Too Many Paramedics?

October 22, 2006

I read an article in the September issue of Emergency Medicine News which reported that FEWER paramedics save more lives when patients are having heart attacks. This seems counter-intuitive. One of the points was that paramedics targeted to this population had special expertise and had more opportunities to use their skills (such as airway intubation). The authors think that too many paramedics dilute the skills of “targeted paramedics”. Thus fewer paramedics improved the outcome of the patients.

I spoke to the physician director of EMS in Houston. I told him about Peoria’s unfortunate situation. Emergency Medicine News stated that he did a study three years ago in connection with Baylor College of Medicine and several other institutions. They looked at cardiac arrest survival as a function of ambulance deployment and strategy. This study showed that cardiac arrest patients’ outcomes improve when they are cared for by paramedics than by basic EMTs.

It seems to me, that the Peoria Fire Department (PFD) paramedics should not have to be asked by Advanced Medical Transport (AMT) to use their paramedic skills at the scene of a cardiac arrest. Firefighter paramedic skills need to be kept sharp. The Peoria Fire Department arrives at the scene quicker than AMT the majority of the time and if one believes the conclusions of the studies reported above, the cardiac arrest victim needs the paramedic skills to increase his/her chance at survival. Why should the Peoria firefighter who is a paramedic have to wait for AMT to arrive, and then wait until AMT asks the Peoria firefighter-paramedic for help? It can hurt the patient’s outcome and, at the same time, decrease the skills of the paramedic Peoria firefighter.

The Project Medical Director in Peoria needs to change the philosophy in Peoria but has too many obstacles to overcome. Ask Dr. Jim Hubler how things went for him when he was Project Medical Director and became too friendly with the Peoria Fire Department. Prominent businesses, the Peoria Journal Star, and Peoria’s hospitals support AMT and their monopoly over paramedic and transportation of Peoria’s prehospital patient.