# Is EMS Medicine or Public Safety or both



## fortsmithman (Jun 20, 2009)

What is your opinion


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## 46Young (Jun 20, 2009)

Both, definitely. the ones that write commendation letters to your agency aren't typically the ones in dire straits, but the ones who needed a lift assist at 0300, or the interfacility trip from the hosp. to rehab, NH, residence, or whatever. The money phrase, in the back, after everything is squared away, is "what can we do to make you more comfortable?". Most of the time, be it 911 of IFT, it's overwhelmingly customer service. If one can be at peace with that, they will likely have a long and fufilling career in the prehospital arena.


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## Flight-LP (Jun 20, 2009)

Personally, I practice medicine under the guidance of my medical director. No part of my practice involves public service.


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## Shishkabob (Jun 20, 2009)

We service the public with medicine.


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## fortsmithman (Jun 20, 2009)

I put both because my service will be doing bicycle rodeos and giving presentations to the local school on what to do in an emergency.   So in my view my service is both.


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## 46Young (Jun 20, 2009)

Flight-LP said:


> Personally, I practice medicine under the guidance of my medical director. No part of my practice involves public service.



Ground txp is another beast entirely.


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## fortsmithman (Jun 20, 2009)

Ground ambulance and air ambulance are indeed 2 different forms of EMS.  In air the medics I know don't assist police in getting persons who refuse medical assistance into the police vehicle.  Air ambulance don't have to carry hose to assist FD.   Members from my service do.


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## HotelCo (Jun 20, 2009)

EMS is EMS. I don't know how else to put it.


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## daedalus (Jun 20, 2009)

I am with Flight. I provide medicine in conjunction with my medical director. I do not preform any public safety activities and will continue not to do so.


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## 46Young (Jun 20, 2009)

Public service isn't limited to public functions. Public service becomes evident on most of our calls. If not, we would present as cold, unfeeling robots who could care less about whether we shut the pt's lights off, calling the pt's family to let them know what's up, putting their furniture back after moving the pt because they will be too weak to do it themselves, speaking with family during a critical event, handing out blank forms for the pt to provide demographics/PMHx, meds, etc for the next time, showing up at the residence at 0dark30 to place grandma back in bed since she's too weak to do it herself, with a pleasant attitude and a smile on our face, etc.


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## B.K. (Jun 20, 2009)

definitely both


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## 46Young (Jun 20, 2009)

daedalus said:


> I am with Flight. I provide medicine in conjunction with my medical director. I do not preform any public safety activities and will continue not to do so.



You're "with flight" As an EMT-B(medic student)? I thought you had to be either a flight medic or a flight RN?


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## Ridryder911 (Jun 20, 2009)

The ones that usually describes EMS as Public Safety are the ones that does not know what public safety really consists of. What portion of or formal training of true "safety" courses did you ever attend? Where does EMS have any authority in regulation of safety or even provide safety to anyone? 

The question was *Public Safety NOT Public Service *which are total different things!

Again, showing ignorance of not even knowing the difference. Providing a service and public safety having nothing in common. Everyone involved in medicine provides a service in some form or another. Public Safety such road construction, Law & Code Enforcement, Animal Control, Fire Service are unique that they not only provide but have the duty to regulate and study, develop programs to reduce injuries and mortality by their functions and roles regarding the public and promotion of safety. 

We are medical nothing more. We are a extended branch of medicine alike Public Health, Home Health and even Hospice. Unfortunately, we just have not developed fully yet because we still have to have discussions such as this. 

R/r 911


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## daedalus (Jun 20, 2009)

46Young said:


> You're "with flight" As an EMT-B(medic student)? I thought you had to be either a flight medic or a flight RN?



I said I am with Flight, as in the emtlife forum member Flight-LP. He posted before me and was right on with what I was thinking.


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## silver (Jun 20, 2009)

46Young said:


> Public service isn't limited to public functions. Public service becomes evident on most of our calls. If not, we would present as cold, unfeeling robots who could care less about whether we shut the pt's lights off, calling the pt's family to let them know what's up, putting their furniture back after moving the pt because they will be too weak to do it themselves, speaking with family during a critical event, handing out blank forms for the pt to provide demographics/PMHx, meds, etc for the next time, showing up at the residence at 0dark30 to place grandma back in bed since she's too weak to do it herself, with a pleasant attitude and a smile on our face, etc.


So wouldn't in-patient nursing be considered public safety by using those examples?
nurses/other hospital staff call family members, set up transportation means, educate patients on healthy living, community education about diabetes  AIDS  obesity  heart disease, smoking/alcohol/drug cessation, social work, set up follow ups, hand out discharge medication lists and instructions...all with a smile because social medicine is all the rage

I voted medicine only


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## fortsmithman (Jun 21, 2009)

I think in either 2004 or 2005 the Government of Canada declared that EMS is a public safety occupation.


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## EMTinNEPA (Jun 21, 2009)

ridryder911 said:


> we are medical nothing more. We are a extended branch of medicine alike public health, home health and even hospice. Unfortunately, we just have not developed fully yet because we still have to have discussions such as this.
> 
> R/r 911



+ 999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999999 points


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## ResTech (Jun 21, 2009)

EMS is both. EMS play's a large role in injury prevention through community programs such as safety advocacy in school's, car seat safety check programs, seat belt campaigns, handing out free bicycle helmets, and the list goes on.  As an EMS provider when I am working, I feel I have a responsibility to radio in when I see a small child on infant riding in a vehicle on the lap of an irresponsible parent... of which I have done before. How is this not public safety?


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## Flight-LP (Jun 21, 2009)

Direct from Wikipedia for those who have independent perceptions and assumptions........

http://en.wikipedia.org/wiki/Public_safety

"Public safety involves the prevention of and protection from events that could endanger the safety of the general public from significant danger, injury/harm, or damage, such as crimes or disasters (natural or man-made)."

"Emergency Medical Services ** Are often included in public safety, but while EMS is an emergency service, it is medical service that is part of the greater health care system, despite the superficial trappings shared with Police and the Fire Service."


