Every Day Heroes
This month, from May 15–21, providers across the country will celebrate EMS Week, which is supported by the American College of Emergency Physicians (ACEP).
When we asked JEMS readers how they plan to celebrate, we received a lot of great responses and ideas. Although some agencies have been challenged by budget cuts, others won’t let a tough economy spoil their fun.
Derek Gray, EMT-P, is a paramedic with American Medical Response (AMR) in Riverside, Calif., and a member of the AMR C.A.R.E. team—a team strictly devoted to employee satisfaction.
“Our goal is to improve morale and help increase employee satisfaction at AMR,” says Gray.
The CARE team has decided to celebrate EMS Week with a barbecue for AMR providers and their families on Saturday, May 21, and Sunday, May 22. The barbecue is broken into two days because AMR shifts are split by front and back halves of the week. This way, everyone will have the opportunity to attend. Gray says they’re planning for 1,600–2,000 attendees.
Children attending will have a host of activities to choose from: face painting, magic shows and inflated jumpers to play in. Families can participate in three-legged races and other games. However, Gray suspects one of the biggest attractions will be a dunk tank. Employees will have an opportunity to dunk their bosses.
Other EMSers plan to spend EMS Week participating in the National EMS Memorial Bike Ride. The “muddy angels,” will honor fallen providers, or those who have become sick or injured on duty, in their rides across part of the U.S. Judi Costa will honor three fallen responders by biking more than 600 miles from Boston to Alexandria, Va.
“I’m riding … this year to honor them and their contribution and dedication to the citizens and visitors of Onslow County [N.C.],” says Costa, who will be riding with a friend who has participated in the past three rides.
Whether you choose to ride with the muddy angels or attend a barbecue, we’d like to know how you’re celebrating this year. Visit http://connect.jems.com/forum/topics/plans-for-2011-ems-week to share your plans with your colleagues. —Lauren Hardcastle
Infection Control Concerns
Safety is a concern for all EMS providers, but two recent line-of-duty deaths have made responders question just how rare it really is to pick up a deadly infection on the job. Orange County (Fla.) Sheriff Deputy Sebastian Diana died after battling an infection he caught while performing CPR on an infant in 2006. And in Long Island, N.Y., an EMT died from an infection that may be attributed to his work in the field. These deaths have forced EMS workers to rethink their own body substance isolation procedures.
“While these two cases seem to be the exception more than the rule, my worry comes from the lax attitude we see sometimes on a daily basis when it comes to protecting our staff,” says Steve Pawlak, MSM, MICP, and chief of Edison (N.J.) EMS.
Each death raises questions about the origins of the infections and what role responders may have played in their own exposures.
Orange County Sheriff officials say 40-year-old Diana died after a five-year health battle stemming from a virus he caught while performing CPR on a 3-month-old male pediatric patient who eventually died. Sheriff spokeswoman Cpl. Susan Soto says all officers are provided with CPR masks, but Diana didn’t use one that day.
Just more than a month after delivering CPR to the child, Diana was hospitalized with heart problems doctors tied to a viral infection. Autopsy results from the pediatric patient revealed respiratory syncytial virus (RSV). The department and workers’ compensation later accepted Diana’s exposure in the 2006 CPR case as the cause of health problems.
“In many ways, very likely the life he was trying to save may have cost him his own life,” Sheriff Jerry Demings told reporters. “There are probably things that could have been done, but he simply took action in 2006. He just got in and did what he needed to do to save his life.”
On Long Island, Nassau County Police and health department investigators were looking into the death of Steve Linzer, a 45-year-old EMT. His death was initially pinned on a fast-moving infection. At press time, investigators were scouring call data for the patients Linzer had come into contact with before his death.
Katherine West BSN, MSEd, CIC, a consultant with Infection Control/
Emerging Concepts Inc., and JEMS Editorial Board member, says workplace laws presuming people get such diseases on the job, along with HIPAA rules, make proving connections to job infection hazards difficult.
“This is a reality, but it is rare,” she said. “This is what goes along with being a provider of healthcare.”
“I think cases like these serve as an excellent catalyst for change,” Pawlak says. “We now need to examine how this happened ... and learn from these incidents so that history doesn’t repeat itself.”
—Richard Huff, NREMT-B
Man Your Buzzers
A little friendly competition for a trophy has jazzed up EMS training in central New York’s Onondaga County.
Director of training North Area Volunteer Ambulance Corps (NAVAC), Chris Dunham’s duties include conducting 11 monthly training sessions each year for EMS providers in his combination volunteer/paid EMS agency. NAVAC was already sharing training duties with two sister agencies in the county—Western Area Volunteer Emergency Services and East Area Volunteer Emergency Services—when the idea of a game-show format came up.
