issue Spring 2023

Respond First

By Dawn Rhodes
Photo by Michael R. Schmidt

Emergency medical services in the United States are “under siege” says Martin Pelletier, CMS ’26.

The COVID-19 pandemic and its strain on emergency health care exacerbated widespread burnout among EMTs and paramedics and worsened turnover. Too few people are in the pipeline to replace those who have left the field, dissuaded from the profession because of long hours, low pay and diminishing morale. Mr. Pelletier, a first-year CMS student, is hoping to change all that. A certified paramedic, he joined two classmates to launch the EMS Advocacy Group at RFU. The prospective emergency care providers hope to troubleshoot parts of the industry, raise awareness about the importance of emergency medicine, provide support and resources for providers, and strengthen collaborations to ensure the best quality of care for patients.

Organizers are planning events and meetings to discuss welfare of emergency medical providers, boost morale, provide training opportunities and more to support the profession, Mr. Pelletier said.

“I wanted to be an advocate for our profession and be a beacon of integrity,” Mr. Pelletier said.

A Team Approach to Emergency Medicine

Mr. Pelletier has wanted to be a doctor since he was 10, but he spent much of his formative years playing competitive tennis in New England.

But “my serve was terrible,” and he was cut from the St. Lawrence University team, he said.

Needing a new passion and clinical experience as a pre-med student, he became an EMT when he was still a teenager. EMTs provide basic life support, including CPR, rescue breathing, administering Narcan or epinephrine, and stopping bleeding.

Then he went to the next level and became a paramedic when he was 21. Paramedics are more advanced pathophysiology providers who undergo hundreds of hours of training. Paramedics can start IVs, do advanced airway management and carry a wider variety of drugs than an EMT.

The path wasn’t easy, he said. He barely passed the EMT exam and was rejected from the first few jobs he applied to. He nearly failed out of paramedic school, he said.

But he persisted and put those skills to work, using both levels of certification as a first responder in a rural area and a busier metropolis for Canton Rescue in New York and Brewster Ambulance Service in Massachusetts.

Then he had a “quarter-life crisis,” Mr. Pelletier said. He struggled in school, grappled with depression and lost two of his closest friends. He graduated from St. Lawrence in 2018, but he wasn’t ready to jump into medical school.

Mr. Pelletier at the EMS Advocacy Group’s inaugural meeting on Feb. 1.

He took time off, traveled and got married. He started extra courses in 2019 to prepare for medical school.

Then COVID-19 hit. Back on the East Coast, he began working again as a paramedic and EMT as the pandemic swept the globe. 

His experiences illuminated how first responders are a vital factor within a larger continuum of care, Mr. Pelletier said.

“Working as a paramedic, you learn that it isn’t just a doctor, it isn’t just a nurse involved in ideal patient care; it’s a team approach with multiple facets coordinating that makes patient care successful,” Mr. Pelletier said.

And that was part of the spark for the EMS Advocacy Group when he enrolled at RFU last fall, he said. 

Mr. Pelletier joined two colleagues from the CMS Class of 2026 to co-found the group: Mike D’Elia, who worked as an advanced EMT for Austin-Travis County EMS in Texas, and Arjuna Karikaran, who came in with background as an EMT with Grady EMS in Atlanta. 

They recruited members from RFU and throughout the Chicago area. The group has about 15 people, including physician assistants and other emergency care providers, Mr. Pelletier said.

“(It) was important to include these other entities, because we don’t want EMS to be living in a bubble of just EMTs and paramedics. We want to be interacting with the medical providers,” Mr. Pelletier said.

As one of their first orders of business, organizers brought in two North Shore fire department chiefs to share their experiences in the industry and how being part of a larger medical community supports their work.

Collaborations That Save Lives

Nowhere was that collaboration more critical than the July 4 mass shooting in Highland Park, when seven people were killed and 48 wounded, Fire Chief Joe Schrage said at the group’s meeting in February.

The small department, minimally staffed because of the holiday, was quickly overwhelmed by the disaster, Chief Schrage said. But he added that several things worked in their favor to help wounded people. 

The department’s trucks arrived on the scene in under a minute, Chief Schrage said. Police helped keep paramedics and EMTs safe at the scene to help patients. The Mutual Aid Box Alarm System brought first responders from throughout the North Shore to help.

Numerous local off-duty doctors jumped in to help, Chief Schrage said. Some luck was involved, too. An on-duty surgeon finishing another procedure got a critically wounded 8-year-old boy into surgery within minutes to stabilize his condition, according to Chief Schrage.

Paramedics had no time to fill out paperwork, which made it trickier to help families track down wounded loved ones. But Chief Schrage told the EMS Advocacy students that by working with the hospital, first responders were able to get that information to frantic relatives at the scene.

One thing they would have done differently was contact NorthShore Highland Park Hospital sooner, Chief Schrage said. He added that the first patients who showed up to the ER were the least severely wounded.

“We will look to you as our partners and our co-workers, and we need you as much as you need us.”

“So if you have no knowledge of an active shooter, what’s your inclination? You’re going to stick that in your critical care room, your trauma rooms,” he said. “But your sickest people are yet to come. Your people with the most damage and the most trauma are yet to come.”

That preparation is key — “Don’t think it’s not going to happen in your community,” he warned. He added that first responders and medical providers should share mass casualty plans in advance, and ask for help right away for these types of emergencies.

“We will look to you as our partners and our co-workers, and we need you as much as you need us,” Chief Schrage told the students.

Chief Siebert answers questions about how the Lake Forest Fire Department managed operations during COVID-19.

Also addressing the EMS Advocacy gathering was Peter Siebert, chief of the Lake Forest Fire Department, who recounted how his personnel had to scramble when COVID hit and how they grappled with mixed messaging about the largely unknown virus. Whatever leftover PPE they had expired. Normally more concerned with masking up a contagious patient, they had to switch gears to wear masks themselves and mitigate their risk of exposure. 

Eventually his department started weekly conferences with the Lake County Health Department to keep better informed on how to protect themselves and patients. Chief Siebert feels that the overall experience will help everyone be ready for the next health emergency.

“COVID … I don’t think is done. But who knows what’s the next thing coming down the road? We just try to be as prepared as we can and have a system,” he added. 

Chief Siebert agreed it’s a struggle to recruit firefighters and paramedics, and he encouraged students to join them for ride-alongs to learn more about the profession. He said he supports what Pelletier, Karikaran and D’Elia are trying to do with the group.

“I hope more comes of it,” Chief Siebert said. “I think there’s sometimes a disconnect between the hospital environment and EMS. They see the patient in a different light. It’s finding that happy medium. A lot of stuff happens in the beginning, and we’re the first point of contact for people.”

Mr. Pelletier and his co-founders have much more on tap for the group this year, including events for National EMS Week in May and continuing outreach efforts to foster strong relationships between EMTs and physicians and other healthcare professionals.

Though Mr. Pelletier is considering several options for his career as a physician, he said “emergency medicine is the number one seed at this point.”

“Regardless of specialty, I will always feel committed to and dedicated to the EMS profession,” he said.

Dawn Rhodes is a Chicago-based writer and editor. She’s worked in journalism for more than a decade.