Again, NOT public safety, public service perhaps. The closest coorelation I see is the car seat service, but even that is usually provided by individuals other than an on duty crew (i.e. someone else PR'ing).


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## fortsmithman (Jun 21, 2009)

Flight-LP said:


> Direct from Wikipedia for those who have independent perceptions and assumptions........
> 
> http://en.wikipedia.org/wiki/Public_safety
> 
> ...




As I previously posted EMS was declared a public safety occupation by the Government of Canada in either 2004 or 2005 after lobbying by the Paramedics Association of Canada.  So I guess here in Canada we are public safety.  Is it not some legislators belief in the USA that EMS is public safety as there are laws making it a crime to obstruct EMS personnel.  If the legislators were to believe that EMS is not public safety would they repeal said laws.  Is it an offence to obstruct Physicians and nurses in the performance of their duties I think not.  Remember that offence has to clearly state obstructing a physician or physician assistant or nurse in the performance of their duties.  The Paramedics Association of Canada lobbied for this for the same retirement and tax benefits of other public safety personnel.  Just a note air traffic control is also a public safety occupation.


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## firecoins (Jun 21, 2009)

I voted for both.  However I have slightly changed my mind after reading several posts.  Several people made some good points.   

EMS is medicine and and an emergency service.  It isn't necessarily a public safety.


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## fortsmithman (Jun 21, 2009)

Maybe EMS si different here in Canada since a majority of EMS is run either by municipal or provincial govt's, and health authorities.  Also that here in Canada we have higher education requirements.  With the education I believe we in Canada may require a bachelors degree for EMS before the USA.  The main reason we were declared a public safety occupation is fpr the income tax reasons and retirement benefits to be on par with fire and police.


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## TransportJockey (Jun 21, 2009)

We are medical. Nothing else.


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## fortsmithman (Jun 21, 2009)

I think thi topic will have EMS providers debating this like the armed vs unarmed EMS.


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## firecoins (Jun 21, 2009)

fortsmithman said:


> I think thi topic will have EMS providers debating this like the armed vs unarmed EMS.



I think EMS providers are better with arms.  I use my arms all the time.


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## cbjfan (Jun 21, 2009)

I think it differs between agencies. My agency provides extrication, fire rehab support, and limited SAR, as well as our ALS services. So that is why I voted both, then the ems agency next to us in our county provides just ALS, so they are just medicine. 

There have been many good points on here, but I do believe it is agency dependent.


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## Ridryder911 (Jun 22, 2009)

cbjfan said:


> I think it differs between agencies. My agency provides extrication, fire rehab support, and limited SAR, as well as our ALS services. So that is why I voted both, then the ems agency next to us in our county provides just ALS, so they are just medicine.
> 
> There have been many good points on here, but I do believe it is agency dependent.



I ask again, what safety training did you recieve? What service of safety do you do? 

Does anyone so far acclaiming to provide safety, even know what that includes? How many are Green Cross Certified or involved with them? Do you provide seminars for seatbelt safety, anti-cell phone (while driving), proper lifting classes, safety on the workforce? Again.. public safety.

R/r911


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## boingo (Jun 22, 2009)

Yes, we do seat belt and child car seat inspections, several public health initiatives such as kids don't fly, a PSA program with resources for window guards to prevent kids from falling out, a summer time problem here, bike helmets for low income kids, violence prevention programs in the public schools, operate a multi-diciplanary operations center for public health emergencies, trained staff in mass vaccination, hazmat training for public safety and hospitals, etc...I think we qualify as both.


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## Sasha (Jun 22, 2009)

Are we really so superficial that we care how other people refer to us as? This is almost as bad as crying over being called an ambulance driver. 

There are too many problems in EMS and health care in general, to have a coronary over if people believe it's pure medicine or public service/safety. 

Personally I think of EMS as medical, but if someone thinks of it as public safety. Eh, let them. I'm more concerned about the fact some people think of it as a trade or a hobby rather than a profession.


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## Ridryder911 (Jun 22, 2009)

Sasha said:


> Are we really so superficial that we care how other people refer to us as? This is almost as bad as crying over being called an ambulance driver.
> 
> There are too many problems in EMS and health care in general, to have a coronary over if people believe it's pure medicine or public service/safety.
> 
> Personally I think of EMS as medical, but if someone thinks of it as public safety. Eh, let them. I'm more concerned about the fact some people think of it as a trade or a hobby rather than a profession.



The problem it is really necessary for many legal and work purposes. It is not superficial by far; since Public Safety has certain regulations that contain both Federal and State as well exemptions and regulations for pay, benefits, grants, etc. So what may not mean much to you, means a lot for the profession. Federal laws, regulations are all based upon the roles & responsibilities placed upon the profession. If you still believe we are safety try to apply for the death benefits offered to those that just provide EMS. Again, you have to step outside the box, there is a lot more out there. 

Again, such classes alike seat belt training, bike safety rodeos are nice but are * NOT * really considered safety programs rather more a PR and wellness promotions. Even hospitals have such, but would not be considered a safety industry. When was the last time your service consulted with a Safety Engineer to develop a loss of injury work program or fall risk program, intersection and safety lighting studies, a traffic flow, etc. Again, how much formal safety training and education did you receive? How familiar is your crews with the "_Life/Safety Codes_" and things involving safety?  

One has to be very careful of attempting to use terms as _generic _. For example; I may own a dog, but I am not a trainer or breeder


R/r 911


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## cbjfan (Jun 22, 2009)

Ridryder911 said:


> The problem it is really necessary for many legal and work purposes. It is not superficial by far; since Public Safety has certain regulations that contain both Federal and State as well exemptions and regulations for pay, benefits, grants, etc. So what may not mean much to you, means a lot for the profession. Federal laws, regulations are all based upon the roles & responsibilities placed upon the profession. If you still believe we are safety try to apply for the death benefits offered to those that just provide EMS. Again, you have to step outside the box, there is a lot more out there.
> 
> Again, such classes alike seat belt training, bike safety rodeos are nice but are * NOT * really considered safety programs rather more a PR and wellness promotions. Even hospitals have such, but would not be considered a safety industry. When was the last time your service consulted with a Safety Engineer to develop a loss of injury work program or fall risk program, intersection and safety lighting studies, a traffic flow, etc. Again, how much formal safety training and education did you receive? How familiar is your crews with the "_Life/Safety Codes_" and things involving safety?
> 
> ...




