Kane: Summit County Ambulance needs a bread maker
July 25, 2013
Summit County Ambulance needs a bread maker
As a paramedic, I've been following the series of articles about Summit County Ambulance, and the future of EMS in Summit County.
Chief Parmley of Lake Dillon Fire points out that "It's widely utilized because it works" in reference to Fire based EMS. Actually, EMS started out with firefighters because those responders already existed. It was easy to take the local bucket brigade and teach them CPR and first aid. These were the core skills of the first EMTs. Paramedicine, like many other things, is more sophisticated in 2013 than it was in 1976. As a result, the job of a paramedic working in a transporting EMS system is too complex to be combined with additional job functions, and still be performed at a high quality standard.
Additionally, there is nothing fiscally magical about combining the fire department services of fire prevention and suppression, with the delivery of prehospital medical care. The economy of scale argument is only theoretical, and is not realized by placing two dissimilar response functions together under one chief or director.
It's not easy to build or maintain the paramedic skill set and knowledge base. It takes daily repetition of a paramedic's repertoire of skills, procedures, and the daily application of their knowledge base to maintain a high level of proficiency. Education is important, but frequency of patient contact is even more relevant to the maintenance of these crucial job functions. Responders lacking in this area become ineffective.
Jim Keating at Red White and Blue even notes in the third Summit Daily article that "Our paramedics rarely have the opportunity to practice what they went to school and continue to receive education for." Red White and Blue's Chief has correctly identified that they are at a significant deficit in patient contact time. I can not be more precise, but I can tell readers that Red White and Blue performs around 10-20 patient transports a year, while Summit County Ambulance provides around 3000. I think we would all prefer to be treated by the paramedic who has hundreds of repetitions performing a procedure, than the paramedic who watched a PowerPoint presentation on the procedure for some education credits.
"Fire service officials say their firefighters have the same level of training, are subject to the same tests and laws and — given the proper equipment — could deliver the same level of care as paramedics and emergency medical personnel with the ambulance service," the Summit Daily reported. This statement is flawed. Credentials and regulatory compliance do not create proficiency. Proficiency comes from education, experience, and exposure to knowledge application and skill performance.
As a community, we should look to the future and find a way to fund quality, dedicated EMS for our residents and guests. We can be better prepared to be the premier resort community in Colorado.
Eagle County paramedic
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