EMS System Review - State of New Jersey

State of New Jersey, DHSS, OEMSConsulting Services: EMS System Review• There is no evidence that supports having two paramedics instead of one providingALS skills. The EMS system can no longer afford to operate on assumptions that lackdata.• A one paramedic response unit will be able to provide a paramedic in training withmore opportunities to practice skills under supervision. Paramedics field trainingshould be more meaningful.• If some programs choose to keep the two paramedic minimum, data could becollected to answer the one vs. two paramedic question.Emergency Medical Technician-IntermediateThe National Registry of EMTs offers a certifications at an intermediate level betweenEMT-B and EMT-P known as EMT-Intermediate (EMT-I). EMT-Is are trained beyond theEMT-Basic level to perform skills such as cardiac monitoring, IV access, medicationadministration, oral endotracheal intubation and similar skills. EMT-I training can beaccomplished in one-third the time of paramedic training and allows for a considerable numberof skills to be performed.With the above said, we do not feel that EMT-I is appropriate for the New Jersey EMSSystem for the following reasons:• It could produce a rapid demand for training courses that will overwhelm trainingassets.• What appears as a quick way to train ALS providers is false economy as manysystems do not support the skill maintenance level necessary, the turnover rate ishigh, and the quality of care may be questioned.• Systems may not be able to afford the increased training costs, medical direction costsor insurance for increased liability.• The current paramedic cadre is well-directed and providing excellent care. The mainissues involve the delivery system.• Adding another licensure/certification level will cause poor time use issues for alimited state regulatory staff.• Medical oversight at all levels becomes more cumbersome and system controlbecomes more difficult.TriData, a Division of 115September 2007System Planning Corporation