So R/r according to your statements, does that mean law enforcement and f.d. are not public safety? Just from what I got out of your post made it seem like they aren't. Also in your last post you said seat belt classes are P.R. but in your post before that you asked if people provide seat belt classes, which was one of your examples of public safety.

To answer your previous question, we provide CPR training for any community member (or someone who works in our community) who is interested, we do have proper lifting technique classes as requested by employers in town, we provide basic first aid classes, in the high school we team up with the drivers ed class to teach about safety. We have done other things in the past, and we have other things planned.


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## ResTech (Jun 22, 2009)

EMS has a strong foundation in public safety... some just like to think their too good it sounds like.

If you don't like some of what comes along with EMS then you should probably stay off the street and in the hospital. I enjoy the public safety education part that comes along with EMS. What better profession or group to educate the public?


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## VentMedic (Jun 22, 2009)

Actually, EMS is not considered public safety by the definitions established by the U.S. DOJ. This was an issue when concering benefits to those at 9/11 and new legislation was drawn from that since EMS did not fit into the category of Public Safety.

Florida also had a case concerning "Duty to Act" and the definition of Public Safety was brought into play. Only some Public Safety Officers have a duty to act while off duty and that is usually within Law Enforcement and Corrections. The Fire Department is part of public safety but at the time of Shane Kelly's (Oviedo FF) off duty death assisting at an MVC, there was no duty to act while off duty law that pertained to him. Thus, his family was not entitled to any benefits. 

A statute was eventually added to include those that work for the State, municipal or county agencies to be included in the Workman's Comp act while performing tasks that pertain to their paid job when off duty. 

If you look up Public Safety degrees in almost any college, you will find Law and Fire under that section with EMT(P) under health sciences. 

Florida had numerous Public Safety departments at one time where EMS was also a role. When they separated, EMS came under a different category as did their Duty to Act status by definition of the statute at that time. However, since Shane Kelly's death those that work in EMS for a government agency, even though not by the definition of Public Safety, they can be entitled to some benefits if injured or killed. 

So yes, terminology is very important for many reasons and most still don't understand what Duty to Act means on duty and off duty for legal purposes.


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## firecoins (Jun 22, 2009)

since fire departments are trying to pick up the EMS role, does EMS become public safety than?


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## Ridryder911 (Jun 22, 2009)

firecoins said:


> since fire departments are trying to pick up the EMS role, does EMS become public safety than?



Not if their primary role is that of EMS. Folks, don't confuse the issue of medicine and safety as the same or as one. It is two different and complete things. Ever met a safety engineer? How well do you know OSHA codes and or your state safety boards? NO? Then your not safety. 

This is where Federal Wage & Labor Board even wants to know how much time is spent in extrication and rescue versus providing patient care for pay distribution. Fire Service can be included because their actions are considered preventitive. 

Offering courses on prevention and basic safety is nice but should not be considered "safety" when observing what truly what the safety profession consists of. 

It would be alike someone who takes a CPR class acclaiming they are now a health care professional and know medicine because they know how to do a medical procedure. 

Our primary role as an EMS provider is Emergency * Medical * Services. No, don't see anywhere any safety discussed. Examine and review the curriculum, I dare anyone to see any formal safety training or education within it. It's just not there. For a reason.  

The Emergency Nurses Association has a pool safety program and as well anti-drunk driving and safe driving course, are they safety too? No. It's just they offer courses containing some safety ideologies. 

It's not that I am too proud, but at least I know what my profession is and what it is not. I even have a degree in Fire Science and Safety Engineering; I know what the difference is. Even with that, I will acclaim I know very little of Safety in comparison of those of professional safety. Again, those in safety primary focus are in prevention of occurrences. This would be the case of Fire Service with pre-planning, code enforcement, sprinkler systems, and weight distribution, etc. Public Safety, again what preventative measures is a daily part of our job? Police do crime statistics and highway monitoring to reduce MVC's, Fire does inspections, Safety Engineers monitor and attempt reduce workmens injuries and all develop methods to reduce problems with code enforcement to back them to ensure that those methods will be carried out. 

R/r 911


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## ResTech (Jun 22, 2009)

This is really an argument of semantics more then ne thing else. Regardless of the classification by some technical definition, EMS provides a safety role to the public... some EMS agencies more then others and this is a VERY IMPORTANT role. I don't perceive having personnel certified to inspect child restraint seats, performing seatbelt awareness, DUI consequence awareness, talking to kids in schools about safety, or any other injury prevention program as a PR campaign. Sure, it opens up interaction with the community which is awesome.... but the aforementioned are not planned strictly as a PR puppet show. 

Since when did injury prevention fall out of place as one of the primary mission element of EMS????? It's something we do not do enough of. It's easier to let injuries happen and then intervene instead of investing time and resources into preventing them. 

Injury prevention programs = PUBLIC SAFETY.


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## boingo (Jun 22, 2009)

VentMedic said:


> Actually, EMS is not considered public safety by the definitions established by the U.S. DOJ.  QUOTE]
> 
> http://cms.firehouse.com/web/online/News/Medal-of-Valor-Recipients-Honored-by-Department-of-Justice/46$28646
> 
> 2 of the recipients are paramedics....


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## VentMedic (Jun 22, 2009)

ResTech said:


> This is really an argument of semantics more then ne thing else.


 
No it is not according to our government in the United States. Did you research any of the information I presented in my last post or the information Rid has posted? 

