EMS Committees

[JJR512]

This question is intended for those of you who practice EMS as part of a volunteer fire organization.

Does your volunteer fire company or department have an EMS Committee, and if so, what are the responsibilities and duties of the company? How is it organized, how many people are on it? How often does the committee meet?

If your station is a combination station (volunteer station supplemented by personnel from the county or local career fire department), do you have a representative from the career personnel on the committee as well?

 

[MedicBender]

We have an "EMS sergeant" that is supposed to over see training and day to day stuff. She doesn't. We've formed various other committees for EMS related things. They usually meet once then they forget about it. It's a pretty broken system right now, but my station was more or less forced into getting an ambulance by our county, so all the fire guys avoid it like it's the plague. The career staff use our equipment during they day, but we've never really had a problem with them. They stay out of our way we stay out of theirs.

I'd like to see a stand alone division for the EMS side of things. Right now our captain is trying to run things and it's more of a side project. Until then I'm just going to keep riding the ambalampse

 

[mycrofft]

Our CERT just formed one.

Being volunteers, they have to be "led and fed" as it were. We have to interdigitate with medical control of our parent FD.
The main thrusts we will have are training (keeping it useful, keeping it current and appropriate), quality control (pt contact report review, helping answer concerns, answering scope of practice issues), and retention of people with EMS tendencies.

I see the commitee being optimal at about five really active volunteer operative members under one chairperson who answers to the program manager, and is in frequent contact with Training and Medical Control. I don't want to expand to include the medical trainers, but that is probably goiong to occur down the line, if the money holds out.

The tendency is to get lots and lots of commitee members but no one is in charge, or the chair is doing it as an additional duty and not given resources and time to do it, or the others all want to run things.

 

[DrParasite]

This question is intended for those of you who practice EMS as part of a volunteer fire organization.

Does your volunteer fire company or department have an EMS Committee, and if so, what are the responsibilities and duties of the company? How is it organized, how many people are on it? How often does the committee meet?

The reality is, many FDs consider EMS to be a burden, an afterthought, and something to do in between Fire operations.

the problem (as I see it, and I have been known to be wrong before) is that more fire departments are doing more EMS than actual firefighting. So they should be EMS departments with a Firefighting committee :rofl: You shouldn't have an EMS committee; you should have a Chief officer in charge of EMS, an EMS captain and an EMS Lt. If you do a lot of EMS, you should have a "chief medical officer" who is in charge of all patient care issues. You shouldn't have a committee of people who want to be in charge of EMS, you should have EMS line officers who are in change of EMS (and equal in rank, responsible, and authority as their fire counterparts). Training and funding should be split between fire, rescue and EMS, if you provide all services, and having a chief officer to oversee that can ensure that it happens.

If your station is a combination station (volunteer station supplemented by personnel from the county or local career fire department), do you have a representative from the career personnel on the committee as well?

at my former combination ALS FD, almost all of our career staff were paramedics (except for our Career Captain and Career Chief, although that has since changed since i was there), and one of our paramedics (who is now a Lt) is the Director of EMS.

If career staff are going to be holding supervisory positions, or doing the job, they should have a voice in how things are done. Won't always make them right, but they should be heard.

 

[mycrofft]

MAybe this is a vollie dept. Over 70% are still volunteers.

EMS has been the bread and butter of most fire departments for decades.
In a volunteer dept., you must have professional medical control, be in concert with local EMSA, etcetc, not something to be done by volunteers alone. I'm swapping between two and four emails daily with my paid handler and we aren't even up and operating yet.

 

[JJR512]

EMS has been the bread and butter of most fire departments for decades.
In a volunteer dept., you must have professional medical control, be in concert with local EMSA, etcetc, not something to be done by volunteers alone. I'm swapping between two and four emails daily with my paid handler and we aren't even up and operating yet.

What is "EMSA", and what is a "paid handler"?

