By Brian Sebastian, Northwest EMS Program Coordinator
[The Northwest EMS Program is a Bureau of Land Management and U.S. Forest Service interagency group in Oregon and Washington that provides medical direction to 35 employees who are trained and certified as EMTs.]
As an IC or a DIVS, it’s great to know how many EMTs you’ve got on your fire or division.
But when you inquire “Are you an EMT?” do you really know what you’re asking for?
On the flip side, as an Emergency Medical Technician (EMT), it feels great to put your hand up in response to that question—or maybe it doesn’t. It’s actually a complicated issue that can’t really be answered with a simple hand-raise.
Did you know that our trained medical responders may not be legally covered or obligated to provide care on an incident? For instance, they might actually be an expired EMT, an EMT without reciprocity for the state in which their current incident is located, or they’re an “off-duty” EMT.
Our Northwest EMS Program has come up with an alternative way for supervisors or project leaders to ask: “Are you an EMT?” First of all, we recommend asking: “Are you a practicing EMT?”
We have developed five elemental questions to determine if someone is an authentic, lawfully practicing EMT. Individuals who aren’t in alignment with these five elements may be taking on undue personal liability by acting as an EMT.
The Appropriate Recognition of EMTs on Incidents
At the Northwest EMS Program’s 2019 annual protocol review, our key discussion topic was the appropriate recognition of EMTs on incidents. The following two bullets come from this annual review:
- EMTs employed by the federal government routinely provide care though rarely meet all of the five elements. Some EMTs may be hired as Administratively Determined (AD) employees or under contract to specifically perform emergency medical care which means they have a duty to act. However, many government employees who happen to be EMTs have an unofficial expectation to provide medical care.
- More specifically, seasonal hires are often selected because of their EMT training and given medical gear, thereby creating an implied expectation of duty to provide medical care. It’s subtle, but this expectation is inappropriate because it adds undue liability to our newest, least experienced, and therefore most vulnerable employees.
Training, Certification, Authorization, Equipment, and a Duty to Act
Here are the aforementioned five elements that EMTs and Paramedics must have to legally provide care:
- Trained: EMT completed accredited training to apply for certification and/or licensure.
- Certified: EMT received certification or licensure from the state they are working in, showing they have met the standard of competence and approved to practice medicine within that state.
- Authorized: EMT authorized by a local physician (medical director) to perform interventions under their direction according to the state’s scope of practice.
- Equipped: EMT has the necessary tools and gear to perform the skills of an EMT.
- Duty to Act: EMT is officially employed and on duty as an emergency care provider.
If people don’t meet these five elements—can’t answer “Yes” to all five—they may assume personal liability for providing medical care.
Supervisors, Burn Bosses, Incident Commanders and Project Managers should ask: “Is anyone a practicing EMT?” instead of simply: “Who’s an EMT?” This clarifies if a care provider is present and meets the five elements. Or they may identify themselves without meeting all five elements and voluntarily accept the ensuing liability.
Medical Provider Definitions
The Northwest EMS Program also provides the following definitions:
- Wilderness First Responder (WFR): Requires 70-80 hours of coursework focusing on remote treatments.
- Emergency Medical Technician (EMT): A common emergency medical qualification. It requires 150+ hours of classroom and clinical time focusing on patient assessment, stabilization and transportation.
- Paramedic: Requires about 2 years of classroom and clinical time.
If you have any questions, dialogue with your medically trained coworkers or contact me, Brian Sebastian, Northwest EMS Program Coordinator, at firstname.lastname@example.org.