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Policy Dilemmas of Resource Management


For those in entry level positions in emergency management, it can be difficult to see the whole picture when it comes to managing a situation. Because these positions are essentially cogs in the system, it can be difficult for workers to see all of the necessary components of managing an emergency the way someone in a supervisory role would contemplate the entire scenario.

Managing resources effectively is an important piece of emergency management in general. If one is able to manage resources, potentially fewer issues will arise in the future.

Emergency Medical Services (EMS) instructors typically do a great job in teaching Emergency Medical Technicians (EMTs) to conserve their resources. However, somewhere in the shuffle, EMTs can lose sight of the overall picture as it relates to managing one emergency, or all of the 911 resources there are serving the same area in a regular work day. This is why it is important for an EMT to contemplate the larger picture when answering 911 calls, as it can help manage situations that have not yet happened. It can help to get ahead of the game.

However, there are a few policy issues that can intersect, making resource management difficult at best for EMS. Effective resource management and the Duty to Act can present numerous obstacles when it comes to effective patient care.

Managing Resources

Answering 911 calls for EMTs is time consuming. EMTs need to respond quickly moving a patient to the hospital if the patient is suffering from a medical, traumatic or psychiatric emergency. EMTs also need to be able to effectively lift the patient into the back of the ambulance, and document everything they did for a patient for their medical chart.

From the moment they get the call to the moment they’re put back into service at the hospital could take an hour…  it can be very time consuming. So, if another EMT happens to have a call taken for them, (i.e. another EMT or paramedic arrives on scene first and takes the patient to the hospital), they’re often very happy that someone else will be taking care of the patient. They no longer need to worry about all of that paperwork or heavy lifting.

Certainly, a paramedic can handle all sorts of calls, but this versatility brings forth an important issue. Once a paramedic takes a patient, they're out of service for the next big emergency. For example, if specific paramedic takes a basic life support call and but he/she is trained in advanced life support, then the overall resources are not being handled appropriately. For paramedics, this can be a very frustrating scenario.

The Duty to Act

The Duty to Act requires that an EMT or paramedic respond to a 911 call. The act also requires that an EMT pass along patient care to someone of equal or higher training – and conversely, a paramedic cannot relinquish care back to an EMT.

Thus, it could be negligent for a paramedic to relinquish care to an EMT – even if it made sense to free up the paramedic for potential advanced life support patients. 

Thus, this issue presents a conundrum in resource management. It can be very difficult to effectively manage resources, when there are important policies such as the Duty to Act already in place.

Ultimately, all resources need to be carefully weighed during any emergency. It is important to be at least one step ahead of the game when it comes to managing resources. But, every once in a while, policies intertwine suddenly creating complicated issues that one simply cannot avoid. Resource management can be one of these issues in emergency medical services, especially where patient care is involved. For EMS, each agency may be different and may be able to create their own policies that help manage potential situations like this.

Allison G. S. Knox Passionate about the issues affecting ambulances and disaster management, Allison focuses on Emergency Management and Emergency Medical Services policy. Allison has taught at the undergraduate level since 2010. Prior to teaching, she worked in a level-one trauma center emergency department and for a member of Congress in Washington, D.C. She holds four master’s degrees in Emergency Management, National Security Studies, International Relations, and History; a Graduate Certificate in Homeland Security; and a Bachelor of Arts in Political Science. Allison is an Emergency Medical Technician, Lifeguard, and Lifeguard Instructor, and is trained in Technical Large Animal Emergency Rescue. She serves on the Board of Trustees for Pi Gamma Mu International Honor Society as Chancellor of the Southeast Region, Vice Chair of the Tactical Emergency Medical Support Committee with the International Public Safety Association, and serves as the Advocacy Coordinator of Virginia with the National Association of Emergency Medical Technicians. She is also a member of several committees including the Editorial Committee with APCO, the Rescue Task Force Committee with the International Public Safety Association, and the Advocacy Committee with the National Association of Emergency Medical Technicians. She also serves as Chair of the Leadership Development Program for the 2020 Pi Gamma Mu Triennial Convention. Allison has published several book reviews and continues to write about issues affecting ambulances, emergency management, and homeland security.