Last Word - @

Last Word



| Wednesday, October 29, 2008

The Republican National Con_vention (RNC) brought some 50,000 delegates, dignitaries, reporters and protestors toMinnesota_s Twin Cities Sept. 1Ï4. The feds provided $50 million to help public safety handle this volatile mix of visitors, but most of the money went to law enforcement, leaving little forEMS expenses. Nevertheless, the area_s 29EMS agencies rose to the occasion, spending a fortune in donated time and resources, and reaping valuable intangibles along the way.

˙Minneapolis,St. Paul and the region took this opportunity to collaborate and create something that will last. There was total collaboration, even on the part of the hospitals,Ó says Metro Region EMS Coordinator Ron Robinson, MA, NREMT-P.

˙The planning experience alone brought the localEMS community together as agroup; there was a ton of collaboration. This strengthened relationships between EMS services inMinnesota, and not just between metro-area services,Ó says Jeffrey Lanenberg, EMT-P, South Metro manager for Allina Medical Transportation (which covers many Twin Cities suburbs).

Area EMS leaders also developed new mutual aid agreements, ambulance strike teams, tactical medics, collaborative infrastructures and resources, including the first template for staging EMS for a national security event. ˙There was no such template,Ó says RNC Chief Medical Officer R.J. Frascone, MD, medical director for Regions Hospital EMS, St. Paul Fire Department and St. Paul Police Department. He says the new template should soon appear in a peer-reviewed journal ˙so each community won_t need to reinvent the wheel.Ó

According to Kurtis Bramer, CEM, operations supervisor for Hennepin County Medical Center EMS (Minneapolis_ 9-1-1 provider), the most critical componentin EMS planningand deployment forthe RNC was thenew Metropolitan Reg_ional EMS Multi-Agency Coor__di__na__tion Center, a central body that bringseverything together.

Despite de_mon__stra__tions, duringwhich police used tear gas, pepperspray, concussion grenades and other ˙less-than-lethal devices,ÓEMS saw far fewer patientsduring the RNC than expected. One reason may have been the 38 volunteer ˙street medics,Ó a mixture of professional health-care providers and volunteers with little medical training, who provided first aid to protestors during demonstrations.

Before the RNC, the Hennepin County EMS Council and a local physician group handed out cards to these street medics thanking them for their efforts and asking them to help control the crowds whileEMS moved patients to ambulances. ˙I think that was very professional and really helped contribute to the well-being of people in the street,Ó says Simon Cecil, EMT-B, spokesperson for the North Star Health Collective, the activist group that recruited, trained and coordinated the street medics.

Cecil faults police for arresting 24 street medics, sometimes while they were caring for patients, but says, ˙I_ve nothing but positive things to say about what [local]EMS did and how they responded to our medic teams on every level. When we transferred patients to them, they were very helpful.Ó

JEMS also has only positive things to say about how Twin Cities EMS leaders and responders met the RNC challenge.

A Gutsy Medical Director

Collier County (Fla.) EMS Medical Director Robert Tober, MD, pulled the drug box off Naples Fire Department_s (NFD) ALS first response engine after only two of the department_s 14 paramedics passed a test onthe medications they carried and interactionsbetween those meds.

He notes the paramedics had several weeks_ warning before the test, but unlike the other three ALS first response departments in the county, NFD ˙had no one doing training and no training officer.Ó Tober also contends, ˙over the past 12 months, they_d never opened that drug box.Ó

He vowed to replace the drug boxes once the paramedics bone up on their meds andpass a re-test. But those drug boxes won_t con_tain all 16 meds they once did. Tober re_cently removed eight of 16 meds from drug boxes carried byall ALS engines in the county. ˙They weren_t using them,Ó he says. ˙When you have someone giving you drugs in an emergency, you want someone who_s trained and who has relatively recent experience.Ó

Thirty years ago, Tober helped create award-winning Collier County EMS(CCEMS), which provides all emergencytransports. He resisted the advent of ALS firstresponders in the county, concerned that non-transport paramedics wouldn_t have enough opportunities to use their advanced skills to keep them sharp. Because of short CCEMS response times, he says, ALS first responders ˙are hardly doing anything but vitals, oxygen, some cardiac monitors.Ó He wants first responders to focus on their BLS skills.

˙This has caused a firestorm,Ó Tober says. ˙I_ve suffered tremendous adversity from fire chiefs and firefighters.Ó

Naples Fire Chief Jim McEvoy declined to comment.

At its recent conference, the Florida Association of Medical Directors unanimously backed Tober_s right to make medical decisions for the community.

Thumbs Up to a courageous medical director who puts patients above politics.JEMS

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Related Topics: Leadership and Professionalism, Operations and Protcols, WMD and Terrorism

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