EMS Information & Editorials-2
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                      YOU WANT TO BE AN EMT OR PARAMEDIC
In the State of Michigan prior to certifying as a Paramedic you must first complete the Basic Emergency Medical Technician (EMT) training and certification. Basic EMT training is conducted by many Private EMS Education programs and several community colleges in Michigan.

        Your first step is to enroll in EMT training. EMT requirements are as follows:

1. You must have a high school diploma or GED and be 18 yrs of age.

2. It must be a state approved EMT program

3. You must be able to pass a physical examination and be signed off by a physician as having sufficient health to perform the responsibilities of an EMT.

4. No Felony, Drug, or DUI convictions.

5. Pass the schools prescribed EMT course with an average of 80%

6. Take both the State of Michigan’s EMT Basic, EMT Specialist, or EMT Paramedic’s exam as well as take and successfully pass the National Registry Exam

After meeting the above requirements, an applicant will need to enroll in a Paramedic training course given by many institutions and community colleges to prepare to become a State certified Paramedic.  Michigan also mandates that a Paramedic Candidate must take and pass the National Registry Exam.

After you pass the State and National Registry Exams In the state of Michigan paramedics must recertify every 3 (three) years this is accomplished by attending continuing education classes that provide the 45 credits necessary to recertify as a Paramedic.

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.

Working as a paramedic is different throughout the U.S., a lot of EMS agencies are privately owned services, other EMS services both Municipal and Volunteer operated.    In the 1990’s several cities and suburbs began contractual bidding for EMS services with companies like Trans-Med, American Medical Response, MAST, and American Ambulance services. Many private service’s personnel work eight or twelve hour shifts working an average of 4.5 days per week.  Local government and fire services who provide EMS coverage work a 24 hour shift consisting of one day on two off. Many rural EMS services depend heavily on bond revenues that are voted on during general elections.  Also a major part of EMS providers consist of Volunteer companies, Volunteers are often forgotten about these men and women work full time in various jobs and volunteer their off time to responding to medical and trauma call for little to no compensation.

The average income varies significantly from agency to agency and state to state.  E.M.T.’s base salaries nation wide average $18,000 to $22,000.00. Paramedic’s average income nation wide ranges in the area of $28,000.00 to $32,500.  Municipal agencies average a much higher income level that can go as high as $42,000.00 based on a salary survey conducted by the Journal of Emergency Medical Services in 2003.  Private and Municipal EMS Services do of medical and dental benefits however a lot of Medical packages are low end, with high premiums and co-pays.

A medic’s duties start at the beginning of their shift with the responsibility of checking their units that involves inventory, restocking and safety checks prior to leaving their base to insure that all the equipment is operating at 100 percent.  Many private services especially in large communities utilize Computer Aided Dispatch Center’s, (CAD) with the exception of Municipal services Units are distributed through out there territory and sit (point) that is they are geographically positioned in parking lots, near highway on ramps which reduces response times by dispatch the closes Unit.   When a Unit is dispatched to a call, other units are repositioned by dispatch to maintain rapid response.  EMS Services also use a “Status Level Program and stagger the time of new oncoming medics.  For example Mercy Ambulance would operate 16 Units at all times, when is unit is dispatched the status level drops to level 15 and on and on.  When available unit coverage drops below 3 units are redeployed to “Central Locations,” through out the city, and then as units clear the coverage level rises and units are again re-deployed.

Fire based EMS Service’s do not generally employ the above concept instead  they operate out of a variety of stations through out the city  and while "on duty, " they have nice warm and dry crew quarters that includes beds, a complete kitchen, living room with cable TV, lockers and showers. Basically, it’s just like being at home in many ways.  

Many EMS calls are dispatched as “emergencies,” also known as “priority one calls,” or “code one,” however after you arrive on scene 60 percent of the calls end up as non-emergency situations and sometimes you arrive to hear that the patient has Medicaid and want a ride to the hospital because they can’t afford a cab. (It really happens)  The other 40 percent of the emergency response calls turn out to be major trauma calls or medical emergencies.  This is where you skills are put to their fullest test as you fight to save the life of an infant, child, teenager, adult, or a senior citizen.  When you have been in Emergency Medical Services long enough you will encounter those calls where you will arrive at the scene and be confronted by a yelling family member for tracking mud on their new living room rug, after you have fought to save a patient found to be in cardiac arrest.  When you been in Emergency Medical Services long enough you will learn to eat you meals such as a sloppy hamburger in three large bites because OSHA no longer allows you to eat in the cab of your rig. 

You must remember that when you join the Emergency Medical Services family you will encounter call’s that no matter what you do, with all the skills you were taught and all the equipment at your disposal and medications patients will die despite every thing you and your partner do. You must remember that you are not God, or a super medic the minute you start thinking you are is the day you must leave Emergency Medical Services.  Keep in mind that as long as you have done everything that you are taught, you have done all that is humanly possible.  Emergency rooms loose patient’s every day and they are in a controlled environment, you are not.  You treat patients who bodies are twisted around metal that once was a car, treating patient is the back of an ambulance as your partner rushes to the hospital fighting traffic that won’t yield for the lights and sirens slowing your response to get your patient to either a trauma center or E.R.

In Emergency Medical Services you will be called to motor vehicle accidents, (MVA) in which you have several critical teenage patients on prom night who had been drinking prior to the accident, which they piled into a car, and didn’t use their seat belts.  And when they cross the center line of a road and struck a vehicle head on or plowed into an oak tree that has launched some of you patients into the windshield or having the patient thrown out of the vehicle turning an accident from a potential minor traumatic injury to a major traumatic injury.

Emergency Medical Services is a wonderful profession; you will have good days with a birth of a child in the back of your unit to bad days where a child ran into the street and being struck by a car that dies from severe traumatic injuries.  You will meet patients of every race, color, nationality, and religion.  You will treat newborns to senior citizens suffering from medical, traumatic, and emotional problems. You will work with a partner who will become as close to you as your own spouse. Your office is on four wheels, you will treat patients in the rain, snow, ice, and extreme heat, and you will treat patients in their homes, offices, churches and synagogues.  You will have patient who will be gladden to have you at their side and you will have patients who will hate you and not want your help.

In Emergency Medical Services, you will take an oath to treat patients without prejudice, you will wear a uniform and sometimes a badge, you are not armed, as a EMT or Paramedic your armory will consists of a rolling Emergency Room filled with oxygen, Intravenous Solutions, (I.V.) medications, defibrillators, bandages and ice packs just to name a few.  You will endure the name and the label of an “ambulance driver,” even after you trained and were both state and nationally certified as an “EMT” or a Paramedic.” 

In Emergency Medical Services, you will face danger in many different ways such as a vehicle or truck that fails to yield to you lights and sirens and hits your unit broadside at an intersection, a hostile act involving a knife or gun as you arrive to find the assailant still on the scene who may turn on either you or your partner or both of you.  Treating a patient involved in an accident only to have an irritated or inattentive driver who fails to slow down and ends up striking you or your partner, your patient, and your rig.  Being assaulted by an emotionally disturbed patient, or an over dose patient, even a distraught family member of your patient.  In Emergency Medical Services, you will be injured and or assaulted at least three times over the course your career.  Medics were targeted by the two teenagers at Columbine High School and shot at several times as they risked their lives to pull students out of harms way and render critical treatment. 

