On June 26, Paul M. Maniscalco MPA, Dr.BA(c), EMT/P, executive council member and past president of the National Association of Emergency Medical Technicians (NAEMT) testified before the U.S. House of Representatives Committee on the Judiciary Subcommittee on Crime, Terorrism, and Homeland Security hearing on the Hometown Heroes Survivors Benefits Act. Maniscalco asked the committee to “carefully weigh the facts and recognize the importance of insuring that those that help us in our time of crisis will not be left without proper protection and assistance in their time of dire need.” His testimony follows.
Executive Council Member & Past President
National Association of Emergency Medical Technicians
Written Testimony For The
U.S. House of Representatives
Committee on the Judiciary
Subcommittee on Crime, Terrorism, and Homeland Security
“Hometown Heroes Survivors Benefits of 2003.”
2141 Rayburn House Office Building
June 26, 2003
Mr. Chairman, members of the committee and fellow public safety officers, my name is Paul M. Maniscalco and I am a Past President and current Executive Council Member of the National Association of Emergency Medical Technicians (NAEMT).
NAEMT represents the interests of the more than 870,000 Emergency Medical Technicians and Paramedics nationwide, many whom are volunteers. It is these men and women who place their lives on the line daily to defend our communities, serve the citizenry in times of dire need turning victims into patients and saving countless lives annually.
Members of the committee, as an integral component of the public safety system, these EMT’s and Paramedic – Public Safety Officers, need your assistance to support them while they support and protect the local community. NAEMT asks that you “protect the protectors” by co-sponsoring, endorsing and passing the Hometown Heroes Survivor Benefits Act Across this nation, our EMT’s, Paramedics, Law Enforcement Officers and Firefighters are dedicated and prepared professionals. When the call for assistance is received the only questions asked are “what is the emergency,” and “where are we going?”
While the tragic events of public safety officers shot, struck by cars, stabbed, burned, trapped in structural collapses and killed in terrorist attacks receive much media attention, the silent killer of heart attacks and stroke go unnoticed and ignored.
Heart attacks and strokes are one of the greatest threats to public safety officers. It is only recently that medical science and academic research is truly beginning to comprehend the long-term cardio-vascular and physiological affects of extended and cumulative physical and psychological stress, especially to those who have had consistent extreme exposures such as the EMT, Paramedic, Law Enforcement Officer and Firefighter. It is these individuals who personally confront chronic exposure to the extremes, both physical and mental daily.
In a nanosecond, the Public Safety Officer’s body goes from a normal physiological status to one flooded with adrenalin while concurrently engaging in intense physical activities as a result of the actions required responding to, operating at and mitigating the emergency or crisis that they have been called to meet head-on. It is well documented in the medical literature that the physiological response to stress includes an elevation of blood pressure, increased heart rate and vasoconstriction of the vascular system, sometimes at great extremes dependent upon the situation being dealt with and the level of personal threat being faced. This is in addition to the physical stressors experienced by the individual during the course of required activities at the scene of an emergency. The combination of these factors increases the risks to the public safety officer for heart attack or stroke.
In fact, almost half of all firefighter deaths are due to heart attacks and strokes. Fighting fires is dangerous, exhausting, and extremely stressful work. Indeed, a firefighter’s chances of suffering a heart attack or stroke greatly increase when he or she puts on their turnout gear and rushes into a building to fight a fire. EMT’s and Paramedics are called upon to carry almost 100 lbs of equipment into the scene, climb into confined spaces, render lifesaving treatment throughout and then have to carry not only the equipment back out to the EMS vehicle but also the patient. This illustrates just the physical and mental stresses and does not articulate the amplification factors such as extreme weather conditions that these tasks must be executed in and are contributing physical stress influences. Likewise, Law Enforcement and Correction Officers face daily situations that place unusual stress and strain on the heart.
Further complicating this problem is the insidious presentation of the symptoms associated with these aliments and the often time delay before true recognition that the responder has experienced a progressive cardiovascular event.
In one case involving an EMS member that I am personally familiar with the member, with no cardiac history, reported feeling a strange sensation in his chest at the scene of an emergency, he dismissed this as a muscle strain from the activity associated with the emergency response. He would later go home after getting off duty and several hours later the pain worsened. He was taken to the local hospital only to discover that the pain he was experiencing, while simultaneously being masked by the adrenalin rush of the response, was in fact a significant heart attack. This member can no longer perform emergency response activities, is totally disabled, can not support his family other than social security benefits and is not entitled to receive the PSOB benefit because of the lack of coverage for non-trauma related events.
As I cited earlier, a majority of emergency responders in the United States are volunteers. These individuals that comprise our emergency services are also the local hardware store owner, schoolteachers, librarians and factory workers who give of their own time freely to serve and protect the local hometown. If the scenarios we are discussing today were to befall them, in addition to the associated physical harm or demise that they would personally experience, the lack of existing PSOB coverage to address this void would also place their families in jeopardy. Is this the legacy we as a nation wish to engender? We encourage citizens to volunteer and show civic commitment but where it would really make a difference in protecting the protectors we continue to turn our backs and ignore this woeful oversight. How can we really expect individuals to leave their families to assist their community in times of crisis if they cannot be assured that their loved ones will be protected should tragedy once again befall the public safety officer community in the form of a line of duty death related to a heart attack or stroke? NAEMT believes that failure to address this important issue amounts to an undue burden for the brave and selfless men, women and their families that serve this nation in the role of EMT, Paramedic, Firefighter and Law Enforcement Officer.
The National Association of Emergency Medical Technicians asks that you carefully weigh the facts and recognize the importance of insuring that those that help us in our time of crisis will not be left without proper protection and assistance in their time of dire need.
Thank you for the opportunity to share with the House Committee on the Judiciary – Subcommittee on Crime, Terrorism, and Homeland Security our position on the “Hometown Heroes Survivors Benefits of 2003.”