enrollment, billing and eligibility verification) electronically. Most health insurers, pharmacies, doctors and other health care providers were required to comply with these federal standards began on April 14, 2003. Common questions about the rule, as well as explanations and descriptions about key elements of the rule and are available at: http://www.hhs.gov/ocr/hipaa.
PATIENT PROTECTIONS:The privacy regulations ensure a national floor of privacy protections for patients by limiting the ways that health plans, pharmacies, hospitals and other covered entities can use patients' personal medical information. The regulations protect medical records and other individually identifiable health information, whether it is on paper, in computers or communicated orally.
Key provisions of the new standards include:Access to Medical Records. Patients generally should be able to see and obtain copies of their medical records and request corrections if they identify errors and mistakes. Health plans, doctors, hospitals, clinics, nursing homes and other covered entities generally should provide access these records within 30 days and may charge patients for the cost of copying and sending the records.
Limits on Use of Personal Medical Information.The privacy rule sets limits on how health plans and covered providers may use individually identifiable health information. To promote the best quality care for patients, the rule does not restrict the ability of doctors, nurses and other providers to share information needed to treat their patients. In other situations, though, personal health information generally may not be used for purposes not related to health care, and covered entities may use or share only the minimum amount of protected information needed for a particular purpose. In addition, patients would have to sign a specific authorization before a covered entity could release their medical information to a life insurer, a bank, a marketing firm or another outside business for purposes not related to their health care.
Confidential communications.Under the privacy rule, patients can request that their doctors, health plans and other covered entities take reasonable steps to ensure that their communications with the patient are confidential. For example, a patient could ask a doctor to call his or her office rather than home, and the doctor's office should comply with that request if it can be reasonably accommodated.
Complaints.Consumers may file a formal complaint regarding the privacy practices of a covered health plan or provider. Such complaints can be made directly to the covered provider or health plan or to HHS' Office for Civil Rights (OCR), which is charged with investigating complaints and enforcing the privacy regulation. Information about filing complaints should be included in each covered entity's notice of privacy practices. Consumers can find out more information about filing a complaint at hipaa or by calling (866) 627-7748.
The First organized Ambulance Service in the United States was started in Cincinnati in 1865 by the Cincinnati General Hospital.
The father of Modern EMS (In the mid-1950s) was J.D. "Deke" Farrington, MD, FACS. Dr. Farrington and Dr. Sam Banks developed in the mid 1960's 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 six points of the star were named by Leo Schwartz in the seventies, Schwartz was the Director of the U.S. D.O.T.
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.
Are all ambulance services the same?
No-Some are private providers, some are housed in fire departments, some are connected to another service like a hospital, some are run by municipal government. No studies have been done that show whether one type of service is more effective than another.
Though titles vary from state to state, typically the beginning level is made up of first responders who have basic first aid and emergency training.
Basic Emergency Medical Technicians, or (EMT’s), typically have about 150 hours of training that allows them to administer oxygen, treat wounds and immobilize spines.
Paramedics have an additional 1,200 hours of Advanced training allowing medics to administer IV fluids, intubate patients and monitor heart conditions, and be qualified to do a number of more aggressive treatments and administer drugs.
The State of Michigan has 389 first response services, which aren't allowed to transport patients but can help until an ambulance arrives; 175 basic life support services, which must have at least one EMT and one first responder on board an ambulance; 20 limited advanced life support services, which have at least one basic EMT and one EMT with advanced training; and 172 advanced life support services, which have at least one paramedic and one EMT.
What's the difference between an Emergency Medical Technician and a Paramedic?
Do EMS Companies hire people just to drive ambulances?
No-That job category was phased out years ago. Now, everyone onboard has to be at least an EMT.
Are all ambulances the same?
No-One type is a conversion truck cab and chassis with a separated box and cab. Another is a van type with integrated cab and body. A third type is a cutaway van with an integrated cab and body. There is
not enough in-depth analysis of ambulance crashes to know whether one kind holds up better in a crash.