As a member of the Emergency Medical Services field today the number of EMT’s and Paramedics injured and or killed has dramatically risen over the past ten years at an alarming rate, in a recent study conducted by Brian J. Maguire showed that EMT’s and Paramedic’s that more EMS providers die on the job than anyone had ever suspected, making our occupation as dangerous as police officer’s or firefighter’s, according to the first-ever national study of EMS fatalities. "Occupational Fatalities in Emergency Medical Services: A Hidden Crisis," which was published in the December issue of Annals of Emergency Medicine, the peer-reviewed journal of the American College of Emergency Physicians, (by Brian Maguire, MSA, EMT-P, the studies chief researcher and author) conducted Between 1992 and 1997, the study found out of 114 EMT’s and Paramedics who died in the line of duty death showed that more than half of the medic’s lost their lives in ambulance response accidents. The study shows that EMS has a 12.7% fatalities rate per 100,000 EMS personnel, making Emergency Medical Services equaling the fatality rate with Law Enforcement which has a death rate of 14.2%, firefighters with a death rate of 16.5%, the study further showed that the death rate for EMS Personnel was at more than twice the national average for all workers which was at 5.0%.  “The EMS profession is much more dangerous than people realize.
The study also revealed that EMS personnel, which includes  both emergency medical technicians and paramedics, are exposed to a wide variety of occupational hazards every day, including ambulance accident’s, assaults, infectious disease, hearing loss, lower back injury, hazardous materials exposure, stress, extended work hours, and exposure to temperature extremes.  In addition EMS uniforms can resemble those of police officers, in most cases both have badges, patches, even similar color schemes.  This sometimes leads to EMS personnel being mistaken for police officers and encounter misdirected violence.

The in the line of duty deaths in the field of Emergency Medical Personnel continues to increase with medics being assaulted with guns, knives, and brutal attacks. (See Line of Duty Deaths, previous years and current In the Line of Duty Deaths.)  Many EMS Personnel today purchase and wear bullet proof vest, some private and governmental agencies do provide bullet proof vests, however the percentage is low.  Bullet proof vest cost approximately $500.00 – $600.00 a piece, but is rapidly becoming necessary “equipment,” and in my case (see my bio page) prevented a more severe spinal cord injury had I not been wearing a bullet proof vest which was provided by my employer the   former Mercy Ambulance Service of Grand Rapids.

Medics have been forced to defend themselves, and then have been criticized and even in some cases have been prosecuted. Weak laws and punishments continue to contribute to the increased violence against Emergency Medical Personnel, Federal State and Local Governments have slowly started to write “tougher legislation,” to create stronger laws and penalties for individuals who attack causing injuries, disabilities, and death to Emergency Medical Technicians and Paramedics.  Once stronger laws are passed and implemented prosecutors must not plea bargain down charges.  Judges must hand down firm sentencing, and community service sentences should not be an option.  It is time to send a message that attacks against EMS Personnel will not be tolerated!!

Emergency Medical Personnel are frustrated with the increased assaults against themselves, their partners and spouses who also work in the Emergency Medical Services Field.  Several EMS Agencies have created the feeling that EMT’s and Paramedics are easier to replace then to stand up and support them for defending themselves from assaults. 

One visitor wrote in my guestbook (EMS Dangers) “Look at the hiring lists with some of these departments; there are hundreds of candidates able to take my job. It is easier to terminate an employee than to back them up and defend them to the media and public. We are supposed to be the good guys even if it costs us our health, jobs, or lives. I love my job, but I love my life more.” The visitor goes on to say “I know my department is likely to fire me for defending myself, but I would rather be out of a job than suffer a debilitating or fatal injury at the hands of out of control patient, I am also sorely aware that I am expendable.”

Another medic wrote: (EMS Dangers) “I want to say something about assaults on EMS personal I'm a field training officer for a company in the State of Michigan that provides EMS Service’s to multiple psychiatric facilities, we also service a small city with a pop of less than 60,000 residents.  The city has a epidemic of heroin use, we average about 300 calls a month from this city almost half of these calls are overdose or drug induced psych emergencies we average approx; 3 assaults weekly (against EMS personnel) several have resulted in serious injury ranging from hospitalization to people having to leave their profession.  I personally have been physically assaulted 4 times in the past month.”

“One time I required E.R. treatment, after I was suckered punched by a very large male who was in suffering from a drug induced psychotic state, I was knocked unconscious as the local police were trying to calm the patients family misdirected anger toward the medics.  My partner only a step away came to my defense striking the patient knocking him unconscious, he was not arrested (the patient) because he was petitioned for psych evaluation.  My partner was suspended for a week for injuring the patient, later the patient attempted to sue, the case was eventually dropped.   Frankly I'm sick of it, the individuals who assault medics get little or no punishment for there actions.”

The medics goes on to state, “I carry a set of handcuffs, pepper spray and a 20inch ASP which is in direct violation of company policy, I don’t care I'm going to protect myself. (It is illegal to carry the above defensive equipment in the State of Michigan and for the fact many of the states. (Off duty police officers who work in EMS as well are not permitted to carry their off duty weapons) My company seems to be more concerned with preventing lawsuits than protecting our safety


           Should EMS Personnel be armed? 

                  Yes (595)  75% 

                   No (168)  21%

            Not Sure (31)  4% 
                                         794 total votes as of 01/01/2012 

Emergency Medical Services since September 11, 2001, have now taken on a major new role these men and women are the first line of defense, today EMT’s and Paramedic’s are part of the country’s new Homeland Security’s front line of defense, accompanied along with several Law Enforcement departments and agencies, Firefighters, the United States Coast Guard as well as the National Guard.  On September 11, 2001, EMS played an enormous role in New York, Washington D.C, and Pennsylvania.  On that awful day hundreds of medics responded to the various locations, and are family (EMS) suffered the following Line of Duty Deaths and Injuries: 

                     Number of Emergency Medical Service Providers Injured: 116
                                            Total FDNY-EMS injured: 65
                             Total Volunteers EMS and Private EMS Providers injured: 51
                                             Total Number Injured:116

                     Number of Emergency Medical Service Providers who were killed: 42
                                                 Total FDNY-EMS Killed: 2
                                                 Total Volunteer & EMS Providers killed: 2
                                           Total Private Ambulance Providers killed: 28
                              Total Other  02
                                                 Total died after 9-11: 14  (Updated on 10-02-2014) Police-Fire-EMS
“Be there’s no greater gift than a man or woman who sacrifices their life so that others may live.” These are the words that our Emergency Medical Personnel, Police Officers, and Firefighters and live by everyday.

Today there are over 155,000 nationally registered Emergency Medical Technicians (EMT) and Paramedics, 1 million firefighters in the United States, of which approximately 750,000 are volunteers, Local police departments have an estimated 556,000 full-time employees including about 436,000 sworn personnel along with  Sheriffs' Departments have approximately 291,000 full-time employees, in addition to 186,000 who are sworn reservists.  These men and women wear the uniforms of their chosen professions, today they are providing police protection; firefighters are providing haz-mat and containment training in the event of chemical and or biological attacks. EMT’s and Paramedics are training for both mass casualty incidents, (MCI) and chemical or biological exposure from potential terrorist attacks.  The potential for EMT’s,  Paramedics, Police Officers, and Firefighters, losing their lives has becomes a greater risk since September 11, 2001, as they will be the first responders to further potential attacks as they will be the ones, who will again respond to any location and will once again risk and sacrifice their lives so that others may live.

EMS (Emergency Medical Service’s) is still a young profession; the concept for pre-hospital care began during the Korean War, with the military using surgeons and nurses in field hospitals called “mobile army surgical hospitals,” (MASH) these units actually increased the survival rates for wounded soldiers.  In the mid sixties pre-hospital care moved from funeral homes that provided first aid trained attendants which highlighted the “Carrying of portable oxygen.”  In the 1950’s and sixties these attendants were often called “Ambulance Driver,” because patients were generally loaded into the back of station wagons and Cadillac’s and rushed recklessly to hospitals. 

