Paramedic's Logbook

IT'S NOT TOO LATE: VOTE AGAINST THE NAEMT BY-LAWS CHANGE

2009-09-24T12:28:00.000-07:00

Any NAEMT member who reads the by-laws should ask the question:

"Would I be able to run?"

If you are good enough to represent your state or local EMS organization, and you have skills and talent, in my opinion, that should make you the perfect candidate for a national office.

How valuable you would be to your local agency or state office, after spending some time on the board of NAEMT, meeting federal government officials, and then being able to come back and capitalize on that experience in your community.

If you cannot run for an office in NAEMT, because of the by-laws change, and you have skills and talent, just ask yourself 'Why'?

Lets try and apply the by-laws change to any member of NAEMT.

What if you are a member of NAEMT, but you are not an instructor. Well you would not be able to run.

OK, you say, but if you go to the conference, that would make you eligible to run.

But what do you do if you cannot afford to go to the NAEMT Conference on your own or your employer in these tight economic times cannot pay to send you to the NAEMT conference?

How will you meet the first two parameters of the by-laws change?

Well you can be appointed a liaison or serve on a committee.

How do you come to the attention of NAEMT to become appointed a liaison or representative?

Look at most of the liaisons. They are all appointed by the president of the Association. Most of them are people from the presidents home state, with some being holdovers from previous presidents (who knew them, etc.).

Please do not get me wrong. They are good people, qualified to do the liaison job. But if the president makes the appointments, and historically he appoints people he knows, if you are an unknown, how will you get appointed as liaison or a representative on a committee?

Look at the last category, the affiliate advisory committee. That was the old Board of Governors. Historically it has been the president or past president of the state association, or some other board member for the state association. Few state associations have travel budgets, so if the president of the state association is going, they will frequently have him be the affiliate advisory representative.

Look at the affiliate advisory committee:

http://www.naemt.org/affiliates/affiliates_landing/our_affiliates.aspx

All of those people are excellent well respected leaders, with many years of experience and knowledge. But there is very little turn over there. If we look back at the OLD Board of Governors for NAEMT you will see most of the same people from then, still sitting on the advisory council now!

How does someone who has valuable knowledge, who is hard-working, with great skills, and organizational capabilities, bump some of these tremendous state leaders out of the way?

I am not saying they should, those state leaders and their experience is invaluable to NAEMT and to their states, but it doesn't present a wide-range of opportunities for people to present themselves to NAEMT to run for a leadership position.

Vote against the by-laws change, we do not limit the people who can run for office in a free and open society, we shouldn't do it here,

Stay safe, I hope to see everyone in Atlanta,

Daniel R. Gerard, MS, RN, NREMT-P

http://www.linkedin.com/in/dangerard

Why?

2009-09-20T20:01:00.000-07:00

In 2000 and 2001 while I was the Chairman of the National Paramedic Division for NAEMT, I authored a report on occupational injuries in our profession. If you would like a copy of this report, please email me at daniel.gerard@comcast.net. The scope and purpose of this report was to survey ALL of the nation’s EMS offices and various departments of labor, to try and find out the answer to these pressing questions:

How many EMT’s and Paramedics are injured in the line of duty?

How many EMT’s and Paramedics die in the line of duty?

How are they injured or killed?

The report, in summary, stated that we do not collect critical information and we don’t know how EMT’s and paramedics are injured in the line of duty. Now I know what you are going to say, ‘But Dan, guys are injured from lifting and moving and generally get killed from motor vehicle collisions’.

True, from my gut feeling I would tend to agree, but if we don’t measure numbers, how do we know when we do institute measures to reduce injuries, that what we are doing is effective?

We need to make comparisons within our own organizations, but also between other organizations as well.

If we were to compare injury rates in one location, to injury rates in another location, with similar populations, similar call volumes, and we found one had a significantly lower EMS occupational injury rate than the other, wouldn’t you want to know why?

EMT’s and paramedics are our most precious asset for any organization. We need to protect them, take care of them, provide as safe an environment for them as possible.

Let me ask another question: How many EMT’s and paramedics were injured due to acts of intentional violence?

I don’t know, no one does.

Even more important, what can we do that is effective in limiting career ending injuries and line of duty deaths?

Another excellent question.

If you or anyone else were to ask the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.

Was the investment and development of life-saving body armor worth the time and effort?

Without good data, we cannot even begin to assess if the methods we are employing are working or aren’t working. Let me give you an EMS example. A member based organization developed a poster to reduce an aspect of EMS occupational injuries. They disseminated the poster.

That was it.

Some people will say, what was wrong with that?

In a better designed program, you would measure injuries associated with what you are trying to reduce for a 6 months to 2 period prior to implementing the poster.

You would create an EDUCATIONAL piece to go with the poster, incorporating the information from the prior 6 months to 2 year period. You would then deploy the poster, and then collect information for the next 6 months to 2 year period. You would then compare the results.

In this example of the poster, none of this was done.

Was the poster effective? We will never know. If you can’t tell me there is a correlation between your poster and injury reduction, then you probably just wasted your members money.

If you talk to the National Institute of Justice, their body armor program was a resounding success. In 2006, the last year complete data is available, motor vehicle collisions exceeded penetrating trauma as the leading cause of death for law-enforcement officers in the United States.

What area of law enforcement occupational injury do you think the National Institute of Justice is concentrating on now?

Even better, why can’t EMS have that same information?

A good question…

I always thought it was interesting that this national EMS organization choose a poster. It is almost like they are out of touch with how we communicate. Is a poster how we communicate most effectively?

EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world (http://www.youtube.com/watch?v=6biw3LEq_0c ). I know guys who have it bookmarked on their PDA’s so that they can show people during impromptu educational sessions.

A poster? Is that how they are trying to get their message out?

We are talking about the lives of our brother and sister EMT’s and paramedics. THAT was their best effort?

This same organization is developing an EMS Safety Officer Course. Again, how will we know the course is success if we don’t measure injuries from year to year? How will I, or you, or your organization KNOW that the EMS Safety Officer is doing a good job?

An EMS Safety Officer Course? Why develop a course for one person? Why not a program for an entire organization? How about a complete program for reducing injury, hazard, and death in our profession? How about working with other agencies, who may have programs of excellence to develop a complete program that we could distribute?

EUREKA! What we need is an EMS Safety PROGRAM!

A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of the original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to training, to response, on-scene, during a large scale incident. Again this was part of my original set of recommendations for the Association, to identify programs of excellence, and then look to incorporate what they have accomplished into a COMPREHENSIVE program.

For some strange reason, after I wrote my report to NAEMT, my recommendation to examine programs of excellence was not acted upon.

Yet everyday EMT’s and paramedics are still being injured or losing their lives in the line of duty.

EMS need’s a program, with a toolbox full of tools for organizations large to small, volunteer to paid, to help reduce EMS occupational injuries. Something that encompasses all phases and flavors of what we are. We could partner with insurance companies to develop meaningful programs to identify hazards, reduce risk, and eliminate line of duty death and disability. This will reduce the cost for program development, in addition to we can leverage the knowledge of insurance companies to develop MEANINGFUL programs for injury prevention. In addition they will provide us with tools to measure our success.

If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.

Let us have an honest discussion. If you can’t tell me that you have made any inroads in reducing death and disability, because you don’t have a quantifiable number of how many people are being injured, we will never know if our efforts are effective because we won’t have any information to compare it to.

If anyone read my report, and if we followed my recommendations, we would have had 8 years worth of data by now, 8 years worth of information in order to develop programs to reduce death and disability. All we needed was one or two years worth of data to begin identifying and working toward reducing death and disability.

Wow. 8 solid years of working on reducing injuries and deaths in our profession. How many people could we have helped...

The first question I think of when I think that SOMEONE or SOME ORGANIZATION is going to develop an EMS Safety Officer Course is: how much money is this organization going to charge for this program?

Most of the EMT’s and paramedics in our field pay to take courses like ACLS, PALS, PHTLS, AMLS, PEPP, and EPC out of their own pocket because they want quality education. What will someone charge to give them the requisite training to protect their lives and the lives of their co-workers?

Yet no national organization or even anyone in the federal government still cannot answer the fundamental questions:

How many EMT’s and paramedics were injured and killed in the line of duty last year?

How did they get injured or killed?

No national EMS organization can say that their injury reduction efforts have made any impact on EMS occupational injuries, and they never will be able to say that. Right now who suffers? EMT's and paramedics in the field are suffering and we as a profession aren’t doing anything effective.

I have been to funerals for EMS personnel. We owe it to them and their families to get this one right.

WHO STANDS UP FOR YOU?

WHO PROTECTS YOU?

WHO UNDERSTANDS YOU AND WHAT YOU NEED?

WHO IS INTERESTED IN PROTECTING YOU IN THE FIELD, AND WILL ASK THE HARD QUESTIONS AND DO THE HARD WORK NEEDED TO GET THE JOB DONE RIGHT?

I WILL.

I am Dan Gerard, and I am running for the Region IV Director for NAEMT.

I am not interested in a travel a club or free trips, I want to work hard for you the dues paying member.

I know this issue thoroughly. I authored the first two reports on EMS occupational injuries for NAEMT. I know the topic and the national leaders for EMS occupational injuries. I will follow through on the initial recommendations for reducing EMS occupational injuries by:

Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries. Then we can begin to collect meaningful, useful data to analyze on how we are injured in the field.

Partner with one of the 13 Injury Control Research Centers funded by the National Center for injury Prevention and Control at the Centers for Disease Control and Prevention, in order to analyze our data and develop programs for reducing workplace hazards and improving health and safety

Develop a program in concert with our partner Injury Control Research Center/CDC to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.

Don’t let another EMT or paramedic suffer a needless injury. Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.

