Administration and Leadership, Columns

Staffing and Writing About Paramedics

Issue 6 and Volume 40.

Recognizing EMTs & Paramedics

This month, JEMS Editor-in-Chief A.J. Heightman, MPA, EMT-P, responds to a reader who expressed her concern over the overuse of the term “paramedic” in JEMS articles. Also, the researcher from the focus study of February’s Street Science column “Speak Up: Don’t let on-the-job assault & harassment go undocumented,” by Keith Wesley, MD, FACEP and Karen Wesley, NREMT-P, thanks the authors for their astute analysis of her findings. Finally, our Facebook fans sound off about Heightman’s From the Editor column “Too Many Medics: Why we don’t need Johnny & Roy on steroids,” from the April issue.

Providers Snubbed?

All I ever read is paramedic, paramedic, paramedic. What happened to EMRs, EMTs and AEMTs? Are we not needed anymore?

Sue Reinen
Via email

Editor-in-Chief A.J. Heightman, MPA, EMT-P, responds

I, too, object to so much emphasis on paramedics when, in fact, most of what’s done in the field (probably 80–90%) is BLS. I personally add “EMT” in most article areas where an author–stuck in the paramedic paradigm–simply refers to everyone as a paramedic.

Also, all our articles are written with the EMT and paramedic in mind. For example, we all assess and treat diabetics. Most of the assessment, care and packaging is standard for us all. Though, simply because there’s a finger-sick, blood draw and amp of D50 given doesn’t make that an ALS article. So JEMS doesn’t label them that way. At our conferences, CECBEMS and many states require us to label a diabetic talk, including any level of ALS intervention, as an ALS/paramedic-level talk–which is baloney. But we have to do it.

We specifically have columns such as Back to Basics because we realize the importance of EMTs and the need for paramedics to never forget the main skills they use, which are BLS skills. We strive to also highlight them all, even in photos.

I hope that explains my, and the JEMS, position. EMS could never survive without BLS content and skills. We respect EMTs, AEMTs, EMRs and all first responders.

From the Researcher

I was just browsing the February issue of JEMS and found on page 34 the commentary by Dr. Wesley and Ms. Wesley on my recent publication about violence toward paramedics.

First, thank you kindly for selecting this article for review. It’s great to see that it’s receiving attention south of the border. While the results of the study are clearly disappointing, they must be shared widely so that reporting increases and action is taken.

Second, thank you for your careful analysis and aggressive advocacy. You both hit the nail on the head and I hope sites like the Center for Leadership, Innovation and Research (www.event.clirems.org) continue to become strong repositories of information that lead to change. As you both concluded, it’s about culture; to stand up for paramedic wellness, professionalism and advancement.

My sincere appreciation to you both.

Blair Bigham, MSc, ACPf
Via email

Facebook — Should we staff fewer paramedics?

Most calls can be run without a paramedic. Most, not all. I, for one, like this. — Keith M.

I disagree. This field is constantly changing. Evidence-based research gets proved and disproved and reproved over time. There’s no way decreasing the availability of high-level care could ever be a good thing. — Bill T.

Where I live, we’re flooded with ALS providers. This causes the EMTs to forget a lot of skills because most calls are dispatched ALS. Essentially they become the dreaded “ambulance driver.” I love having ALS right around the corner but our CAD needs to be more accurate here in my part of Maryland. 8/10 calls on average are dispatched ALS, where in Pennsylvania, the same call would only get a BLS response and be just fine. — Bryan R.

Get rid of EMT basics. Make AEMT the minimum standard. Then run one medic and one AEMT. — Kevin T.

AJ needs to remember that not all EMS systems are urban and running a right-minute performance clock. ALS level care is now also provided in the rural environment and small cities where a tiered response is not appropriate. — Chris M.

As a paramedic, I see both sides of this article. BLS providers in our state are, in my opinion, quite shortchanged most of the time by running a medic and EMT per unit. I agree that in a perfect system that would be the way to roll, however, I think many of the younger paramedics today (especially in my area) come right out of EMT into paramedic with absolutely no idea the importance of their EMT partner and furthermore don’t value their EMT as they should. I believe we should have a mixture of BLS and ALS units. — Tabitha F.C.

These plans work great in big cities where you’re only a sneeze away from a hospital. But in rural areas, forget it. You need paramedics. From a schedule-filling position, a paramedic can fill an EMT slot but an EMT can’t fill a paramedic slot. — Trevor Q.