During the mid sixties as the Vietnam war soldiers were trained as field medics and treated wounded soldiers right on the lines during combat with amazing success rates.  This coupled with the need for better pre-hospital care became the focus of the national highway transportation administration.  As Vietnam veterans “field medics” returned home many joined private Ambulance companies.  States began EMT programs and standards that rapidly changed the role of the pre-hospital provider. 

By the 1970’s “Paramedic programs became very intense medical training,” Medics were provided with advanced training that allowed medics to provide advanced life support to the sick and injured.  EMS agencies went from “load and go,” to “treating and stabilizing patients on scene and in transport.”  Ambulances began the transformation from band-aid wagons to highly specialized transport units equipped two way communications with emergency rooms and Doctors, portable defibrillators,  cardiac medications and I.V. solutions to advanced airways utilizing such equipment as advanced airway management known as endotracheal intubations (advance airways) the results of  “in the field patient treatment radically changed patient outcomes.   In 1972 Director Jack Webb produced the television show “Emergency,” which NBC aired and educated the publics for the first time as to the field of Advance Life Support.  The characters “Johnny Gage and Roy Desoto,” showed that paramedics were extensively trained, certified, and equipped with very sophisticated medical equipment and were able to provide treatment to a patient who use to have to wait to receive advance medical assistance and procedures until they arrived at an E.R..  The television showed EMT’s and Paramedics as professionals no longer “Ambulance Drivers,” EMT’s and Paramedics joined Law enforcement and Firefighters as a separate division of   Emergency Medical Services.  When you have completed your Emergency Medical Technician Training and you become a certified EMT, or Paramedic you become a member of a very proud profession and become an extended family member.  Emergency Medical Services is a profession in which you will deal with life and death and you must be able to make quick decisions in order to save an infant, child, adult, or senior citizen suffering from either a traumatic injury or medical emergency.  It is not always a happy profession nor one were you will earn a fortune, but you will make an impact whether it is delivering a newborn in the back of your unit, to treating a critically ill or injured patient along with providing comfort to a patient pinned in a car as rescue personnel work to free him or her.
These are very dedicated and very special men and women who work as Professional Emergency Medical Technicians and Paramedics.

This a true glimpse of EMS today, if you want to make a difference and you truly want to be an EMT or Paramedic, you need to join our family, we would love to have you join our special and caring family who give their all.
David--10-2004 Updated 08-2010
                                       Emergency Medical Services
                                             Emergency Medical Technicians and Paramedics
                                                This is Who We Are and What We Do!!
Emergency Medical Services Personnel are very special group of men and women that are committed to the sanctity and preservation of life.  Our office is a custom built vehicle which is called an “Ambulance.” There is no telephone or office chair, instead the ambulance is equipped with several thousand dollars of high tech radio equipment capable of communicating with a dispatcher, and this is the person with whom you will first speak with when you need help, Dispatchers are the third partner to a Paramedic crew.  The sophisticated radio equipment also allows EMS personnel to speak to an emergency room and the E.R. doctors.

Instead of a chair, are office has two bucket seats, which are equipped with the most critical lifesaving piece of equipment called which is called “seatbelt’s”; this device saves thousands of lives every year. The ambulance also has a rear compartment that is equipped with a cot which is also known as a stretcher, along the walls are specially built cabinets that hold’s many medical supplies. The rear compartment is referred to as the patient compartment; it is a mobile emergency room, and intensive care unit, that is equipped with everything that you would find in a hospital emergency room. At the head of the stretcher there is a bucket seat and to the right is a bench seat that allows the medics to administer to the sick and injured.

Outside of the ambulance are placards that identified our office, there is a star of life located on both sides of the ambulance and one on each rear door window. Also there are 911 stickers that are also located on both sides of the ambulance. On the hood of the ambulance spelled backwards is the word ambulance. (ecnalubma). This highly technical vehicle has on its roof, lights that are called flashers, and in the front grill are speakers which wind out several sounds which is called a siren, on the front quarter panels are strobe lights referred to as intersection lights, there is also four lights on both sides of the rig and generally two to three additional lights on the back of the unit.

Once someone has become ill, and or injured a crew which is generally made up of two people that I referred to as partners and highly trained, and very professional emergency medical technicians, emergency medical specialists, and paramedics, are dispatched and answer your call for help. In an emergency the partners, activate their flashers and siren and begin the journey to come your aid.  The individual who is driving this high tech vehicle known as an ambulance is also a medic, just like the medic he or she is sitting next to. These highly trained medics are rushing to your assistance, is not an ambulance driver at the wheel, instead this is the person who is driving the vehicle while enroute to render assistance. He or she is not an “ambulance driver,” instead he or she are simply the professional who is fighting with time and traffic, hoping that drivers will obey the law and yield the right away for this emergency vehicle, hoping that other drivers hear their siren and see their flashing lights and will pull to the right and let them pass. The other medic is scanning the road watching intersections, for drivers who fail to yield for the emergency vehicle.

The partners know that time is critical, and for every vehicle that does not yield, take’s second’s even minutes away from someone who is in need of our help. Every time the medics are cautiously racing to someone's aid, they always remember that their own lives are in danger from driver’s who do not pay attention, which could lead to a serious even a fatal collision which in addition could and would deprive the patient that they were responding to help, treatment that could cost the patient their life.

Emergency Medical Technicians, Emergency Medical Specialists, and Paramedics, work in large urban cities, small towns, and rural communities. Most emergency medical services providers are volunteer services located in rural communities and private ambulance services run by private EMS agencies. Over the last several years fire services in major cities such as New York, Detroit, Chicago, and Washington DC operate Emergency Medical Services through its Fire Department’s. The National Transportation Safety Administration indicates that the majority of licensed Emergency Medical Personnel actually work for non-profit volunteer agencies as well as privately owned services such as life EMS, American Medical Response, and Mast.

Across the United States Fire Departments now serve as certified Medical First Responders, who are also dispatched with an ambulance, in an effort to provide quicker response times in to provide earlier patient intervention especially for a patient in cardiac arrest, armed with a new tool which is called an automatic defibrillator. (AED)

A survey conducted by the National Transportation Highway Administration, indicates that the average pay scale for these highly trained professionals amounts to approximately $12.00 to $14.00 an hour. The average work week consists of 48 to 52 hour weeks. $12.00 to $14.00 an hour, why in God’s name would someone work these kind of hours and for these atrocious wages?  These men and women generally have families that consist of a spouse and children that they raise with an income that places Emergency Medical Technicians and Paramedics in the poverty range. 

Yet we still do the job why?  The answer is very simple, these men and women who are called Emergency Medical Technicians and Paramedics do the job because of their passion for the job, the joy of assisting in bringing a new life into the world, the satisfaction of bringing a life back from the brink of death. The tremendous pain that is encountered by these people, these heroes when they encounter a child who’s been viciously abused, a teenager whose life ended from a gunshot or a stabbing over colors that are worn, or the six teenagers who were returning home, from their high school prom, that lay dying and dead, because alcohol that was consumed impaired the drivers judgment causing the driver to miss a curve that resulted in their vehicle to end up wrapped around a tree.

$12.00 to $14.00 an hour; A spouse, who is also a medic says goodbye to his or her family and drives to work to start another shift of providing and utilizing their medical skills to help another, victim whose family needs and wants their loved one to live. Already this year 2004 we’ve seen one paramedic shot and murdered and three others shot and seriously wounded, as they attempted to provide care and instead were shot down. Nine more, Emergency Medical Technicians, Paramedics and Air Medical Flight Crews have died responding to a call for help.