Daniel R. Gerard, MS, RN, NREMT-P

http://www.linkedin.com/in/dangerard

What is Best for EMS

2009-09-17T07:16:00.000-07:00

I think back to when my cousin served in Congress. Even as the population continued to change, he did one thing that was crucial…he continued to serve and REPRESENT the needs of his community.

What federal government agency represents us?

When we look at our police and fire service brothers, they have a clear identity. When they go to the federal government, they can go to U.S. Fire Administration and the Department of Justice. The Department of Justice has a huge budget, and the capability to hire and fire, as well as give out grants, underwrite programs. They have a national training academy run by the FBI in Virginia. The U.S. Fire Administration has a large budget, and the capability to hire and fire, as well as give out grants, and underwrite programs. They have a training academy in Maryland.

What federal agency represents EMS?

EMS, while it responds to more calls than it’s fire service brethren, has been relegated to the Federal Interagency Committee on EMS or FICEMS for short, an arrangement that has no program budget, no hiring or firing capability, cannot issue grants, and it’s ‘biggest’ stick so to speak is to an issue a report to Congress, that Congress is under no obligation to act-upon. Some people will over that this is just as good.

It isn’t. Someone explain to me how is this just as good as the Department of Justice or the U.S. Fire Administration? Doesn’t EMS deserve better?

For those of you who don’t know, FICEMS has existed in the federal government in one form or another since the 1970’s. Yes ladies and gentlemen, FICEMS has been around since the 1970’s, being re-authorized in the mid-80’s and again in 2005. It didn’t do anything for EMS in the 1970’s and FICEMS hasn’t done anything for us now.

There are at least 10 different federal agencies that compose FICEMS. Ten. TEN SEPARATE directors, with SEPARATE employees, TEN SEPARATE budgets, TEN SEPARATE mission statements, and TEN SEPARATE grant programs.

What does FICEMS do? The 10 different agencies that compose FICEMS is tasked with discussing EMS issues and writing reports and recommendations to Congress.

FICEMS CANNOT make policy. FICEMS CANNOT institute programs. FICEMS has no budget, FICEMS CANNOT hire or fire anyone. FICEMS CANNOT issue any grants. FICEMS does not provide any training or education

NOT one of those members of FICEMS is dedicated to EMS. All of them have different missions and different goals. Have you ever read the mission statement for the Department of Transportation or for the National Highway Transportation Safety Administration where the EMS office lives? It doesn’t mention EMS at all in their mission statements.

In my current state of California and where I was originally from in NJ, EMS has one agency, in California it is the EMS Authority in Sacramento and in NJ it is the Office of EMS in Trenton. No other state in the United States breaks up EMS between 10 different agencies and then tries to manage it by committee.

Isn’t it just possible, that what has been working in the individual states over the last 40+ years, that ONE agency, with ONE purpose and ONE mission is the right way to do this?

Yes EMS overlaps with the fire service, as well as the police. Just as EMS overlaps with the fire and police services, fire overlaps police, and police overlaps fire.

No one would ever say that the police service or the fire service do not deserve their own departments or agencies in the federal government. No one is suggesting that police and fire aren’t multidisciplinary services, they are, and they are UNIQUE and extremely complex, JUST AS UNIQUE AND COMPLEX AS EMS.

The Institute of Medicine is a learned scientific body. In 1966 they saw a need for change in our community. EMS was horrible hodge podge of service delivery models, running from one extreme to another. Private funeral homes, without any training to first aid and rescue squads, providing the best they could with text’s from the American Red Cross.

In 1966 the Institute of Medicine realized that we were in danger, researched the issue and published this report ‘Accidental Death and Disability: The Neglected Disease of Modern Society’.

Consider this:

Do you and your community need EMT’s?

Do you and your community need paramedics?

Do you and your community need an EMS system?

Do you and your community need a trauma system?

All of these components of the EMS system were proposed and written about in the Institute of Medicine in their 1966 report ‘Accidental Death and Disability: The Neglected Disease of Modern Society’. If it wasn’t for this report we would not have EMT’s, paramedics, EMS Systems, and trauma systems, or even the National Registry.

Where is the science or expert opinion to support an assertion that FICEMS was the best option for EMS?

In 2007 the Institute of Medicine published a new report, ‘Emergency Medical Services: At the Crossroads’. One of their most important recommendations - Create a lead federal EMS agency, that the federal government should consolidate all functions related to emergency care that are currently scattered among multiple agencies into a single agency in the Department of Health and Human Services (DHHS).

Let me ask you a question: why, would anyone not support the Institute of Medicine’s recommendation for a single federal agency for EMS?

EMT’s and paramedics are smart. They already knew we needed our own EMS agency! Prior to the IOM report, EMT’s and paramedics in several nationwide polls OVERWHELMINGLY stated that they wanted a single federal agency, with one purpose, to advance the mission of EMS and to represent EMS as effectively as police and fire within the federal government.

What do we need? We need somebody to say that the FICEMS isn’t the best for us, somebody who is supposed to FIGHT and not take the easy way out. That isn’t the EMS way, we do a job no one else can handle. We don’t take the easy way out.

In my personal opinion, FICEMS is doing EMS a disservice.

I am a paramedic. I earned my EMT-A card in 1981 and my paramedic certification in 1985. Am I not an equal to my brothers and sisters in the police and fire services?

In my personal opinion, FICEMS doesn’t work and this is an example why:

Everyone knows the EMT-Basic curriculum. When Medicare came out with the negotiated rule making committee for the Ambulance Fee Schedule, they stated that Medicare wouldn’t re-imburse service providers for an IV, because it was a basic skill.

Everyone knows initiating of an IV, by and large, is the domain of Intermediates and Paramedics. Where was the EMS Office from NHTSA during this process? Better yet, where was FICEMS? As FICEMS stood idly by, show me where did they weigh in on the fee schedule? What was FICEMS recommendations? If FICEMS really worked, this would never have happened.

We need our own federal EMS agency. Please read the IOM report, 'Emergency Medical Services: At the Crossroads' you can access it here for free: http://www.nap.edu/catalog.php?record_id=11629#podcast

My name is Daniel R. Gerard, I am a paramedic, and I want to represent EMT’s and paramedics. I have 28 years in the field and I am proud of my service to the community.

I am running for the NAEMT Region IV Director. If you haven’t voted for me, vote today, I will fight for what is right and for what you want. I will make it my mission to get a federal EMS agency, one that will effectively represent the needs of the EMS community.

I will represent the profession passionately, with pride, and without prejudice. I am not afraid to say what I believe in. I am not afraid to do what is right.

Stay safe my brothers and sisters, I will see you in the street,

Daniel R. Gerard, MS, RN, NREMT-P
http://www.linkedin.com/in/dangerard

An open letter to the members of Region IV

2009-09-13T19:29:00.000-07:00

My name is Daniel R. Gerard, MS, RN, NREMT-P, and I am running for the NAEMT Region IV Director. I have worked the streets as an EMT and paramedic in one of the busiest EMS systems per capita in the United States for over 20 years. I know what we do and how difficult our job is.

I started as a volunteer EMT in Newark, NJ in 1981, switching over to a career position in 1983. I became a paramedic in 1985, and I have served as an EMT Instructor, dispatcher, EMS Tour Chief, paramedic instructor, continuing education coordinator, college professor, clinical coordinator, QI coordinator, and EMS director. I have served NAEMT as Chair of the Paramedic Division, program development for AMLS, liaison to CECBEMS, and CAAHEP. Other leadership positions I have held, I am the past-President of the NJ EMT Association, past-Treasurer of the San Francisco Paramedic Association, and I currently serve as the Chairman of the Occupational Injury Prevention Committee for the International Association of EMS Chiefs. In addition I was the lead consultant for the ambulance service re-design in Hong Kong and I worked with the Pan American Health Organization in the Bahamas.

NAEMT is a member driven organization. As a member of NAEMT I have consistently dedicated myself to the Association and the membership.

I am not running to advance my resume, to get a new job, or to make money. I am running because I believe in who we are and what we do. I believe that we deserve better. I believe that as a profession we deserve equal consideration with other healthcare and public safety professions.

I seek this position with no illusions.

In my personal opinion NAEMT has let us down in regards to how they manage our finances and responding to EMS occupational injuries.

How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know?

Previous officers have said that this year we are budgeted for 21% travel. Twenty-one cents out of every dollar goes to travel. My question is how many DOLLARS did we spend?

No one has answered that question.

Out of the 79 cents left, we still have to pay salaries, benefits, of the staff in Clinton, operate and maintain the building, taxes, print and mail the newsletter, correspondence, computers, paper, and last but not least, benefits to the membership.

If we spend 21% of every dollar on travel, how much money do we spend on the members?

If I am paying you my money what do I get from the Association, in dollars and as a percentage of the total budget for my dues that I paid during the last completed fiscal year?

I have not received a response yet.

The officer making comment on first class travel asked for the information that I had regarding travel, and another officer stated that no one had any upgrades to first class. I then referred them to the Clinton Travel Agency records for the last three years, specifically the credit card receipts and to please look for the 500 Mile Upgrades purchased to be utilized for upgrades in travel.

I have not had a response yet.

I am also stating that the Association has paid for the frequent flyer club membership for officers. They maintain they haven’t. This is a misstatement of facts by the Association.

Last but not least, the biggest problem I have is that the Association flew several officers to the retirement party for another officer of the Association. I am sorry, this is wrong. We don’t fly officers/board members to a party.

I am against the new by-laws change. My opponent is for the new by-laws. Let me state clearly that the by-laws change does not affect my opponent or myself. I believe that I am speaking for the membership by being against the change. I feel in my personal opinion, that the by-laws will not open opportunities for members to run for office, but instead limit the opportunity to a narrow group of people. Again this is my personal opinion, but what I would ask you to look at the by-laws change, and say ‘if I wanted to run for office, under these by-laws, would I be able to run?’

I think at that point, it will be clear.

