In 2009, after hearing about a vacationing EMS colleague who responded to an in-flight medical emergency, I had an idea about formalizing an arrangement between off-duty paramedics and commercial airlines, whereby medics would fly first class in return for their vigilance en route. I was so enthusiastic about wider seats — I mean the chance to help — I wrote to the guy in charge. Of the country. Who better to coax the FAA than POTUS?
The then-new President must have been busy studying sub-Saharan trade agreements, because I got one of those machine-generated replies that didn’t even mention my scheme. It just said something about our nation facing “serious challenges,” which I took to mean fire departments running EMS.
Here we are almost eight years later and there’s been no progress on my paramedic passenger plan. With a new administration coming into office in January, I’d like to expand my original proposal to seven EMS initiatives for President Trump to address within 100 days of taking office.
I was going to say 90 days, but I want to leave enough time for the First Family to get settled in the White House, change the wallpaper, learn to work the alarm system and find a good Chinese restaurant.
I’m kidding about the Chinese restaurant, but serious about these suggestions:
1. Medics get travel perks for being on duty during commercial flights
This was my original idea. We’d sign in at the gate, show evidence of certification, maybe get a quick in-service on equipment and procedures, then relax in seats much more soothing to our decrepit lumbar areas. On rare occasions when we’re needed, we’d answer the call with other medical professionals who’d be eligible for the same perks.
I doubt any of us would be summoned as often as my brother, Jeff, an EMT who flies a lot for business. Jeff says he’s witnessed about 15 in-flight medical emergencies during his travels. I’m pretty sure that’s a coincidence, but the AHA has considered downgrading Jeff’s mere presence on an airplane to Class III – potentially harmful.
2. Replace fun facts from the national curriculum with an hour or two of algebra, psychology or self-defense
I’d like to see us cull out superficial material, like the pros and cons of horse drawn ambulances, that has a low return on time invested. Educators could reduce time spent on the history of EMS, radio technology and ambulance design and cover broader topics more valuable to street-level personnel.
Algebra shouldn’t be an issue for high-school graduates, but it is. I haven’t met too many medics who are comfortable even with fractions and decimals. Unless we want our responders to rely on contrived shortcuts like “Midnight Rules” and the “Lidocaine Clock” to calculate drug doses, we’re going to have to offer supplementary instruction in basic math.
3. A radio distress signal for EMS providers
We need a universal way to stealthily alert headquarters that the situation is definitely not 10-4. In New York City, the distress signal is 10-13.
Not everyone uses ten codes anymore, so maybe a secret, absurd word or phrase would be better – something like, “Bring me the spare MAST trousers.”
4. Required rest periods like airline pilots have
Society has already conceded that people who fly airplanes need sleep. Shouldn’t there be similar concerns about EMS providers doing invasive procedures or driving ambulances after 24 hours without rest? I propose agencies mandate three hours of sleep for every 18 hours worked.
I’m remembering how I used to feel around midnight after running calls since 0700. I might get by on adrenalin around 1 or 2 a.m., but I wouldn’t want me treating me between 0300 and 0500 without any sleep since the previous sunrise.
5. Background checks that are at least as thorough for prospective EMS employees as for handgun buyers
How conscientious do we want to be about hiring people who play well with others? Many EMS agencies are thorough about investigating prospective employees, but some treat the application process as a superficial exercise that merely maximizes the candidate pool and minimizes delays in getting new hires on the truck.
Take a look at the federal Firearm Transaction Record for over-the-counter sales (ATF Form 4473). Verifying the “No” answers to questions about criminal behavior, substance abuse, mental disorders and dishonorable discharges should be a no-brainer for EMS, too. I’d also check applicants’ Facebook posts for sociopathic musings.
6. A national superset of treatment protocols
Some EMS systems take years to embrace well-documented improvements to treatment modalities. What if agencies could create or supplement local protocols from a national bank of vetted practices — the latest ACLS algorithms, for example? I could see that approach leading to fewer regional differences based solely on subjective preferences.
7. Incentives for younger semi-retirees in good health to join EMS
This is the one I’m most excited about. There are lots of successful, middle-aged individuals out there who’ve been able to cut back on their work hours due to good fortune. Some of those folks would be superior caregivers with lots more life experience than the average medic or EMT. I’d love to see a national initiative that channels healthy and properly motivated mid-lifers into EMS.
That’s my list. I’ll give the new President a chance to establish world peace, then forward these suggestions with my resume.
What would you add?