$12.00 to $14.00 an hour; several hundred Emergency Medical Technicians and Paramedics will be injured and suffer disabilities over the course of this year. They will be assaulted, attack and injured by the very same people who called for their help. Emergency Medical Technicians and Paramedics will be injured and killed in traffic accidents because of inattentive drivers, drunk drivers, and impaired drivers.  A supervisor today, next week, and next month, will be given the worst task of his or her career, as they must ring a doorbell of a fallen comrade’s home informing him or her that their hero and their children’s mother a father, has paid the ultimate price, their life.

The 6:00 p.m. news will report that an “ambulance driver,” was killed or murdered for three minutes the news channel will air a report of the incident, and we must continue to do our job despite the fact that we have lost a professional, a hero, and a friend. The news will move on to the weather forecasts for the next day and by then will you remember later that night that you’re town has lost an Emergency Medical Technician or Paramedic?

Paramedic’s and Emergency Medical Technicians, are truly professionals, and all too often these unsung heroes are forever lost, the news papers, the media, often fail to credit the men and women who make up Emergency Medical Services for their work and sacrifice.

Do you need proof?  Almost three years after our country came under attack by several groups of terrorist using passenger jets that attacked the New York City Trade Center, and Pentagon. At the WTC, 343 FDNY firefighters lost their lives, New York City Police Officers and Port Authority Officers lost their lives.  Today we still here of the Firefighters and Law Enforcement Officers who perished when those buildings collapsed, and we should be hearing about these heroes who paid the ultimate price with their lives. 

Though how many times since September 11, 2001, have you read in the newspapers and reported by the news media of the many Emergency Medical Technicians and Paramedics who lost their lives as they were treating patients in one of the WTC Towers? 

Several Emergency Medical Technicians and Paramedics were treating and extricating individuals from the towers, and then re-entered the WTC Towers, to continue to treat the injured when suddenly the towers collapsed on them, costing the American people several Emergency Medical Technicians and Paramedics.

EMS Personnel, Firefighters, and Police Officers gave their all, and should never be forgotten.  Remember they worked as a team and have been credited with saving over 25,000 people lives, because these three professions, work as one and as a result many people are alive today because of  their dedication, professionalism, heroism, and bravery.

The news media, newspapers, and many local and federal politicians, failed to report and give recognition for the many EMT’s and Paramedics who made the ultimate sacrifice with their lives so others would live on, after September 11, 2001.  The public, news media, and newspapers need to be educated that Emergency Services is composed of three (3) Services; Emergency Medical Services, Firefighters, and Law Enforcement Officers.

Remember all the disasters, civil unrest, violence, and terrorism that Emergency Medical Service Personnel who played such a major role in response to the above situations. In the 1993, at the World Trade Center was first attack, many people in the building suffered smoke inhalation, stress induced trauma, and other medical problems, in fact several schoolchildren and there teacher where trapped in an elevator, in which a paramedic was subsequently lowered down at great personal risk and assisted with the extrication of all the students and their teacher.

When the Federal building in Oklahoma was bombed, Emergency Medical Services Personnel remained at several pts side, even after receiving news that there was possibly additional explosive devices on site. Again Emergency Services, consisting of Emergency Medical Services, Firefighters, and Law Enforcement Officers work as a team in the rubble despite the risks of falling debris. As patients were brought to staging areas, a R. N. lost her life after being struck in the head by falling debris.

Again, Emergency Services were activated during the columbine incident involving several victims injured and dying from being shot on school property.  Paramedics from American Medical Response also came under fire immediately after arriving on scene, as they were working on patients that had been shot outside of the school. Again, Emergency Medical Services Personnel worked aggressively and at great risk along with the Firefighters and Law Enforcement Tactical Teams.

Emergency Services is comprised of Emergency Medical Technicians and Paramedics, Firefighters, and the Law Enforcement Agencies continue to work collectively in all sorts of situations, the aftermath of hurricanes, devastating tornadoes, and factory and chemical fires and explosions just to name a few.

Private EMS providers and Volunteer Agencies are currently suffering from financial difficulties because of the major reduction in payments from both State Medicaid and Federal Medicare programs, along with cuts made by HMOS.  The cost of EMS vehicles continue to escalate, in addition EMS vehicles must meet Federal KKK specifications that are set by the NTSB which were just recently upgraded, these increased specifications adds to increased costs for new EMS vehicles.

Since September 11, 2001, Emergency Services consisting of Law Enforcement, Firefighters and Emergency Medical Services have become the United States new front line of defense. In addition the President of the United States along with the United States Congress has formed the new Federal Department of Homeland Security; the Department of Homeland Security has developed and has implemented a five stage National Alert System.

Since the conception and deployment of the National Alert System, the threat level has been raised five times; along with the formation of the Department of Homeland Security has put together federal block grants which have been made available to hundreds of Fire Departments and Law Enforcement Departments for new equipment and training.

Unfortunately Emergency Medical Services is not receiving equal grants for equipment and training, mainly because private and volunteer Emergency Medical Service Provider’s, are not affiliated with city, state, or Federal Agencies.  Fire Departments that operate Emergency Medical Services such as the New York City Fire Department, Detroit Fire Department, and the Chicago Fire Department just to name a few have received funding under the Fire Department grants for equipment in additional training.

Since Emergency Medical Service Providers respond to major incident scenes, it is very critical that the private sector and volunteer sectors of Emergency Medical Services are provided with the same significant grants and funding for equipment and additional training for Emergency Medical Technicians and Paramedics. Many EMS providers already train with Law Enforcement Tactical Teams.  However all three (3) Divisions of Emergency Services must still do a better job of working and training together. In addition it is time that the negativity between these three agencies ceases and mutual respect and cooperation increases.

This is also the time for the public to become better educated about Emergency Medical Services, and the men and women who are so deeply dedicated and committed to the job that they do, and the professionalism they show in the way they perform their duties, and sacrifices that they make. Emergency Medical Technicians and Paramedics deal with life and death every day equaled to a Hospital Emergency Department.  However there is a major difference in the type of environments that they work in. 

EMS personnel work in many hostile environments, all types of whether such as the rain, snow, cold, and extreme heat. We crawl into twisted steel that once was a vehicle and treat the injured. We work on patients in million dollar homes and old refrigerator boxes patients live in underneath highway overpasses.

If I had a penny for every time someone has asked me, why I do what I do, I would be rich and would never have to work again.  We do what we do not for the glory, definitely not the money, we do our job because we are committed to helping the sick and injured.

Emergency Medical Technicians and Paramedics,

This is who we are and what we do!!

Written by:  David D.
Site Owner:  Dave’s EMS Headquarters
                                                      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 (C)
Written by: Dave D.   05-15-1991 (c) (Copyrighted)

The brave fearless 'Fighters' that step out into the night, working under extreme conditions, for which we have no insight.

Their continued schooling is never ending, for to them, your life is only just beginning.  Crawling through pieces of what used to be a car, to find a person lying there in need of CPR.  They are called Paramedics, a link between life and death, all give a priceless gift, the gift of breath.

The equipment they must carry, you may not understand, but one kneels beside you, as another takes your hand.

They feel the Angel standing there, but refuse to let you go, searching their deepest thoughts of knowledge that they know.

Until such time their job complete, and you return to them, only then will they place you in a physician's hand.

They no sooner leave the hospital, another call comes through, lights flashing, sirens screaming, fighting traffic to get to you.

