My NACFD Resignation

My NACFD Resignation

I resign as a volunteer firefighter for the NACFD.

I was disappointed in Board Chair Jim Bailey’s knowledge of what an EMR or Emergency medical Responder’s skills were. Saying an EMR was just someone who took a first aid class.

I did some checking on EMR’s before we started the class at NACFD. In the Arizona Bureau of EMS Statutes and Rules Book where I found that under Arizona law “an emergency medical responder is someone who is employed by an ambulance service” and “whose primary responsibility is the driving of an ambulance”.

ARS 36-2201 

6. "Ambulance attendant" means any of the following:

 (b) An emergency medical responder who is employed by an ambulance service operating under section 36-2202 and whose primary responsibility is the driving of an ambulance.

8. "Basic life support" means the level of assessment and care identified in the scope of practice approved by the director for the emergency medical responder and emergency medical technician.

16. "Emergency medical responder" as an ambulance attendant means a person who has been trained in an emergency medical responder program certified by the director or in an equivalent training program and who is certified by the director to render services pursuant to section 36-2205.

I also went to the National Registry of Emergency Medical Technicians web page. These are the people who nationally certify you as an EMR, EMT, or paramedic before you get certified by your state EMS Bureau.

On the National Registry of Emergency Medical Technicians Arizona Bureau of EMS page under EMS License Levels it says Arizona licenses Emergency Medical Responders, Emergency Medical Technicians, Advanced Emergency Medical Technicians, and Paramedics. https://www.nremt.org/rwd/public/states/state-ems-agencies/az

So unless someone actually called the Arizona EMS Bureau and asked, “do you certify EMR’s” it says so on the National Registry of Emergency Medical Technicians web page, and in the ARS, but what do they know?

I checked the National EMS Scope of Practice Model at EMS.gov and found there’s really not a lot of difference between an EMR and a EMT Basic with no additional training.

NOTE The Arizona EMS Bureau DOES NOT Recognize EMR’s WHY is what we need to ask….

I love when people listen to rumors and BS rather than check for themselves, especially when it comes to the law. It always makes them look ignorant.

Chairman Bailey EMR’s can do CPR, but yes you were kind of right about that, but EMR’s do so much more than a first aid person.

EMR’s do need to take the American Heart Association Basic Life Support CPR and AED program for BLS providers. The very same Basic Life Support CPR and AED program that EMT’s and Paramedics are required to take.

EMR’s can also use Airway and Breathing Adjuncts including the insertion of airway adjuncts intended to go into the oropharynx or nasopharynx. They can use positive pressure ventilation devices such as the bag-valve-mask to assist in breathing.

When someone’s airway is obstructed with vomit or bone, an EMR can suction the upper airway, and give supplemental oxygen therapy. And if that time comes, do CPR and use an automated external defibrillator.

They can do some very limited pharmacological interventions, manually stabilize suspected cervical spine injuries, do manual stabilization of extremity fractures, and control bleeding.

Chairman Bailey does that sounds like a basic first aider?

The National Scope of Practice says “A major difference between the Emergency Medical Responder and the Emergency Medical Technician is the knowledge and skills necessary to provide medical transportation of emergency patients”

So they get more training on loading and transporting patients than an EMR and they can do these additional skills.

1.   Airway and Breathing Insertion of airway adjuncts intended to go into the oropharynx or nasopharynx

2.   Use of positive pressure ventilation devices such as manually triggered ventilators and automatic transport ventilators

3.   Assist patients in taking their own prescribed medications

4.   Administration of the following over-the-counter medications with appropriate medical oversight: Oral glucose for suspected hypoglycemia and aspirin for chest pain of suspected ischemic origin

5.   Trauma Care Application and inflation of the pneumatic anti-shock garment (PASG) for fracture stabilization

So the only difference between an EMR and an EMT Basic with no additional advanced training is the EMT can:

1.   Use a better airway to secure your airway

2.   Help you open your own medicine and take it

3.   Use an positive pressure ventilation device as opposed to a bag valve mask

4.   They can give over-the-counter medications like glucose (sugar) or aspirin with appropriate medical

5.   In trauma they can use a pneumatic anti-shock garment what we used to call MAST Pants.

6.   Has the training to load and transport a patient by ambulance.

It’s sad when people who oversee vital services like the fire service understand so little about what firefighters and EMS providers do, and their levels of training.

Thank you for allowing me to train with the firefighters of NACFD

Jay Fleming

Dolan Springs AZ

LINK to Chief Eder's Blog