Ambulance Attendants

[CG206 29]

In Mohegan VAC, there is a pridominent number of attendants riding the ambulances with CPR and First Aid. Although they are an added part of the crew, they are a very big asset. The training of these attendants include thoroughly knowing the equipment and operation of the equipment before allowed to ride. Is there anything else besides this that should be taught to attendants? How do other departments train attendants, require for them to do, etc.?

[Guest EMFAS_26-21]

What Mohegan VAC does is part of a growing trend in Emergency Care. I ride on the Englishtown - Manalapan First Aid Squad in Englishtown, NJ, and since the early to mid 80s, they have been running rigs with a crew of 3 to 4 people. A standard crew consists of three people: 1 Driver and 1 EMT up front, and another EMT/attendant in the back, who readies certain items while en route to the call scene. These third (and fourth if appliciable) EMT/attendant(s) is essential because it frees up time when the rig first arrives. We carry a "jump bag," which contains every imaginable medical device, an O2 canister, and suction (if needed) into the scene, which is readied while we are responding. We place them on the stretcher, and as soon as the rig pulls up, the third attendant pops the back doors and pulls out the stretcher while the lead two enter the scene.

In terms of training, these attendants are NJ Department of Heath Certified EMTs, so their position in the rig falls just by the rotation and seniority of the particular duty crew. Since I am the "FNG," I am usually the one in the back, however, in other instances, like I said, it just falls by seniority. All of us are Certified and can do just about anything except administer drugs - under NJ state law, that is left solely to Paramedics. In regards to thoroughly knowing the equipment and operation, every single member is required to complete a "Rig Checklist" once a month in order to refresh their memories about what a particular piece of equipment does, and where on the rig it is located. This keeps us sharp, which is one of the reasons why we have the most thorough BLS (Basic Life Support) response/care/transport stats in Western Monmouth County. Personally, I believe that all VACs should run crews of three to four people, not only because it is easier on the crews in terms of readying the rig, but also in the interests of patient care.

[WAS967 97]

Fortunatly your VAC is blessed with just a large compliment of trained personell as to be able to staff each run with 3-4 EMTs. Unfortunatly your VAC is in the minority. In this day and age of working families with many people working 2-3 jobs to "get by", VACs in many areas have been suffering from a lack of manpower in general, with trained EMTs often being a scarce commodity.

Generally, when we refer to an attendant, we mean a 3rd (and sometimes 4th or god forbid 5th) person on the crew whom is neither driver nor EMT/Crew Chief. Yes they can be an EMT as well, but generally they are "First Aiders" who (as Chris said) are trained in CPR/First Aid.

Do you have any tips for recruitment for us since you seem to have a plethora of EMTs? Recruiting and retaining members is paramount in the survival of any volunteer agency these days, and yours seems to be doing it quite well.

By the way, in NJ, can EMTs start IVs and Intubate? You mentioned that you can do just about everything except drugs. Just curious as I don't know Jersey's certification levels well, but I do know that EMTs from New York can go to New Jersey and work without reciprocity.

[Guest EMFAS_26-21]

We don't really have a "plethora" of EMTs, we just have a lot of signs throughout town and I guess a lot of people feel compelled to join. Many of our members are also members on the three fire departments (2 districts in Manalapan and 1 in Englishtown). I guess the best recruitment technique is to make up some signs, put them out, and always make sure that your rigs are in the public's eye. I also live in a town of about 30,000, and I guess we have about 75 or so active members. There are times, usually overnights, when it is a bit hard to get a duty crew, but on average, we have about 3 people to a crew. I've only been on the Squad since October, but the best thing I can say is to make sure you're always in the public's eye, ie. signs, driving around town, membership drives, etc.

As far as IV's and intubation, that is also left up to Paramedics/Advanced Life Support Personnel. It's just the way NJ law is written. EMTs are Basic Life Support - Paramedics are dispatched on the same frequency as the town First Aid units and usually ghost us on all calls unless we cancel. EMTs are deliniated into B grade (Basic), D grade (Defibrillator Trained), and I grade (Mobile Intensive Care / Paramedic). I'm not sure about be able to transfer from one state to another, but it is something I'd like to look into because I think I may use it to pay for Law School in a year and a half.