Types of Abuse?
Battering is a pattern of behavior used to establish power and control over another person through fear and intimidation, often including the threat or use of violence. Battering happens when one person believes they are entitled to control another. Assault, battering and domestic violence are crimes.
Definitions:Abuse of family members can take many forms. Battering may include emotional abuse, economic abuse, sexual abuse, using children, threats, using male privilege, intimidation, isolation, and a variety of other behaviors used to maintain fear, intimidation and power. In all cultures, the perpetrators are most commonly the men of the family. Women are most commonly the victims of violence. Elder and child abuse are also prevalent.
Acts of domestic violence generally fall into one or more of the following categories:
Physical Battering:The abuser’s physical attacks or aggressive behavior can range from bruising to murder. It often begins with what is excused as trivial contacts which escalate into more frequent and serious attacks.
Sexual Abuse - Physical attack by the abuser is often accompanied by, or culminates in, sexual violence wherein the woman is forced to have sexual intercourse with her abuser or take part in unwanted sexual activity.
Psychological Battering -The abuser’s psychological or mental violence can include constant verbal abuse, harassment, excessive possessiveness, isolating the woman from friends and family, deprivation of physical and economic resources, and destruction of personal property.
Battering escalates.It often begins with behaviors like threats, name calling, violence in her presence (such as punching a fist through a wall), and/or damage to objects or pets. It may escalate to restraining, pushing, slapping, and/or pinching. The battering may include punching, kicking, biting, sexual assault, tripping, throwing. Finally, it may become life-threatening with serious behaviors such as choking, breaking bones, or the use of weapons.
Rural and urban women of all religious, ethnic, economic, educational backgrounds, of varying ages, physical abilities, and lifestyles can be affected by domestic violence. There is not a "typical woman who will be battered." The risk factor is being born female. Over 50% of all women will experience physical violence in an intimate relationship, and for 24-30% of those women the battering will be regular and on-going. Every 15 seconds a domestic instance occurs.
Are you a Victim of Domestic Violence?
Does your partner
Embarrass or make fun of you in front of your friends or family?
Put down your accomplishments or goals?
Make you feel like you are unable to make decisions?
Use intimidation or threats to gain compliance?
Tell you that you are nothing without them?
Treat you roughly - grab, push, pinch, shove or hit you?
Call you several times a night or show up to make sure you are where you said you would be?
Use drugs or alcohol as an excuse for saying hurtful things or abusing you?
Blame you for how they feel or act?
Pressure you sexually for things you aren’t ready for?
Make you feel like there "is no way out" of the relationship?
Prevent you from doing things you want - like spending time with your friends or family?
Try to keep you from leaving after a fight or leave you somewhere after a fight to "teach you a lesson"?
Remember that Men can also be victims of Domestic Vioelnce
CALLING 911 CRITICAL ISSUES
You, as the 911 caller, are a vital link within the EMS system. The information you provide the dispatch operator helps EMS help you. The following lists the guidelines for communicating the 911 call:
• Try to remain calm — emotions can deter effective communications.
• Speak slowly, deliberately.
• Respond to all questions presented by the dispatch operator.
• Give a brief, concise description of the emergency, including: the nature of the illness, for example, chest pain with difficult breathing; the mechanism causing the injury, for example, a fall from a 6-foot ladder; the number of patients involved and the types of treatment being rendered by bystanders or first responders.
• Know the complete residential or business address, including street number and community, especially if you are calling from a cellular phone.
• Assist emergency response to the address by ensuring the house number is visible from the street and turning on porch lights. You might send a bystander to meet the ambulance.
• Do not hang up until directed by the dispatch operator.
Deciding to become a part of the EMS workforce can and will be a life changing decision. You must take into consideration many factors that will hamper your efforts and ability to perform your duties both professionally and personally. First violence against Emergency Services and Emergency Medical Service personnel has continued to climb at alarmingly rate. Over the past several years EMT's and Paramedics and First Responders have become targets in both urban and rural areas. EMS personnel frequently enter scenes both in the inner city as well as urban regions and have come face to face with a variety of dangers that include, assaults, shootings, and stabbings perpetrated against Medics.
