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Dr. Teel continued that the second major flaw is the <br />distribution of the paramedics. By pairing one paramedic with <br />either a volunteer EMT or an EMT from the Fire Department, they <br />would be placed under the direct control of people who have less <br />knowledge in the field of emergency medical services. He then <br />reviewed the history of deciding to hire paramedics instead of <br />paid EMTs so as not to endanger the existence of the volunteer <br />ambulance squads and noted that they think that asking the <br />volunteers to provide 5 shifts of EMTs and drivers will put a <br />Targe strain on their existence. The Volunteers have had trouble <br />staffing in the past, and he believed this will continue to <br />occur. If the Fire Department has to be called upon to fill some <br />of these shifts, he felt it will lead to the early demise of the <br />ambulance service. <br />The third problem is lack of expertise in an area the county <br />is now assuming it can provide. The county is being asked to <br />make a decision to take the system away from people who have a <br />combined experience of 25-30 years running paramedic programs and <br />turning it over to people with much less, if any, experience. <br />Dr. Teel then referred to a letter written by Mitchell Smith <br />of Humana Hospital which stated that Indian River Memorial <br />Hospital has been stealing patients from his hospital. He noted <br />that this issue was brought up two years ago, at which time they <br />went back through 6 months of records in the ALS office and found <br />only two cases that were questionable. Dr. Teel emphasized that <br />Mr. Smith is welcome to look through the records and see that the <br />protocols which have been written toprevent this type of thing <br />yp <br />have been followed to the letter. He continued to stress that if <br />County uplan is chosen,the Board will be destroying the o <br />Y 9 a plan Y <br />that has worked and choosing a plan that the medical staff very <br />strongly feel will endanger the public welfare. <br />Commissioner Bird requested that Dr. Teel give a scenario <br />of how the present system functions with communications between <br />the Emergency Room staff and the paramedics in the field. <br />11 <br />DEC 2 o 1988 <br />BOOK .75 FAL 411 <br />