What really blows my mind is that the system we currently operate in does not mandate any minimum standards for providers (mainly BLS, as ALS is in my opinion OVER regulated), does not require an ambulance to be licensed by the Department of Health nor meet any minimum standards, nor mandate minimum response times. Better yet, EMS in New Jersey isn’t even considered an essential service like police, fire, and municipal services are. It’s simply, sickening.
Beginning January, 2011, a Medical Director is required for all ambulance services in the Commonwealth of Pennsylvania. Additionally, the ability to contact Medical Command is required of all ambulance services as well. This seems as if we are heading in the right direction regarding oversight. Up until now, AEDs were optional for BLS ambulance services. The mandate that they are onboard has prompted the need for having a Medical Director. Hopefully, this will generate some quality control. Hopefully, this will not be a localized step forward in one individual state.
It seems as if the overall system for Emergency Medical Care is in need of reinvention. A centrally controlled scene command, an assurance of minimal skill and proficiency for EMTs and first responders, and an ability of hospitals to have a built in cushion to absorb patients, are all core components of an effective disaster preparedness system. This reinvention must be realized on a state or regional level. Failure to address these issues could prove disastrous in the future if such circumstances ever reoccurred
Jordan Barnett, MD, is an Emergency Medicine Physician in the Philadelphia Suburban Region. He has previously worked as a volunteer firefighter, was a member of New York City EMS, and provides Medical Command for several ALS Ambulance Services. Dr Barnett provides EMS consultation services. Additionally, he is actively involved with EMS education.