There is a letter from the attorney of NAEMT regarding the by-laws change. I have asked that the letter be provided to the membership so that they can make an informed choice. For whatever reason, the Association has not or will not provide the letter to the membership. Various people have quoted from the letter, but no one will make the entire letter available to the members. Why?

If it is a positive letter, let us see it and then we can get behind the by-laws change. If it has negative comments or ascertains, let us see that as well, so that we can be well-informed and make a decision that is right for us.

In regards to a single federal EMS agency, I will ask you a couple of questions:

Are you better off today than you were last year, 2 years ago, 5 years ago?

Do you think we have equal representation with the police and fire services on a federal level?

Do you think we have a powerful voice in the federal government, to advocate for us, and to advance an agenda to improve our profession?

If you say yes, then I would have to disagree, please read my previous posts. If you say no, then you and I are on the same page.

Every one deserves to have a safe environment to work in. In regards to health and safety issues let me ask one more question:

Do you feel any safer than you did last year, 2 years ago, 5 years ago?

If your answer is no, who has been representing you?

My goals if elected:

Work toward creation of a national EMS administration, as the membership has stated in previous polls

Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries

Develop a program to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.

Responsibly manage your money, reduce cost, by eliminating frivolous travel

Answer and be accountable to the membership

Do you work hard for your money? Do you work hard for the money that you make to pay your dues to NAEMT? What do you get for that NAEMT membership money?

How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know?

In all of my time in EMS, I have always felt that EMT’s and Paramedics must stand up and defend their own rights. There is no end to this battle, when we are old and no longer able to carry on the fight, what we fought for will live on in the future of our brother and sister EMT’s and paramedics.

I have answered every question, EVERY question that has been put forth by the membership.

Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.

Stay safe, I will see you in the street,

Daniel R. Gerard, MS, RN, NREMT-P

WOW 2 in a row!

2009-09-13T18:16:00.000-07:00

Another GREAT question from GAEMTPARA:

To GAEMTPARA:

As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.

As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”

If you want additional information, or documentation, email me at daniel.gerard@comcast.net

GAEMTPARA, thank you for the excellent question.

“What are your priorities with regards to EMS at the National Level?”

To answer your question GAEMTPARA:

First and foremost I would seek to have NAEMT adopt a resolution supporting the creation of a federal agency or administration as proposed by the Institute of Medicine. I would also make it our mission to work with other stakeholders in advocating for and ultimately the creation of a single federal agency. We desperately need a single federal agency to raise our identity within the federal government, and to advocate for issues that are important for EMT’s, paramedics, and EMS systems.

The Department of Justice has a huge budget, and the capability to hire and fire, as well as give out grants, underwrite programs. They have a national training academy run by the FBI in Virginia. The U.S. Fire Administration has a large budget, and the capability to hire and fire, as well as give out grants, and underwrite programs. They have a training academy in Maryland.

EMS, while it responds to more calls than it’s fire service brethren, has been relegated to FICEMS, an arrangement that has no program budget, no hiring or firing capability, cannot issue grants, and it’s ‘biggest’ stick so to speak is to an issue a report to Congress, that Congress is under no obligation to act-upon.

FICEMS has existed in the federal government in one form or another since the 1970’s. I was amazed too when I learned this fact, yes has been around since the 1970’s, being re-authorized in the mid-80’s and again in 2005. It has always been weak and ineffective, and to date still has not accomplished anything.

There are at least 10 different federal agencies that compose FICEMS. Ten. They all have SEPARATE directors, SEPARATE budgets, SEPARATE mission statements, SEPARATE grant programs, and SEPARATE employees. Not one of those 10 agencies of FICEMS is dedicated to EMS. All of them have different missions and different goals.

If you ever read the mission statement for the Department of Transportation or for the National Highway Transportation Safety Administration, neither one of them mentions EMS in their mission statements.

In my current state of California and where I was originally from in NJ, EMS has one agency, in California it is the EMS Authority in Sacramento and in NJ it is the Office of EMS in Trenton. No other state in the United States breaks up EMS between 10 different agencies and then tries to manage it by committee.

The Alameda County EMS Agency, in California has a budget of almost $30 Million and a staff of 28 people. The only office that comes close to being identifiable with EMS national is the National Highway and Transportation Administration, and it has a staff of 7 people and a budget of around $4 Million.

Isn’t it just possible, that what has been working in the individual states over the last 40+ years, that ONE agency, with ONE purpose and ONE mission is the right way to do this? FICEMS = 10 different agencies. EMS in your state = ONE agency.

No one would ever say that the police service or the fire service do not deserve their own departments or agencies in the federal government. No one is suggesting that police and fire aren’t multidisciplinary services, they are, and they are UNIQUE and extremely complex, JUST AS UNIQUE AND COMPLEX AS EMS.

All of the essential components of an EMS system were proposed and written about by the Institute of Medicine. NAEMT supports these ideas. The Institute of Medicine says we need a single federal agency. NAEMT does not, they think we are better off with FICEMS.

If it wasn’t for the Institute of Medicines report ‘Death and Disability on America’s Highways’ we would not have EMT’s, paramedics, EMS Systems, and trauma systems. We wouldn’t have the National Registry. If we didn’t have the National Registry, we wouldn’t have NAEMT!

Please GAEMTPARA remember that EMT’s and paramedics nationwide in several polls, wanted a single federal agency, with one purpose, to advance the mission of EMS and to represent EMS as effectively as police and fire within the federal government.

This why we need a single federal agency, and why I will press for this, and keep the membership updated as to out progress.

GAEMTPARA the other issue I am passionate about is occupational injuries in EMS.

I wrote a report when I was Chairman of the Paramedic Division concerning occupational injuries in EMS. The greatest problem we have as an industry is that we have no quantifiable information on how many EMT’s and paramedics are injured in the line of duty or how they getting injured. My suggestions were that we work with the U.S. Department of Labor to devise a unique coding mechanism to begin to collect this information. My other suggestion, is that we identify programs of excellence that have been successful within a particular jurisdiction or company to reduce injuries.

Why is data important? Without data, we cannot design effective programs to reduce injuries/deaths because we cannot make a meaningful comparison. This would tell us if our efforts are making an impact on the EMT and paramedic in the field.

If you or anyone else talk to the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.

If you talk to the NFPA, they can make specific reference to reductions in line of duty injuries and deaths due to addition of bunker gear for firefighters.

NAEMT spent money and developed a ‘Buckel-up’ poster campaign. We don’t know if anyone was positively affected by the poster because we have no data to do a comparison. We don’t know if poster program did any good. Are we using methods to distribute information to the public that isn’t reaching the intended audience?

EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world (http://www.youtube.com/watch?v=6biw3LEq_0c )

The poster was not our best effort to reduce occupational injuries. How many people here have seen the NAEMT poster for the ‘Buckle-up’ campaign? The members need better.

NAEMT is developing an EMS Safety Officer Course. We will be in the same situation as we were with the poster, we will develop a program, market it to EMTs and paramedics, but because there is no data on how EMT’s and paramedics are injured/killed in the line, we will never be able to tell you if the program is effective.

The first question I think of when I think of regarding an EMS Safety Officer Course is: how much money are we going to charge for this program?

Most of our members pay to take NAEMT courses like PHTLS, AMLS, and EPC out of their own pocket because they want quality education. The economy is in a downturn, there is less money in the pockets of EMT’s and paramedics, and while I understand that NAEMT needs to generate revenue, going to the pockets of EMT’s and paramedics by developing another course is not the way to do it.

What we need is an EMS Safety PROGRAM. A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of my original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to continual training, to response, on-scene, during a large scale incident, etc. Again this was part of my original set of recommendations for the Association.

If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.

If you want a copy of the Paramedic Division Occupational Injury report, email me at daniel.gerard@comcast.net

If you get a chance to read my report and recommendations, we already could have begun to identify programs of excellence for reducing death and disability, and we could then begin to develop a national PROGRAM from these programs of excellence. We could then use this program we develop to assist organizations in reducing death and disability, something any agency could use.

A course for one person? Why not a program for an entire organization?

I have been to funerals for EMS personnel. We owe it to EMT’s, paramedics, and their families to get this one right. This is where we have the chance to give back to the EMS profession. Develop an entire program that we can give to the EMS community, so that they in turn can reduce death and disability to our profession.

In summary the three priorities I have regarding EMS on a national level:

Creation of a national EMS administration

Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries

Develop a program to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.

Thank you GAEMTPARA for your excellent question, stay safe and I will see you in the streets.

Daniel R. Gerard, MS, RN, NREMT-P

FINALLY A GOOD QUESTION!

2009-09-13T11:52:00.000-07:00

From Michael Hay, Reno, NV:

Dan

I appreciate your long service and accomplishments during your career. Your strong advocacy efforts in the field are well known in the Bay Area and are appreciated by many people. There are a couple of questions that I am curious to hear your take on. These are areas that I feel will have an impact on each of us as we continue to evolve as a profession in the next few decades.

1. Do you see ems as public safety or public health? why

2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accrediated program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavour?

3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?

4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?

Would you support a bylaw change advocating term limits for board members? why or why not

Thank you for your attention and good luck in the election

My response to Micheal:

Michael:
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.

As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”

If you want additional information, or documentation, email me at daniel.gerard@comcast.net

Thank you Michael for your excellent comments.

