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EMS News in Focus
by Arthur Hsieh

Why EMS needs to step out of the Dark Ages

Allowing units to cross government lines would reduce the "territory" mindset and send the closest available unit to the call

By Arthur Hsieh

Editor's note: With Kent County's three ambulance companies agreeing to major changes in how they respond to cardiac arrests, Art Hsieh takes look at the wider issues.

EMS has been depicted in many different ways over the years. Many have not been in the best light ("Trauma," anyone?)

Still, you would have imagined that over the years the need to keep proprietary calls close to the vest would have diminished in cases of critical emergencies.

It appears that we're still there in the Dark Ages of ambulance contracts a la "Mother, Jugs and Speed."

Now don't get me wrong — I'm all for staying in business and generating revenue so that employees are paid and provided benefits.

But towns and city boundaries generally lie right next to each other. Those border calls should be serviced by the closest unit.

Given the technology of communications and GPS available, it would seem pretty reasonable to implement systems to address border issues.

This is really an addition to the "mutual aid" concept, where services call in additional help.

Allowing units to cross government lines would reduce the "territory" mindset and send the closest available unit to the call.

Reciprocity agreements could be written to preserve reimbursement pathways. Regardless of the approach, it's time to get over arbitrary lines (literally) and promote an optimal response to a medical emergency.

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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