Eight emergency drugs removed from fire trucks

Eight emergency drugs removed from fire trucks

By Mike Essian, WINK News

Story Created: Sep 23, 2008 at 7:19 PM EST

Story Updated: Sep 23, 2008 at 7:58 PM EST

COLLIER COUNTY, Fla. - Eight potentially life-saving drugs have been ordered removed from all fire trucks in Collier County.

The EMS Medical Director Dr. Bob Tober says fire fighters don't need them, but fire fighters say, not having them puts you at risk.

Tober has already pulled advanced life support drugs from the city of Naples Fire Department because 12 of 14 fire fighters failed certification tests.

But fire fighters in North Naples say they're qualified and removing the drugs is a dangerous mistake.

Advanced life support drugs include beta blockers, heart rhythm stabilizers, and seizure medicine, tools fire fighters rarely have to use.

"It's not something they use everyday, but if you use a drug one time this year, one time this month, obviously that's directly impacting someone's life," James Cunningham, the president of the North Naples Fire Fighters, said.

Monday, Dr. Tober ordered eight of those medicines removed.

"The public is much safer for them to step back and receive basic life support until a guy or girl arrives on scene who uses these drugs daily," Tober said.

Cunningham says in some cases, EMS takes too long to respond, and they have to use ALS drugs.

But Dr. Tober says they only use ten percent of the ALS drugs he issued them, and some have gone unused for more than a year.

"I realized, gosh, these guys aren't using 90 percent of those drugs, I'm gonna get those off these trucks so that there's no opportunity for them to misuse a drug," Tober said.

North Naples fire officials say their personnel are trained to administer them and the drugs have never been misused, but still, Dr. Tober insists they be removed.

"It's much safer to be given basic life support and wait for the next tier of medical expertise and training to come to you than to hand you drugs that may be over your head."

North Naples fire fighters welcome more training from Dr. Tober if he thinks it's necessary, but Tober says that would be over-training them, and instead, he's focused on keeping his 120 county paramedics qualified.

In a move Tuesday by the Board of County Commissioners, the board voted to rewrite the contract for the medical director, requiring the director to answer to the commissioners.

Tober says the move is a technicality, saying ultimately, he's always answered to the board. Others say it's a step in the right direction, hoping the decision will allow them more access to the director.

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A Day in the life of a Paramedic

A Day in the life of a Paramedic

Are you familiar with the people running the stretchers through the door and shouting numbers at the doctors on the television show “ER”? Those are paramedics and Emergency Medical Technicians (EMTs). Paramedics are the highest level of pre-hospital providers; EMTs are the basic level personnel. Paramedics and EMTs are often the first medical people at the scene of an accident or sudden illness; they give immediate care to heart attack victims, car crash victims, gunshot victims, and poisoning victims. They even assist in childbirth. The sick or injured are then transported to healthcare facilities in specially equipped emergency vehicles. On arrival at a medical center, the paramedics transfer the patient to nursing personnel and report their observations and treatment procedure to the attending physician. The guidelines or procedures followed by EMTs are directly related to their level of training. The EMT-Paramedic is at the upper rung of a three-level hierarchy. Paramedics administer sophisticated prehospital care. They are trained in the use of complex medical equipment, such as EKGs, and are capable of administering drugs both orally and intravenously. EMT-Intermediates have more advanced training than EMT-Basics who bandage wounds, stabilize blood pressure, assist heart attack victims, and treat accident victims for shock. All three levels of EMTs can be talked through care procedures in the event they are confronted with a difficult or complicated situation. Thus EMTs may maintain radio contact with a dispatcher and keep him apprised of the situation. Should the need arise, senior medical personnel (physicians) will then take charge. For EMTs and paramedics, helping people can be an athletic experience; you have to be where people need you. Like fire fighters or other emergency response personnel, paramedics and EMTs are involved in life and death situations. Their work can be richly rewarding, as when a child is born despite difficulties, or terribly sad, when, even after administering proper care, a patient dies. Conditions are tremendously stressful, hours long and irregular, and salaries low. Paramedics must be physically and emotionally strong enough to do backbreaking and sometimes dangerous work, and ready to hustle on a moment’s notice, whether they feel like it or not, as someone’s life may be on the line. The paramedic never knows what conditions they might meet on any given day, so emotional stability is at a premium. “It’s a lot of stress and anxiety,” says one EMT who has been on the job for three years. “But some days you go home feeling like you really made a difference, and that’s a real good feeling.”