To answer your question:
1. Do you see EMS as public safety or public health? Why?
I view EMS as having feet in both camps, but most importantly I think we have not paid as much attention to public health as we should have. There are 2 distinct traits of public health that interface perfectly with the mission of EMS, the first is dealing with prevention and the second is identifying at risk populations and dealing with health care issues for a given population.
The fire service has been providing fire prevention services in the community for decades. It is through these efforts that they have made fantastic strides in reducing damage to property, death, and disability over time.
If EMS applied that same model, in the context of public health, and put forth the same effort and achieved the same level of success, what would EMS be able to do in our own communities to reduce death and disability? It boggles the imagination.
If we used the public health template to develop service delivery models to target our at risk populations, we would achieve greater efficiency in service delivery, by concentrating on efforts and resources on large portions of the population.
It is also critically important to maintain a foot inside the public health arena as well, in order to provide them the resources they require for emergency response. As we deal with issues such as large scale disasters, H1 N1, bio-terrorism, health consequences related to hazardous materials exposure, public health needs to be able to have access to an emergency response capability and infrastructure. EMS allows public health to have the capability, command, communications, and control capacities that they require to respond to an event. It allows them to do this without having to re-invent the wheel.

2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accredited program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavor?

I realize this is a tremendous burden for many organizations. Unfortunately, there are some less than stellar paramedic programs in the United States. When there are poor paramedic programs, they are performing a disservice to people who want to enter the profession, and it lowers the standard of paramedics that ultimately enters our field. This in turn decreases our standing amongst other health care professionals.

Let us examine what has gone on with physicians. In medicine, until the release of the Flexner report, education of physicians in the United States run the gamut from extremely poor to excellent.

After the Flexner report, with the setting of standards and accreditation of medical schools, training and education improved, and so did the standard of care. If we want to do the same thing and have the same respect as all other health care providers, we need to move in this direction.

The best way to assist rural and frontier organizations is to improve delivery methods of lecture material via distributive learning (distance education). This way we could provide world class lecturers to everyone. If you have taken PHTLS and have had the opportunity and pleasure to hear Dr. McSwain, it is not only a privilege, but it is an outstanding learning experience. Using distributive learning, we can not only provide that experience to rural and frontier EMT’s and paramedics, now we can provide that knowledge to every EMT and paramedic in the United States.

Now lets expand that further: what if we took the best lecturers/educators, in every subject topic? Cardiology, Respiratory, Anatomy and Physiology? Imagine the world class education we could deliver to everyone.

There are incredible resources for education and health care in every state. If we partner with the leading academic and health care centers in each state, while I feel that there are numerous challenges, it is nothing we cannot overcome. We could then develop programs that would meet the requirements for CAAHEP accreditation.

3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?

I not only support this concept, I think that this is a fantastic opportunity to provide competent, caring health care providers, to improve primary health care in the community. The key to success is having a medical director for EMS who is in sync and working in partnership with the medical director for primary care services.

The positive effect of such a relationship is two fold. First patients benefit from receiving excellent primary care services from competent, skilled, and caring providers.

Second, those providers are given the opportunity to use a greater variety of skills, in a relaxed less pressured setting. They will have a greater opportunity to further refine their skills and this will benefit emergency as well as primary care patients.

Third, the EMS providers are out in the community, and this will give them a greater interaction with the residents, in a setting that is more conducive to have an exchange of information. When we are on an emergency call, there are many things I wish I could sit down and talk to patients about, but for a variety of factors, I cannot.

In a primary care setting, they can share that knowledge that they have, without having to worry that there is another assignment waiting.

Once the EMS team becomes a familiar face, you have greater buy-in when there is an emergency, hopefully there are less interpersonal conflicts, and overall with greater access to care, you will improve the health status of the more vulnerable members of the community. People will identify with the primary care paramedic, just as they used to do back in the day when the cop walked the beat in their neighborhood.

4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?

I would. EMS has not leveraged our relationships with other medical groups to our advantage.

EMS has had particular success with developing systems, whether they are trauma, stroke, or STEMI systems. This expertise, especially on the community level, needs to be capitalized on. This knowledge and expertise should be shared in all communities in the United States and around the world.

Raising the health status for at risk populations is a noble mission, one that we are cut out for. NAEMT has had some success with education in regards to PHTLS, but we need to take that a step further. Let us do more work in regards to trauma system development. We have demonstrated successfully that NAEMT’s educational endeavors work, let EMS show you what we can do for the development of trauma systems.

Thank you again for excellent question, stay safe,

Daniel

Sparring with the NAEMT Treasurer

2009-09-12T22:02:00.000-07:00

I have been going round and round now with the Treasurer for NAEMT. I am echoing my responses from the NAEMT Forum, because they stand the possibility of being edited and removed. This has already happened, and while I am not happy, I will explore all options to have this rectified. Until then...

Anyone who wants a copy of the NAEMT Treasurers Report from 2008, please contact me.

Rick Ellis has decided to ask a question. Rick is the Treasurer for NAEMT, and while I have a lot of respect for Rick, I am sorely disappointed.

Rick's Question to me on the NAEMT...Please make sure you read my follow-up response, there is very little dynamite in this, but toward the end of MY response is a shocker.

Rick Ellis:

Dan:

I would very much like to see the information you have regarding NAEMT paying for members to fly first class.

If members get an upgrade at no cost to NAEMT due to their frequent flier miles then that is something they earned and NAEMT is not being charged.

Also to let you know, if you add all travel lines in the budget (to cover instructors teaching our expo precon courses, PHTLS, AMLS, EPC committee travel, BoD travel, staff travel to support our major conference) you would be close to being correct as it accounts for 21% of the projected budget. To date we have spent only 9.8% of that budget.

As you are aware we are in the process of writing the new editions of AMLS and PHTLS textbooks. Much of this work is being done remotely but there is a need for some face to face time with publishers and authors.

If we were to look only at BoD travel, there is 7.3% of the budget projected to account for travel to meet twice a year and to attend meetings representing you the member at national forums and committees. To date we have only spent 55% of the 7.3% projected. By exerting conservative spending ideas, we only spent 50% of the projected budget item for the mid year meeting.

Travel was drastically reduced after the past Treasurer's concerns were raised in his departing report and continue to be scrutinized.

Thanks for your concern and request for information and clarification.

Richard Ellis, BSOE, NREMT-P
Treasurer

My Response to Rick:

Chief Ellis,

As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.

As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”

If you want additional information, or documentation, email me at daniel.gerard@comcast.net

To answer your question:

You stated that due to the last treasurers report, that issues relevant to travel were addressed and travel was scaled back.

What other issues in the past treasurers report were raised that you have addressed?

I am curious because previously, on this forum, another officer spoke disparagingly of that report, and now I am confused because you are stating that you have actually acted on some of those issues.

If anyone would like to see what was said previously, please email me and I will supply you a copy of what was said. My email is daniel.gerard@comcast.net

You stated Chief Ellis, and I will quote you here “I would very much like to see the information you have regarding NAEMT paying for members to fly first class.”

Sir this is very easy, as you already have them in your possession. Please refer to the Clinton Travel Agency records for the last three years, specifically the credit card receipts. Please look for the 500 Mile Upgrades purchased to be utilized for upgrades in travel.

They are all right there.

Are you also saying that we never paid for the frequent flyer club membership for any officer of the Association? NEVER?

My original question, sir, with all due respect accorded your position, I asked how much money was spent. If I wasn’t clear sir, my apologies, but I want to know a dollar amount, not what you have budgeted.

Why? You have a budget of 21%. That budgetary number is just what you have allotted, it wasn’t what you spent. You are going into the most expensive time of the year, and in past years, because the conference is in the last quarter, we have historically had a difficult time.

So that I am clear, and others understand, before we spend any other money, we have allotted 21 cents out of every dollar for travel. Out of the 79 cents left, we still have to pay salaries, benefits, of the staff in Clinton, operate and maintain the building, taxes, print and mail the newsletter, correspondence, computers, paper, and last but not least, benefits to the membership.

If we spend 21% of every dollar on travel, how much money do we spend on the members? If I am paying you my money what do I get from the Association, in dollars and as a percentage of the total budget for my dues that I paid during the last completed fiscal year?

To go back to my original question, please tell me and everyone else, what did the Association spend, in dollars and as a percentage of the total budget for travel the last 3 years?

What business was accomplished by the board of directors on this travel?

Why do I want to know this? If we are flying officers and Board members to state conferences to increase recruitment, the paid membership of the Association is between 6,000 and 7,000 members. The rest of the membership is composed of ‘free’ members who do not contribute anything in the way of dues, but have gained access for 1 year free by attending a PHTLS, AMLS, and EPC class.

Since we are not gaining a huge number of members, wouldn’t our money be better spent by keeping the officers and board of directors home, and letting local members of the Association staff the booths? This way we can kill two birds with one stone, develop local leaders, and put a real face on the organization, a member of the local EMS community who is also a member of NAEMT? What better person to explain the benefits of NAEMT than the guy or gal next door.

If the Association is growing by leaps and bounds because of the efforts of the officers of the Association, all well and good, it was worth the effort. Please provide the number of paid the members over the last 10 years (not the ‘free’ members who get their membership from AMLS, PHTLS, and EPC). Start from 1998 and show me how sending the officers to state conferences has increased membership.

I understand that travel is touchy subject, but since you brought it up Chief Ellis, have we spent any money to fly the officers or board members of the Association to a retirement affair for an officer of the Association?

I am sorry sir, regardless of how much I respect the officer in question, flying the officers and board members to retirement party is wrong. If it is wrong for AIG, Washington Mutual, and other bank executives to go to Las Vegas, it is equally as wrong to fly the officers of the Association to a retirement affair.

Our members are struggling, this isn’t responsible, it is reprehensible.

I can understand sending a couple (meaning no more than two) of the officers or members of the board for the National EMS Bike Ride. This is important for the Association and the EMS community as whole. I applaud the efforts of Jennifer for undertaking this.

I cannot and will not support flying officers to a party to have a good time on Association money, money that comes from the pockets of our members.

Previously I asked for and have yet to receive a response:

Which officers and board members traveled?

Where did they go?

What official business were they on?

How much did it cost?

Respectfully,

Daniel R. Gerard, MS, RN, NREMT-P

Communication in the New Millenium Part II

2009-09-12T16:33:00.000-07:00

Well I got a response from Pat Moore, President of NAEMT.