A child this time in need of help, unsure of what went wrong, they begin their protocol of survey, soon realize this one is gone.

On bended knee, heads hung low, a tear slips down their cheek, always asking questions, looking for answers that they seek.

The shift will be a long one, twenty four hours to be exact, a proud profession that they chose, without even looking back.

And the next life that they save, to bring a loved one home, perhaps it will be your life, or it could be their own family.
The next time you hear a siren in the distance; don't just say a prayer for the victims and their families.   Say a prayer for the people that face these tragedies every day and do the best they can to save someone that is loved. We never see the tears of these brave men and women, but God does.
                                                         When God Made 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 to save, 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.
The Next Time You Hear A Siren
                                    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

                 Medics are First to Respond to the Health and Safety Needs through-out America’s Communities

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 administration, application of splints and 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 and ambulance service’s role during a natural disaster or public health emergency includes patient triage, decontamination, treatment, transport and disaster shelter 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 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.
New WTC Health Coordinator Position
Ground Zero Rescue personnel may benefit from the creation of a WTC Health Coordinator, which will monitor patients being treated at various hospitals and clinics in New York.

New York FDNY and EMT’s and Paramedics that includes private EMS Providers who responded to the World Trade Center on September 11, 2001, continue to face serious health and respiratory ailments that was a resulted of their heroic response to the World Trade Center on September 11, 2001.  Many medics have been forced to retire and leave their jobs as their health continues to decline.

Although the city and Fire Department have tracked the Firefighters who were exposed but the data of the medics have not been collected and evaluated for an overall comparison that could lead to better medical management.  With the introduction “of a WTC Health Coordinator,” this will enable a more uniformed tracking of the medical situations that has already taken the lives of three medics thus far.

Dr. John Howard, Director of the National Institute of Safety and Health, was appointed to the position in February of 2006, after Staten Island Congressman Vito Fossella and Manhattan Congresswoman Carolyn Maloney pressed for the development of a federal 9/11 Health coordinator.

In early march 2006, $75 million dollars in federal money was finally reinstated to aid those who were injured and have since become sick with respiratory ailments.  This site Dave’s EMS Headquarters was contacted by news agencies regarding its ongoing commitment to expose the issues faced by the EMT’s and Paramedics who continue to be affected and continue to be denied medical benefits and Disability benefits.  This site (Davesems.com) will continue to address this issue and keep the publics attention.

We are losing highly trained and very experienced EMT’s and Paramedics, they need our help, please remember they responded along with Police and Fire Personnel and as a team helped to successfully save an estimated 70,000 lives.  Today they need your help please contact your congressman and Senators and ask them to help EMS.
Dave D.
Owner: Dave's EMS Headquarters
Click text: "EMS Hero's Lost on 09-11-01"
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As you all should be aware, Senate Bill 169, also known as Michael's Law, was amended to include First Responders, EMTs, Intermediates, and Paramedics performing 911 calls, or Paramedic Intercepts.  The bill went to the Executive Departments and Administration Committee last week.  It was sent to the complete senate with a 3-0 vote of the committee to amend the bill to include EMS providers.  The full senate voted on the bill today.  They voted 14-10 to keep the amendment, and 24-0 for the original bill.  This means the bill is still intact and now heads to the Senate Finance Committee, since it is a funding bill. 

The discussion on the floor implied that the Finance Committee will be looking at ways to fund the bill.  Presently the bill is being funded by the Group II retirement system.  Non-Fire based EMS services are not paying into Group II system, so there has been a lot said about that.  This is a topic that needs to be studied closely so that the bill can move forward.  We will still need everybody's help.  There is a long way to go before the bill becomes a law. 

I did speak with Paramedic, Pat Banken.  Pat is a friend of my from my NYC EMS days.  Pat is the Union President for the EMS Local of FDNY EMS.  He sent me 50 supplements that appeared in the October 2001 JEMS Magazine that had pictures, and articles pertaining to 9/11.  The cover says the most.  No words, only an FDNY EMS Ambulance covered in debris with it lights on.  I will pull those out when we need them.  I did have a conversation this afternoon with Govenor Lynch.  The Governor thought the bill was not going to be a problem.  I thanked him for his support, and offered him one of the JEMS supplements to read.

I want to thank EVERYBODY for their assistance and support of this bill.  Everybody that wrote a letter to a Senator, everybody that sent an e-mail, everybody that "phoned a friend", EVERYBODY!  Without everybody, this bill would not have made it as far as it has.  The fight is not over yet.  Two hurdles down, several more to go.  I want to make sure that everybody knows that this was a group effort of the EMS Community.  This was not Dave Hogan from the Paramedic Association, Jennifer or myself doing all the work.  WE as an EMS community deserve the credit for a job well done.  Again, I want to remind you that we are far from complete, but we have cleared some big hurdles.

There are also a lot of people outside the EMS Community that also deserve our thanks.  I do not know everybody involved, there, but please pass on our thanks. 

Keep up the good work. 
Gary Zirpolo, EMT-Paramedic
Vice President
NH Association of EMT's
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 will be held throughout the nation May 18-24, 2008 to celebrate the history of EMS and honor EMS providers. 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.

Using five as the best I would Rate this Site Page?

Who operates your local EMS Services
Paid on Call
Private Company
Fire Operated
County Run

What is your Current  Level of Training
Medical First Responder
Flight Paramedic
EMS Instructor Coordinator
Emergency Medical Dispatcher

What would you do if you were driving down a country road and your car was struck broadside pinning you inside your vehicle, and you were critically injured?  What would you do if your son or daughter were crossing a city street headed for school and was struck by a vehicle, your child lays crumpled and bleeding with multiple open fractures?  What would you do if you were shopping with your spouse in a department store and he or she suffered a heart stopping sudden cardiac death?  What would you do if this country suffered another horrific event similar to September 11, 2001, leaving thousands of injured and dying victims?  What would you do if a gunman once again enters a school or university classroom and opened fire on your children leaving dozens in need of medical attention?

The answer to the above six questions sounds so easy, call 9-1-1 prompting a response by our three Emergency Services, which currently would consists of Police, Fire and EMS.  When you call 9-1-1, in most cities and counties your tax dollars fund Police and Fire Services, even Volunteer Fire Departments.  However in most cities throughout the United States, the vast majority of Emergency Medical Service Providers are made up by “Private for profit,” EMS Companies, who hire the largest number of Emergency Medical Technicians (EMT’s) and Paramedics.  Medics employed by these providers are also the lowest paid.  In rural area’s EMS is widely provided by volunteer EMT’s and Paramedics. Counties operate EMS as a taxed based EMS System providing higher pay and better benefits.  Several large cities such as New York, Detroit, and Los Angles Fire Departments operate Fire and EMS Divisions which offer rather reasonably higher salaries and benefits.    

The United States Bureau of Labor Statistics list the national “mean salary,” for a Paramedic at just over $27,000.00. (2006-2007)  Today the fundamental responsibilities of an EMT-Paramedic is to conserve life, to alleviate suffering, to promote health, to do no harm and to provide both quality and equal availability of emergency medical care. The EMT-Paramedic must be qualified in advanced pre-hospital emergency care and services by a competency-based educational program of clinical, didactic, and practical certified by the States Departments of Emergency medical Services. The standard of practice of the EMT-P must be in accordance with the most current edition of the US DOT “Emergency Medical Technician-Paramedic: National Standard Curriculum.

The minimum qualifications and requirements for today’s EMT’s and Paramedics include but are not limited to the following:

High school diploma (Same as Police and Firefighter)
College Education preferred. 

Minimum age requirement for certification: 18 years of age.