Paying Your Dues

Training to become an EMT is offered by police, fire, and health departments and in some hospitals. Many colleges and universities offer nondegree courses. Basic training to become a first level EMT requires 100 to 120 hours of classroom sessions plus ten hours of internship in a hospital emergency room and twenty to fifty hours on field rescue or ambulance companies. An additional thirty-five to fifty-five hours of instruction in patient assessment, intravenous fluids, antishock garments, and esophageal airways are required in intermediate training. Paramedics usually undergo between 750 and 2,000 hours of training. But the real training comes with experience. Although registration is not generally required, it does enhance the possibility of advancement and employment opportunities. A certified EMT must renew his registration every two years, which requires that he remain active in the field and meet a continuing education requirement. However, a paramedic seeking advancement must leave fieldwork if she is to move up to operations manager, administrative officer, or executive director of emergency services.

Associated Careers

Because of its high-stress environment, many paramedics suffer from burnout. A lack of advancement opportunities and low salaries leads to a high turnover in this profession. On the other hand, police, fire, and rescue squad departments offer attractive salaries and benefits. For paramedics looking to switch careers, the health care profession offers several avenues. With a rapidly aging population and scientific breakthroughs which prolong life, the proliferation of residential retirement communities, nursing homes, adult daycare centers, and health care agencies, the need for health care professionals is virtually assured. With more schooling, paramedics can become R.N.s, occupational and physical therapists, doctors, and other health care workers. Closer to the field, paramedics can make the transition to EMT instructor, dispatcher, law enforcement, or fire fighter.

EMS Billing

City of Newark, Ohio Increases Safety Services with EMS Revenue Recovered by MED3OOO EMS Billing

Last update: 7:30 a.m. EST Dec. 16, 2008

PITTSBURGH, Dec 16, 2008 /PRNewswire via COMTEX/ -- MED3OOO, Inc., a national healthcare management, technology, and Emergency Medical Services (EMS) billing company, has been able to help the City of Newark, Ohio recover lost EMS transport revenue that was not being billed to insurance companies.

After partnering with MED3OOO for EMS Billing and Revenue Recovery, the City of Newark Division Fire & EMS department is now able to bill and collect revenues from insurance carriers for ambulance transports more efficiently and with no out-of-pocket expense to the community.

Mayor Bob Diebold recently announced that the EMS revenue recovery program, which he championed as a council member in 2007, has earned the City $1,680,000 for the 12-month period ending November 30, 2008. When the program was originally passed, the former council member and current mayor projected maximum revenues of $1,525,000 annually for the City.

"The EMS revenue we have recovered has allowed us to hire an additional seven fire fighters to provide increased safety services to the residents of Newark, and has provided important funding for capital improvements," said Mayor Bob Diebold. "Our EMS billing partner, MED3OOO, has done an outstanding job producing important revenues for the City. This program is a huge success for the City of Newark and is providing important funds during very difficult financial times."

MED3OOO offers municipal Fire and EMS service organizations a cost-effective alternative to doing in-house ambulance billing and revenue recovery through its M3/EMS ASP and Revenue Cycle Management technology. The services are designed to meet agency needs to capture accurate reimbursement and collections while complying with regulatory requirements. MED3OOO's well-trained and expert staff are certified by the American Academy of Procedural Coders and use the most advanced technology to streamline the billing and collections process to minimize costs and reduce the time it takes to process claims.