Gangs frequently associated with large cities, have today branched out into suburbs and small towns, where the selling of illicit drugs and the violence they cause. Medics are responding to overdose calls and now are finding themselves faced with physical attacks, and ambush situations.
Recently EMS Personnel have been ambushed coming under fire once they have arrived on scene. Medics are finding themselves in the middle of scenes the have rapidly turn violent and find themselves in the midst of physical danger. EMT’s and Paramedics have found themselves in a quagmire as they are unarmed, and responding to render aid to the sick and or injured, and must make difficult decisions to reach a victim in need of vast their skills and abilities, or back out and wait for Law Enforcement to secure a scene in order to get back in.
Medics must be extremely careful regarding any attempt to defend themselves from an attack, especially from a patient. Recently large EMS Agencies have disciplined by suspending and firing EMT’s and Paramedic’s who have been forced into defending themselves. Medics have also faced prosecution for defending against attacks. Both Patients and or family members, who have attacked EMS personnel, have filed suit or have sworn out criminal complaints with Law Enforcement and Prosecutors. As an EMT, or Paramedic the average Medic hourly based salary is between $10.00 to $14.00, and Volunteer EMT and Paramedics are not paid, Medics who maintain mal-practice insurance, however mal practice insurance does not cover legal expenses or judgments from defending themselves during an assault. EMS Personnel are skilled professionals and highly trained yet are grossly under paid. These are men and women whose skills save lives. Where as a Medic hourly incomes of $10.00 to $14.00 per hour, there pay in largely incompatible to a Firefighter or Police Officer, in most cases a Medics salary is even far less than a factory worker.
EMT's and Paramedics put their lives in direct jeopardy frequently while performing their duties, besides the many risks faced in the over all response, on scene treatment and transport, Medics have found themselves faced with acts of violence, as well as responding to both domestic terrorism as well as acts of international terror acts committed on U.S. soil.
An important part of Emergency Medical Service’s training is learning how to cope with the stresses of the job today. Divorce, Traumatic Stress disorder, and Suicide rates have also climbed for both EMT’s and Paramedics over the past decade. In order to deal with these rises EMT’s and Paramedics are being taught how to recognize the signs and symptoms of PTSD, so that help may be provided. New programs are slowly being implemented by EMS Agencies, following the events at Columbine, Oklahoma’s Federal Building bombing and the terrorist attacks on September 11, 2001. Today’s Medics must cope with the stress caused by the response to such horrific scenes. Counseling can be effective to ease emotional issues that are associated with stress. Untreated stress can lead to psychological and physical deterioration of a Medic, leading to divorce and suicides. It also can results in leaving the field of EMS, causing a shortage of qualified Medics both paid and volunteers.
EMT's and Paramedics are a critical key to your communities Emergency Services and contribute professional and skilled Pre-hospital life support response, treatment and transport. The purpose of the EMT and Paramedic is to provide highly skilled and professional personnel in the Pre-hospital setting with the highest level of treatment being provided to the sick and injured.
Every day EMT’s and Paramedics face many physical and mental challenges. To be effective as an EMT, and a Paramedic you must reflect on your past performances, and see the difference you make in your community. As an EMT/Paramedic you will be faced with life altering decisions, that today include the fact that while performing your duties you may come under attack from the very patient who called for your help. You must learn to deal with the stressors involved with the duties of an EMT or Paramedic.
You must be willing to dedicate yourself to the knowledge that those in your community rarely understand the role of an EMT or Paramedic, until your presence and skills are needed by a member of your community who has become ill, or has been injured. This site as well as other sites pertaining to EMS serves to educate the public as to the role and responsibilities of EMT’s and Paramedics.
Deciding to Become a Part of EMS Considerations to Think About
EMT & Paramedic Job Description
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. EMT’s also work as flight crew’s of helicopters that transport critically ill or injured patients to hospital trauma centers.