Since there are lots of ways to run things, perhaps I might need to explain the details of how things are run here. In this county there are several volunteer fire companies. There is also the county fire department. The VFCs and county FD are closely integrated. The county FD provides supplemental staffing to all VFC stations; all stations, volunteer are not, are staffed 24/7 by county FD personnel. (It would actually be more accurate to say that the volunteers supplement the county staffing, but I guess tradition dictates we say it the other way 'round.) The county supplies an ambulance to every station; these are almost always in service as medic units staffed by the county. Some VFC stations own an ambulance of their own as well, which is staffed by volunteers whenever they're around. (My VFC does not own its own ambulance, but the county does keep a reserve unit here, which is staffed by volunteers whenever possible. Interestingly, the reserve unit is actually marked with our VFC name and patch despite the fact that we never owned it; it seems that someone in county fleet operations, who was formerly a member here, had a flashback to his volunteer days when he was specifiying how this particular unit should be marked.) To my knowledge, all medical supplies, consumables, equipment, etc. are provided by the county. The county FD has a medical director who provides medical direction to all stations, including the VFCs; no VFC has its own medical director. There is only one set of protocols in effect in Maryland, with the exception of a handful of pilot programs or jurisdictional optional local protocols. Also, all emergency services provided in and by this county are completely free, funded by taxes, so although EMS is the majority of what we do, it isn't strictly accurate to call it our bread and butter (but I do understand what you were getting at).

My VFC does not currently have an EMS committee at all, nor do we have an EMS officer. I've only been here a bit over a year, so I never saw it first-hand, but I know we did used to have both a committee and officer (and I assume the officer was on the committee, possibly the head of it). Some of the VFCs have committees and officers, some have one or the other, and some have none.

There are a few members here in my VFC who, like me, are more EMS-oriented than most of the membership, and would like to see the people who truly care about EMS have a bit more autonomous control over certain aspects of operations than is currently the case. One major example is how new EMT-Bs get cleared as primary care providers. Currently, they have to run ten calls as a third person on the ambulance, then they're cleared as primary providers. Ostensibly they demonstrate some skills and competence during the clearing process, but this isn't necessarily the reality. We (the EMS-oriented few of us) would like to see that change.

So the reason behind my question is to see what other EMS committees out there are doing, so we here can outline what it is we would like an EMS committee to do here. The one thing I mentioned could realistically be created by a one-time task force, and then handled in an ongoing basis by a single EMS officer. But some of us here think that an actual committee would better-serve the station, since EMS is the majority of what we do. I have some ideas of my own but I'm looking for other ideas about what an EMS committee could or should do, to help justify the creation of one.

It's difficult to judge how much support or opposition there will be to reinstituting an EMS committee within this VFC. On the one hand, it takes some EMS specifics off of fire-minded people, and I would think they'd be greatful for that. On the other hand, it's taking a bit of power away from certain people, and nobody likes to give up power.

 

[usafmedic45]

What is "EMSA"

EMS Authority. Think MIEMSS, only likely more functional, less dogmatic and led by people who may have actually read a research article on trauma, critical care, prehospital care, HEMS or resuscitation within the past 10 years.

 

[JPINFV]

EMS Authority. Think MIEMSS, only likely more functional, less dogmatic and led by people who may have actually read a research article on trauma, critical care, prehospital care, HEMS or resuscitation within the past 10 years.

Technically, he's talking about the "Local EMS Agency," which is the regional/county EMS regulator.

/me wacks Mycrofft for using regional terminology.

 

[JJR512]

Ah...So MIEMSS.

Yeah I think the only interaction we have with MIEMSS at the station level in this county is when they come to inspect the ambulances. Other than that, it's all handled by the county.

 

[Hunter]

EMS has been the bread and butter of most fire departments for decades.