About MED3OOO

MED3OOO, a leader in EMS billing and revenue recovery, healthcare management, and information management technologies, advances the quality and performance of healthcare delivery for providers. Focused on improving operational, financial, and clinical outcomes, MED3OOO empowers over 15,000 physician, hospital, employer, and municipal clients across the United States. For more information, please contact Karla Sartori, MED3OOO Corporate Marketing at 412-937-8887 or Karla_Sartori@MED3000.com and visit http://www.MED3000.com

About the City of Newark Division of Fire & EMS

The City of Newark Division of Fire & EMS has been protecting and aiding the citizens of Newark, OH, since 1886. The department has progressed from horse-drawn hose wagons and bucket brigades to a modern-day department with 3 Engines, 3 Medic Units, a Tower, a Ladder, and a Command Unit. The Newark Fire Department (NFD) provides a vast array of Emergency Services, from EMS to Haz-Mat, with 80 members including 62 firefighters and paramedics, 3 Units, and Administrative Officers. Specialized units include Hazardous Materials Units and a Dive Rescue van. NFD professional firefighters and paramedics are aided in their work by state-of-the-art turnout gear with self-contained breathing apparatus and thermal imaging cameras to find hidden fires.

This release was issued through eReleases(TM). For more information, visit http://www.ereleases.com.

What does a paramedic do?

People's lives often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics. Incidents as varied as automobile accidents, heart attacks, slips and falls, childbirth, and gunshot wounds all require immediate medical attention. EMTs and paramedics provide this vital service as they care for and transport the sick or injured to a medical facility.

In an emergency, EMTs and paramedics are typically dispatched by a 911 operator to the scene, where they often work with police and fire fighters. (Police and detectives and firefighting occupations are discussed elsewhere in the Handbook.) Once they arrive, EMTs and paramedics assess the nature of the patient's condition while trying to determine whether the patient has any pre-existing medical conditions. Following medical protocols and guidelines, they provide appropriate emergency care and, when necessary, transport the patient. Some paramedics are trained to treat patients with minor injuries on the scene of an accident or they may treat them at their home without transporting them to a medical facility. Emergency treatment is carried out under the medical direction of physicians.

EMTs and paramedics may use special equipment, such as backboards, to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. These workers generally work in teams. During the transport of a patient, one EMT or paramedic drives while the other monitors the patient's vital signs and gives additional care as needed. Some paramedics work as part of a helicopter's flight crew to transport critically ill or injured patients to hospital trauma centers.

At the medical facility, EMTs and paramedics help transfer patients to the emergency department, report their observations and actions to emergency department staff, and may provide additional emergency treatment. After each run, EMTs and paramedics replace used supplies and check equipment. If a transported patient had a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance and report cases to the proper authorities.

EMTs and paramedics also provide transportation for patients from one medical facility to another, particularly if they work for private ambulance services. Patients often need to be transferred to a hospital that specializes in their injury or illness or to a nursing home.

Beyond these general duties, the specific responsibilities of EMTs and paramedics depend on their level of qualification and training. The National Registry of Emergency Medical Technicians (NREMT) certifies emergency medical service providers at five levels: First Responder; EMT-Basic; EMT-Intermediate, which has two levels called 1985 and 1999; and Paramedic. Some States, however, have their own certification programs and use distinct names and titles.

The EMT-Basic represents the first component of the emergency medical technician system. An EMT trained at this level is prepared to care for patients at the scene of an accident and while transporting patients by ambulance to the hospital under medical direction. The EMT-Basic has the emergency skills to assess a patient's condition and manage respiratory, cardiac, and trauma emergencies.

The EMT-Intermediate has more advanced training. However, the specific tasks that those certified at this level are allowed to perform varies greatly from State to State.

EMT-Paramedics provide the most extensive pre-hospital care. In addition to carrying out the procedures of the other levels, paramedics may administer drugs orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations, and use monitors and other complex equipment. However, like EMT-Intermediate, what paramedics are permitted to do varies by State.

Work environment. EMTs and paramedics work both indoors and out, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers risk noise-induced hearing loss from sirens and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to diseases such as hepatitis-B and AIDS, as well as violence from mentally unstable patients. The work is not only physically strenuous but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others.

EMTs and paramedics employed by fire departments work about 50 hours a week. Those employed by hospitals frequently work between 45 and 60 hours a week, and those in private ambulance services, between 45 and 50 hours. Some of these workers, especially those in police and fire departments, are on call for extended periods. Because emergency services function 24 hours a day, EMTs and paramedics have irregular working hours.

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