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How EMS differs across the country

First Responders
First Responders
September 1, 2022
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The public’s understanding of what EMS can legally do tends to be limited. EMS rules and regulations vary from state to state, and with that, so does the understanding of what is allowed to happen in the back of an ambulance. 

Below are a few examples of how regional laws affect how EMS works:

Move it or lose it

When an ambulance puts on its lights and sirens, most states require surrounding vehicles to slow down and or pull over. This is referred to as the “move over law.” Nearly every state requires drivers to, at the very least, slow down when an ambulance or other emergency vehicle has its lights and sirens on. But the rules can vary a lot by area.

One of the last places to adopt a “move over law” was Washington D.C. The 2019 law requires drivers to move to the right lane, or curb, for emergency vehicles. Not following the law (pulling over to the left or following within 500ft of a responding fire truck) may result in a $150 fine

This is important to look into before your next road trip.

“Thank you, healthcare heroes”… (EMS need not redeem) 

Ever notice how there is a wide variety of EMS services? Have you ever talked to an EMT or Paramedic who has three different jobs at three different agencies? Ever wonder why the average salary of an EMT is only 27k-52k a year, where paramedics make only 34k-63k? Afterall, aren’t these people supposed to be saving lives? (Read how first responders pay rank across the country by clicking here.)

It's because their services are not seen as essential. That’s right, the jobs of those who responded to every emergency call, heart attack, shooting, and everything in between, that saved the lives of thousands is actually non-essential. 

Unless you live in one of the mere 11 states that consider EMS necessary, your state is not funding the local services. Most ambulance agencies are privately owned or run out of a hospital.  

Just what the doctor ordered

Consider the implications of privatized and locally run EMS services. Instead of being something federally funded, EMS loses out on the ability to teach, serve, and retain their providers. Aside from that, without the government actually having monopoly over EMS, the DEA has left out standardized rules for providers to follow. The DEA is the federal agency of Drug Enforcement Administration. 

Due to this haphazard guidance, it is up to the state to determine what drug regulations EMS can follow. Your care can vary from state to state depending on what your providers are allowed to do, even if on a national level certain protocols are explicitly recognized. 

This type of variance results in the issue of possible overlap when working with other agencies, confusion, and the lack of streamlined care that is offered to the public. This means you may be treated differently, with different practices and medicines, depending on what state you live in.

For example, there is a new law heavily restricting the use of ketamine in Colorado. One of the stipulations of administering the drug is an officer must be present, and the medical provider must weigh the patient prior to administering the drug. If there is nothing to facilitate weighing the patient prior to transport, two medical providers certified in weight estimation must agree on an estimate. 

Considering that ketamine is frequently used during episodes of psychosis or aggravated delirium, weighing a patient may be difficult. The anesthetic may also be used if a patient has full body burns, which would also make weighing them a hazard. 

Educating yourself on the local laws and regulations that your EMS follows is important. Understanding how local first responders are able to interact with the public helps with the overall health of the community. Your health starts with you. 

About the author: Samantha Harvill graduated, with honors, from the University of Pittsburgh with a Bachelors of Science in Emergency Medicine and was recently commissioned as a Lieutenant in the US Army Reserves. She is an avid runner, and is currently training for her next marathon.
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