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Emergency Medical Services: New Year, New Challenges for EMS

The elections are over, the end of the year is almost here and before you know it, 2013 will be in full swing. As we say goodbye to 2012 and hello to the New Year, with this, there are some things we need to watch.

To start with, Colorado and Washington State voted to legalize the use of marijuana beginning in 2013. This isn't just medical marijuana; this is the use of all marijuana for regular consumption, just like alcohol or tobacco. While I'm sure there's going to be significant legal wrangling over states' rights versus federal law, we need to begin planning for this now.

There are a whole host of issues associated with this, including use by employees, use by patients, insurance and death benefits and legal grow operations and the list goes on and on. I've previously addressed the issue of medical marijuana in this column, but this has the potential to be a significant issue for those of us in fire and EMS. So, please stay tuned.

Did you hear that the FDA is considering reclassifying AEDs? The Sudden Cardiac Arrest Foundation (SCAF) reported in early November that if the FDA reclassifies these devices, it could significantly impact the availability of AEDs to the general population. Apparently, a grandfathering clause allowed AEDS to be regulated as a Class II device even though they're considered Class III. The issue at hand is that there's a push to require them to be reclassified as Class III devices, which means the testing is much more extensive (read costly) than the current test.

The belief by SCAF is that these testing requirements will significantly drive up the cost of AEDs to the point that they're no longer affordable to the public. "If AEDs are changed to Class III devices, the effects would be detrimental to the cost, availability, and innovation of future AEDs," according to the SCAF. We all know the effectiveness of AEDs; this could significantly impact prehospital care and survival rates. This is another one to stay tuned on.

President Obama has been reelected, and federal healthcare reform is here to stay. A number of folks thought that if the presidency or control of Congress changed hands, the Affordable Care Act would be overturned. Well, that's not going to happen.

If you haven't been getting up to speed on the Affordable Care Act, you need to start now. Although there are still lots of assumptions and guesses on how this will affect EMS, one thing is certain. It will affect EMS, and you do need to be paying attention to this.

The EMS Section will be working to develop resources to let members know how this will affect you, what you need to consider and what you need to do to stay ahead of the curve. You can start right: reach out to your local hospital system or medical director to get involved in their meetings so you begin to learn as much as possible about what they're planning to do. One more to stay tuned to.

Finally, we need to keep working together to move EMS forward. As I've written about before, the patient doesn't care what the patch on your shoulder looks like, nor do they care about the color of your apparatus. They just want a qualified, caring EMT or paramedic to show up and help them with their problem.

This may mean that they arrive in a fly car as a community paramedic with a nurse practitioner. It may require just an ambulance or medic unit, or it may require a full fire and EMS response. Any of these units could be staffed by volunteers, third service, private, public health or fire-based EMS personnel. As long as the community supports that EMS system, it should strive to provide the best care possible.

We need to stay engaged with our communities, our customers and our employees. We need to set aside our differences and work with, not against, each other to continue to move EMS forward.

The times are rapidly changing, and we must not only keep up, but stay ahead of the change. We need to direct our future, and not have it dictated to us. But it will require give and take from everyone involved to ensure our success. It won't be an easy road, but I've found that there are very few of these types of roads left. Everything always seems to be a challenge. So, accept that challenge and, most of all, please stay tuned.

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