Have you even looked at the issues presented with 9/11? Do you know why Good Sam laws were revised? Did you look up Public Safety employees responsibilities and benefits? Do you understand the workmans comp's laws, survivor benefits and Fair labor laws as they pertain to you? 
What laws of enforcement concerning Public Safety codes are you responsible for? Which public office has given *you* these powers that you say you have? Do you know where to find your duty to act laws under your public safety department, state or municipal, as they pertain specifically to you? Again, who is specifically enforcing these regulations for you to call yourself Public Safety?



boingo said:


> http://cms.firehouse.com/web/online/News/Medal-of-Valor-Recipients-Honored-by-Department-of-Justice/46$28646
> 
> 2 of the recipients are paramedics....


 
Thank you for that link.




> A “public safety officer” is a person (living or deceased) who is serving or has served in a public agency, with or without compensation, as a firefighter; law enforcement officer, including a corrections, court, or civil defense officer; or emergency services officer, as *determined by the U.S. Attorney General.*


 
Here is a list of the recipients for the past few years since this Medal of Valor was established.

http://www.ojp.usdoj.gov/medalofvalor/mov_awardees.html

The Paramedics have been part of a Fire, Police or Public Safety Department.


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## ResTech (Jun 22, 2009)

It is really an argument of semantics... the question posed was "Is EMS medicine or public safety, or some of both"? In what context is the question being asked? In reality of what EMS does or how EMS is perceived by certain governing bodies? And to me, this question was being asked to assemble the opinions of forum users since its in the form of a poll.  

I didn't say I nor EMS in general "have any special powers". All I said was as EMS providers, we have a history and obligation to provide a form of public safety which is the practice of injury prevention within our communities. Whatever the government wants to classify EMS as is all on them and Im not debating what they may classify us as. 

Reality speaking and given the history of EMS, public safety falls within the realm of EMS. How can one disagree that injury prevention programs are not a role of EMS or a form of public safety? Again, what context are we talking here??????


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## VentMedic (Jun 22, 2009)

ResTech said:


> It is really an argument of semantics... the question posed was "Is EMS medicine or public safety, or some of both"? In what context is the question being asked? In reality of what EMS does or how EMS is perceived by certain governing bodies? And to me, this question was being asked to assemble the opinions of forum users since its in the form of a poll.
> 
> I didn't say I nor EMS in general "have any special powers". All I said was as EMS providers, we have a history and obligation to provide a form of public safety which is the practice of injury prevention within our communities. Whatever the government wants to classify EMS as is all on them and Im not debating what they may classify us as.
> 
> Reality speaking and given the history of EMS, public safety falls within the realm of EMS. How can one disagree that injury prevention programs are not a role of EMS or a form of public safety? Again, what context are we talking here??????


 
Semantics? If you are injured or killed on the job, you and your family might think it is more than semantics. I am only talking about Public Safety as the legal definition established in the U.S. with the benefits and privileges associated with that title. I am not talking about "opinion". 

Right now, the one issue that the Public Safety definition has been expanded is in terms of survivors benefits for on the job death and this has come about since 9/11.

For duty to act other than on the job which the "duty to act" per your license pertains, EMS, unless employed by a government agency may be excluded from Federal and state definitions of Public Safety Officer. 

Our country's legal system is built on terminology and definitions. 

Again, don't mix up opinion with facts. "I teach CPR" does not make one a Public Safety Officer.


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## ResTech (Jun 22, 2009)

I think were debating on two different wavelengths... Again... the question posed was to seek PERSONAL OPINION on what individuals thought EMS was!!! and to me its BOTH. I don't know about you, but I have performed a deal of public safety over my decade and a half of EMS service. I know what my death benefits are, I know 9/11 raised question and concern with EMS. More power to you for knowing the ins and outs of what constitutes a technical and all official Public Safety person. 

Its like arguing if EMS is all about medicine, rescue, or both... guess since EMS is all about strictly medicine we have to be confined to that and not be able to offer other services that will enhance public safety and services delivered.

This has turned into such a dumb argument.


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## el Murpharino (Jun 22, 2009)

ResTech said:


> I think were debating on two different wavelengths... Again... the question posed was to seek PERSONAL OPINION on what individuals thought EMS was!!! and to me its BOTH. I don't know about you, but I have performed a deal of public safety over my decade and a half of EMS service. I know what my death benefits are, I know 9/11 raised question and concern with EMS. More power to you for knowing the ins and outs of what constitutes a technical and all official Public Safety person.
> 
> Its like arguing if EMS is all about medicine, rescue, or both... guess since EMS is all about strictly medicine we have to be confined to that and not be able to offer other services that will enhance public safety and services delivered.
> 
> This has turned into such a dumb argument.



I don't care about the public's safety...I do care about my own safety, however


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## cbjfan (Jun 22, 2009)

ResTech said:


> I think were debating on two different wavelengths... Again... the question posed was to seek PERSONAL OPINION on what individuals thought EMS was!!! and to me its BOTH. I don't know about you, but I have performed a deal of public safety over my decade and a half of EMS service. I know what my death benefits are, I know 9/11 raised question and concern with EMS. More power to you for knowing the ins and outs of what constitutes a technical and all official Public Safety person.
> 
> Its like arguing if EMS is all about medicine, rescue, or both... guess since EMS is all about strictly medicine we have to be confined to that and not be able to offer other services that will enhance public safety and services delivered.
> 
> This has turned into such a dumb argument.




I agree with ResTech, some people have forgotten it was personal opinion. I know what the DOJ says, and yes Vent thats fine. However, how can I, and my agency as well as many others, be strictly medical if we do extrication? There is nothing medical about cutting open a car.


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## VentMedic (Jun 22, 2009)

cbjfan said:


> , be strictly medical if we do extrication? There is nothing medical about cutting open a car.


 
Extrication? Public Safety?

Extrication comes after the MVC or whatever. It is plain and simple a means of gaining access to a patient for medical purposes as most levels.


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## cbjfan (Jun 22, 2009)

VentMedic said:


> Extrication? Public Safety?
> 
> Extrication comes after the MVC or whatever. It is plain and simple a means of gaining access to a patient for medical purposes as most levels.