Again as I am concerned this will be removed by NAEMT, I am echoing my responses here.

Pat's response:

Patrick Moore, President 12 Sep, 04:56 PM
Dan
The FACT is that NAEMT has not and does not reimburse anyone for first-class airfare. This has been the policy for as long as I can remember and that policy is still in effect today under my administration.

My response to Pat Moore:

Sir,

I would respectfully disagree with you. But before I answer your question:

As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.

As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”

If you want additional information, or documentation, email me at daniel.gerard@comcast.net

Mr. Moore, perhaps you would want to reconsider your response when you state '...that NAEMT has not and does not reimburse anyone for first-class airfare...'

I do not know if you are familiar with the United Airlines Program the 'Red Carpet Club' or that upgrades have been activated under this program.

If you do not have the information at your disposal I would be happy to supply you or any other officer/member of the board of the Association or any member of the Association with the particular information and then you can see what I am referring to.

My best to Leslie,

Stay safe,

Daniel R. Gerard, MS, RN, NREMT-P

Communication in the New Millenium

2009-09-11T23:22:00.001-07:00

The Board of NAEMT has removed my posts to a forum where I am running for office. Anyone who wants to see or know what was removed, please email me: drg1963@hotmail.com

I am also mirroring whatever I post to the NAEMT Election forum here, as I cannot be assured it is or is not being edited by NAEMT, because the 'monitor' does not like what is being written.

I do not condone their editing of my responses, and I have not gotten a satisfactory answer as what is or is not acceptable.

Don Walsh posted a question:

Dear NAEMT Candidate:

I would like your views on how will you reach and support your NAEMT members in good standing if elected.

Respectfully,

Don Walsh
NAEMT Member

My response, unedited, to Don Walsh:

Don,

As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.

As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”

If you want additional information, or documentation, email me at daniel.gerard@comcast.net

To answer your question:

To reach the members I will leverage resources such as Youtube and Facebook.

For example, NAEMT spent money on a poster campaign to reduce occupational motor vehicle injuries. While it was an honest attempt to reduce injuries, NAEMT nor any other organization collects EMS occupational injury rates, so making an honest evaluation on how the poster reduced injuries, is impossible. Honestly, are posters really the best way to get information to the membership?

EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world ( http://www.youtube.com/watch?v=6biw3LEq_0c )

NAEMT sent out a poster to remind people to buckle up. I disagree with this. This is a difference of opinion, but one that is telling. I feel, in my personal opinion, that this was not NAEMT’s best effort and we owe it to EMT’s and Paramedics to do more, to reach them using forms of media that a broad base of the population is comfortable with.

In regards to supporting the membership, It is our duty to support the membership, and I take this duty seriously. I have worked in EMS in a government configuration for most of my adult life. I have taken an oath to protect and defend the Constitution of the United States, and as such, when I see something wrong, regardless of where it is, I am duty bound to stand-up and do the right thing.

I will stand up for the membership of NAEMT.

As an example, 25% of the budget for NAEMT is spent on travel. I feel that this is wasteful and does not benefit the membership. The outgoing treasurer wrote a report on the finances of the Association, and this was one topic that was brought up (please email me at daniel.gerard@comcast.net for your own copy of this report)

I do not think, in my personal opinion, that it is appropriate that that much money is spent on travel. It is more economical to teleconference. I am in a large county in California. I am 10 to 30 minutes from any of my colleagues. We meet frequently on a variety of issues, but we do most of our meetings via teleconference.

I would want to know how much money was spent on travel, by officer, who got upgrades, and who flew first class. I do not feel this is unreasonable for the members to know. We pay dues, we pay to attend classes, we have rights as members of the Association.

Now the Officers of the Association and the Board of Directors differ with me on this. I do not feel that it is appropriate that officers of the Association fly first class, or get club upgrades/memberships. I do not feel that members of the board or officers should be silent on this issue. Again, this is a difference of opinion, nothing more.

Members of the Association have rights. The Officers and the Board of Directors have a responsibility to be prudent with our members money. Our members work hard. Some are struggling, to pay mortgages and to hold onto jobs. We owe them. Again, I will point out this is a difference of opinion on travel.

I want to know how much money was spent on travel, by officer, who got upgrades, and who flew first class. I do not feel this is unreasonable for the members to know. We pay dues, we pay to attend classes, we have rights as members of the Association.

If some Officers or members of the Board of Directors turn a blind eye to this practice, or accept it as fact, I am disappointed that they have done so. I feel this is wrong

I will respect the rights of the members and I intend to honor the membership by protecting those rights and being responsible with their money.

As another example, the current, proposed by-laws change, I feel does not serve the best interests of the membership. NAEMT has always been a breeding ground for leaders in our field. This by-laws change limits opportunities for people to progress in the organization.

Let me note, the by-laws change does not affect me one bit, nor does it affect my opponent. I go to the conference every year, and I pay my own way. I am also an instructor in all of the disciplines of the Association. I have served on various committees for the Association. When I say I disagree with the by-laws change, I am speaking in advice for the membership.

It seems to me, in my personal opinion, that the only people who will benefit from the new by-laws is the status quo.

I would want to hear what the attorney for NAEMT says in regards to the by-laws, and I would want to have the opportunity to view any correspondence in regards to this. If elected, I would want the membership to have the opportunity to view the correspondence, as well as any pro or con statements in support of the by-laws. Please correct me if I am wrong, but except for statements from some of the officers supporting the by-laws change, there were no opposing statements provided, nor was any correspondence provided to the membership between the Board of Directors and the attorney for NAEMT.

It is the right of the membership to view that correspondence, they pay for the attorney through their dues and classes.

If you would like more information, please email me directly at:

daniel.gerard@comcast.net

Respectfully submitted,

Daniel R. Gerard

Yes it is that time again...

2009-08-31T00:36:00.000-07:00

My name is Daniel R. Gerard, MS, RN, NREMT-P, and I am running for the NAEMT Region IV Director.

I started as a volunteer EMT in Newark, NJ in 1981, switching over to a career position in 1983. I became a paramedic in 1985, and I have served as an EMT Instructor, dispatcher, EMS Tour Chief, paramedic instructor, continuing education coordinator, college professor, clinical coordinator, QI coordinator, and EMS director. I have served NAEMT as Chair of the Paramedic Division, program development for AMLS, liaison to CECBEMS, and CAAHEP. Other leadership positions I have held, I am the past-President of the NJ EMT Association, past-Treasurer of the San Francisco Paramedic Association, and I currently serve as the Chairman of the Occupational Injury Prevention Committee for the International Association of EMS Chiefs. In addition I was the lead consultant for the ambulance service re-design in Hong Kong and I worked with the Pan American Health Organization in the Bahamas.

I have over 27 years in the field, mostly in the urban environment, working in Newark, NJ, Jersey City, NJ, Bergen County, NJ and Alameda County, CA.

NAEMT is a member driven organization. As a member of NAEMT I have consistently dedicated myself to the Association and the membership.

I am not running to advance my resume, to get a new job, to make money from our vendors, or to get free travel. I am running because I believe in who we are and what we do. I believe that we deserve better. I believe that as a profession we deserve equal consideration with other healthcare and public safety professions.

I seek this position with no illusions.

Every one deserves to have a safe environment to work in. Let me ask you question: How Many EMT’s and paramedics were killed or injured in the line of duty last year?

Ask the police and fire services and they can give you a number.

Ask NAEMT and no one knows. How do we begin to address the problems associated with occupational injuries and deaths when we don’t know where to start? How do we know we are on the right track if we cannot measure our success?

NAEMT has let us down in this endeavor.

While I was the Chairman of the Paramedic Division, I authored two reports on occupational injuries in EMS. We identified that the scope and magnitude of occupational injuries in our profession was impossible to determine. We made several recommendations to improve reporting and collection of data in order to reduce occupational injuries in EMS.

Seven years later these recommendations have yet to be acted upon. If elected to the Board, I will make it my priority to address this critical issue.

EMS deserve's our own voice in Washington, D.C. Let me ask you another question: Which federal agency is the voice of EMS in the federal government?

There are multiple agencies that have this responsibility in the federal government, and they all sit on the Federal Interagency Committee on EMS (FICEMS).

Yet none of these programs have budgetary authority and none of them may hire or fire personnel. They have the capability to write reports, but as of yet, in the entire history of the federal government and FICEMS, the federal government has NEVER acted on a FICEMS recommendation.

I have always been an advocate for a separate federal EMS administration. When the membership stated that they wanted a national EMS office on par with the U.S. Fire Administration, I was one of their most ardent supporters. The Institute of Medicine, a scientific body, had long ago identified that EMS needs a single lead federal EMS agency, yet we still have a fragmented system. Are we any better off today?

Since that time, look at the situation that EMS is in. In 2008 the federal EMS Office in NHTSA was funded for two million dollars, with a staff of 11. In comparison in Alameda County California, the County EMS Office is funded to over $28 million with 33 staff members. In 2005 EMS received only 4 percent of the federal funding for first responders. In the last federal budget EMS and trauma programs received zero dollars.

If you look to the fire service they have been very active, establishing a National Fire Academy and a U.S. Fire Administration.

Law enforcement has the Department of Justice, with a national academy run by the FBI in Quantico.

EMS STILL has nothing remotely comparable on the federal level. I am a member of NAEMT and I want to know WHY?

WHY doesn’t NAEMT support a SINGLE federal agency, with a national academy for EMS?

I will make it my mission to have NAEMT support the IOM’s recommendation, issuing a position statement supporting a federal agency. The membership overwhelming supports a federal agency, I support a federal agency, EMT’s and paramedics nationwide deserve a federal agency, funded and staffed to be equal with the police and fire services.

