A warm response?
This month we focus heavily on feedback about last month’s article, “Inside the Warm Zone: Blacksburg Volunteer Rescue Squad partners with police to create a rescue task force,” by Will Bulloss, NREMT-I. Readers voiced their opinions on both our Facebook page and in the comments section of the online article, sparking many debates and conversations. (For another perspective on tactical EMS, read “In the SWAT Stack: Lawrence County (Ohio) establishes armed tactical EMS team to respond with law enforcement in hot zones,” by Peter M. Lunsford, BA, EMT-T.)
We also feature some comments from the jems.com article “EMS Doesn’t ‘Diagnose’ … or Do We?” by W. Ann “Winnie” Maggiore, JD, NREMT-P, in which she makes a case supporting a “field diagnosis” in EMS. Read the article at www.jems.com/field-diagnosis.
We shouldn’t be going in to unsafe scenes like this. If a group of individuals would like to get advanced training (SWAT medics) and agree to added risk (for added pay) that’s their prerogative. Combat medics in the military are armed. Why would our medics go into a combat zone with nothing to protect themselves? The cops need to take some of the drug money and grants that they receive and join forces in budgeting the training of SWAT medics for their safety and the public’s.
I’m an active duty Army infantry soldier. After Columbine, we trained for school shootings (9/11 ended that train of thought). Part of our training was having a group of medics follow the initial assault team for patient care. Was and is a great idea!
This is absolute nonsense. There’s no reason to send minimally-trained volunteer first-aiders into an active shooting zone. This is why I am moving out of 9-1-1 response. I will not be a part of a program that is too stupid to see why sending people … to die is a bad idea. When EMS starts becoming about evidence-based medicine, and not about trying to recreate bad cop movies, give me a call. There’s no reason these duties can’t be performed by law enforcement agents. You take someone, you give them 120 hours of training and a MOLLE vest, and they’re going to think they’re something they’re not. You have money for level III body armor but still can’t get simple pain control to the people you respond too. Perhaps your priorities
I don’t understand some people’s limited perception. Having been a medic for over 18 years, as well as a SWAT medic for the last 8 years, I’ve seen the benefits of this implementation in our area as well as others!
You want to be close to the action? Quit EMS and become a cop. I understand my place and it’s behind the closest unit or my truck until the scene is secure.
In response to William T.: Don’t sit there and unilaterally state that EMS doesn’t belong in a situation like that. Speak for yourself. Some of us don’t want to sit on the sidelines and watch as innocent people die when we could be in there helping them. It’s a training course. If you want to be that coward than don’t take the course.
I absolutely agree with what you have presented in this article. From a personal perspective I like the terminology “working diagnosis.” We do have to ultimately make decisions in emergent situations with the minimal diagnostic tools available whether in the BLS or ALS capacity. My reason for a “working diagnosis” is that you’re attempting to diagnosis and treat appropriately with minimal resources that may not provide you with a concrete diagnosis. We take calculated interventions and risks with every patient we come in contact with from using whatever diagnostic tools available, even simply intuition at times.
This is a question that doesn’t even deserve a response. There’s no grey area: Paramedics don’t treat “shortness of breath,” they make a diagnosis in order to treat asthma (vs. COPD vs. CHF). You can add whatever caveat to it you want: “field,” “presumptive” (NYC’s version), etc., but it’s a diagnosis.