I didn't say that it was public safety, I simply said that extrication is not medical. The medic in the car doing patient care while we are cutting is medical, but the guys with the jaws and such are not doing anything medical...well maybe its car surgery.


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## VentMedic (Jun 22, 2009)

cbjfan said:


> I didn't say that it was public safety, I simply said that extrication is not medical. The medic in the car doing patient care while we are cutting is medical, but the guys with the jaws and such are not doing anything medical...well maybe its car surgery.


 
Doctor uses ring cutter to get someone's finger out of a ring. Extrication? Medical or not?


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## cbjfan (Jun 22, 2009)

VentMedic said:


> Doctor uses ring cutter to get someone's finger out of a ring. Extrication? Medical or not?



Fire Fighter uses a pry bar to open a locked screen door at a house where there is a person trapped in the burning house. Medical or not?


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## VentMedic (Jun 22, 2009)

cbjfan said:


> *Fire Fighter* uses a pry bar to open a locked screen door at a house where there is a person trapped in the burning house. Medical or not?


 
Fire Fighter? Is the person in need of medical care after being rescued? Is the FF also a Paramedic? Is there an area at the scene established for medical treatment by Paramedics? Are the Paramedics provided by a separate EMS agency?

When a FF is at a fire scene and assigned to fire fighting duties, that is his/her only responsibilty along with getting people out of burning buildings. If the FFs are also Paramedics, one of them will be assigned to patient care and will not be fighting the fire as long as there are patients.


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## fortsmithman (Jun 22, 2009)

VentMedic said:


> Doctor uses ring cutter to get someone's finger out of a ring. Extrication? Medical or not?


In my neck of the woods it's an RN who would use the ring cutter not the physician.  I use the word physician because here in northern Canada we get british trained physician who's degree is MB (Bachelor of Medicine) not MD.


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## cbjfan (Jun 22, 2009)

VentMedic said:


> Fire Fighter? Is the person in need of medical care after being rescued? Is the FF also a Paramedic? Is there an area at the scene established for medical treatment by Paramedics?



The fire fighter is a first responder, and the person is in a house thats on fire. It makes as much sense as you talking about a doctor cutting a ring off of somebody's finger.


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## VentMedic (Jun 22, 2009)

fortsmithman said:


> In my neck of the woods it's an RN who would use the ring cutter not the physician. I use the word physician because here in northern Canada we get british trained physician who's degree is MB (Bachelor of Medicine) not MD.


 
We're a teaching hospital. The doctors are hands on.

The nurses may also have 10 - 15 other patients each to be concerned about while we have an endless supply of med students and residents.


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## fortsmithman (Jun 22, 2009)

So far we've had paramedics who are also nurses and respiratory techs say EMS is medicine.  What about physicians when I say physicians I mean the ones who have never been a EMT or paramedic who just only has medical school under their belts.  Would they say public safety or medicine or both.  Whether or not EMS is either of the 3 is up to the individual agency.  For those that say they would never do public safety and your agency says do public safety and the medic says nope.  Then that medic may be either released from that service or have their shifts cut back, or transferred to ift from 911.  Like i stated earlier in this post it's agency dependent on what EMS is.


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## fortsmithman (Jun 22, 2009)

VentMedic said:


> We're a teaching hospital. The doctors are hands on.
> 
> The nurses may also have 10 - 15 other patients each to be concerned about while we have an endless supply of med students and residents.



Here at our town's hospital there would be some days when we have no physician in town.  When that happens if a pt needs to be admitted then they are air medevaced to our territorial capital.  Here in the north our RNs work acute care,  long term care, ambulance dispatch, and ER and these are all done by the same RN.


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## cbjfan (Jun 22, 2009)

fortsmithman said:


> So far we've had paramedics who are also nurses and respiratory techs say EMS is medicine.  What about physicians when I say physicians I mean the ones who have never been a EMT or paramedic who just only has medical school under their belts.  Would they say public safety or medicine or both.  Whether or not EMS is either of the 3 is up to the individual agency.  For those that say they would never do public safety and your agency says do public safety and the medic says nope.  Then that medic may be either released from that service or have their shifts cut back, or transferred to ift from 911.  Like i stated earlier in this post it's agency dependent on what EMS is.



I agree 100%!!! It is completely agency based, yes we know what the DOJ and some states say. However, it is local government and agency based. The city I work for has a Director of Public Safety, he has 3 agencies that answer to him and they are: police, fire, and ems.


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## fortsmithman (Jun 22, 2009)

Also as I stated earlier the federal government here in Canada has declared EMS to be a public safety occupation.  So that makes up both medical and public safety here in Canada at least.


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## VentMedic (Jun 22, 2009)

fortsmithman said:


> So far we've had paramedics who are also nurses and respiratory techs say EMS is medicine. What about physicians when I say physicians I mean the ones who have never been a EMT or paramedic who just only has medical school under their belts. Would they say public safety or medicine or both. Whether or not EMS is either of the 3 is up to the individual agency. For those that say they would never do public safety and your agency says do public safety and the medic says nope. Then that medic may be either released from that service or have their shifts cut back, or transferred to ift from 911. Like i stated earlier in this post it's agency dependent on what EMS is.


 
Let's not forget you also have those of us replying who have a FF background with degrees in Fire Science or Public Safety as well as a medical education. There is a difference.

I'm sure Rid could also tell you about the details his degree went into for Fire Science which is usually in the College of Public Safety department in the Universities.

If an area is placing EMS under Public Safety it may be solely for the purpose of gaining benefits such as PSOB but that does not have to mean you are functioning in a public safety compacity as by definition.


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## fortsmithman (Jun 23, 2009)

There are those of us who say we are both.  Those of us who say medicine only. Those of us who say public safety.  as well as those f us who just don't car if we're public safety, medicine or both.  So people can we just agree to disagree,  I still would like to read he opinions of others on the subject.


