Administration and Leadership, Commentary, EMS Week

EMS Week and Going ‘Beyond the Call’: The Federal Perspective

The first EMS Week was celebrated in 1974, shortly after the creation of the Division of Emergency Treatment and Transfer of the Injured at the National Highway Safety Bureau—the predecessor of today’s Office of EMS in the National Highway Traffic Safety Administration (NHTSA). Since that time, NHTSA has supported national EMS projects that have shaped the profession for more than a generation. In 2019, NHTSA and its federal partners have continued to build on that legacy with the release of EMS Agenda 2050 and the 2019 National EMS Scope of Practice Model and other projects of national significance.

In May, communities across the U.S. will once again be celebrating EMS Week. We asked Jon Krohmer, MD, director of the NHTSA Office of EMS, about this year’s EMS Week theme of Beyond the Call, recent national EMS projects and what’s on tap next for NHTSA and its federal EMS partners.

Q: What does this year’s EMS Week theme, Beyond the Call, mean to you and to the NHTSA Office of EMS?

A: This year is the perfect time to recognize how EMS professionals go beyond the call every day. In the last few years, we’ve seen examples where people have stepped up during natural disasters, dedicated themselves to ensuring their colleagues’ safety and mental health, and creating innovative programs to tackle public health issues from chronic disease to drug overdoses. At NHTSA, we have always relied on EMS professionals across the country who give their time, expertise and insight in order to advance the profession. EMS Agenda 2050 was only successful because 10 amazing people came together on the project’s technical expert panel to solicit and process input from hundreds of their colleagues who went beyond the call because they cared about the future of the profession. The same is true for other initiatives we’re involved in, from the new EMS Scope of Practice Model to CPR LifeLinks, a guide to help EMS agencies and 9-1-1 systems collaborate and improve cardiac arrest survival rates.

Q: How will the NHTSA Office of EMS celebrate EMS Week this year?

A: We’re excited to once again be an official partner of the EMS Strong campaign and EMS Week. We have a long history of working closely with national organizations working to improve EMS, including the National Association of EMTs, the American College of Emergency Physicians and all the organizations who support EMS Week at the national level. My boss, NHTSA Deputy Administrator Heidi King, is a former EMT and 9-1-1 dispatcher, and we couldn’t have a more eager advocate in NHTSA’s leadership. This year we’ll also be celebrating EMS Week in our own community—the U.S. Department of Transportation headquarters in Washington, D.C. We’ll be talking to our colleagues throughout the department about the great work EMS professionals are doing in communities everywhere. We’re excited to be collaborating with ACEP to teach our colleagues hands-only CPR and how to Stop the Bleed on May 23, in conjunction with National Stop the Bleed Day. It’s a great chance for us to remind ourselves that although the work we do at the national level is immensely rewarding, EMS is inherently a local activity that relies on a system of people going beyond the call—including bystanders who can play a critical role in saving a life.

Q: You mentioned some of the recently completed initiatives supported by NHTSA. What’s next on the horizon?

A: We have a lot of great things going on. Our office also houses the National 9-1-1 Program, which is busy getting ready to award millions of dollars of Federal grants to help 9-1-1 systems upgrade to Next Generation 9-1-1. Talk about going Beyond the Call—new technologies will revolutionize how we communicate with 9-1-1 callers, with each other and with our partners in public safety and healthcare. We continue to support data collection and use, both through the National EMS Information System (NEMSIS) and by partnering with colleagues across the federal government to find ways to facilitate data sharing at local, state and national levels.

In addition, we’ve recently kicked off some new projects. Along with our partners in the EMS for Children program within the Health Resources and Services Administration (HRSA), we’re supporting the revision of the National EMS Education Standards, which were published in 2009 and have guided curriculum development for EMS practitioners since. The revision is being led by experts from the National Association of EMS Educators, but we also have received great input already from many other organizations and individuals, and there will be several opportunities for public comment over the next year or so.

Another initiative is in response to a topic discussed by the National EMS Advisory Council (NEMSAC)—we really take the council’s advice seriously and I highly recommend people out there in the EMS community learn more about NEMSAC and how it works by visiting EMS.gov. In this case, NEMSAC tackled the issue of whether the phrase “emergency medical services” really is the best way to describe the practice of EMTs and paramedics, or whether other terminology is appropriate. We recently brought together more than two dozen representatives of stakeholder organizations to have a conversation about nomenclature in EMS, and they’ll be meeting again later this year.

Q: NEMSAC recommended using the term “paramedicine” to “describe the distinct discipline and profession which has emerged within the out of hospital health care field.” Would that replace the phrase “emergency medical services”?

A: Not necessarily. First, we decided to step back and bring EMS leaders together to discuss the broader issue before moving forward with the NEMSAC recommendations. There’s still not a consensus within the profession, and our hope is to see where there is agreement, and where there might be disagreement. So while NEMSAC recommended using “paramedicine,” we started this initiative without any assumptions about what the final outcome might be. In the end, it will be up to the EMS community to choose the terminology it wants to use—we can certainly use certain words or phrases in federal documents, but we can’t decree to states, local agencies or organizations that they use one word or another.

The NEMSAC recommendations did not say that “paramedicine” would replace “EMS” in all uses. In fact, one reason some people think a new term is needed is precisely because they still want to use “EMS” to describe the system—from bystanders and prehospital care to hospital and post-acute care—but not necessarily to describe the entirety of what EMTs and paramedics are trained and authorized to do.

Q: Why are NHTSA and HRSA taking this approach to address the NEMSAC recommendations?

A: At the federal level, we have always tried to work collaboratively with the national EMS community on significant projects. We want to ensure broad EMS community participation and feedback on this important topic. It’s important that we get input from multiple organizations to make sure we, as a profession, remain as unified as possible in setting the course for our future. That’s why we’ve invited all EMS organizations and some of our partners to participate and will be having opportunities for public comment as well. In the end what’s most important is that everyone’s voice is heard and we feel that we helped the profession come together and move forward after having a thorough conversation about the issue.

Q: How can people find out more and become involved in this project and others happening at the national level?

A: We have a page about the nomenclature project on EMS.gov, and we’ll keep that up-to-date with opportunities for public comment, drafts of the white paper that the initiative will be producing, and more. The best way to stay informed and not miss any chances to get involved is by signing up on EMS.gov for our email list. The more people who are invested in the future of our profession and go beyond the call by contributing to these important national projects, the better they will be and the more prepared we’ll all be to take advantage of the opportunities the future will bring.