It’s Well Past Time

It is 2021. COVID-19 is still active, and infection rates have continued to shift upward.

We as EMS professionals continue to be the tip of the spear for healthcare response, now including vaccinations. This has created extreme stressors on both our personnel and our response capabilities.

We are seeing EMS agencies being forced (politically and logistically) to enact policies and deal with political decisions that are restrictive and potentially disastrous, just to maintain their response capabilities. Daily we hear about EMS agencies having to:

• Conserve oxygen by restricting which patients can receive it in the field;
• Stop resuscitation efforts and transports to EDs if patients do not obtain return of circulation in the field in restrictive time frames;
• Manage hospital ED bypass orders for extended periods;
• Manage extended wall waits in EDs (reports of 2–3-hour waits are not uncommon);
• Enact forced overtime and extended shifts for EMS providers;
• Isolate from their loved ones to protect them;
• Deal with compassion fatigue and sleep deprivation;
• Wait for COVID-19 vaccines—in some states EMS providers have been designated second or third tier for receiving them.

Too many of our brethren have died from COVID-19, and we have seen an alarming increase in EMS provider suicides, compassion fatigue, and stress disorders.

The politicians and the media call EMS providers heroes, and they are that, and much more. However, every time I hear a reporter or politician make that statement, I can’t help but think back to a phrase I heard in an EMS scene safety class early in my career. Hero, the instructor informed us, is an acronym for He expires real often.

It is well past time for politicians and bureaucrats to recognize that EMS professionals are first-tier healthcare providers and that for us to remain vigilant and respond as the tip of the spear, we need support.

Federal and state officials need to stop with the politics and rhetoric and open their eyes and wallets. We need:

• EMS professionals to be protected with COVID-19 vaccines now;
• Immediate financial support to maintain appropriate supply, equipment, and staffing levels;
• Integration into the public health system to allow system access, support, and cooperation;
• Support systems set up and financed to help combat compassion fatigue, reduce cumulative stress levels, and support EMS provider mental well-being and health;
• A seat on the national transition COVID-19 advisory board as well as state advisory boards;
• A singular federal EMS agency to support and improve our profession and advocate for out-of- hospital healthcare.

In the 43 years I have been an EMS professional, I have never been prouder of my colleagues and profession than I am today. EMS professionals stand proud in protection of our brethren, being our patients’ advocates, and providing our best out-of-hospital healthcare to every patient we see, no matter the circumstance. We take this stand knowing the toll it takes on our bodies, our minds, and our families. We take this stand because we care. God bless you all.

John Todaro, BA, NRP, TNS, NCEE, CHSE, CHSOS is the Cardiac Arrest System Assessment Program Manager at Resuscitation Quality Improvement Partners. He is a member of the EMS World editorial advisory board.