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## VentMedic (Jun 23, 2009)

fortsmithman said:


> There are those of us who say we are both. Those of us who say medicine only. Those of us who say public safety. as well as those f us who just don't car if we're public safety, medicine or both. So people can we just agree to disagree, I still would like to read he opinions of others on the subject.


 
My point for making the distinctions have more to do with making some understand how the laws are made in their state as well as where their funding for staying in business might originate.  To few understand the basics of how EMS and Public Safety systems function.  This is also where the duty to act confusion comes into play and some of the consequences by those making like whackers with their tricked out vehicles and trauma kits can run into problems if they get injured or cause injury.


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## fortsmithman (Jun 23, 2009)

VentMedic said:


> My point for making the distinctions have more to do with making some understand how the laws are made in their state as well as where their funding for staying in business might originate.  To few understand the basics of how EMS and Public Safety systems function.  This is also where the duty to act confusion comes into play and some of the consequences by those making like whackers with their tricked out vehicles and trauma kits can run into problems if they get injured or cause injury.


That's one thing you will not find in any vehicle I may own is emergency lights and siren.  I say leave them on the rig.  The only ambulance radio I have is the one the service issued me  I will not spend the 1500.00 it costs to buy one.


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## EMTTim (Jun 23, 2009)

firecoins said:


> I think EMS providers are better with arms.  I use my arms all the time.



CPR can be done just as effectively utilizing repeated headbutts to the chest. Plus, it would be three times cooler to watch. I vote for unarmed.


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## TransportJockey (Jun 23, 2009)

EMTTim said:


> CPR can be done just as effectively utilizing repeated headbutts to the chest. Plus, it would be three times cooler to watch. I vote for unarmed.



Man talk about a killer headache


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## VentMedic (Jun 23, 2009)

As I explained in my previous threads, there are PSOB benefits for survivors of LODD and some states have taken to defining it as it pertains to their own state. I've already explained Florida and the national stance, now here is Missouri. However, the term Public Safety may still differ for other things within a state such as duty to act.

*Missouri Passes Responder Benefits Bill*
Tuesday, June 23, 2009




> Standing inside a Kansas City fire station, Gov. Jay Nixon today signed a bill to benefit the families of Missouri emergency personnel killed in the line of duty. House Bill 580, which establishes the Line of Duty Compensation Act, allows a claim to be filed with the Division of Workers' Compensation on behalf of a *law enforcement officer, firefighter, emergency medical technician, air ambulance pilot or air ambulance registered nurs*e for a benefit of $25,000.


 
http://www.emsresponder.com/article/article.jsp?id=9759&siteSection=1


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## fortsmithman (Jun 26, 2009)

I might of voted medicine only if the uniform were scrubs as opposed to what is currently worn by a majority of EMS worker which is a public safety type uniform.  If our uniform were scrubs with a duty belt to hold our radio in place without causing the pants to fall down.  Since our current uniforms make us look like public safety the we are part public safety.  If we want to be considered medicine then change the uniform to a medical looking one.


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## Ridryder911 (Jun 26, 2009)

fortsmithman said:


> I might of voted medicine only if the uniform were scrubs as opposed to what is currently worn by a majority of EMS worker which is a public safety type uniform.  If our uniform were scrubs with a duty belt to hold our radio in place without causing the pants to fall down.  Since our current uniforms make us look like public safety the we are part public safety.  If we want to be considered medicine then change the uniform to a medical looking one.



So if you wore a lab coat you be?... Your going to classify a profession by what they wear? So you do know, that the sanitation department wears reflective vest and uniforms similar to EMS, so we are sanitation too? 

How about those in medicine that don't wear scrubs? I suppose their not in medicine... C'mon. 

R/r 911


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## fortsmithman (Jun 26, 2009)

It's more about public perception of EMS dress like public safety and the public assumes public safety.  Dress in scrubs then the public perceives us to be medical one thing I thing EMS should lose are the breast badges worn by EMS.


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## BLSBoy (Jun 27, 2009)

I technically work for the State of New Jersey when I am deployed with the state EMS Task Force. I am assigned to Staging Branch.
I have NO patient contact. 
What am I?


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## Shishkabob (Jun 27, 2009)

BLSBoy said:


> I technically work for the State of New Jersey when I am deployed with the state EMS Task Force. I am assigned to Staging Branch.
> I have NO patient contact.
> What am I?



Hopeless???


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## paramedicmike (Jun 27, 2009)

BLSBoy said:


> I technically work for the State of New Jersey...



I think the first part of your sentence describes the problem.  No one *works* for the State of New Jersey.  They just sit around, collect a paycheck while nothing gets done, the State falls deeper into debt and falls apart around them.

Too bad PA and NY can't just pull the pins on the bridges and just let NJ float off and sink into the Atlantic.

It's interesting, though.  I've not seen a single valid argument as to how or why we should be considered public safety.  And this conversation has been going on for how many pages now?


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## CAOX3 (Jun 27, 2009)

I would vote for whatever benefits the profession as a whole.  Im not too interested with titles or perception of others.


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## VentMedic (Jun 27, 2009)

paramedicmike said:


> I've not seen a single valid argument as to how or why we should be considered public safety.


 
You did not see the posts about PSOB for the provider and the family especially for LODD or workman's comp? 

It is because of that inclusion of EMS providers to the Public Safety title that have benefited the families of those kill in the LODD. So, for this purpose, EMS providers are considered "Public Safety". 

This is recent but not all the *other* mandates/regulations for someone working under a Public Safety title applies to everyone in EMS.


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## Shishkabob (Jun 27, 2009)

So... when it comes to pandemics, or other viral outbreaks such as bio terrorism, are we still JUST medicine, no matter the preventative measures we do?

You CAN be both safety and medicine.  If you keep the public safe in one form or another, guess what?  You're public safety.


It's not a degradation to be considered public safety.   I can't think of a single person who would look down on someone considered a "public safety" worker, and anyone that actually does is not someone who I care about their opinion.


