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Home > Columnists > Arthur Hsieh
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EMS News in Focus
by Arthur Hsieh

Video shows unacceptable face of EMS in Detroit

Change won't come easy — it never does — but being unnecessarily in harm's way is wrong

By Arthur Hsieh

In America's fourth largest city comes yet another report about the sad state of affairs in EMS. There have been many articles about Detroit's crumbling EMS system, and many plans to change it.

Yet, as this video appears to show, Detroit EMS continues to place its community and its providers at risk.

Having spent one evening on the floor of my ambulance when shots rang out at our standby point, I can empathize with the paramedic who recorded the incident.

In fact, it's a little unnerving to see how "calm" he appears as he speaks, rather matter of factly, about what is happening around his broken down unit.

I mean, ambulances break down. I get that. But to break down so often that the provider is resigned to its inevitability is not right.

An EMS system has to have a lot going for it in order to perform, even at a minimum level.

From hardware and clinical equipment to people and processes, everything has to work synchronously in order to permit field providers to reach their destination and provide appropriate care.

No system is perfect in this regard; however, good systems strive to get there, continuously innovating and examining what they do in the pursuit of system optimization.

No two systems are the same, yet each system should similarly follow basic quality improvement principles to effect change and show progress.

Systems that become complacent or adopt the "this is the best we can do given our resources" mentality simply give up on quality. That means great care occurs by happenstance rather than by design.

I hope Detroit's EMS field providers continue to shine light on what's going on there. They deserve to work in a system that is on par with other systems across the nation.

Change won't come easy — it never does — but being unnecessarily in harm's way is unacceptable.

Ring of Gunfire: Detroit EMS Unit Stranded on New Year's Eve :

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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