[Guest EMSwhitecloud]

At YVAC we have a lot of attendants, but they dont stay like that for long....the deal is( i think and dont quote me on this), 2 years after you join you have to be in or completed an EMT class....so the point to us having attendants is to help them with the EMT class....kinda makes sense.

[CG206 29]

I would like to see all attendants eventually become EMT's, but I cant really see forcing someone into EMT, if they dont want to. Its alot of extra time needed. I am a Driver/Attendent right now and never really even thought about becoming an EMT. However, through some convincing from a special someone, I'm finally going to take an EMT starting in January. Thanks EMSwhitecloud!

[Guest EMSwhitecloud]

Hey no problem....

[Guest EMFAS_26-21]

The attendants are definitely beneficial and are even moreso when/if they decide to become EMTs. The extra pair of hands always comes in handy.

[CG206 29]

Having an attendant on board the ambulance made all the difference Sun night. With the snow/ice on the ground, the extra pair of hands helped tremendously when moving the patient to the rig on the stretcher. Attendants also are valuable when doing lift assists and moving patients on stair chairs. Even the simpliest calls can use attendants because they can do as little as carry the ems bags or help back the rig into a driveway, but in the end they are a big part of the crew!

[Guest EMFAS_26-21]

I definitely agree. This is the time of year when the extra pair of hands is crucial. Plus, it's also good to have an extra crew member cuz when it's quiet, it's yet another person to chill with.

[Guest alsfirefighter]

The biggest recommendation I can make for attendants is having a organized orientation training program prior to just throwing them on the ambulance. That way they know what a NRB is, a pulse ox, how to take a blood pressure. One thing that is certainly a plus is having a ALS provider show them how to spike bags and put on leads, these are the small things that shave off minutes here and there. They are valuable if they are given the tools to be valuable, nothing is more frustrating then to have someone in there with you that has no clue as to where or what anything is.

______________________

IACOJ Bureau of EMS Chairman

FOOPS Contributing Editor

www.foops.org

[CG206 29]

Mohegan EMS has been training about 10 new attendants over the past 2 Monday nights. All these new members have been intoduced to the operation of all the equipment on the rigs and have showed the training officers where equipment and supplies are kept in the rigs when asked to get it. This is all mandatory attendant training on top of CPR and First Aid before even allowed to ride the rigs. Hopefully by next week, there will be a new batch of people to help out on calls!

[DRD 0]

How many hours is NYS EMT-B these days and how long does it usually take to complete the course (2 months, 3 months, depending on how many days a week u take it...)? I have always wanted to pursue that certification but it is so hard to work, go to school, be a volunteer firefighter, and take an EMT class. Would CFR-D be a better route for a firefighter who just wants to help out but not really be a full time gung ho member of an ambulance corp...? What is really the difference both in hours of training and what you can legally do at a scene?

[unleashedff248 3]

The NYS EMT-B course is usually around 5 months going 6 hours a week with a few extra days thrown in. It is a very time intensive course and is not practical for everyone to attend. Attendants are extremely important in the EMS field, and are often neglected and abused by senior crew members. People don't like to ride as attendants in my department because they aren't always involved in patient care. They do the "dirty work" for the emt and driver, such as lifting and paperwork. Its not right to have an attendant ride and make them sit there and do little to help. They're most often there to learn...the next generation of EMT's if you will. Make them useful! #-o

[RES20CUE 40]

I don't believe that "in your department" that the attendant is NOT used in patient care. If I happen to have an attendant riding with me, I have them do almost all the patient care, under my supervision, so they can learn, after 15 years of doing this, the younger generation needs to learn to take over! If this is occuring, it is the fault of the EMT who is riding, not the Dept. Maybe you should advise your officers, so they can speak to the EMT's.

[unleashedff248 3]

Thanks res20cue. I know that some people do involve the attendants, and I was misunderstood if you thought I meant all EMT's. I can recall MANY times where I have learned valuable information and training. Sometimes, however, it becomes more of a work detail than a learning experience. I have raised this issue with the officers and the problem will hopefully be corrected. Thanks and sorry if I offended anyone.