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## paramedicmike (Jun 27, 2009)

Linuss said:


> So... when it comes to pandemics, or other viral outbreaks such as bio terrorism, are we still JUST medicine, no matter the preventative measures we do?



Yes.  We are still just medicine.  We are responding after the fact to provide emergency interventional health care.  We are not affecting safety.



> You CAN be both safety and medicine.  If you keep the public safe in one form or another, guess what?  You're public safety.



From what are we keeping the public safe?


Vent:  I missed that post.  But I'm inclined to think that the inclusion of EMS in LODD benefits is more a political maneuver.


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## boingo (Jun 27, 2009)

We have worked through city and state government to be included as public safety, for the benefits associated with it. The fact that I can go to a call for a building collapse, crawl through a pile of rubble to care for a patient, a firefighter slips and breaks his leg, a cop cuts his head and go out on 100% pay, and up to a few years ago, I could expect 60% pay.  Also, if I get killed in said action, the cop and firefighter's family would recieve compensation for their LODD, and I, as an EMS paramedic, killed in the same event, would recieve less.  I don't care what they call us at the end of the day, but if I am to respond to, and perhaps die at the same incident as the other two, the least I should be able to expect is equal compensation for my family.  At least that is how I see it.


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## Ridryder911 (Jun 27, 2009)

Linuss said:


> So... when it comes to pandemics, or other viral outbreaks such as bio terrorism, are we still JUST medicine, no matter the preventative measures we do?
> 
> You CAN be both safety and medicine.  If you keep the public safe in one form or another, guess what?  You're public safety.
> 
> ...



Actually that would not be Public Safety, rather Public Health. Two totally different professions. 

I am definitely not demeaning Public Safety by far, quite the opposite. EMT are not trained adequately or receive any training per safety, within their studies.  Might as well call them rocket scientist too.....

R/r 911


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## Shishkabob (Jun 27, 2009)

paramedicmike said:


> From what are we keeping the public safe?



Injuries?  Illness?  It doesn't have to be a human opponent.





Ridryder911 said:


> I am definitely not demeaning Public Safety by far, quite the opposite. EMT are not trained adequately or receive any training per safety, within their studies.  Might as well call them rocket scientist too.....R/r 911



Oh, so this whole argument you're throwing out that we are medicine and not public safety, is to make sure public safety is not smeared by EMT's and their lack of edumakation?


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## paramedicmike (Jun 27, 2009)

Linuss said:


> Injuries?  Illness?  It doesn't have to be a human opponent.



Then wouldn't we be engaging in preventative medicine?  Sounds like health care to me.






> Oh, so this whole argument you're throwing out that we are medicine and not public safety, is to make sure public safety is not smeared by EMT's and their lack of edumakation?



I hope you're being sarcastic.  It's hard to tell in this type media.


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## Shishkabob (Jun 27, 2009)

paramedicmike said:


> Then wouldn't we be engaging in preventative medicine?  Sounds like health care to me.



Which is why it can be both.  

Police officers are law and public safety.

Firefighters are fire and public safety.

Why can EMS not be medicine and public safety?  Some agencies DO do public safety functions.  Just because yours doesn't, doesn't instantly mean yours is the model we should base EMS off of.






> I hope you're being sarcastic.  It's hard to tell in this type media.


Couldn't tell by my spelling of education?


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## Ridryder911 (Jun 27, 2009)

Again, I ask what formal training do you have in safety? What codes or laws are enforced by EMS?


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## Shishkabob (Jun 27, 2009)

Ridryder911 said:


> Again, I ask what formal training do you have in safety? What codes or laws are enforced by EMS?



Safety =/= law.  



And again I ask you, what does it matter if we get considered part of public safety?

Are you offended as such?  Can you not still practice medicine while people think you are part of public safety? 

What would you consider the CDC and the WHO?  They are medicine, which also has a place in public safety, yet neither makes / enforces laws.  

What about SAR teams?  They make or enforce no laws, provide medicinal services, and are still considered part of public safety.


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## paramedicmike (Jun 27, 2009)

Ok.  Let's try this.

What public safety functions do you see EMS providers routinely performing?  What formal training have they had in order to engage in these public safety measures?  From what, exactly, are they protecting the public?

And in a very real sense, safety does, in fact, equal law.  Public safety as enforced by the FD includes inspections and code enforcement.  Those codes are laws.

BTW, Centers for Disease Control and World Health Organization are both medical organizations.  They work in the field of health care.  Disease control and world health, I think, are the give aways.


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## Shishkabob (Jun 27, 2009)

Which is exactly why I brought them up.

No one can deny that they are medicine.  But are they not public safety as well?  Do they not protect the public, even vicariously, from infectious diseases?



You have yet to answer my question; 

What's so bad about being considered part of public safety?  


Anyone who looks down on you for being public safety is an idiot who doesn't deserve your time of day anyway.


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## fortsmithman (Jun 27, 2009)

paramedicmike said:


> Ok.  Let's try this.
> 
> 
> A Public safety as enforced by the FD includes inspections and code enforcement.  Those codes are laws.



Here in the NWT our FD's do not enforce any legislation.  The NWT Fire Marshal's Office does all the enforcement.


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## CAOX3 (Jun 27, 2009)

I would say nothing usually in public safety there is usually more funding,  better benefits and retirement.


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## atropine (Jun 28, 2009)

LAFD is public saftey, which provides ems


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## VentMedic (Jun 28, 2009)

http://www.ems1.com/ems-advocacy/ar...would-extend-benefits-to-paramedics-families/




> MONTPELIER, Vt. — Vermont's two U.S. senators are sponsoring legislation that would extend death benefits to relatives of paramedics who work for nonprofit ambulance services and are killed in the line of duty.
> 
> The legislation is named after Vermont paramedic Dale Long, who was killed last week when the ambulance he was driving veered off the road and hit a tree.
> 
> ...


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## Ridryder911 (Jun 28, 2009)

Linuss said:


> Safety =/= law.
> 
> 
> 
> ...