The ability to pass a background check and have no felony or high misdemeanor convictions

Posse a valid State Driver’s License, that includes no DUI convictions or other traffic citations with a driving record that is in compliance with insurability.

Many agencies require defensive driving certification or require within the first year of employment.

Poses State Licensure and or National Registry Certification as an EMT or Paramedic.  (Many States require both)

Must hold and maintain certifications along with the level of Licensure for the following:  BCLS, ACLS, PALS, BTLS OR PHTLS Provider Certification.

(Basic Cardiac Life Support Certifications Advanced Cardiac Life Support, Pediatric Advanced Life Support, Basic Trauma Life Support, and Pre-hospital Trauma Life Support.)

Medics must posse effective oral, written and interpersonal communication skills and high moral and ethical standards.

My Training Started in the Late 1970’s then at Davenport College in West Michigan, my training began at the Basic-EMT level, followed by EMT-Specialist, and completing the Paramedic program. My out of pocket expense for my classes, books, equipment, and lab fees exceeded $17,000 and did not include the subsequent cost needed for certifications required in Basic Cardiac Life Support Certifications Advanced Cardiac Life Support, Pediatric Advanced Life Support, Basic Trauma Life Support, and Pre-hospital Trauma Life Support. 

When I graduated Davenport College I received an Associates Degree in EMS Management and Certification as a Paramedic.  I was eligible to take the State of Michigan’s written and practical examinations required to become a State Licensed Paramedic that was required to seek employment and work as a Paramedic in the State of Michigan. 

In Michigan all EMS Licensure's must be renewed every three years and may only be renewed after obtaining a minimum of forty-five credit hours of continued education for the duration of one’s career as a Medic and no subsequent felonies or DUI convictions

As of 2008, the United States is currently experiencing an alarming shortage of both licensed EMT’s and Paramedics both in Suburban and Rural areas.  Cities such as Ohio, Pennsylvania, and many others are desperate for medics.  Private Providers, County run EMS, and City Fire/EMS Agencies are also in financial distress from the dramatic reduction of Medicare payments, rising gas prices, the lack of health insurance coverage or under coverage leaving Ambulance treatment and transportation bills the sole responsibilities of patients, many who are unable to pay.  In addition EMS Medical Services are frequently abused by individuals who call an EMS Personnel for minor cuts, minor ailments, simple nosebleeds, muscle strains, to transport themselves or family members to a hospital because “I didn’t want to wait in the ER waiting room, or “your faster than a cab,” unfortunately these are too often true statements, and generally defaulted bills for service by the patient. 

Today’s Ambulances are high tech mobile emergency rooms, equipped with thousands of dollars of medical equipment and devices, and are generally staffed with either two Paramedics or a Paramedic and an EMT who are both highly dedicated and extremely professional Medics.  Today’s Medics are the most under paid individuals in the Emergency Services System.  EMT’s and Paramedics are not recognized or appreciated until they are needed.  The men and women who work in the Field of Emergency Medical Services work in a highly stressful and increasing dangerous profession.  Most suburban medic’s work either 8 to 12 hour shifts and are frequently held over for “late calls.” Rural medics are mainly volunteers or paid volunteers (paid by the call and generally will work 24hour shifts, or respond similar to Volunteer firefighters who are toned out from their homes using paging systems, who then respond to the “ambulance barn,” meeting their partner, then respond in an Ambulance to either medical or trauma care.

Prior to 1966 many funeral home’s provided ambulance service as well as many “here today gone tomorrow Ambulance Services,” that consisted of individuals who were mainly trained in simple first aid and “ambulances that were stocked with bandages and splints, that provided emergency transportation that consisted of arriving placing an injured or sick patient on a stretcher putting them in the back of non professional station wagons with a siren a flasher and lettered “ambulance” that often transported a patient frequently without an attendant riding with the patent, the driver would drove like hell to a local hospital ER.  This was referred to as the “load and go days.”  Patient survival rates were extremely low and were equal to really no on scene or transport treatment of the sick or injured.

                                                                                 Arlie House Conference
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.

                                           1969 American Medical Association Commission on EMS formed.

Although EMS has continued to evolve and grow through the last fifty years, medic’s today are trained professionals who are able to stabilize patients both on scene and over the course of transportation  Today both EMT’s and Paramedics work together treating and stabilizing patients prior to and enroute to Trauma-one Medical Facilities.  Paramedics are well trained and provide advanced life support assistance to the sick and injured including the ability to read 12 lead e.k.g.’s, treat patients with clot busting medications, stabilize irregular heart rates with medications, provide advance airway management, administer intravenous solutions and medications, provide pain relief and provide many more advanced skills. 

Medics continuously receive new training on a new piece of life saving equipment, updated CPR practices, continued education, re-licensure which is a continuous, until you choose a new profession and decide not to seek relicensure, so there is a big commitment, especially if one chooses to continue to work as a Medic, underpaid does show the character and dedication of these medics who struggle financially to provide for their families, yet the climb into an ambulance unaware that the next radio crack will send them to an address, an intersection, a crime scene, or the aftermath of a terrorist attack in an effort to fight to preserve a life, that may place them in a situation that may cost the medic’s own life.

The Field of Emergency Medical Services creates many forms of stress, anxiety, and post traumatic stress disorder, known as PTSD which can occur after such incidents as September 11, 2001, the columbine high school shootings and the many other mass casualty incidents. (MCI)  EMT’s, Flight Nurses, Pilots and Paramedics face many dangers, drivers who fail to yield for Ambulances in the course of an emergency response or transport, assaults, helicopter malfunctions, Medics have been shot by patients, taken hostage, hit and killed while on scene of traffic accidents as they were treating patient’s, by inattentive drivers.  These dangers continue to lead to the alarmingly number of EMT’s, Flight Nurses, Pilots and Paramedics, injured, become seriously ill, and have lost their life’s “In the Line of Duty.”  Dave’s EMS Headquarters has two site pages dedicated to EMT’s, Flight Nurses, Pilots and Paramedics who have lost their lives in the performance of their job.

EMT’s and Paramedics frequently suffer from back injuries caused by repeated lifting of patients over several years.  The recently rise in the number of medics who have sustained injuries and disability caused by the lifting of obese patients has led to many EMS Providers in both the U.S. and Canada to purchase specially built and customized ambulance’s that are designed for over weight patients. 

Today a full time Paramedics average salary based by the United States Bureau of Labor and Statistics list the national “mean salary,” of a Paramedic to be just over $27,000.00.  Income aside Medics continue to answer your call for help at a moment’s notice, which often is the difference between life and death for the sick or injured. 

A March, 2008 Career Builders article by Anthony Balderrama at CareerBuilder.com,
Compared several professions and their salaries with that of a Paramedic, below are three of those comparisons. 
What they do: Paramedics respond to emergency situations and attempt to provide the necessary medical care, whether it involves transporting patients to a hospital or treating them on the scene. 
Salary: $27,070. Seeing as paramedics have high stress jobs that require them to be on call and ready to save lives at a moment's notice, you might expect their mean annual salary to be higher.

                                                                       Court reporters
What they do: Court reporters transcribe court proceedings, meetings, speeches and other events where verbatim documentation is necessary. Any time someone says "Strike that from the record," court reporters are the ones writing that record.
Salary: $59,970, you might not have thought typing could earn you so much money, but once you realize court reporters can't miss a word – often in fast-talking situations – it makes more sense.

                                                                     Fashion designers
What they do: Fashion designers design and create new clothes and other fashion accessories to be sold to the public in retail stores. Depending on whether they work for their own label or for someone else's, they might set new trends or follow existing ones.

