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Message from Las Vegas


Doing more with less could have been the theme for the 2011 EMS World Expo. Las Vegas Fire and Rescue Fire Chief Mike Meyers welcomed the attendees with a quick overview of his department over in the last decade. Like many other agencies, Las Vegas Fire is experiencing a significantly increasing call volume with only slightly more responders and fewer clerical and training staff. Meyers encouraged the attendees to capitalize on the opportunity to start becoming more business smart, to motivate and energize their workforce and to deliver the best possible care.

Before Connie Meyer, president National Association of Emergency Medical Technicians’ (NAEMT), presented the group’s national awards, attendees were asked to take a moment of silence to remember the responders who were lost ten years ago during the September 11 attacks.

The NAEMT award winners included:

  • EMT of the Year: William Rise, a volunteer EMT-I with Grant-Roberts County Ambulance Service
  • Paramedic of the Year: Anne Edwards, Indianapolis EMS
  • Volunteer Service of the Year: Bayshore-Brightwaters Rescue Ambulance, Bayshore, NY
  • Paid Service of the Year: Sussex County EMS, Georgetown, DE
  • National EMS Management Association EMS Executive of the Year: Tom Quillin, Leon County Emergency Medical Service, Tallahassee, FL

Few attendees were surprised to learn that keynote speaker, FEMA Deputy Administrator Rich Serino was busy with his day job assisting communities affected by Hurricane Irene, and was unable to attend. Instead, popular speaker Mike Smith, BS, MICP, program chair for Emergency Medical Services at Tacoma (WA) Community College, stepped in to deliver the keynote address. He encouraged the audience to consider their investment in EMS. “It is a seductive profession,” Smith warned. There is always one more shift or one more class to take. However, without a healthy outlet, EMS can take a toll both emotionally and physically.

He offered 10 tips to responders that he hopes will help them succeed in this challenging profession.

  1. 1. Be ready to learn. “Nobody gets better by accident,” he says.
  2. 2. Hope for the best, but plan for the worst. “You represent the hope for success, Smith says. It is also your job to prepare for the worst-case scenario.
  3. 3. Accept the unfairness of life. As responders, we often witness the utter injustice this world has to offer.  “We can’t change that. Our job is to take care of those in need,” he says.
  4. 4. Love what you do and do what you like. Smith encouraged the audience to make a difference in a people’s lives. “It will make a difference in your life,” he says.
  5. 5. Know in your heart that the job is important. “We touch people’s lives in so many ways,” he says. Our job is to reduce pain and suffering. “The most common thing we do is the simplest,” he adds.
  6. 6. Get in (and stay in) good shape. Smith says it’s part of doing a good job.
  7. 7. Build relationships and strong support network. Smith says that EMS responders see things no humans should see. “We get touched by evil sometimes,” he says.
  8. 8. Expect to be humbled by the complexities of medicine. There is simply too much to retain and apply, Smith says. “All we can do is strive to do better,” he says.
  9. 9. Cultivate and nurture a great attitude. “No whining about a call,” he says. “We should not complain when we get work.” To which the audience erupted in spontaneous applause.
  10. 10. Achieve and maintain balance.  “If you’re not careful, your EMS bank account gets stripped to nothing,” he says. He encouraged the crowd to cultivate friends who do not wear a star of life on every piece of their clothing. 
  2. Smith notes that since 9/11, there is even more need to work smarter and harder. “Our mission hasn’t changed, but the execution of the mission becomes much more challenging,” he says.

Management Forum
Later in the day, a forum sponsored by the National EMS Management Association and led by a six-member panel, identified key issues that face EMS administrators, managers and chiefs.

Panel member Aarron Reinert, NREMT-P, executive director of Lake Region (MN) EMS, urged EMS leaders to learn to speak with one voice. By bickering in public, EMS agencies often leave the table with nothing. The reality, he says, is that “99% of the challenges, we agree on. We need to focus on that,” he says.
Part of the problem, he says, is that too many people are willing to accept the minimum and don’t fight to do what’ right. Courageous leaders must be fostered and nurtured. “EMS can no longer be voluntary—it’s your turn because you’ve been here the longest. We must develop leaders,” he says.

One issue everyone agreed on is that the delivery model for EMS is changing. William Sugiyama, fire division chief/manager for Oakland (Calif.) Fire Department says EMS must take a global view of its delivery model and expand to community health. Skip Kirkwood, MS, JD, EMT-P, EFO, CMO, Chief, EMS Division; Wake County (N.C.) Department of EMS, agrees that EMS must expand its services, but within the boundaries of the organization. It must be part of a business plan that operates on a new approach—one in which the community needs are defined and an education system is built to meet those needs.

As the profession evolves beyond basic rescue and transportation, training the workforce to respond in this new reality dominated the discussion. NEMSMA treasurer Sean Caffrey, MBA, CMO, NREMT-P believes we are seeing the last generation of EMS as it existed. Changes in the health care laws will influence EMS of the future. He noted that a similar evolution took place for physicians and nurses. “They didn’t throw everybody out. They brought everybody along,” he notes

Las Vegas Fire and Rescue Medical Director David E. Slattery, MD cautions that rather than continually expand, “we must completely own EMS care,” he says. “We must be excellent at what we do. Measure that with data and bridge prevention based on the communities’ needs.”

Sugiyama believes that to improve quality, training departments must face the reality of the job. “We spend 90% of training on skills used less than 4% of the time,” he says. “We need to reboot our standards and practices."

Part of what is sorely needed, according to Kirkwood, is a system to analyze data in order to turn it into information. He believes that information exchanges, like the one his agency is undertaking, offer the opportunity to close the feedback loop and provide needed information.

For Kirkwood the question of “Is EMS health care or public safety” comes down to an issue of funding. The reality, he says, is that EMS needs to be good at both. Public safety is viewed as essential service. He is concerned that if EMS were to move solely into the health care arena, it will no longer be considered an essential service.

Fiscal sustainability is an imposing issue for most departments. Sugiyama says that, faced with a budget shortfall at his department, “everything is on the table.” He is looking at collaborations with the Public Health Department and corporate sponsorships with large industries to gain a level of support.

“The answers are everywhere,” Caffrey says, suggesting that some solutions may come from outside of the United States and outside the industry.

Kirkwood agrees. “Learn from anybody,” he says. Whether it’s from a fire-based department or a community college, if they have a good idea, try it. “It’s not a zero-sum game,” he says.

Trade Show
There was a perceptible focus on EMS safety at the trade show. Of particular note are the technical innovations in gurney lift devices. The primary impetus is to help reduce the cumulative stress on provider’s backs. While some of the devices featured are still in the testing phases, the next few years should bring significant advances in designs that reduce the repetitive stress of lifting and moving gurneys into and out of rigs. Many of the current examples are expensive, but considering the cost of a single back injury, the price is relatively reasonable. With the number of alternative solutions proposed, managers will need to look closely to determine the best solution for their agency.


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