Fire chief pushing to add paramedics

Chief Joseph Herr starts a 5-year campaign to add 50 of the most-skilled EMTs to the county's fire department

April 06, 2005|By Melissa Harris | Melissa Harris,SUN STAFF

Minutes after two of Lt. Greg Frank's advanced medics whisked an elderly woman with chest pains to the hospital yesterday morning, headquarters dispatched the returning team members to a sick man in an Ellicott City office building.

Frank, a certified paramedic, activated Engine No. 19's sirens and turned the vehicle around. The team reached the man, vomiting from vertigo, several minutes before an ambulance arrived.

That's the kind of flexibility Fire Chief Joseph A. Herr wants to bring to every fire company in Howard County. Despite a nationwide shortage, he has launched an ambitious and costly five-year campaign to station a paramedic on every piece of fire equipment at all times.

Every Howard County firefighter is trained as an emergency medical technician, who can give cardiopulmonary resuscitation, bandage wounds and assess patients. Paramedics, the most skilled of EMTs, don't need a doctor's permission to administer painkillers or other medication. They can help patients breathe by sending a tube through the nose into the patient's throat. They also must be trained as firefighters.

Herr hopes to add 50 paramedics to the department during the next five years, for a total of 130. Recruiting and training them, however, has not been as easy as he expected.

Herr offered jobs last summer to 14 paramedics from outside the department. Only six prospects accepted his offer, and within a week, the group of recruits had dwindled to two.

"Believe me, it was pretty depressing," Herr said.

When recruiting from the outside failed, Herr created and trained a new class of emergency responders from within the fire department.

The recruits, called emergency medical technicians-intermediates, possess skills on a level between those of an EMT and the more advanced paramedic.

They can insert a tube through the nose into the throat of a person struggling to breathe, run IVs and, with permission from a doctor, administer medication to patients.

The 12 members of the inaugural class, which includes three volunteer firefighters, are taking their final tests this month. The training cost about $300,000," Herr said.

The EMT-Intermediate status is basically a stepping stone. Herr expects all of the new class to complete another six months of training to become paramedics within the next year.

Fire departments struggle to recruit paramedics because with only a little more training, paramedics can become registered nurses and earn twice as much money.

Dr. Robert R. Bass, director of emergency medical services in Maryland, said that no research exists that proves that hiring more paramedics saves more lives.

Although Bass lauded the county's effort to get to victims more quickly, he pointed to a March USA Today report on 12 large cities that found that money would be better spent training everyone - firefighters and citizens - in CPR and use of defibrillators than building up an elite squad of emergency responders.

"We're still trying to figure out what's best," Bass said.

Although a smaller cadre of paramedics may work in big cities, where the same group works with several nearby hospitals, Herr said that system won't work in Howard County because it only has one hospital.

"We don't have four-minute travel times to hospitals like cities do," Herr said. "The most important thing a paramedic can do, that a basic EMT can't, is open a patient's airway. And when a patient is dying because he can't breathe, that's the one skill you need to have."

As paramedic Frank put it, "You want the person caring for you to be able to do everything possible to save you."

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