The three-round Central New York EMS Challenge is patterned after TV’s Jeopardy!, with 50 questions on such topics as general trivia, general anatomy, burns, trauma, assessment and New York state protocols. The two-person teams, made up of an EMT-B and a paramedic, have 10 seconds to answer each question. This year they added a “big buzzer system,” according to Dunham. The 2011 final question was to write out the N.Y. state protocol for an active-seizing adult. The winning team gets $400 and year-long custody of the trophy, which Dunham describes as “like the Stanley Cup, just not so grand.”
The competition is keen, the enthusiasm high and the scores always close. Dunham says winning the game always comes down to the last question.
24-Hour Shift Debates
A year after the Kansas City (Mo.) Fire Department (KCFD) absorbed Metropolitan Ambulance Services Trust (MAST), issues continue to fuel the controversial merger.
The fire department had announced it would put more EMS providers on 24-hour shifts, but that plan was scuttled when questions about labor laws and overtime arose.
The discussion about pensions for former MAST employees was tabled until after the vote on a city tax. (It passed on April 5.) Will EMS be folded into the city’s pension system with credit for their time at MAST?
Former MAST employees condemn some of the changes. There are allegations of union manipulation and strong-arming. The training program that MAST took great pride in has been gutted. Accusations have been made of threats of reprisal for employees who talk to the press about working conditions.
At the same time, KCFD Chief Richard “Smokey” Dyer says, “There is great cooperation within personnel” and “greater and greater integration.”
Medical Director Joseph Salomone, MD, says, “The same people are providing the same care” and “clinical outcomes have not suffered” since the merger. “Any transition takes time.”
Pro Bono Pregnant Employees
Know the Law before Making Blanket Rules
There are many misconceptions about the law related to pregnancy in the EMS workplace. Seemingly well-intended managers may get in trouble when they remove a pregnant employee from field duty simply because she’s pregnant. They may feel there could be “liability” if something happens to the mother or unborn child while lifting a patient. Those are biased, outdated notions that are a smack in the face to the law.
The general rule with pregnancy in the EMS workplace is that it should be treated like any other temporary disability. The key questions to consider center on whether the pregnant employee can perform the essential functions of the job and whether she can meet the basic physical requirements. The Pregnancy Discrimination Act (PDA) of 1978, as well as state anti-discrimination laws where the PDA doesn’t provide coverage, sets forth some fundamental principles that must be followed:
- It’s illegal for an EMS employer to choose not to hire a woman who is pregnant due to her pregnancy or a condition related to pregnancy, or based on any prejudice from co-workers, customers or potential clients. Tip: Never ask a woman in a job interview if she’s pregnant, or if she intends to have children. That should not be a factor in personnel decisions, such as hiring or promoting.
- An employer can’t determine the work capability of an employee based on conditions related to pregnancy. Tip: Don’t tell a pregnant provider she can’t work because of potential harm to the unborn child, “exposure” to hazardous conditions or potential for pregnancy complications. Employers do have the right to request a doctor’s statement before granting sick leave, just as with any other reason for sick leave. So you can generally require medical verification that the pregnant staff member can perform the essential functions of the job if there’s an indication that she can’t do so—as long as this procedure is applied equally to all employees who exhibit physical limitations when performing their work.
- Female employees who are unable to work temporarily due to pregnancy or conditions related to pregnancy must be treated in the same manner as other employees who are disabled temporarily. Tip: Treat pregnant employees no differently than you would someone with a back problem. The question in both cases should be: Can this person meet the physical requirements of the job?
- Employers must permit the pregnant employee to do her job for as long as she’s capable of performing it. No set time periods exist for how long a pregnant employee should be permitted to work. Many pregnant EMS field providers are able to function in the field throughout pregnancy, and in some cases, right up until their delivery date. Tip: Don’t establish a blanket rule that says pregnant employees can’t work in the field during the last weeks or last trimester of a pregnancy. Only take action if objective indications that the employee can’t meet the physical requirements of the job are present.
- When an employee goes on leave due to pregnancy, an employer must keep their job open for the same period of time that jobs are kept open for staff members who go on disability or sick leave. Federal and state laws, such as the Family and Medical Leave Act, may provide added unpaid leave benefits for childbirth, as well as for the parent to care for a newborn child. Tip: Ensure you have a clear policy on medical or disability leaves and that pregnancy or “maternity” leave is treated the same as any other leave under that policy. Know the law on unpaid and paid leaves in your state.
In today’s society, women have become a much greater presence in EMS, and field staff and their leadership must avoid any bias or traditional notions regarding what a woman should be allowed to do while pregnant and working. Unless there are objective indications the pregnant employee isn’t physically capable of functioning, that choice should generally be left up to her.
Source: Equal Employment Opportunity Commission, Facts on Pregnancy Discrimination: www.eeoc.gov/facts/fs-preg.html
Pro Bono is written by attorneys Doug Wolfberg and Steve Wirth of Page, Wolfberg & Wirth LLC, a national EMS-industry law firm. Visit the firm’s website at www.pwwemslaw.com for more EMS law information.