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.
EMS providers at rated separately at four levels: First Responder, EMT-Basic, EMT-Intermediate, and EMT-Paramedic.
The first 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 (Specialist) 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-P) 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
EMT’s and paramedics held about 172,000 jobs in 2000. Most career EMT’s and Paramedics work in metropolitan areas. There are many more volunteer EMT’s and Paramedics, especially in smaller cities, towns, and rural areas.
They volunteer for fire departments, emergency medical services (EMS), or hospitals and may respond to only a few calls for service per month, or may answer the majority of calls, especially in smaller communities. EMT’s and paramedics work closely with firefighters, who often are certified as EMT’s as well and act as first responders.
Full- and part-time paid EMT’s and paramedics were employed in a number of industries. About 4 out of 10 worked in local and suburban transportation, as employees of private ambulance services. About 3 out of 10 worked in local government for fire departments, public ambulance services and EMS. Another 2 out 10 were found in hospitals, where they worked full time within the medical facility or responded to calls in ambulances or helicopters to transport critically ill or injured patients. The remainder worked in various industries providing emergency services.
THE EMS WORK FORCE
God's Creation of Paramedics
When the Lord made Paramedics, he was into his sixth day of overtime when an angel appeared and said, "You're doing a lot of fiddling around on this one." And the Lord said, "Have you read the specs on this order? A paramedic has to be able to carry an injured person up a wet, grassy hill in the dark, dodge stray bullets to reach a dying child unarmed, enter homes the health inspector wouldn't touch, and not wrinkle his uniform."
"He has to be able to lift 3 times his own weight, crawl into wrecked cars with barely enough room to move, and console a grieving mother as he is doing CPR on a baby he knows will never breath again." "He has to be in top mental condition at all times, running on no sleep, black coffee and half-eaten meals. And he has to have six pairs of hands." The angel shook her head slowly and said, "Six pairs of hands...no way." "It's not the hands that are causing me problems," said the Lord, "It's the three pairs of eyes a medic has to have."
"That's on the standard model?" asked the angel. The Lord nodded. "One pair that sees open sores as he's drawing blood and asks the patient they may be HIV positive, " (When he already knows and wishes he'd taken that accounting job.) "Another pair here in the side of his head for his partners' safety. And another pair of eyes here in front that can look reassuringly at a bleeding victim and say, "You'll be all right ma'am when he knows it isn't so."
"Lord," said the angel, touching his sleeve, "rest and work on this tomorrow." "I can't," said the Lord, "I already have a model that can talk a 250 pound drunk out from behind a steering wheel without incident and feed a family of five on a private service paycheck." The angel circled the model of the paramedic very slowly, "Can it think?" she asked.
You bet," said the Lord. "It can tell you the symptoms of 100 illnesses; recite drug calculations in its sleep; intubate, defibrillate, medicate, and continue CPR nonstop over terrain that any doctor would fear...and still it keeps its sense of humor. This medic also has phenomenal personal control. He can deal with a multi-victim trauma, coax a frightened elderly person to unlock their door, comfort a murder victim's family, and then read in the daily paper how paramedics were unable to locate a house quickly enough, allowing the person to die. A house which had no street sign, no house numbers, no phone to call back."
Finally, the angel bent over and ran her finger across the cheek of the paramedic. "There's a leak," she pronounced. "I told you that you were trying to put too much into this model." "That's not a leak," said the Lord, "It's a tear." "What's the tear for?" asked the angel. "It's for bottled-up emotions, for patients they've tried in vain tosave, for commitment to that hope that they will make a difference in a person's chance to survive, for life." "You're a genius," said the angel. The Lord looked somber. "I didn't put it there," He said.
A Definition of a EMT?