Let me ask you one more question: Do you work hard for your money? Do YOU WORK HARD for the MONEY that YOU MAKE to PAY your DUES to NAEMT?

How much money does NAEMT spend on travel? What is the result of the travel that the leaders of NAEMT have engaged in? What happened to the financial audit that the membership was told was going to take place? What happens with OUR money? Don’t we deserve to know? Where is the accountability?

If we don’t have a safer work environment and we do not have a federal agency representing our interests, what is going on?

Have you seen the by-laws changes proposed by the Association?

The new by-laws changes will restrict the opportunity for members to run fun for office, essentially limiting the opportunity for people to run, unless they have been selected by the President of NAEMT. Even the ATTORNEY for NAEMT said that the new by-laws change was a bad move.

Where is that letter from the attorney for NAEMT and what does it say?

So with unrestricted travel, no accountability for finances, and restricting who can run or who cannot run for office, how do you the DUES PAYING MEMBER benefit?

This is just an opportunity for people to use your hard earned money, without question, to support their own activities.

This is wrong. I will hold the organization accountable to the dues paying members, and I will do everything in my power to over turn the latest by-laws change that the Board of NAEMT is seeking.

Who stands up for you, the dues paying member? Who represents you and your interests and who want’s to do the right thing for YOU?

WHO?

NAEMT is not an organization that benefits a select few at the expense of the many. It is a MEMBER organization, representing men and women, built on their personal and professional sacrifice. There is no easy way to success, and we shouldn’t exclude our brothers and sisters from seeking office to benefit a select few. In all of my time in EMS, I have always felt that EMT’s and Paramedics must stand up and fight for their own rights. There is no end to this battle, there is only a moment until the next battle emerges. When we are old and no longer able to carry on the fight, what we fought for TODAY will live on in the future of our brother and sister EMT’s and paramedics.

NAEMT has a DUTY to the membership. I have a duty to the membership. Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the EMS flag to a new tomorrow.

A true story

2008-09-11T09:24:00.000-07:00

Before I wrote the first report on EMS occupational injuries for NAEMT, I knew more than my fair share of EMS brothers and sisters who had suffered back injuries, were involved in car wrecks, TOO TOO MANY who were physically assaulted, unfortunately one guy who was shot, and a couple who were stabbed.

As part of the EMS honor guard I had done line of duty death services for many of our own in the NY, NJ, and PA area. Every-time we went to ceremony, I always felt terribly guilty, because afterward I said "It wasn't me...it wasn't anyone I knew..."

My response was never like the scene from "Full-Metal Jacket", where the Marines are standing around one of their own, and the view is from the deceased's perspective...

One guy says "Go easy Cowboy", and they go around from one to the next, another guy says, "Semper Fi" until they finally get to a guy called Animal, and he says "Better you than me"...

I was never like that! While people wanted to talk about how our long loved brother or sister had lived their life, or if they were injured, the great times they USED to have, I wanted to find out the who, the what, the why...

Why did they have to die or get hurt...

Was there a better piece of equipment to use...

Could we have done a better job designing equipment for them to do their job...

Was there a safer ambulance...

Were there better radios/methods of communications...

Was there a better way we could train or prepare people for work...

Better procedures...

Because I didn't want it to happen AGAIN. I admit this is always painful, but I wanted to KNOW.

One young man in particular, stands out, his story will always live with me. We had sent our honor guard over from UMDNJ for his funeral. Units came from all over, as far north as Boston and as far south as Washington, D.C. This young man was an EMT who was killed while loading a patient into the back of his ambulance.

He was struck and killed by a drunk driver who drove into the back of his EMS unit, killing him and critically injuring his partner. I don't know if he even knew what happened, but I do know one thing, he was at his most vulnerable, he couldn't even throw his hands up to protect himself because he was holding on to the stretcher. He wasn't going to let his patient fall, he never left her side.

I wanted to ask someone "Was there anything that could have been done to protect them..." but somebody else asked the question. Nobody knew the answer.

Now I know that you will say "well just keep drunks off the road...there was nothing you could do..." but what if there was?

Was there? When I became Chairman of the National Paramedic Division and I started to ask questions, the one thing I found out, there was little data and even less research on how or why we are injured in the line of duty.

Every-time someone was injured, every-time someone died, I heard the same thing..."Never again"or "lets learn from this one boys..." .

But how? We didn't share information, we didn't have any data to develop meaningful injury prevention programs. If we had good data, GOOD INFORMATION, we could then begin to incorporate this information into EMT and paramedic classes, into training programs for CPR, ACLS, PHTLS, perhaps even preventing someone from dying in the line of duty or suffering a career ending injury.

Then I heard about Nadine Levick, who was talking about ambulance crashes and how we should make our vehicles safer...I had good friends who were doing the beginnings of EMS injury research say "...we really don't understand the MAGNITUDE of this problem..."

Why wasn't anyone else paying attention to what these people were doing?

It still begged the question: Without data, without information, how do we develop meaningful injury prevention programs? How do we stop repeating the cycle of injury, disability, and death?

There were so many things we didn't know and and we needed to learn, from wellness-fitness programs for EMS providers, to how to respond to terrorist incidents, how Mercedes Benz crash tests ambulance. So many different ways to protect us. Were any of them fool-proof?

No, but it was better than what I knew, which was nothing.

It just made me ask:

If we had better ambulances and better driver training, would deaths in emergency motor vehicle collisions decline?

If we had wellness-fitness programs and better training would we have less back injuries?

If we had better procedures and training, such as what you see in Israel, could the injuries suffered by the police in the abortion clinic bombing in Sandy Springs in 1997, have been avoided?

I knew in my heart what the answers were, but did anyone else?

While I knew quite a few people who had suffered line of duty injuries, I never lost a partner. I had known cops and firemen who had died and it was always a terrible loss. It was from other peoples tragedy and loss that I became motivated to try and find out what I could about EMS occupational injuries. I wrote the first occupational injury report, and it was at this point I knew what I didn't know! Yet there has to be a better way I thought.

Still every-time someone died, it was never anybody I had been partnered with. I asked every night I went out on the street, "Please let me and my friends come home tomorrow..." It wasn't until I lost someone close to me that the mantra "Never again" took on whole new meaning...

At 9 pm on September 11 I spoke your name. I was afraid to ask, but I had to know. We were organizing the volunteer squads for stand-by at Rutgers University in Newark. They had too many people down at Liberty State Park. I had waited too long to ask about you, but now I was at the point I had to know, I had to ask because I couldn't concentrate on what I was doing.

In a small voice I said "did anyone hear from Dave or Bobby?"

Mario Piumelli said to me "Bobby called his wife and told her he was OK...nobody has heard from Dave..."

I took a deep breath...Dave Lemagne was my relief for 5 years...a happy guy with an infectious smile, I said a soft prayer and hoped for the best. Maybe he would turn up at a hospital somewhere. Police officers from NYPD had turned up at a slew of hospitals in NJ, I hoped Dave would show up somewhere.

I was too scared to ask about anybody else.

The next day on September 12 I talk with Bill C. I said to him whats up, and I should have been suspicious, because Gene O turns his head away when I ask this question. Gene can't hide his emotions very well.

Bill tells me "they found Bobby's radio-car..."

I don't comprehend this because I say, "ya, but Bobby's ok, he called his wife..."

Mario, who s standing next to me, jolts me back to reality "Danny, he called his wife before he went inside...nobody has heard from him since..."

I went numb.

On September 26, I BEG to bring personnel over to NYC. It is the last day NJ will have resources on scene at the World Trade Center. On the ride over it is very quiet. Gene O looks over and asks me, 'are you ok?'

"Ya I 'm good"

I go inside with Gene and he introduces me to several people from FDNY EMS he has been working with. I make an excuse to go outside. I walk to the fence and I stand looking. Words escape me as I look around. This is the one time in my life I don’t know what to do or say. Overwhelmed by the magnitude of this event, it is one thing to see it on the news, it is another to stand here and look. I still cannot comprehend the what, the how, or the why. This is one time I cannot bear to ask, "what could we have done better to protect our own"...I step forward, staring into the faces coming off the pile, and I wonder 'will I see you...', but like specters, they come toward me, appearing, but you aren’t there…still I hope, maybe you will appear...

I must have looked overwhelmed because I feel a gentle hand on my back. I hear Gene behind me say, “You OK brotha’?”

I turn to Gene. “Ya, thanks, I’m good, bro’ ”

A Paramedics Tale

In my neighborhood, where I grew up, it was tough. You had a mix of people around to serve as examples of what was right or wrong. I knew people who were stone cold hoodlums, arch-criminals. I had friends who became junkies, addicted to pills, heroin, you name it, they would do it. I had friends who became cops, firemen, accountants...

In my family I had people who were writers, artists, doctors, lawyers, a U.S. Congressman even! It was a definitely a different way of life, because you made choices early on.

When I first got involved in the field of emergency health services, I was fortunate enough to meet many people who had a profound impact on who I became and what I do. I feel I have been graced to have met the different people I have throughout my life.

I remember my first EMT instructor, my first partner, my first boss. Maybe it is a New Jersey thing.

I am serious!

Wait hear me out…

Being from New Jersey, you are ultra sensitive about who you are and where you are from. Some people, some people from NJ have this overwhelming feeling that you need to make excuses for where you’re from, where you lived, where you went to school.

It was almost as if being conceived and born here was the ultimate stigma. You were constantly the butt of jokes, from Lou Costello on up. You would catch Dave Letterman making “Jersey Jokes” on his talk show during the opening monologue.

It was strange, but even within New Jersey there was a pecking order. If you were from Newark or Jersey City, it was over! Those were the worst “Jersey Jokes”.

Maybe that’s why people from New Jersey will bond together, avoid the “jokes” made at our expense.

We seek out other people who have the same experiences, the same memories. We walk with a certain confidence, least we let anyone see us sweat. If you were from Newark or Jersey City though you never cared what people thought because you were cool.

