To read all of my posts about the New Jersey State First Aid Council, and the struggles of EMS in New Jersey, just click here. For more information on the NJSFAC click here. Earlier this month, I had a friend from New Jersey send me the latest information sheet put out by the New Jersey State First Aid Council in regards to State Bills S818 and A2095.  While the bills are slowly gaining momentum with the current vote on Bill S-818 resulting in 21 “Yes” 15 “No” and 4 “Not Voting” as an official for the NJSFAC stated in a recent email, “The fight is not over.”  EMTs and paramedics that live and work in New Jersey need to understand the true fabric and importance of these bills. The First Aid Council’s intention was to share their views which are in the form of oppositions to many of the amendments that were recently made to the bills.  Here is my rebuttal to a few of their arguments.  Please take a good look at this, especially if you are a New Jersey EMT. FACT: The New Jersey State First Aid Council opposes the establishment of a new lead agency for EMS.  For some reason, the NJSFAC opposes this amendment because it would give “. . . complete control over and all facets of EMS in the state including some that are already overseen by other groups. . .”  My question to this is: what’s the issue? EMS is a fragmented profession, and New Jersey is no exception to this.  In fact, in many aspects the fragmentation of EMS is magnified in New Jersey.  In some states, differences exist in counties.  In New Jersey, the unique setup of each EMS system right down to staffing and equipment varies from town to town and squad to squad.  Rules and regulations vary depending on whether or not you are a volunteer ambulance service or a professional one.  In New Jersey, an ambulance is not an ambulance and an EMT is not an EMT. Establishment of a lead agency for the state would create one entity for everyone to answer about everything.  Standardization could be developed.  Studies could be...

Almost a year ago, I wrote a post about NJ State Bill S-818 which was set to change the landscape of EMS in New Jersey.  In the year since that article was written, the bill and a second one also making its way through the New Jersey legislature have been revised, but the opposition has remained. I got my start in EMS at the Jersey Shore on a small volunteer first aid squad.  We ran, on average, around 400 calls a year, pretty busy for a town of our size.  Often times, it was not uncommon to have two or three, or sometimes even four EMTs standing in your living room in my town ready to render you emergency care.  The communities around us were no different than we were.  We all took pride in what we did, and knew that we could deliver better service than any paid provider who came into the area because we held ourselves to a very high, very professional standard. To this day, I am still proud of my accomplishments as a volunteer.  I was an active member of two excellent services, and the staff of those services taught me to be the caring, compassionate, knowledgeable provider that I am today.  My roots in New Jersey run deep, and I have been very troubled by what I have been reading lately. As time has progressed, and the political and economic climate in this country has changed, volunteer EMS has taken a turn, and is not as prominent as it was even ten years ago.  Families are working harder to support themselves, and the call volume and expectations of care have grown and evolved.  Some might say that these factors spell the end of volunteer EMS, and I hope every day that it isn’t the case.  It’s not the time to expect less from our volunteers; it’s time to expect more for our patients. Sadly though, the New Jersey State First Aid Council seems content with the past.  Their staunch opposition to Bill S-818 has taken the focus off of where it needs to be: the patient and put their stress on what EMS is about on the provider. ...

