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Emergency Medical Services: Second Verse, Same as the First

No, this article isn’t about the song by Herman’s Hermits, nor is it a reference to Patrick Swayze in Ghost. It’s a reference to my 2011 On Scene article, Time for a Truce. In that article, I discussed the constant fighting between fire-based and non-fire-based EMS organizations and associations that’s preventing EMS as a whole from moving forward.

Sadly, this still holds true today and, in some cases, has even morphed into fire-based EMS systems disagreeing with each other on which direction our services should be moving.

In the four years since that article, little progress has been made in unifying EMS, and quite frankly, I think it’s actually gotten worse. Let me give you a few examples.

The Field EMS Bill that the National Association of EMTs (NAEMT) authored and had introduced in Congress is an attempt to try to unify EMS and move the profession forward. There are many good pieces in this bill that would serve EMS well. Yet, there are also significant challenges related to funding and leadership for EMS at the federal level.

The IAFC and others had concerns about these challenges and opposed the bill as previously written. A new bill was introduced into the current Congress and after review is essentially the same as the previous bill with all the same challenges.

When the IAFC attempted to reach out to NAEMT to try to negotiate changes, we were basically told “No,” and so we remain opposed to the EMS Field Bill in its current form.

Second verse, same as the first.

Another recent issue is the NFPA solicitation for the need to develop an NFPA standard for EMS Officer qualifications, similar to NFPA 1021, Standard on Fire Officer Professional Qualifications. The National EMS Management Association (NEMSA) has developed and published their “Seven Pillars of National EMS Officer Competencies” and believes there’s no need for an NFPA standard.

While their document is well thought out and very comprehensive, it hasn’t been widely adopted in EMS and has even received some pushback in their own organization. On top of that, several fire-based organizations have come out against an NFPA standard, stating it isn’t needed and there are other ways to accomplish the same thing.

So, here we are, arguing against others as well as ourselves. Sound familiar?

Finally, we all agree that improved ambulance design and safety is a must. We really haven’t modified ambulance design or safety since its inception, except to make the patient compartment roomier and easier to work in.

The NFPA established a multidisciplinary consensus committee to develop a standard, and NFPA 1917, Standard for Automotive Ambulances, was born. Before it was even published, it received many negative comments from non-fire-based EMS organizations, and when it was published, it immediately went into revision to try to address those concerns.

Apparently, that wasn’t good enough, so the Commission on Accreditation of Ambulance Services (CAAS) proposed and is currently working to develop their standard for ambulances.

Again, the IAFC and others have opposed the duplicative CAAS effort, but it’s just another example of the fractured environment where EMS resides.

At some point, we need to decide when enough is enough. There are so many major issues facing EMS that we can’t afford to continue fighting against the non-fire-based organizations, much less against ourselves.

We need to find common ground and move forward as a whole. Until we do, we’ll keep singing the second verse, which unfortunately continues to be the same as the first.

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