In my case, I would immediately identified with a guy from an urban area, even if it wasn’t Newark, because you had the same memories of crowded public schools, catching public transportation, hot summer nights on the corner with your friends…

Besides identifying with a guy from being around the way, now we add the EMS factor. Whether you are talking Newark, Jersey City, Elizabeth, NYC, Philadelphia, San Francisco, Chicago, I don’t care where you are from, you are in a special brotherhood. Next to police and fire departments, I used to tell new guys at work we are members of the third largest street gang in our city.

Where I worked, one of the busiest EMS systems per capita in the United States, you have seen so much death, despair and heartache, something really has to be bizarre to get you to turn your head.

You can tell the difference between a car that backfires and real gunfire.

You know what it means to “hump” (work HARD) in the summer time.

You know what it’s like to depend on your partner.

Robert Cirri, (Bob actually, Robert was only used when he was in trouble he told me), was a guy you could trust, a guy you could depend on. He was a likable easygoing fellow. Like me he was an Italian-American kid who grew up in a big city (I grew up in Newark and Bob grew up in Hudson County/Jersey City). We had many a discussion on good Italian home-cooked food and what it was like growing up in the dwindling Italian neighborhoods of metro NY-NJ.

I was assigned to his paramedic unit and he was going to teach me about being a field paramedic. With an infectious smile that could light up a room, Bob was the ultimate “no pressure” preceptor.

You could be in the middle of the worst trauma, faced with a difficult intubation and Bob was always right there, ready to help out, with either words of encouragement, maybe a little cricoid pressure, something. He never “hovered” right over you, making you feel more pressure then there already was. Now I don’t want to leave out Debbie Eiling, she was just as important as Bob, she was Bob's partner and the other preceptor entrusted to my development, don’t get me wrong, but I will talk about Debbie another time.

If you did a good job, he would give you a hearty back-slap when all was said and done and tell you “That was great bro’!” (another word used as a term of endearment was “cuz” an abbreviation of cousin. Cuz and Bro are endemic to the Italian-American culture in the Northeast. Hey you have to be from NJ...Fuggedaboutit).

If you made a mistake, he never chastised you but instead he would say, “Hey I know that is pretty tough, can I show you a better way to do that…”

Bob would quiz me on different drugs or pointed out the intricacies of the different equipment we had to use. He was clinically astute, always reading, always asking questions. Bob always knew the best places to eat as well as where to “people watch” to let the day go by faster. Smooth as silk, he never got himself into a situation on the job where he had words with people, and if he unknowingly walked into a situation that was “in progress” he always had your back.

He was all and all the kind of guy you would want for a steady partner and a friend.

I think I really connected with Bob because we both enjoyed helping people. Bob was an Auxiliary Police Officer and he wanted to ultimately become a full time police officer in a large department. He said the pension and benefits were better then in EMS.

I asked him if he was going to give up being a paramedic when he became a cop and his reply was “Never. I worked to hard to get this and I love doing it”.

After I became certified as a paramedic I had the opportunity to work with Bob in Jersey City and again later on when Bob worked per diem in Newark, NJ.

When I was promoted to Supervisor/Chief in Jersey City, Bob gave me my rank insignia for my collar. He then took me out after work for a beer to Jules Tavern in Jersey City to celebrate.

We always had a good time, and not only at work either. It could be running over to Manhatten for some late night Chinese food at Wo Hop, going for dinner at Laicos in Jersey City or bar hopping in Hoboken, we always had fun.

I remember when Bob got hired by the police department. He loved that job but he still loved being a paramedic. We continued to work together for a while. I would see him at different times too, either at an ACLS class or a conference, or even when he was working as police officer.

If I was in the dispatch center every once in a while on a weekend I would hear him calling in a report to the hospital where he still worked as a paramedic.

As with all things in life we move on to different places. I started to become more involved in education. Bob studied hard and got promoted and eventually moved into training. Our opportunities to interact were fewer and farther between, but if we did see each other we could generally be found laughing about something, “Do you remember the time when…”

No matter what though, whenever I saw him he still had that ear-to-ear grin and that same look on his face. It told the whole story...

Hemingway once said that "Man is not made for defeat. A man can be destroyed but not defeated, you cannot destroy his will to survive..."

Hemingway also said every true story ends in death.

On September 11, 2001 terrorists hijacked two planes and flew them into the World Trade Center Towers in New York City in one of the worst events to occur on American soil.

A scene imagined by Dante in his wildest imagination could never equal this. Victims running everywhere, flaming debris and human bodies raining down from 90 floors up.

In his office in the Training Academy, Lieutenant Bob Cirri of the Port Authority Police Department (and Hackensack Medical Center Paramedic), responded to the Towers.

Donning his self-contained breathing apparatus, he headed into the World Trade Center, after calling his wife to tell her he was OK. He directed rescue operations and proceeded to the upper floors to ensure that patrons who could not navigate the stairs got out. He and his men assisted several people down to the ground level, who otherwise could not get out.

Inside the World Trade Center Lieutenant Cirri was last heard from via radio, coolly and calmly, directing and participating in rescue efforts.

The Port Authority Command Post updated Lieutenant Cirri that one tower had already collapsed, and the building he was in was also in danger of collapse, to abandon all rescuer efforts and exit the building immediately. He was given the order to evacuate.

Lieutenant Cirri stated that they were carrying down a person who was wheelchair bound, who couldn’t get out otherwise. He advised the command that he and the 5 other Port Authority officers and the men from FDNY with him were going to get her out.

His last radio transmission was “…we are in the lobby, I can see daylight…”

Cirri and his men were listed among the missing. On February 11, 2002, while removing debris from what would have been the lobby of 1 World Trade Center, a woman was discovered strapped into a rescue chair belonging to the Port Authority Police. Next to her were Lieutenant Cirri, his men from the PAPD, and the other members of the FDNY. They never left her side.

Lieutenant Robert Dominick Cirri is survived by his wife Eileen and two children, Robert Jr. and Jessica, of Nutley; another son, Anthony of West New York; three stepchildren, Bianca Jerez, Francesca Jerez and Kara Jerez of Nutley; and his parents, Maria and Dominick Cirri of Guttenberg.

He will be missed and loved by all who knew him.

Buon viaggio mio fratello.

NEVER FORGET, NEVER AGAIN.

PAPD PO Steve Huczko RN, EMT-B and PAPD PO Dave Lemagne, MICP, I didn’t forget you brothers, I am just too heartbroken to write anything else.

Today's posting is dedicated to all of the men and women of the Port Authority Police Department that I have come to know over the years, to the personnel of the PAPD, FDNY, FDNY EMS, NYPD and my other brother and sister EMTs and paramedics who gave their lives so gallantly. Their stories are no less poignant.

Stay safe my brothers and sisters. I will see you in the street.

Hello

2008-09-03T15:10:00.001-07:00

Who I am

I have 20 years experience as field EMS provider in Newark, NJ. I was first certified as an EMT-A in 1981 volunteering as an EMT on the North Ward First Aid Squad, Newark, NJ. In 1983 I then secured a position working EMS as a Basic EMT in Newark NJ. I became a paramedic in 1985. At this time I became involved in education, first as a CPR and EMT instructor, later as an ACLS, PALS, PHTLS, and AMLS instructor. I then became a faculty member at the George Washington University paramedic program.

I was a Tour Chief for Jersey City Medical Center and later on I was the EMS Director for the Saint Barnabas Health Care System. My activities in NAEMT include: Immediate Past Chairman National Paramedic Division/NAEMT – I authored the very first report to NAEMT on EMT and Paramedic Occupational Injuries in 2000 with a follow-up report in 2001, I was the NAEMT representative to CAAHEP and to CECBEMS, I also served on the NAEMT Committee for the development of the first AMLS program.

I have worked as a consultant to the Pan American Health Organization and Bahamian Ministry of Health on EMS. I was also lead consultant to the Hong Kong Fire Services Department on the Paramedic Ambulance Service Re-Design.

I am currently the EMS Coordinator for the City of Alameda Fire Department (Alameda, CA) and the Treasurer of the San Francisco Paramedic Association. I was featured in the book "Into the Breach" by Jana Abrams-Karam.

What I believe

We need to be engaged, as engaged as our brothers and sisters in the police and fire services. Only through an active membership and leadership will we accomplish great things for the EMS community.

What is NAEMT's position on the Ryan White Care Act?

In 2006, the emergency-response provisions were removed from the Ryan White Care Act by Congressional staff members. This omission places every emergency responder at risk. This wasn't a malicious act, but it is an issue of vital importance to the health and safety of EMS personnel everywhere.

NAEMT must actively engage the leadership and members on this critical issue. We need to contact every member of Congress and we need to do it yesterday. This is a vital issue and the Executive Board of NAEMT must be INVOLVED. NAEMT must put out a policy statement on this issue, so that the media and members of Congress know where we stand.

EMS Occupational Health

I wrote the first report on occupational injuries for the Association. I know how important this issue is. Look at the International Association of Firefighters and the Fraternal Order of Police, these groups have truly stepped up for their membership.

What do we need to do?

NAEMT must sponsor a national occupational injury summit during our national meeting. I would seek to bring the various stakeholders in EMS and occupational health together, to develop an agenda and work plan for reducing occupational injuries in EMS. We also need to recognize EMS organizations that are working strides in reducing occupational injuries. We must provide this information on those successful programs to all EMT’s and paramedics.

NAEMT must also approach Congress to give us the tools we need to protect EMT's and paramedics and to gather data so that we may begin to understand the scope of the occupational health problem in our profession. Only then can we begin to develop curriculum for health, safety, and well-being of EMS personnel everywhere.

We owe this to our profession.

