Publisher’s note: This is the second installment in a series of profiles of emerging EMS leaders written by one of the profession’s most respected advocates. — Keith Griffiths
Leechburg is a small town east of Pittsburgh that doesn’t appear on an average-sized map of Pennsylvania. Historically, it’s the home of Lower Kiski Ambulance. You may not know that name, but it’s important, because an EMS giant came from there.
Doug Kupas says he’ll never forget the day when Lower Kiski paramedic Mike Yee conducted a tour for Kupas’ Cub Scout troop, thereby welcoming him to EMS. Kupas joined the service on his 16th birthday as a volunteer; he became a paramedic during his first year of college, with Yee as his preceptor. Two years later, Kupas’ younger brother joined up, and the pair often worked as partners. Both eventually became physicians; Kupas says he did so because he wanted to understand more about the physiology he was seeing in front of him as a medic.
You’ve probably heard of Kupas. Aside from serving since April 2000 as the EMS medical director for the commonwealth of Pennsylvania, he’s authored plenty of EMS literature—perhaps most notably the December 2002 position paper by the National Association of EMS Physicians on restraints published in Prehospital Emergency Care. He’s written extensively about the importance of proper EMS death notification for families, and his paper on the use of lights and sirens was one of the first highlights of the JEMS Research Forum in 1993.
When he’s not practicing or teaching at Geisinger Medical Center in Danville, Pa., teaching wilderness EMS, or offering his wisdom at EMS gatherings like the Colorado EMS Safety Symposium, Kupas serves as the medical director for the EMS crews in his hometown. Danville Ambulance Service answers 5,000 calls a year, and its crews are accustomed to having Kupas show up on scenes—particularly in situations involving cardiac arrest.
Kupas says he responds to about four runs a month, in his personal vehicle and without warning equipment. When he does show up, he says, “There aren’t many things I can do that the medics aren’t already doing.”
But when it appears that a patient isn’t going to survive, he takes the family aside and facilitates their grief process. He thinks we transport too many people with CPR in progress, because most of us haven’t learned how to break bad news. That’s not good for anybody, he says. In fact, it’s dangerous for us, because it forces us to work without safety restraints. It also results in less-than-adequate CPR, and it’s unfair to families. At the time of this writing, he’s been teaching EMTs how to do death notification for all of the 15 years since he joined Danville Ambulance.
Kupas gives generous credit for his career to Citizens Ambulance Service in Indiana, Pa., the state’s first ALS service. He worked there as a paramedic between 1982 and 1987. During that time, at least half of the service’s crews were college students, although most were pursuing careers other than medicine. Still, 22 of his fellow providers eventually became physicians.
Kupas says he thinks those kinds of people recruit their own kind.
Thom Dick has been involved in EMS for 39 years as an EMT, paramedic, writer and keen observer of the field. He is currently the quality care coordinator for Platte Valley Ambulance Service in Brighton, Colo. You can reach him at boxcar_414@yahoo.com.
