HEADS UP!!

[Guest guest]

EMS personnel in Texas are not mandated by legislative statute. In fact, in

Texas there is no law that requires governmental entities (counties, cities,

school districts) to even provide EMS. If you look at the more progressive

states (Wisconsin, Kentucky [yes Kentucky], and others), they have an EMS

Board that was created by the legislature and is charged with overseeing EMS

and standards and practices. Thus, in Texas, EMS is a quasi-governmental

entity regulated by the Texas Department of Health (whose charge has little

to do with EMS). In some states (Ohio, for example), EMS is part of a

mandated Department of Public Safety that governs police, fire, EMS,

disasters, etc.

Ideally, Texas should have a Board of EMS Examiners, appointed by the

governor, that consists of practicing ECAs, EMTs, EMT-Is, Paramedics, EMD,

administrator, physician, lay person, or similar structure that is charged

with overseeing EMS and licensing EMS people by statute (in Texas, even

" licensed paramedics " are not really licensed). This is similar to the Board

of Medical Examiners, Board of Nurse Examiners, Board of Chiropractic

Examiners, State Board of Pharmacy, etc. Then, the agency could appoint a

state medical director should they deem it in the best interest of Texas

EMA. Such a move would help EMS in rural Texas where local services cannot

pay for a quality medical director or do not have access to one. The agency

and the medical director (or council of medical directors reporting to the

medical director) would establish baseline statewide protocols and standing

orders. Then, each local governmental entity could use the state protocols

or add to them as they see fit for their area.

Possible pitfalls:

1. Legislature should not mandate what EMS practice is (i.e., California,

New York). This would actually hold EMS back.

2. Medical director should be board-certified emergency physician with

extensive knowledge of EMS who is chosen by the Board and approved by the

Governor. The medical director's performance should be periodically

reviewed by the board.

3. Liability limits should be legislatively placed to protect those who

serve in these capacities and set rules and regulations.

4. Process falls down if it becomes politicized. In Wisconsin and Kentucky,

the state EMS association is quite strong and plays a major part in working

with the Board on EMS issues. We need to support our state EMS association.

In my opinion, and I have been to at least 3/4 or more of the US states and

most of the Canadian provinces and all of the Australian states and

territories, and I can say that Texas EMS oversight (laws, organization,

rules) is among the very worst in the first world.

This ought to upset some folks in Austin for at least a week or so.

Bledsoe, DO, FACEP, EMT-P

Midlothian, Texas