Here’s what you told us on JEMS Connect:
>> “Cardiac Arrest Save Recognition (big night at the performing arts center for responders, survivors, and their families), open house at the downtown station and Community EMS Day at a big supermarket in town.” —Skip Kirkwood
>> “Our agency spends much of EMS Week out in all of the local schools (preschool through high school) providing education relating to injury prevention, safety, CPR and first aid. We also take time to recognize our members internally with some type of ‘let-your-hair-down event.’”
—Fred W. Wurster III
On the Web
We asked you about your plans for EMS Week on the JEMS fan page. Here’s what one fan had to say:
“We take our ambulance to the elementary school and eat lunch with the kids. They love touring the ambulance and looking at the equipment. Kids always ask great questions, and they think it’s SO cool to have an EMT sitting with them at lunch. My daughter is just beaming when her mom walks in, full gear. We also have a Heart Walk at the park: A one-mile walk in different locations, healthy snacks, door prizes, healthy recipes, CPR station and other fun activities.”
Awards Across the nation
The Veterans of Foreign Wars (VFW) makes annual awards to EMS, fire and law enforcement personnel. According to Steve Van Buskirk, “Our members have always gravitated to those fields,” so it’s natural to acknowledge first responders’ achievements.
One of the state winners is Alan Tom. Tom was named Nevada Paramedic of the Year after almost 30 years in EMS. He’s the special events manager for Regional Emergency Medical Services Authority (REMSA) in Reno. He’s certified in hazmat, ski patrol, swift water rescue and dive master rescue.
“This is quite an honor,” says Tom. “I didn’t know I was nominated until someone told me I was Paramedic of the Year.”
The VFW National Paramedic of the Year is Mike Pinson of Dougherty County (Ga.) EMS. Pinson is an ACLS, PALS and CPR instructor, as well as the field training officer for his shift. He also handles public relations and the public school EMS program for the agency. In addition to being honored by the award, he said, “I’m really humbled by the experience.”
The American Heart Association gave the New York State Advocate of the Year Award to instructor and author Bob Elling, EMT-P. “My passion for three-and-a-half decades [has been] AHA programs,” says Elling. After successfully advocating for AEDs in all schools within the state, he’s pushing for statewide student CPR training.
Equity Firms Buy Ambulance Companies
Two major ambulance companies have been bought by private equity firms. In February, Clayton, Dubilier & Rice LLC (CD&R) announced it had reached an agreement to purchase AMR’s parent company, Emergency Medical Services Corporation (EMSC), for $3.2 billion. In March, Warburg Pincus LLC purchased Rural/Metro Corp. for $437.8 million, excluding debt.
Reports claim the AMR/EMSC deal is being held up by shareholders’ litigation over “possible breaches of fiduciary duty.” The agreement between EMSC and CD&R would pay shareholders $64 per share, although the stock was selling at more than $70 per share just days before the deal was announced. The settlement is expected to take as long as the rest of 2011.
The Rural/Metro sale appears to be moving forward with no complications.
Michael DiMino, Rural/Metro’s chief executive, released a statement that said, “Partnering with Warburg Pincus provides the resources and flexibility to fuel our organic and strategic growth initiatives, and to leverage our strength as the best-in-class operator in both the ambulance and private fire protection industries.”
Liz Merritt, managing director of investor relations and corporate communications for Rural/Metro, told JEMS, “There will be no impact on field personnel. Not even on management. And the strong financial backing is very exciting news for us.”
An African manufacturer has created what is believed to be the first underground ambulance: the MV-U40D-AMB. UV Botswana, part of the GHH Mining Machines (GHHMM) group in South Africa, developed the vehicle over a three-year period.
According to statements from GHHMM, engineers worked to create a vehicle with the capacity of a street-level ambulance with the ability to travel underground. One feature is its low profile that allows it to move through mine tunnels to reach injured workers.
In addition to the oxygen and medical supplies one would expect in an ambulance, the MV-U40D-AMB has a filtered-air intake for its rear-load cabin, which will carry patients and medical personnel. A hydraulic winch is at the front and sliding access is at the rear.
The MV-U40D-AMB is a specially equipped version of the company’s MV-U40D class of utility vehicles with interchangeable cassettes. Others in the class include personnel transport, fuel and lube, general purpose, commode and effluent cassettes.
The company is optimistic that the mining industry will welcome this advance in extricating injured workers who are often long distances from a mine’s entrance.
This article originally appeared in April 2011 JEMS as “’Everyday Heroes’: 2011 EMS Week.”
In Breif: For more on EMS Week, visit www.emsweek.org
American Heart Association releases new BLS course: http://tinyurl.com/3gtmc6a
2011 EMS on the Hill Day, May 3–4: www.naemt.org/advocacy/emsonthehillday/EMSontheHillDay.aspx