Salary: $69,270. Aspiring fashion designers are warned that few people can be the next Marc Jacobs, with runway shows at Fashion Week, actresses wearing their dresses at awards shows and millions in the bank – but the less famous fashion designers, who include those working for retail chains, are earning more than you probably thought.

After the above information, you may be asking yourself where all the medics are going.  Many return to school earning degrees in Nursing, others opt to study medicine and have chosen careers as either a Doctor or a Physicians Assistant.  Others have left Emergency Medical Services (EMS) to become either a Police officer or Firefighter, or other higher paying fields, so that they can support themselves and their families, as you cannot support a family on $27,000.00 in the Field of Emergency Medical Services. 

Both EMT’s and Paramedic’s are very dedicated individuals, they are a special breed and as stated most people have no idea what a Paramedic and EMT do until they need them.  In the 1970’s the general public was offered a glimpse in Jack Webb’s series “Emergency,” featuring cross trained Los Angles County Firefighters/Paramedics Roy Desoto and Johnny Gage, and again in the 1990’s in the television series “ER” showing small clips of the City of Chicago’s Fire Department’s Paramedics working out in the harsh field.  The two television shows have shown a small portion of what medics do, but in a very benign way, and of course they are portraying large city fire service employed medics who are much better paid and receive better benefits.

The low salaries medics receive coupled by our weak economy, rising gas prices and the associated fuel cost being passed on in food costs as well as other materials, it does not take a rocket scientist to figure out why and how there is a growing shortage of both EMT’s and Paramedics today.  American Medical Response along with many others “for profit,” EMS companies are now offering “sign on bonuses, “ranges from $8,000.00 to $20,000.00.  This will entice some medics, but this is a short term solution and still does not resolve the financial woes and does not increase the medic’s actual salary, which will continue to lead to medics leaving the Field of Emergency Medical Services. 

Until the “for profit,” EMS Providers realize that they need to adjust both EMT’s and Paramedics salaries and pay them as the professional’s that they are.  EMT’s and Paramedics are highly educated and trained; medics also must hold several additional certifications besides their State licensure and are required to maintain forty-five to sixty continuing education credits every three years.  The majority of city medics work 12hour shifts, and respond to shootings, stabbings, child abuse trauma, traumatic injuries that result from vehicular accidents, and industrial accidents.  Unlike firefighters who return to their quarters after a call, medics are often receiving another call for help while dropping their current patient off at an ER. 

When they are not running on a call, medics are sent to sit “point,” generally this is strategically positioning ambulance crews through out the city for quicker response times.  Agencies are required to maintain a 90% arrival time of 6-8 minutes arrival time.  The larger private EMS Providers place pressure and at times threats if crews do not quicken their response times.  Sitting “point,” has created dangerous situations for EMS crews, especially at 2:00am sitting in a parking lot and in crime neighborhoods has made easy marks out of medics for thieves and drug seekers.  In 2006 and 2007 there has been a significant increase in the number of medics who have been faced looking down a gun barrel or a knife as they have been robbed by thieves and drug seekers. 

The pressure for quicker response times has led to the increase in accidents.  The divorce rate for Paramedics and EMT’s has risen dramatically due to job stress and financial problems that creates friction between medics and their spouse.  EMT’s and Paramedics are being forced to make is to make a career change to save their marriages and keep their families intact.  This shortage of EMT’s and Paramedics began to become a factor when the “for profit EMS providers,” purchased hundreds of smaller EMS agencies in the mid 1990’s.

Over my own career in Emergency Medical Services I married a wonderful woman and we had five children, I worked for a nationally known EMS Provider in West Michigan as a Paramedic.  Mercy paid their EMT’s and Paramedics very well, and better than most private EMS Providers; Mercy provided a wonderful benefits programs, their 401K plan was great and Mercy provided many other incentives.  Mercy had a very low to near existent turn over rate; their equipment was top of the line, and maintained.  Mercy employed a full time mechanic and their ambulances were assigned to senior medics and a “junior,” partner.  Mercy Ambulance met and exceeded national standards, the rig’s purchased their well built in the 1980’s from the Ambulance Manufacturer “McCoy Miller,” and these Ambulances not only provide patient comfort but were built in a manner that also provided medics additional safety especially in the case of an accident.  Mercy was operated by the Brady family, and that is how their medics were treated as family, and paid medics very well.  Mercy also was not unionized because issues could be resolved openly and honestly with their CEO Scott Brady and his management team. 

Mercy was sold to American Medical Response in the mid 1990’s.  Many of their senior medics either left or were gradually replaced with new medics paid lower wages.  American Medical Response operated in both the east and west side of Michigan.  In December of 2006 AMR (American Medical Response) closed their EMS operations on the south side of Michigan citing the States economic situation and losses in revenues.  AMR currently continues operations on the west side of the state of Michigan.  When AMR bailed on the communities, that were dependant on AMR to provide highly trained, seasoned and very skilled Paramedics and EMT’s.  When AMR closed down their operation in Southern Michigan, AMR did offer their Paramedics and EMT’s positions with the company in other markets; however the offer did not include relocation reimbursement and did not guarantee current wages there Paramedics and EMT’s were tossed aside.  EMT’s and Paramedic have become less likely to set themselves up again to face the possibility of being let go again by another agency.

The questions at the top of the page could end with no ambulances to respond to a 9-1-1 call as was the case in Missouri when a major EMS Provider closed down operations and then issued their medics with NSF payroll checks.  Medics who had earned their pay and were already working under paid, received worthless checks.  Pay checks needed to pay mortgages, utilities, and provide food and medications for their families. 

The 2005-2006 National Firefighter data base show a decline large decline in fires throughout the U.S.  Fire departments are today laying off many firefighters in addition many departments are eliminating positions through retirement.

The two most possible and plausible solutions that could assist in resolving the shortage’s of EMT’s and Paramedics, would be one for City Government’s to implement Advanced Life Support Operations by utilizing crossed trained Firefighters and or Paramedics/EMT’s.  The second possible solution is developing a County run ALS Service.  Cities and Counties could provide higher salaries, generate funding for EMS Services by billing for EMS runs and continue to provide their communities with quality EMS Personnel.  The alternatives would result in EMS going backwards; returning to poorly trained individuals to respond to any of the “six what if’s,” at the beginning of this editorial. 

It is really ridiculous when a “tow truck driver,” makes more money jumpstarting a individuals cars dead battery, then a Paramedic who jump starts a child’s heart, or a “Mechanic,” who makes more in a year for fixing a automobiles engine than a Paramedic who arrives at the scene of an accident where a Mother and or father or both are pinned in their car, as firefighters work hard to extricate the patient for transport, while the medics often crawl into the wreckage and treat the patient (s) utilizing I.V. Solutions, intravenous medications, and advanced airways, medics are able to stabilize their patient and transport them to a level one trauma center alive.

On September 11, 2001, when terrorist hijacked civilian jetliners and terrorized the planes passengers innocent men, women, and children and then murdered them after they had taken over four (4) cockpits, these animals slammed the planes into the twin towers, the pentagon, and a field in Somerset Pennsylvania.   Emergency Services was activated consisting of Police, Fire, and EMS, sadly over 3,000 individuals alone lost their lives in the twin towers.  Emergency Services is credited with evacuating and saving over 25,000 lives in New York alone. 

As everyone is well aware over 300 firefighters lost their lives as they fought the fires and worked to evacuate the injured at the World Trade Center.  On September 11, 2001, NYPD and Transit Officers also lost a combined sixty-one (61) officers and one (1) K-9 at the WTC. 

