I am writing in response to the article in the Nov. 11 edition of The Citizen regarding Tri-Town Ambulance. After reading the comments by Greenwood Fire Chief Albert Curtis Sr. and assistant chief David Goodwin, I feel I need to clarify the roles of EMT Basics and Intermediates in rural EMS.
EMT Basics are trained to provide basic life support. They are trained in patient assessment and spinal immobilization. They can maintain an airway, give oxygen, and monitor blood pressure, pulse and respirations. They are also trained in CPR and use of the AED.
EMT Intermediates can do all of the above and also use the Cardiac Monitor to monitor normal heart rhythms (and recognize abnormal ones). They can start an IV and give some medications with permission from a doctor at the destination hospital.
Both EMT Basics and Intermediates operate within their protocol and are trained to know when a Paramedic is needed. If a patient requires a Paramedic, the EMTs on scene will radio for an intercept. Contrary to what Chief Curtis said in the previous article, they do not wait on scene for the Paramedic to arrive. The patient is assessed, loaded onto the ambulance, and started down the road. During this time, the EMTs on board are providing any necessary care and preparing for the Paramedics arrival. Depending on the patient’s condition and the level of EMTs on board, this could include CPR, oxygen administration, monitoring of vitals, Cardiac Monitor, medications, and starting an IV if needed. By the time the Paramedic comes on the ambulance, the patient is ready or nearly ready for the additional treatments only a Paramedic can provide. Even if a Paramedic were on scene from the beginning, these basic treatments would still have to be done before advanced treatments are started.
Assistant Chief Goodwin is quoted as saying that the EMT Intermediate on scene at his mother’s accident made several mistakes and did not provide good, quality patient care. He does not say what mistakes were made, but if protocols were not followed, this is a staff issue between the individual EMT and his chief and/or the board of licensure. It is not fair to judge all EMTs by an isolated incident such as this, especially when we do not have all the facts.
Every EMT has to pass a certification test to become licensed, and is required to keep up with continuing education to maintain and renew his/her license. EMTs of all levels are a vital part of emergency medical response, especially in a rural setting. Many patients are thirty miles or more from a hospital or a Paramedic. EMT Basics and Intermediates can make the difference between life and death when time is of the essence, and the importance of their roles should not be diminished.