The thing is that if you have a "good" fire department then, the area it covers is going to have a good fire code, to prevent fires so you use firefighters on a daily basis a lot less than you do EMS staff, unfortunately I think a lot of firefighters might feel threatened by the joining of EMS/Fire since that would mean that current firefighters would have to go through EMS training to maintain their jobs. We have a small department down ehre that I think has the right idea, they have 3 stations, each run 1 rescue ambulance, 1 hose and 1 fire engine. When you start out, you start out on the engine, you have to be there for a while before you can work on rescue which has more calls, but also gets paid better than the guys on the engine. Ofcourse this may not have anything to do with the OP <.<...

 

[mycrofft]

It's all hanging together, keep commenting.

Most if not all professional fire departments do not have an EMS commitee, they have a short chain (shorter the better) or small cadre to make it work and keep it that way. (Those are the "paid handlers").

For a volunteer organization, or even a mixed one with a crucial volunteer component, a commitee gives those members the chance to help implement the EMS policies/procedures/protocols, and helps buy their cooperation.

Fed (NHTSA) says States need to set standards and form EMSA's, States apportion territory to them, and in each EMSA's district (or whatever it is titled in a given state) it is the final arbiter of who practices, who doesn't, and scopes/levels.


Yes, Hunter, I remember EMS being jammed down the throats of some very good firefighting professionals in the early Eighties, and we lost good men and women who were darn good fighters, but not into the EMS they were being forced to undertake, or be fired. And if fire get less frequent and less close to our homes, the FD starts looking more and more superfluous.

 

[MonkeySquasher]

"My VFC does not currently have an EMS committee at all, nor do we have an EMS officer."

"There are a few members here in my VFC who, like me, are more EMS-oriented than most of the membership, and would like to see the people who truly care about EMS have a bit more autonomous control over certain aspects of operations than is currently the case. One major example is how new EMT-Bs get cleared as primary care providers. Currently, they have to run ten calls as a third person on the ambulance, then they're cleared as primary providers. Ostensibly they demonstrate some skills and competence during the clearing process, but this isn't necessarily the reality. We (the EMS-oriented few of us) would like to see that change."

"I'm looking for other ideas about what an EMS committee could or should do, to help justify the creation of one."

"It's difficult to judge how much support or opposition there will be to reinstituting an EMS committee within this VFC. On the one hand, it takes some EMS specifics off of fire-minded people, and I would think they'd be greatful for that. On the other hand, it's taking a bit of power away from certain people, and nobody likes to give up power."

I apologize if I'm resurrecting the dead thread, but I've worked every day since the 19th. lol

JJR, I understand all too familiar what you're going through here, and I'm in the same situation.

I finished Medic and am currently very close to clearing already at my paid service. Another local EMS-only service I am with said that once I'm cleared at my job, I'll be inserviced and cleared there after 1 successful ALS run. This place is very progressive, does billing to fund themselves, and listens to ideas and input from its members. It IS run by the same group of friends which sometimes leads to some drama, but I feel that having people who know eachother very well for a number of years is doing a fine job at this company.

Then there's my VFC. The company, but more specifically, the EMS is run by one man and his family. What he says goes... Policies are frequently different between different members or even change by the day. There's no real committee, just whatever he and his few clique people like. There's very little training, and no set clearing process. He is our only Medic, with 5 other Critical Care (sort of like an I99 for NYS) techs in our company. And there's a very inconspicuous push for me to either not clear, or leave the department since becoming a Medic. Probably because I'm not quiet about my feelings that the company is poorly run and needs change. And since no one challenges him, and we have no EMS committee or structure for SHOWING people what is being done wrong, nothing changes. It's quite frustrating that a couple people's egos are taking stage over proper procedure and/or patient care.

I feel any agency where EMS is NOT the main organized goal (IE - VFC) needs an EMS committee, which should be run by the people who do the EMS. A committee doesn't need established one-time goals, just something as simple as discussing possible changes, QA/QI, and case studies will ensure a long-term standing of the committee. The real challenge will be getting people to show up and participate.