MOST DON'T REALIZE WHAT AN EMT IS, OR WHAT THEY DO SOME SAY THEY'RE JUST AMBULANCE DRIVERS THIS PLAINLY IS NOT TRUE
THEY DO DRIVE THE AMBULANCE WITH THE LIGHTS AND THE SIREN BLOWING BUT OTHER TIMES THAT SAME DRIVER IS IN THE BACK TRYING TO KEEP A LIFE GOING
OR THAT SOME PERSON MAY BE OUT IN THE MUCK, THE BLOOD, AND POURING DOWN RAIN WORKING TO GET A DRIVER OUT OF THE CAR WHO IS IN SEVERE PAIN
BUT THE CALL THAT HURTS THE WORST FOR ALL EMT'S INVOLVED IS THE CALL WITH THE CHILD WHOSE PROBLEM CANNOT BE SOLVED
EVEN WITH ALL THE TRAINING ONE CAN POSSIBLY HAVE TAKEN SOMETIMES THAT TRAINING DOES NOT MAKE A DIFFERENCE
THAT IS WHEN YOU WILL SEE THAT STRONG EMT WITH TEARS RUNNING DOWN THEIR FACES AND A LOOK OF HUMILITY
THE THOUGHTS OF THIS CALL WILL NEVER GO AWAY BUT THE EMT REALIZES THERE WILL BE ANOTHER DAY
A DAY IN THEIR LIFE THAT THEY LISTEN FOR THE CALL AND WHEN THEY ARRIVE ON THE SCENE THEY REALIZE AFTER ALL
THAT SOME DAYS ARE GOOD AND SOME DAYS ARE BAD BUT ONE THING FOR CERTAIN, WITHOUT THE EMT'S LIFE WOULD CERTAINLY BE SAD
Us, the willing
Led by the unknowing
Are doing the impossible
For the ungreatful. We have been doing it for so long
With so little Pay
That we are now qualified to do anything
"A group of Democratic senators pressed Congress for a $5 billion upgrade of communications equipment that would make it easier for police, firefighters and other law enforcement authorities to talk to each other during emergencies. A similar measure was rejected in July as part of a homeland security bill. "They must be able to communicate with each other. This is a life and death issue," said Sen. Carl Levin, D-Michigan.”--09-13-05
On the heals of Hurricane Katrina and four years after terrorist attacked our country on September 11, 2001, our Government still does not get it. To date hundred is of rounds of “Federal Dollars,” given to Fire Departments and Police Agencies to improve equipment for disaster response. EMT’s and Paramedics work in the field of Emergency Medical Services that has not received the necessary funding to coordinate response for the injured and sick. EMS Services affiliated with twenty (20) percent of Fire Departments and departments such as FDNY have not allocated money they received to better prepare EMS. The remaining EMS Services have yet to receive Federal Funds to improve their readiness.
Wake up and Think, after Katrina struck firefighters roles should have shifted to assist Emergency Medical Services, as they could not battle fires, and Police Officers did not prepare to deploy to restore order. Prior to, during, and after the hurricane, Emergency Medical Personnel conceiting of trained EMT’s and Paramedic’s and are well versed in handling Mass Causality Incidents were not properly equipped and for the matter located in safe area's so that they could move in rapidly to treat the sick, injured and traumatized patients. EMT’s and Paramedic’s administer to both the sick and injured. On September 11, 2001, the initial response was not about fighting fires or crowd control instead it centered on and around rescuing, evacuating and “Treating,” patients who suffered burns trauma, shock, heart attacks, and respiratory emergencies.
So why has Emergency Medical Services, not received the money needed to improve inter agency communications, biohazard equipment to protect the EMT’s and Paramedics who continue to be ignored? One answer is that politicians just do not get it and I mean both Democrats and Republicans. EMS Agencies do not have unions or yet an organized lobbying group that the Firefighters and Police Officers have. Fire and Police Unions court Politicians with special interest groups, which wine and dine Politicians. This in turn guarantees monies go to Fire and Police Services first. Grant awards have created investigations and sanctions to a few Fire Agencies due to inappropriate use.
