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Austin/Travis County EMS may cut some paramedics from ambulance crews

Tuesday, December 7, 2010 by Michael Kanin

The city’s decision to consider reducing the number of paramedics staffing the city’s emergency vehicles has angered the head of the Austin/Travis County EMS Employees Association, who says that the employees who might be affected have not been consulted.


Austin-Travis County Emergency Medical Services is considering a reconfiguration of its ambulance crews, and according to the department’s chief of staff, James Shamard, one possible scenario could include dropping one of the (currently two) paramedics and adding an emergency medical technician to EMS crews. Shamard spoke Monday to the city’s Public Safety Commission.


Such discussions have created tension between the department and the union that represents some 300 Austin/Travis County emergency workers, including paramedics. Union President Steve Stewart told the commission that field paramedics hadn’t yet been adequately involved in discussions that could bring the policy changes.


Some members of the commission also expressed concerns about the process. Vice Chair Mike Levy told Shamard that front line involvement in the department’s deliberations was essential. “The complete planning process needs to have paramedics at the table—not just input but at the table,” he said. A change like this, he said, would be “so profound, so serious, it (would) make such a significant difference to patient outcome.”


For his part, Shamard argued that the process hadn’t yet progressed to the point where officials felt that field paramedics should be involved. “We’re (only now) at that point where we need to start that dialog, where we need to start looking at what the impact of different skill levels would be,” on ambulance crews, he said. He added, “We (were) not far enough along. We’re at a point now where we…are in a position where we can bring the field work group in and say, ‘Okay, here’s what we know.’”


Stewart told the commission that his group needed to be much more involved in the process. “There (are) a lot of issues that haven’t been addressed with the field paramedics to this point,” he said. “I would hope that we can change that as we move forward together and do what’s best for the citizens and the paramedics who are serving the citizens.”


He said he was concerned about the lack of union participation. “We’d be willing to look at (the change) and work with the department to look at the different options…and what’s in the best interest of the citizens, he said. “To this point we really haven’t had an opportunity to do that.”


Levy agreed. “I know from my standpoint that I’ll be looking to the paramedics themselves because they basically have to make this work,” he said.


He illustrated his concerns with a scene that he had observed on a ride-along with paramedics. “We went to a man on the floor with a full (cardiac) arrest,” he said. “The complexity of the resuscitation effort – it was certainly a team effort, it required the skill sets of two paramedics plus a team…(from) the Austin Fire Department – it wasn’t a positive outcome, but so often it is a positive outcome because of two paramedics.”


According to Shamard, the change, if enacted, would reduce the number of paramedics on ambulances from two to one—which is the way that most of the (crews) in the country operate, he said. An emergency medical technician would replace the other paramedic.


He said there would be no layoffs associated with new ambulance staffing guidelines.

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