Updated June 2015
By now you’ve undoubtedly heard of flash mobs that show up in malls or other public locations with a boom box and mannequins to demonstrate “hands-only.” In Santa Barbara, Calif., American Medical Response, the Santa Barbara County EMS Agency and the Santa Barbara City Fire Department are pioneering a different tactic: guerrilla CPR.
This is how it works: An ambulance, lights and sirens blaring, pulls up on a busy street where there are plenty of bystanders. The crew parks, jumps out, hauls out a gurney holding a mannequin, switches on the BeeGees’ “Stayin’ Alive” and starts compression-only CPR. At the same time, other crew members pull out mannequins and lay them on the sidewalk or grass.
Anyone who stops to check out what’s going on is invited to learn how to do compressions, says Mike Taigman, general manager of AMR in neighboring Ventura County, who helps organize the events. “It was really fun,” Taigman says of the first event, held last summer. “We had homeless people, tourists, mohawked skateboarders, and people in robes and turbans, all there on the grass learning CPR together.”
Joey Serna, an AMR paramedic who participated, recruited a group of tourists waiting in line to board the Land Shark amphibious vehicle. In the half-hour the guerrilla CPR event lasted, he estimates they taught 100 people how to do CPR compressions.
“The great thing about compression-only CPR is you can teach somebody to do it in a minute or so, and they can be proficient at it,” Serna says. “People are always going to remember that one day they were in Santa Barbara on the waterfront when people pulled out the mannequin, music was playing and they were told to push hard, push fast. It keeps things simple and helps to save lives.”
Escondido FD hires single-role paramedics for first time
Looking for a cost-effective solution to an increasing volume of medical calls, the Escondido Fire Department plans to hire 24 entry-level paramedics to augment its firefighter/paramedics, who currently respond to and transport all emergency medical calls in the Southern California city of about 146,000.
Paramedics will start at $12.05 an hour, compared to $19.48 for a first-year probationary firefighter. They will be city employees with a pension and benefits plan, and will likely be represented by the Firefighters Association, says Escondido Fire Chief Michael Lowry, although those details are still being hammered out.
The local newspaper, the right-leaning San Diego U-T, responded with an editorial applauding Escondido for paying wages on par with what paramedics for private companies get, while blasting excessive pay for city employees and firefighters in particular. “Unions convinced city councils that cross-trained firefighters at six-figure compensation rates would somehow help public safety,” the paper reported.
The Escondido Fire Department has had paramedics since 1977, Lowry says, and all firefighters are cross-trained as paramedics and work shifts on the department’s ambulances. In 1998, the department hired 12 single-role EMTs, who staffed several BLS ambulances. Then, in 2004, Escondido residents approved a bond to build two new fire stations, bringing the total in the city to seven.
Then came the recession. When budgets were cut in 2008, the EMTs were let go and the BLS ambulances taken out of service. It was also decided that the city couldn’t afford to staff and open the seventh fire station.
More recently, the economic picture has brightened, leading the city, in agreement with the fire department and firefighter’s association, to hire paramedics, as well as three new firefighter/paramedics. In doing so, the city will be able to staff the seventh fire station while adding two additional ambulances during the day and one additional unit at night, bringing the total to six during the day and four at night.
That will help the department better meet its 7 minute, 30 second response time standard, and to better match the resources with the need on scene, Lowry says.
Although paramedics will receive less pay, the position will be a stepping stone to becoming a firefighter/paramedic.
“We’ve been fortunate since the conception of paramedicine in the 1970s to be involved with paramedicine,” Lowry says. “As health care needs change and 911 changes, we need to be ready to embrace it, change along with it and be a part of it.”
National Conference of State Legislatures takes on community paramedicine
The National Conference of State Legislatures, a bipartisan research and advocacy organization for the nation’s state legislators and their staff, recently published a research paper supportive of community paramedicine.
Titled “Beyond 911: State and Community Strategies for Expanding the Primary Care Role of First Responders,” the policy paper discusses 2011 legislation in Minnesota that paved the way for reimbursement of community paramedics, and 2012 legislation in Maine that authorized up to 12 community paramedicine pilot projects throughout the state. According to the Maine legislation, community paramedics are to work with primary care physicians to reduce hospital readmissions of patients with chronic diseases.
The paper also discusses the importance of partnerships between multiple stakeholders in successful programs and of standardizing training and roles for community paramedics. “Using community paramedics to deliver basic primary care offers unique opportunities to reduce emergency room contact and improve health outcomes for underserved patients …,” the paper reads. “Policymakers can play an important role in ensuring that these [community paramedic programs] coordinate public and private resources, track health care and cost outcomes, and foster innovation while also protecting patient health and safety.”
Read the full report here.