Human Life must be the first priority in disaster response, why would you fight a house fire in twenty blocks of water, when the family is out of the home and in more need of medical attention for the preservation of Life. The statistical information is not yet out for Medical and Traumatic Emergencies suffered directly or indirectly from Katrina, but I can guarantee that the biggest need was and remains for EMT’s and Paramedic responders.
On September 11, 2001, the Statistical data is out showing that had the World Trade Center Towers not collapsed, Firefighting would have been secondary to evacuating victims who would have needed treatment for burns, smoke inhalation, and trauma. In addition to the medical emergencies that would most likely include heart attacks, chest pains, and respiratory emergencies. Firefighters, Police Officers and Emergency Medical Personnel focused the primary response at the World Trade Center, the Pentagon, on evacuation, triage, treatment and transport.
It is now time for Congress, the Senate and Homeland Security to wake up and begin providing funding to Emergency Medical Services. It is also time that certain fire departments and it’s memberships wake-up. Too often as shown below firefighters, refer to EMT’s and Paramedics as, “The city's decision to include EMS in the firemen's memorial is disappointing and entirely inappropriate. Where they are assigned is irrelevant. Who the hell follows those orders? The real travesty is that in the coming weeks, EMS will begin sharing qtrs w/ E265/L121/BN47,” “If anything, we need to show them that this CANNOT WORK, so as to prevent any further integration.”
In New York FDNY Firefighters want the September 11, 2001, count altered for the number of Firefighters lost from 343 to 341 because two FDNY Paramedics who gave their lives in an attempt to save victims of the attacks, as well as firefighter who were suffering chest pains and heat exhaustion. In addition, one hundred and sixteen (116) EMT’s and Paramedics were injured in New York as well as nine (9) volunteer and Private Service EMT’s and Paramedics were killed. The merger of NYC EMS Services with FDNY Fire Services came at the demands of the FDNY Fire Commissioner, elected commissioners and then Mayor Giuliani. FDNY Firefighters are now crying over placing FDNY Paramedics and EMT’s in the station house an idea they (firefighters) find repugnant (See red italicized.)
It is time Americans realize that in this new world or terrorism along with “Catastrophic Natural Disasters,” Emergency Medical Services is a very critical component of homeland security and response. Since the September 11, 2001, terrorist attacks, EMT’s and Paramedics still have not received money from the federal government necessary to provide EMS the ability to communicate in a Mass Casualty Incident. Communications channels with Police and Fire Agencies, currently do not allow EMS Personnel to coordinate operations. Funding would provide this critical link and if funding was provided it would allow the additional training and exercises.
Since September 11, 2001, EMS Agencies still have not received federal funding necessary in providing EMT’s and Paramedics with protective biohazard equipment, along with money to purchase much needed equipment. In addition funding would allow EMS to stock surplus backboards, c-collars, first aid equipment such as bandages, and advanced airway equipment.
Do you know the poverty incomes (See http://www.davesems.com/emshq.html paid to highly trained Paramedic’s and EMT’s? EMS Personnel must spend thousands of dollars for training with EMS Educational Programs. Did you know that EMS Personnel must maintain between 45 and 65 credits hour every three years to maintain their state certification? In addition to maintaining State certifications, Paramedics and EMT’s must maintain certification in many States with the National Registry. They must also hold and maintain certifications in Basic Life Support, Advanced Life Support, Cardiac Life Support and finally Pediatric Advanced Life Support.
Did you know that an average of forty, (40) EMT’s, Paramedics, Flight Nurse and Medical Evac Pilots are killed in the Line of Duty each year? Many caused by inattentive drivers who have struck and Killed medics on the road, accidents, assaults, and murders. (http://www.davesems.com/lodd.html) This by no means represents the percentage of medics who have suffered injuries and permanent disabilities from inattentive drivers, accidents, and assaults. (The yearly numbers are very alarming)
The United States Senate, Congress, Homeland Security and the American Public need to know the simple principles of “triage,” should and must be applied with funding dispersal putting lives first rather than last.
Flamers and even some politicians will attack this editorial; however, it is not an editorial. This information is factual and can be verified by several points.