Unfortunately, unlike most EMS providers are not familiar with the categories of health care providers. I doubt most of those in EMS even understand CDC and WHO are Public Health role. As one that have worked with both agencies I can assure you they would never acclaim to be safety or even near it. Again, I find it amusing for those that are barely in the EMS profession to attempt to define what EMS is. When in truth, most lack the education to be able to really make that determination. 

R/r 911


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## Shishkabob (Jun 28, 2009)

Rid;

I have asked you time and time again to tell me what is so bad about being considered a part of public safety, and you have yet to say.  There's one of 2 possibilities for that.  You're ignoring the question, or you CAN'T come up with a reason.  



Not a single thing you have said yet has convinced me that it is a bad thing to be considered public safety.


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## VentMedic (Jun 28, 2009)

Linuss said:


> I have asked you time and time again to tell me what is so bad about being considered a part of public safety, and you have yet to say.


 
He has already given numerous examples and definitions. He is not against Public Safety. EMS by itself just does not fit the definition as defined by mission statements, statute and other legislation. This is why I have been posting links where exceptions are being made to allow those in EMS agencies that are not considered Public Safety to be included for LODD benefits for their survivors.


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## Shishkabob (Jun 28, 2009)

I don't care about definitions.  I care why he is up in arms about being considered part of public safety.

You can tell that he is offended by people thinking as such, because he is starting to resort to personal "attacks" just so he can prove a point.


AGain-- NO definitions---  Not saying we are, not saying we aren't.  Why don't you want to be called part of public safety?


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## paramedicmike (Jun 28, 2009)

But you *do* care about definitions otherwise you wouldn't keep asking over and over again what people have against public safety.

Rid is not resorting to personal attacks.  He has said nothing about you personally.  Please learn to separate criticism of the training one has received from an attack on an individual.  In other words, Rid is saying, "The training you received sucked".  He is NOT saying, "You suck".  Please recognize the distinction between the two.

I doubt anyone here who has been arguing that we are medicine has any contempt at all towards public safety.  Some of us have even worked in a public safety capacity.  We just recognize the difference between the role of a public safety worker and that of an EMS provider.  We also recognize that EMS is not public safety.  We are health care.  Rid and Vent have done a pretty thorough job explaining why that is, too.


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## Shishkabob (Jun 28, 2009)

That's why I put "attacks" in quotation marks, as I couldn't come up with a better word.   He is still using something against someone, true or not, to win a point.



And again, I don't care about definitions.  I don't know how you got it that I do care about them because I'm arguing this, when I have said that I don't care about them.




So, again--

Why are you fighting against being called public safety?  You still CAN practice medicine under the umbrella of "public safety", yet you can clearly tell a couple of you are angered for such a thought.


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## VentMedic (Jun 28, 2009)

Linuss said:


> Why are you fighting against being called public safety? You still CAN practice medicine under the umbrella of "public safety", yet you can clearly tell a couple of you are angered for such a thought.


 
What additional mandatory additions do you want to be included for EMS? Some think they are under paid now for what they do and you want them to do more in between calls? How much more education that doesn't directly pertain to patient care do you want to include in the curriculum? EMS doesn't have enough education required just for patient care and now you want to include code enforcement education and making it a mandatory part of the job description.


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## Shishkabob (Jun 28, 2009)

No vent, thats not what I'm stating at all. 

What I've been talking about this whole thread is how I can see it viewed as both medicine AND PS.  I've also been trying to figure out why some people get offended when someone thinks EMS is a part if public safety 



Not a single time did I ever state EMS should get in the law making / enforcing areas.


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## fortsmithman (Jun 28, 2009)

Before I joined my town's ambulance service I and most non EMS all thought and most still do that EMS is public safety.  If you were to ask a non EMS person on the street chosen at random and without stating your view ask them what EMS is you would get a majority of this answer that EMS is public safety.


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## VentMedic (Jun 28, 2009)

fortsmithman said:


> *If you were to ask a non EMS person* on the street chosen at random and without stating your view ask them what EMS is you would get a majority of this answer that EMS is public safety.


 
You might as well ask the lay person what drug you push in a cardiac arrest and have a better chance of getting the correct answer unless they are involved in benefits or personnel management. 

Not being familiar with Canada's Public Safety Officer benefits, the would be hard probably for some involved in EMS to answer. The differences have been well pointed out for the U.S. 



Linuss said:


> What I've been talking about this whole thread is how I can see it viewed as both medicine AND PS. I've also been trying to figure out why some people get offended when someone thinks EMS is a part if public safety


 
The definition of "Public Safety" is not about "opinion". In the U.S. it is defined which is why legislators have had to petition for passage of Bills to include EMS providers in LODD benefits.

If you want to be Public safety you will have to assume all the responsibilites tha go with "the title".   Again, EMS gets hung up on titles and again with little understanding of their meaning.


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## Shishkabob (Jun 28, 2009)

". Again, EMS gets hung up on titles "


Exactly. This whole topic really means very little, which is why I keep asking why people care, and people keep ignoring that questions and come right back with "we're medicine!"


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## paramedicmike (Jun 28, 2009)

No.  You keep asking what's wrong with being considered public safety not why everyone cares.


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## VentMedic (Jun 28, 2009)

Linuss said:


> ". Again, EMS gets hung up on titles "
> 
> 
> Exactly. This whole topic really means very little, which is why I keep asking why people care, and people keep ignoring that questions and come right back with "we're medicine!"


 
Linuss, I don't know how else to explain this to you.  I care which is why I have quoted legislative issues which those in EMS should be aware of.  Most also don't know how their state's workman comp law pertain to them either and still some continue to care whacker bags hoping to do a terrific off duty save.   They also confuse "duty to act" and usually look under the wrong statute or state regulation for the answers.   If you truly misunderstand your job, you could leave your family hangin' without a pot to pee in if you perceive yourself to be something you are not or think you are protected by the law when you are not.   It doesn't matter what "opinion" you have.  It matters that you know where you stand in your job and in the regulations that protect you and your family if something happens.


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