As some of you may or may not know, I got my start in EMS in the state of New Jersey, and more specifically at the Jersey Shore.For the first 8 years or so I was an active member with two different Squads servicing Ocean County.I still have family and friends in the area who are very active in the EMS Community. New Jersey possesses some unique issues when it comes to Pre-Hospital Care.A large amount of the system State wide is still Volunteer based at the BLS Level.ALS Services are limited, and must be hospital based or hospital affiliated, and largely participate in prehospital care as non-transporting units. While there is a State EMS office, it is often rivaled by the New Jersey State First Aid Council which advocates for what it feels should be beneficial changes to the EMS system in the state to keep Volunteer EMS alive.Membership in the NJSFAC is not mandatory, but they expect departments affiliated with them to maintain the minimum standards they set. As time goes on, more Volunteer departments are having a tough time getting rigs on the road to care for the sick and injured.As a result, many municipalities are starting to turn to paid ambulance services or Municipal Third Service or Police Department affiliated EMS systems.The NJSFAC’s solution in response to this problem though is to lower the required level of care on most ambulances within the state from a mandatory 2 EMT staffing to one EMT and one First Responder/Driver. Paid ambulance services, municipal or not however, are required to have a minimum of 2 EMTs on each truck. While speaking with family today, I was told that they had a conversation with one of our New Jersey State First Aid Council representatives who voiced his displeasure for pending state bill S-818, seeing it as something that could potentially destroy the Volunteer EMS system in the State of New Jersey.Intrigued, I decided to take a look at it for myself. NJ State Bill S-818 was developed in response to a state-wide EMS study that was conducted in 2006 and released in 2007.It is a 150 page document that outlines the accomplishments and short...

A state realizes it is in trouble so they call in a group to do a comprehensive study of their EMS system. After a year long study complete with focus groups lasting 8 hours a piece and evaluations of systems, what kind of group would turn up their noses at the results of the study? One that is blinded by their own ignorance, of course. I am once again firing a shot across the bow of the New Jersey First Aid Council. I took some time over the last couple of days to reread the EMS study done in New Jersey and am once again left shaking my head at what I see. It is no surprise to me that when asked for data about member squads of the NJFAC, they refused to provide any information. When the consulting firm asked the NJSFAC to help facilitate meetings with member sfqeuads to ask their opinions of the direction of EMS in New Jersey, they once again refused to provide any assistance. The goal of the study was to improve EMS in New jersey and an organization that claims to be dedicated to that exact mission refused to participate. So the study went forward, and sound recommendations were made to help improve the system state wide based on established proven best practices and what do they do? They throw a tantrum declaring that the changes could hurt the volunteer EMS system in the state which for the most part is on life support already. . News flash: It’s not 1966 anymore and we are not just talking about turning herses into ambulances and driving them as fast as possible to the closest hospital. Emts and paramedics are now clinicians with decision making ability and interventions potentially at their finger tips that could save lives. None of that matters to the New Jersey State First Aid Council though. Expanding the scope of practice would require more training and training takes time. That is something the NJSFAC doesn’t seem to think it’s members have. They are content with the job they are able to do now and think the general public should be as well because they do...

Oct 17, 2019

The world of social media is full of experts on almost every topic, including prehospital medical care.  When I say experts, I guess I should really be saying “experts.”  There are a lot of people out there who know how we should perform our jobs, and how things should be done.  Let’s take a closer look at one such example that recently made its way on to my timeline. You’re a BLS provider.  A 70 year old male who is experiencing chest pain calls 911.  The patient and his wife tell you that he has a history of an MI which was treated in Philadelphia in the year prior.  They are requesting to go to a community hospital without interventional cardiac catheterization capabilities that is about 20 minutes away.  About 15 minutes past the community hospital is a larger hospital with an interventional cath lab.  The paramedics are on the way, and you have an opportunity to meet them on the highway.  The safest place to rendezvous with them is at a rest area just after you get on the highway. You pull over, and wait for the paramedics to arrive.  The wait is described as causing as long as a “15 minute delay” to perform a 12-lead EKG.  The EKG is done, it comes back as non-diagnostic for STEMI, and the transport to the community hospital is completed.  At the surface, with the theatrics of a storyteller aside, as an “expert” on EMS, it seems appropriate to me.  There was a decision to be made and a determination of what definitive care was for that patient.  If he was positive for a STEMI, an interventional cath lab becomes definitive care, not a community hospital without those capabilities. A husband and wife residing in Sea Isle City, New Jersey disagree with my view.  They felt the care was inappropriate and the delay was not warranted.  They took their concerns to the town council. Barbara Crowley told the city council that “If this delay had been the last time, I would have lost my husband.”  I can play the “what if” game too.  If this delay had happened last time, the patient would have had...