Or the next time you see one of your local EMT’s or Paramedics simply ask them if this material is not one hundred percent factual, they may not tell you about their poverty incomes for the critical community and national service they provide out of privacy, they will however confirm that the data stated here is in fact actual sadly. I wish I was wrong but after 24 years involved in EMS and having tracked EMS Line of Duty Deaths and Injuries since 1999, l am more than qualified to bring this to the light of the public and its disgraceful ignorance shown by Politicians and Government Agencies. The awful and horrific events of September 11, 2001 proved the above information.
Finally, with all the finger pointing by the Mayor, and Governor of New Orleans are the ones to blame for the initial disaster of disaster operations in failing to mobilize the National Guard ahead of time, failing in the organization of Police, Fire and EMS Personnel this is and was inexcusable. In addition, several hundred EMT’s Paramedics and Doctors were in New Orleans prior to Katrina attending a National Association of Registered EMT’s and Paramedic’s of an EMS Expo held in New Orleans. The attendees were not asked to stay and help mobilize for the needs of individuals injured or in need of medical care during evacuations and the aftermath that followed Katrina. And the EMS Personnel and Doctors were not stage in a “safe area,” for rapid response; instead they were left to fend for themselves without medical equipment and or vehicles and boats needed.
NHTSA Creation of the Office of Emergency Medical Services
The National Highway Traffic Safety Administration (NHTSA) is pleased to announce the creation of the Office of Emergency Medical Services EMS). Recognizing the consistent and long-standing contribution of the EMS program and its increasing responsibilities, NHTSA is elevating the stature of the EMS Division to match its expanding role.
The Office of EMS will report to the Associate Administrator for Program Development and Delivery, Marilena Amoni, and will continue its mission to reduce death and disability by providing leadership and coordination of comprehensive, evidence-based emergency medical services and 9-1-1 systems.
This national EMS office, in close coordination with its Federal partners, will serve its constituents with a coordinated, consensus-based process to reinforce the vital role of the EMS community in shaping and realizing its own future.
With a vision of universal and quality emergency medical care leading to optimal patient outcomes, the Office of EMS will function specifically to improve all aspects of EMS systems, at the local, State, and national level.
With its Federal and national partners, and through management of the statutorily created Federal Interagency Committee on EMS (FICEMS), this National EMS office will continue to provide the EMS community with a
mechanism for ongoing Federal coordination of EMS programs. If you have any questions or need more information, please do not hesitate to contact Mr. Drew Dawson, who can be reached at (202) 366-9966
Response to USA-Today Article that claims Study indicates “Fewer Paramedics will save lives.”
A study partially published by USA Today states that by utilizing fewer paramedics in large city will save more cardiac victims, the studies claims by utilizing a tiered response system that will allow fewer Paramedics to horn the skills of intubations and intravenous access will greater than chance of survival.
In Emergency Medical Services there are now four levels of Certification
Medical First Response Life Support (MFR) is the initial level of pre-hospital care in the EMS and is provided by a Medical First Responder at the emergency scene.
Emergency Medical Technicians provide a primary level of pre-hospital care in the EMS system and is provided by EMT Basic Personnel at the emergency scene and/or in transport to a medical facility.
EMT Specialist provides the next level of pre-hospital care in the EMS system and is allowed administer oxygen, treat wounds, immobilize spines, and to administer IV fluids, intubate patients and monitor heart conditions, but may not give medications.
Paramedics are the most highly trained who provide the highest standard of pre-hospital care in the EMS system. Paramedics administer oxygen, maintain airways using advanced airway techniques which can include surgical intervention, the are trained to recognize normal and life threatening arrhythmias including interpreting 12 lead EKG’s. Paramedics also establish intravenous access (IV’s) and administer IV fluids, as well as deliver medications through IV access to treat cardiac arrhythmias and provide pain medications when medically necessary.
Paramedics also hold additional certifications such as Pediatric Trauma life Support, Basic Trauma Life Support, Advanced Trauma Life Support, and Advanced Cardiac Life Support.
