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Specially trained EMTs would benefit combat vets

Montana ballot initiative 179 seeks to train and authorize EMTs to provide non-emergency care to veterans is a meaningful pivot for EMS and patients

Recently I stopped using the term “prehospital” to describe what we do in the field care setting. The view of EMS has pivoted —and for the better.

This article, describing a legislative initiative in Montana for EMTs to provide more effective service to its veterans, is another example of how EMS providers can better engage their patients in a way that is meaningful, can save lives, and doesn’t require high-tech gadgetry.

It’s well-recognized that there is a significant tragedy occurring with our returning military service personnel. Whether or not the frequency of post-traumatic stress syndrome and suicide is greater in this population compared with previous veteran groups, it hardly matters.

Veterans experience the highest frequency of these conditions when compared with civilian populations. EMS providers often see these patients at their most vulnerable — passed out on the street due to drugs or alcohol, having psychotic breaks, or exhibiting unsafe or suicidal behaviors. Traditionally trained EMS providers are not prepared to manage these patients in a “crash” situation.

EMS providers with greater access to better social and mental health services, along with better training and preparation to recognize and handle such events during the first critical minutes can only improve the outcome of veterans. Otherwise these patients — military veterans — would be undertreated for their mental health emergency or misdirected to emergency departments.

It’s with some guarded optimism that I hope the legislation passes, recognizing that the devil is in the details regarding implementation of such services. But it’s a step in the right direction for patients and providers alike.

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor 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 writer, author of “EMT Exam for Dummies,” has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.