Federal Interagency Committee on Emergency Medical Services (FICEMS)

FICEMS represents all of the federal agencies that have their hands in EMS. What is the problem with FICEMS? It has no teeth. It controls no budgets or money, and cannot hire or fire anyone. The reports they will submit to Congress do not have to be acted upon. They cannot dictate policy. This was made evident during the release of the Institute of Medicines (IOM) report on Emergency Medical Services. The IOM stated that we need a single lead federal agency for EMS PERIOD. EMS by committee DOESN'T WORK.

We cannot ignore this fact. When the Ambulance Fee Schedule was first published, and Medicare stated that IV therapy was not an ALS skill where was FICEMS? It was as if Medicare (who controls the re-imbursement money) and NHTSA (who writes the curriculum for EMT's and paramedics) never had a conversation about what is an ALS skill and what is a BLS skill. Yet they both sit on FICEMS. When Medicare stated that EMS providers MUST obtain a verification signature for emergency patients transported to the hospital, where was FICEMS? The EMS event for most patients and their families is stressful enough, never mind what the EMS providers must deal with. Imagine this: You are on an emergency response, it is of a critical nature, with a life hanging in the balance. Now I am going to ask you for a signature for payment, and draw attention to the fact that this may or may not be covered service... This was a good idea? Since Medicare controls the money, they get to decide what hoops we must jump through to get it. Where is FICEMS in all of this? Using my previous example of the Ryan White Act, where was FICEMS?

NHTSA houses the only home for EMS in the federal government. Go to the NHTSA website ( http://www.nhtsa.dot.gov/ ). Where does it mention EMS?

In 2008 the federal EMS Office in NHTSA was funded for two million dollars, with a staff of 11. In Alameda County California, the County EMS Office is funded to over 25 million dollars with a staff of 35. In 2005 EMS received only 4 percent of the federal funding for first responders. In the last federal budget and trauma programs received zero dollars.

We need to do this better!

The U.S. Department of Health and Human Services has already begun to move toward an office of Emergency Medical Services. We need to support this office, ask for federal funding and recognition, and ask that the president bring together all of the current agencies, spread through a myriad of federal departments, be consolidated into this one federal office.

Then, with the power to hire and fire, to control budgets, to provide grants and assistance, will EMS even BEGIN to have the recognition we desperately deserve.

The membership overwhelming supports a federal agency, I support a federal agency, EMTs and paramedics nationwide deserve a federal agency, funded and staffed to be equal with the police and fire services.

NAEMT has to do better!

We need to approach this issue by working collaboratively, we need to listen to the needs of the membership and we need to listen to learned bodies such as the Institute of Medicine. I want an Association that is going to take my needs and the needs of my brother and sister EMT's and paramedics seriously. An Association that is responsive to the needs of its members and that is willing to work for its members.

My name is Dan Gerard and I want a chance to do better for you and the Association. Please cast your vote for me as Director at Large.

Thank you,

Dan

The times they are changin...

2008-07-16T20:02:00.001-07:00

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Where have we come from...

2008-04-10T11:00:00.000-07:00

I think back to my days on the North Ward First Aid Squad, and I have to laugh. How far we have come since the wild and crazy days of 1981...

Typically a call would come in over a seven digit phone number (9-1-1 was still in its infancy in the early part of the 1980's in Newark, NJ!).

We were a BLS unit, as ALS was still a pilot program, so there were only 7 paramedic units in the whole state of NJ, two of them, Jersey City and Hackensack, were the only ones in urban areas. We wouldn't have paramedics in Newark until 1983! The paramedics had no standing orders, and if they wanted to do a fingerstick to check someone’s glucose level they had to call the medical control doctor at the base hospital!

All volunteer, we rode out of a building in the North Ward of Newark, NJ, a city rocked by riots in 1967, still trying to make its way back. You could run a call in a housing project (Sheffield Drive) for a maternity patient or an asthma. Hopefully the elevators worked, if not you were going to have to walk up a few flights of stairs. Maybe respond down on Broadway and Second for a shooting.

Either way we always tried to get the patient to the 'bus' (that is what we called ambulances back then, don't ask me why...ask Mario Piumelli that is who taught me!) and then rock and roll into one of the area hospitals (Martland/College/University, United, Columbus, Claara Maas, St. James, St. Michaels, Newark Beth Israel).

We were scrappy, proud of who were and what were doing. We took pride in our ambulances, and magically, without explanation, we often had better equipment and supplies than they had on the City ambulances...

MANY times we would get calls from outside of the North Ward, our level of care was legendary. I remember one time we actually took a call that came in direct from Newark Police for a child struck by auto, down the street from the South District police precinct on West Bigelow. They had been waiting 20+ minutes for a City ambulance and with no ambulance in sight they called us. Just as we began to load the patient into the ambulance, Martland (which was really College Hospital then, but everyone still called them Martland) showed up.

When we pulled up, the crowd was tense, since this poor child had been lying in the street for so long. The crowd made way and actually applauded us for our quick response. It got very vocal when Martland showed up, and the cops actually ran over to the ambulance to tell them to leave before any other words were exchanged!

January of 1981 I enrolled in my first EMT course, which was 110 hours (with an additional 12 hours in the emergency department) in length. We were part of a visionary program in EMS education lead by Chief Al Freda of the Newark Fire Department. At that time MOST EMT courses were 81 hours (the DOT standard at the time). Chief Freda gave us additional material on mass casualty incidents, HAZMAT, helicopter landing zones, etc. He was truly ahead of his time. At this EMT course I also had the pleasure of meeting for the first time Jud Fuller.

And while Chief Freda was not the only one to run an extended length EMT course in NJ (Keith Holtermann, another visionary in EMS comes to mind), he will always have a special place in my heart for giving me my first shot in this profession. I got the opportunity to pay him back years later, when after I became a paramedic I had the opportunity to do the Anatomy and Physiology, Bleeding and Shock lectures, for the Basic EMT Class at UMDNJ.

Jud Fuller was the director of EMS for College Hospital and also the director of communications, which was called REMCS, the Regional Emergency Medical Communications System. Another outstanding leader, he later went on to work with the federal government to start DMAT (Disaster Medical Assistance Teams) and NDMS (National Disaster Medical System).

When Jud went over to work for NDMS, I ran into him one day at the VA Hospital in East Orange. I asked him what he was up to, and he immediately grabbed me by the arm and led me into his office. He showed me a plan for a disaster he drill he wanted to run in NYC.

The scenario: an earthquake strikes Manhattan, causing catastrophic damage to the Twin Towers, resulting in their collapse. The subsequent damage to other buildings and to New York City would necessitate using resources from outside NYC (which until that time, had not been done been done since a catastrophic fire had destroyed much of Manhattan in the 1800’s and the FDNY called for help from across the tri-state area).

The year Jud wanted to do this? 1991, a full two years before the first attack on the World Trade Center, and 10 years before the tragedy of September 11.

Chief Freda and Jud Fuller taught me so much, it is a shame that they are not with us today.

So much has happened since then, in NJ and around the nation. The one thing that has always been a constant is the people. Never lacking for patients, I have personally not seen an EMS system that has had a DECREASE in call volume. Calls for care keep going up.

On the other hand, the dedication exhibited by providers is not lacking, but the number of providers is. Where ever we look, in urban areas where pay scales and health benefits are attractive for people in an economy that has slowed down, to rural areas, where the sense of community and the spirit to help ones neighbors has always sustained the volunteer community, we can’t seem to attract people to the profession, and those that do come, don’t stay that long.

The field of emergency medical services has allowed me to help people, to respond on assignments from a call for a lost child to large scale mass casualty incidents. I have had patients who not only needed someone to intervene immediately for a life-threatening emergency, but also to just sit and listen, when that is what they really needed.

I have had the opportunity to meet some of the best doctors and nurses in our field, compassionate, caring individuals, who are on the front lines each and every day. I have had the opportunity to see some ground breaking research in our field, field test the latest equipment, new drugs.

I remember one time in 1987, our medical director, a doctor by the name of Tino Gonzalez, wanted to get glucagon approved as a drug for paramedics. We had some very bad diabetics who we had difficulty getting IV access on. Dr. Gonzalez, try as he might, he couldn’t get it approved for a trial study in the field.

What did he do? He went out every time we had a diabetic emergency, and if we couldn’t get the IV line he would administer the glucagon. After he had acquired a statistically significant number of field administrations, he went back to the state medical directors and got the drug approved. If I close my eyes I can still see him running out of the emergency department at Jersey City Medical Center, his lab coat flying, as he jumped into the supervisor’s truck for a Code 1 response.

I have also had the opportunity to work with some outstanding EMT’s and paramedic’s, many of whom are the best in the field. I will never forget the lessons I learned from them, I can't even go on to mention them all here in one space, but I will tell a story about all of them in due time. I owe the success in my career and in my life as much to my former partners. It was truly a family, a brotherhood.

I remember my paramedic clinical with Ray K. He was so pumped up to be at the bedside, practicing new skills and learning from a truly dedicated group of doctors. We were in the maternity ward and he got to do an episiotomy on a woman!

I asked him what it was like and he said the maternity doctor guided him through the whole thing!

Ray was describing the procedure to me and I picked up a pair of scissors and pantomined the procedure...the whole time my hands were shaking! And I was just play acting! I said to Ray: did your hands shake?

He said no, things were happening so fast he didn't have time to be scared! I told him I gave him a lot of credit for doing it, I don't think I could have...

The one thing I learned from Ray: Be a life-long student. Ray was older than me, but he approached everything with his eyes wide open. He was always open to new ideas and techniques. He sat in the front row of every class, taking notes and asking questions. He would be the first one to grab a piece of equipment, take it apart and put it back together.

He told me that true failure came from not trying your best. My grandfather, Richard O'Brien taught me that also. He said that any job is a job worth doing well, to do your best and always to give your best effort.

Stay safe my brothers and sisters.

Dan