The argument that fewer Paramedics will provide better care is nonsense, is is paramount to saying that if you send one fire engine crew to a fire rather than three will cause the firefighters to bring a blaze under control quicker because they have fought more fires is just crazy.
Every Paramedic in the field especially in an urban setting such as Detroit, Chicago, or Los Angles start move I.V’s and Intubations than an Emergency Room Nurse or Doctor.
In addition Paramedics must maintain continuing education programs, with a minimum of 45 credits every three years as well as recertify their licensure which includes written and practical testing.
This is more training and supervision than what an Emergency room nurse or doctor receive, in addition paramedic runs are reviewed by a medical director for there county, and are provided with anatomy lab to practice advanced procedures.
There is a legitimate argument to utilize rapid response vehicles similar to the former 1970’s Nationally Recognized Police Emergency Unit Program that achieved high
Reducing the number of Paramedics will only put the public at risk, the study that was published in a USA-Today article sites only cardiac cases it does not even discuss the ramifications of reducing Paramedics will have in traumatic cases.
Important Information Regarding First Responder/EMS Asbestos Exposure
Listen up Washington Stimulus Packages needed for Emergency Services NOW
A post received by a Site visitor shared, it's a critical lesson to all Medics who respond to Domestic Violence Calls:
Hello, my name is Amy. Back in 1998, I was involved in a domestic dispute with my then husband. It ended up with me having a skull fracture. Thankfully my neighbors heard me screaming and came to my house, one being a paramedic.
I never knew him or any of my local paramedics, until that day! The paramedics were very gentle, kind, and caring also fast! They cleaned and wrapped my head , and kept talking to me to keep me from passing out, I did not see myself to know my injuries and they were that professional that I didn't know I was a trauma patient.
They shipped me to the ambulance and hospital which thankfully was right down the street from my home, and waited by my side in the emergency room as I was given a BIG needle in my head, may I add I was only 16 at the time. All the while keeping me alert and calm. They then had to transfer me to Bethlehem , Pa which was 36 miles away, along the whole ride they kept me comfortable asking normal everyday questions as they also did their work to me. They laughed with me and joked with me.
To make a long story short, I hear daily that many doctors get ALL of the credit for their work at the hospital, as we know they do a great job, but paramedics get looked past somewhat . It is you , police, and firemen/firewomen who are on scene first, not to discredit doctors/surgeons, but I want to say if it weren't for the paramedics,'prepping' me and treating me like family, I wouldn't have had a shoulder at that time to cry on, and I might not be here today.
I just want to say your job is special and gets overlooked sometimes but I thank you for letting me have another chance at life and therefore I have children and a wonderful fiancee. Thank you again and I hope anybody who is deciding on being a paramedic or something similar does become one , because it is rewarding and there are people like me who appeciate what you do. Thank you again, Amy
THE HISTORY OF EMS WEEK
THE HISTORY OF MEMORIAL DAY
On July 7, 2011 A Domestic Violence Situation resulted in a mother/wife her daughter and her parents being murdered by
the victims husband/father/in-laws being shot to death. In addition the Husband then targeted ex-girlfriends killing another three, a former girlfriend her sister and her sisters 10 year-old daughter. The killer then shot and wounded another female friend.
October 05, 2011: Then final report of what occured to a Mother her, child, and Her parents, as well as 2 other women Murdered through the final act of Domestic Violence. For more information click here.
Domestic Violence Awareness Month is observed every October for thirty-one day's public service commercials are aired. Then for the next 11 months News headlines report the senseless attacks against women (and men) EMS, and Police Officers respond everyday to reports of domestic violence and injuries and deaths. Domestic Violence Awareness needs to be addressed daily not just one month out of twelve.
If you need help call the Police, they can refer you to a local Domestic Abuse Center, the Courts, and assist in preventing a disaster.
EMS continues to face cuts in Medicaid and Medicare Reimbursements, EMS Volunteer, Services as well as Private EMS Agencies.