Ranieri opposes single-paramedic staffing and urges retention focus

Thank you, Councilwoman Areola, and I want to thank the New York City Council for holding these public hearings and keeping EMS on the public agenda.

It's been far too long in the making.

So I am Joseph Ranieri.

I'm the executive director of the Regional EMS Council of New York City.

Our body is a nonprofit organization with statutory authority under New York State public health law with coordinating EMS resources throughout our region.

You often do not see us at these public hearings because our primary focus is in medicine, developing good medicine for our EMTs and paramedics to follow.

However, the state of our current EMS system, we felt that it is necessary for us to be here and to reinforce everything that's been stated up until this moment.

EMS has a true retention problem.

One of the things I do want to specifically address was the idea about going single paramedic, having an EMT and a paramedic.

We at the council vehemently think that this is a bad idea.

Paramedics treat very complex patients.

They rely on having two paramedics on the scene to bounce off of each other to help with their clinical judgment.

So to give one example that Councilwoman Arcees will appreciate, in conducting a cardiac

arrest, the ECC guidelines recommend having a cardiac team of at least six individuals to work that arrest.

In EMS, that often will consist of two paramedics, a supervisor, and maybe an EMT crew.

The two paramedics are the clinicians on the scene.

They are doing weight-based medications, some of which, if they get the dosing wrong, will have extremely negative effects on the patient.

So I do want to specifically address that and say that having dual medics provides good medicine to our patients in the field.