However on September 11, 2001, very few people understand that Emergency Medical Services sent EMT’S and Paramedics to all three (3) sites of the attacks and the field where flight 93 crashed.  That Tuesday morning forty-two (42) EMT’s and Paramedics were killed and 116 were injured as they were assisting the victims at the twin towers.  Today our Firefighters, Police officers, EMT’s and Paramedics continue to die from respiratory illnesses, and cancer related diseases, caused from their response and prolonged exposure nearly 7 years ago.  God forbid we not have EMT’s and Paramedics available if this country should sustain such another horrific terrorist Act!

We must begin to pay our EMT’s and Paramedics a salary equal to the professionals that they are, before we loose more medics.
Today our EMT’s and Paramedics who are too often identified by News and Media outlets as "Ambulance Drivers,” Paramedics and EMT’s are educated and professionals and they are not receiving the respect that has been and continues to be earned each and every day.

They are Professionals who treat the sick and or injured, a team that work together in the field Emergency Services.  It's is time that Medics step up and proudly continue to show those in need of emergency help who we are and what we do!

Written By: David D.
Posted: April 10, 2008
Dave’s EMS Headquarters

Dave's EMS Headquarters includes Poems, EMS Stories, Editorials, Line of Duty Death Tributes, and other EMS Stats.  Dave's EMS Headquarters is also a tribute to the men and women who serve in the Field of Emergency Medical Services (EMS)  EMT's, EMT-Specialist and Paramedics respond to your calls for assistance, as well as Mass Casualty Incidents (MCI) such as the 9-11-2001 Terrorist Attacks, School & Universities shootings.  Since this site was built in 2000 sadly over 500 Medics have been killed In the Line of Duty.  The men and women of EMS are Professionals AND ARE NOT "AMBULANCE DRIVERS."
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Over the past few weeks several small and large papers have run stories regarding the public’s hesitance to call 9-1-1 in cases involving Medical Emergencies.  In addition local news as well as papers has run stories regarding delayed Emergency Medical Services delayed responses in major cities such as Detroit Fire and EMS, Denver CO, New York, just to name a few.  Due to gas prices, Medicare reimbursement payments, and already alarming nation wide shortage of both Emergency Medical Technicians and Paramedics,  Volunteer, Private and Municipal run Emergency medical Services have been forced to cut coverage by reducing the number of Ambulance shifts per day. 

Private Agencies across the U.S. are hurting financially, unable to update their ambulance fleets due to lack of assets, up Medics salaries and benefits in order to hire a reduced number of EMT’s and Paramedic’s due to the national shortage of trained Medics.  Volunteer, Private, and Municipal Agencies has been faced with frequent breakdowns of Ambulances with Ford diesel engines, (Class action Lawsuit against Ford.) EMS Providers and only recently been given a choice with both Chrysler and General Motors returning to the production of EMS chassis and engines.  Ford Motor has announced last week the upcoming 2010 V10 gasoline heavy duty ambulances that will assist in providing less costly gasoline versus diesel fuel.    

A few cities have seen the crisis facing Emergency Medical Services and have come to the aid of a few providers with financial assistance in order to maintain EMS Coverage in their communities.  However in Metropolitan Cities such as Detroit and New York and Washington where EMS is integrated with their Fire Services are facing cuts in both Fire Services as well as EMS Services.  In New York, Detroit, and Washington news media have been critical to slow response by EMS Units, the very same cities where cuts have been implemented by Departments in order to trim budgets sacrificing the number of units in service.  Yet were 9-1-1 abuse remains high tying up already depleted resources answering non life threatening calls for minor cuts, non traumatic back pain twisted ankles and the lists goes on.  While EMS crews are attending to the abuse calls depleting available unit’s further patients suffering life threatening emergencies that are time critical are forced to wait for an EMS Unit from another sector to make it to the scene.  That is if traffic yields to the Ambulances lights and sirens, allowing the crews to get to the scene safely, and if that Unit responding is involved by an inattentive driver who causes an accident or a medic driving faster than what is allowed due to repeated calls from first responders to “expedite” (to get to the scene faster) results in an accident, then advanced treatment for the original patient is further delayed.  A recent article in Detroit Connects detroitspeaks shows several such instances that has caused negative articles regarding delayed responses and over worked Medics, as well as 9-1-1 abuse.

Also due to increase expenses faced by Emergency Medical Service Providers have caused the increase in EMS Billing, with the increase rates the General Public has been both hesitant and reluctant to call for an Ambulance opting instead to drive a loved one to a hospital by either private cars or evening attempting to drive themselves to the hospital further risking a survival outcome for the patient, as well as placing the public in danger “by racing to the hospital,” or causing accidents due to medical emergencies.  With the National Unemployment rate rising each month to record highs along with Medical benefits lost or faced with being underinsured, is causing the general public to fail to utilize the 9-1-1 system as reported by the Cleveland News.

The number of Volunteer EMS Providers is facing with dwindling numbers of volunteers licensed as Emergency Medical Technicians, and Paramedics, increased costs and debts, outdated equipment or outdated Ambulances and frequent breakdowns.  As the economy continues to worsen and the shortage of Medics continue and debts increase the number of Volunteer EMS Providers will continue to reduce and cease operations endangering smaller communities who are faced or will be faced with waiting for EMS Providers from other communities to respond increasing the time to getting help to the patient.  

The same fate is also attacking both the private sector EMS provider as well as the Municipal EMS Providers are also facing personnel shortages, increased costs as well as heightening debts are threatening the safety of the general public. 

Washington must include Emergency Medical Services in the Federal Stimulus Package NOW and not later, and not just for Emergency Medical Services Providers.  Law Enforcement and Firefighters are faced too with cuts in personnel caused both by budget deficits and cuts by State, and City Government’s, thereby reducing the number of Police officers in our neighborhoods and is also creating the closure of Fire stations and reduction of fire crews on Rescue Squads, Engines and Ladder Companies.

Emergency Services is made up of Police, Fire, and EMS Services and serves as an essential role in the safety of our communities as well as to our Homeland Security.  Emergency Services together respond to Terrorism caused Incidents as well as Natural Disaster events such as Hurricanes, Tornadoes, and Floods.  On September 11, 2001, Police, Fire, and EMS are credited with saving 25,000 lives. On September 11, 2001, Police, Fire, and EMS were among the 3,000 plus deaths in New York and Washington D.C. as they worked to evacuate, extricate and treat the Occupants of the World Trade Center, and Pentagon.  Even today Police, Fire, and EMS Personnel continue to be diagnosed with illnesses, are have become disabled and have died due to toxins inhaled caused when the towers collapsed.   

If our Politicians and President do not respond with an immediate Stimulus Packages that will both infuse and strengthen our Emergency Service Agencies and Providers, our citizens, and communities, will be faced with a limited number of Rescuers that could seriously increase the number  of rescued that was documented on September 11, 2001, as well as those rescued in the day’s and weeks that followed the Natural Disasters and violent crime sprees that required the response of Emergency Services over the past few years.

If the Government can infuse billions of dollars towards Banking Institutions, as well as the three Automakers just to name two, then the Government must provide stimulus package geared towards the Municipal, Private and Volunteer EMS Agencies to assist with Education and retention of EMS Medics of all levels, Funding for Equipment, Vehicles, Fuels and subsidies to assist patients and families with EMS Bills.  Across the board shoring up of funding for EMS, Police, and Fire Services Nationwide must be addressed immediately
Written By: David D.
Website:  Daves EMS Headquarters
03-12-2009 ©
Listen up Washington Stimulus Packages Needed for Emergency Services
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