Resuscitation in Peoria--June 2007
Thursday, June 21, 2007
Resuscitation in Peoria
In Emergency Medicine News, September 2006, the following was written:
"Three years ago, the physician director of the Houston EMS system with investigators at Baylor College of Medicine, the Houston Medical School at the University of Texas, and Ohio State University looked at cardiac arrest survival as a function of ambulance deployment strategy. Though limited to a single geographic area, this study showed definitively that outcomes for cardiac arrest patients improve when they are cared for by paramedics than by basic EMT's. (Resuscitation 2003;59:97.)
"What was the difference? The busy urban area used paramedics, and a suburb used EMT's (Basic).
"The authors said the study demonstrated better response times and better skills proficiency by the "targeted response" team in the urban core, or as they call it, the TR paramedics."
In Peoria, the Peoria Fire Department (PFD) is Basic. The PFD has paramedics that cannot use their skills to resuscitate patients. This unfortunate decision has been made by multiple individuals. The majority of the Peoria public is not aware that the PFD cannot resuscitate them with advanced life support when the public calls 911.
The medical literature also states that having too many paramedics trained in an area may not be ideal for patient care because an individual paramedic may not be able to keep up his/her skills with competition for procedures by other paramedics.
Thus, the literature is begging these questions:
1. Should the PFD petition the State of Illinois and the Peoria Area EMS (PAEMS) to allow their paramedics to give advanced life support at the scene of a medical emergency? When the PFD arrives before Advanced Medical Transport (AMT) and the paramedic firemen cannot do anything but provide Basic service, which seems suboptimal if one reads and believes the medical literature regarding patients who suffer from cardiac arrest.
2. Should AMT cut their staff of paramedics so as not to dilute the skills of their own paramedics? And if the PFD paramedics were allowed to function as paramedics, less AMT paramedics may be desirable.
Peoria's City Council and PAEMS have to decide what is more important--the business and money generated by AMT or quality of pre-hospital patient care in central Illinois.
Bill 1952 originated from Peoria in 2017 and was written for the benefit of the Peoria Fire Department (PFD) and for the 20,000 people in Peoria who call 911 each year. Bill 1952 proposed that any EMS Engine in Illinois could function at the level of the highest trained medic on the vehicle.
So how would this help the Peoria Fire Department?
Bill 1952 was written to allow Peoria Fire Engines responding to emergency medical calls to function at the Paramedic level if a PFD Paramedic was on board the Engine. Therefore, a Basic Life Support Engine could function as an Advanced Life Support Engine if a Paramedic was on the vehicle. As stated above, this bill would cover not only Peoria but the entire state of Illinois.
Bill 1952 was proposing what I have been advocating for the past two decades--Allow PFD Paramedics to function as Paramedics at the scene.
Did you know that this bill was unanimously voted for by all of the House of Representatives of Illinois except for one? Ryan Spain of Peoria voted "present". Ryan is Vice-President of Economic Development for OSF HealthCare. And he has relatives on the Community Advisory Board of Advanced Medical Transport (AMT).
I assume Ryan believed that OSF and AMT would be in opposition to Bill 1952. Why would Ryan think that OSF and AMT would NOT want the responding Paramedic on the PFD Engine to be able to offer Paramedic care on a 911 call?
And believe it or not, there was a lobbyist in Springfield hired to OPPOSE Peoria being covered in the bill. In other words, the lobbyist wanted to carve Peoria and the Peoria Fire Department out of Bill 1952. She was ok with Bill 1952 for the rest of the state, but not Peoria.
Can you believe this?
Who paid this lobbyist to oppose Peoria Fire Department Paramedics?
Well, the lobbyist works for the Illinois College of Emergency Physicians (ICEP). ICEP is the state medical specialty society representing more than 1,340 emergency physicians in Illinois.
According to ICEP's website, “ICEP is dedicated to the support of quality emergency medical care and committed to the interests of emergency physicians. ICEP provides its members with significant benefits through active committees, continuing medical education programs and other activities including legislative lobbying.”
This same lobbyist sits on an ICEP board regarding the Political Action Committee (PAC) and works with legislators in Illinois.
Why would the largest Emergency physician society in Illinois be opposed to licensed PFD Paramedics in Peoria giving care in Peoria?
Any ideas?
Are there ties between ICEP and Peoria and Bill 1952?
Well, there might be. The past president of ICEP is none other than Dr. George Hevesy. Dr. Hevesy was Director of the OSF Emergency Department and was Project Medical Director (PMD) in Peoria for many years. He helped determine which EMS agencies were Basic Life Support and which were Advanced Life Support. And during his years as PMD, Dr. Hevesy received a "stipend" from Advanced Medical Transport and a salary from OSF. Dr. Hevesy was recently terminated at OSF but still is Executive Director of the Corporate Board of AMT and is the Corporate Medical Director at AMT. And he still finds time to sit on the ICEP EMS Committee. This Committee develops, supports, and implements ICEP positions on EMS issues. Therefore, Dr. Hevesy would have known about Bill 1952 and would have known that ICEP had their lobbyist oppose the bill. This is the same Dr. Hevesy who used to address the Peoria City Council in the 90s and tell them that it would be a “duplication of services” if the PFD were to upgrade from BLS to ALS.
Dr. Hevesy, please respond to this and show us your formal communication with ICEP where you opposed this lobbying activity. And if you did not oppose it, why? You wouldn't have supported it, would you?
Bill 1952 was signed into law in August 2017. Even with the opposition in Peoria and in Springfield, common sense and beneficent medical ethics prevailed.
Several months later on January 2, 2018, PFD Engines 1 and 3 were upgraded to Advanced Life Support.
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