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Last Word



From the September 2008 Issue | Monday, September 15, 2008

Don_t Touch That Bug!

According to a July 7 article on, employees of the Scottish Ambulance Service are outraged about not being allowed to spend appropriate time ˙deepÓ cleaning vehicles after transporting ill patients. An employee was quoted in the article as saying, ˙The emphasis on the eight-minute target is the main problem. Our concern is that we are being refused permission to even clean vehicles between jobs, even if it_s not fit for purpose.Ó Reportedly, the ambulance service insisted that adequate infection-control policies are in place.

Ban Hazing Now!

A recent incident at theUniversity ofMedicine and Dentistry of New Jersey (UMDNJ) appears to have combined hazing with racism. Cell phone photos circulated showing a uniformed UMDNJ paramedic adjusting sheets that had been draped over twoNortheasternUniversity paramedic students who were at the university for clinical rotations. One student held a crude wooden cross, creating an image that evokes Ku Klux Klan comparisons.

UMDNJ immediately fired the paramedic in the photo and two other paramedics involved in the incident, and, according to the Newark Star-Ledger, the New Jersey Department of Health and Senior Services is considering revoking their certifications.

Our culture has long viewed hazing as a rite of passage. But it_s a juvenile practice, with no place in a professional organization, and it_s increasingly resulting in disciplinary actions and expensive lawsuits. It_s time for everyEMS and fire organization to enforce a zero-tolerance policy against hazing.

Paramedics Keep TrainsRunning on Time

The 104-mile Bay Area Rapid Transit (BART) system carries some 350,000 people in theSan Francisco area each weekday through subways and tunnels via 67 miles of aerial and surface track. Approximately 450 train cars make 20-second stops each day. Because most of the system doesn_t have double tracks, a delay due to a medical emergency on one of those cars can throw the entire schedule into disarray.

Last October, BART began a pilot program to deal with medical emergencies more effectively than simply summoningEMS via the 9-1-1 system. Now, King American Ambulance Co. posts a paramedic at the downtown San Francisco Embarcadero station MondayÏFriday 6Ï9 a.m. and 3Ï7 p.m. When the BART dispatch center hears of an emergency, that paramedic hops the next train to reach the patient, or the train carrying the patient rushes to the Embarcadero station. The paramedic rapidly assesses the patient and removes those without head or neck trauma or in cardiac arrest to wait for an ambulance to arrive. The train is then able to go back into service instead of sitting at a station waiting forEMS to be dispatched.

Dan Bobier, King American_s chief paramedic and public information officer, says the program has increased the system_s on-time efficiency by 68% since the pilot_s inception, although the BART paramedics average only two calls a week. (BART Public Information Officer Luna Salavar says using the private company, rather than the San Francisco Fire Department, made more sense logistically.)

Thumbs Up to BART for its innovative idea to speed response times to riders who need medical attention while allowing other commuters to continue to their destinations.

Winning Campaign

The Florida EMS office recently named Lake-Sumter EMS, the cooperative agency run by Lake andSumter counties, as the 2008 Florida EMS Provider of the Year, specifically citing the service_s campaign to educate the public on when to call 9-1-1 for medical care.

The keystone of that effort is a Web site: It lists symptoms and examples of true emergencies, provides reasons to call 9-1-1 instead of driving to a hospital, offers tips on what to do while awaiting an ambulance and explains how theEMS system works. ˙Other agencies are modeling this as a best practice and other organizations are looking at that as well,Ó says Lisa Walker, coordinator of the Florida EMS awards program.

We visited and agree it provides an excellent model forEMS education in any community.

Freedom Isn_t Free

Since 1975, when the federal government began providing states with highway funds even if they failed to enact motorcycle helmet laws, motorcycle riders have convinced lawmakers in 30 states to repeal such laws. Claiming the right to personal freedom, riders insisted on their right to risk head injuriesƒlet alone bad hair.

Recently,University ofPittsburgh epidemiologist Kristen Mertz, MD, and neurological surgeon Harold Weiss, MD, looked at what happened afterPennsylvania repealed its helmet laws in 2003 and reported their findings in the June issue of American Journal of Public Health.

In the two years after the repeal, helmet use in Pennsylvania declined from 82% to 58%, motorcycle head-injury deaths increased by 66%, motorcycle-related head injury hospitalizations rose by 78%, and acute care for such head injuries soared by 132%.

This ˙personal freedomÓ is hardly free to the riders, their families and the taxpayers who often foot the bill for decades of care for uninsured riders who become quadriplegics. Thumbs Down to legislators who can_t do the math.

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Related Topics: Administration and Leadership, Leadership and Professionalism, Legal and Ethical, Operations and Protcols, Training, Jems Last Word

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