Texas EMS Magazine, Volume 33, Number 6, November/December 2012 Page: 26
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The EMS Experience
Saluting those with 20 years or more in EMS
Paul E. Pepe, MD, MPH4
I
Pau F. Pepe, MD. VP!!
What was your first day on the job career in
in Texas EMS? enthusia
It was November 1, 1982, medical
a Monday morning. I reported Departm
to the Houston Fire Department and Mik
(HFD) headquarters as HFD's my fall
inaugural medical director. The remaine
entire command staff was there, I was re
quite curious to know what this new and beca
"entity" would be like and what Emerge
impact it might have. Likewise, I was (statewi
anxious to see what they needed and new pos
how I could support them. that post
At one point I asked if I could back to
review "this past weekend's EMS run director
records." The group chuckled. We Services
were talking about more than 1,000 Health a
incidents I'd be reviewing! Like the medical
proverbial deer in the headlights, I (EMS) s
began to realize the sheer magnitude collabor
of the new task I was taking on. agencies
Then, a very wise (and visionary) Even wr
;_
26 Texas EMS Magazine November/December 2012
assistant fire chief,
Dennis Holder, said,
"Here, just go find out
what our folks are facing
out there on the streets!"
He handed me an HFD
"walkie-talkie" and keys
to a "vintage" HFD
response vehicle.
What happened over
the next several years on
the streets has been well-
chronicled in scientific
studies and media
reports-and it laid the
basis for a whole new
subspecialty-EMS and
prehospital medicine.
Which services have
you worked for over
the years?
I began my EMS
1977 as a naive but
stic assistant to the brilliant
directors for the Seattle Fire
ent, Drs. Leonard Cobb
e Copass. Serving there till
1982 arrival in Houston, I
d at HFD until 1996 when
cruited to Pennsylvania
me their Commonwealth
ncy Medical Director
de EMS medical director), a
ition created for me. I held
until 2000 when I moved
Texas and became Dallas'
of Medical Emergency
for Public Safety, Public
nd Homeland Security and
director for the BioTel
ystem, now a time-honored
ation of nearly 20 EMS
in metropolitan Dallas.
bile I was in Pennsylvania,however, I maintained my Texas
medical license and continued to
serve our state as a medical director
for AED programs in Texas.
Why did you get into EMS?
In Seattle, I was training as an
ICU specialist, conducting high-
profile research at the trauma center.
But I began to appreciate, more and
more, two principal concepts: 1)
"The earlier the intervention, the
better the results" (my #1 mantra);
and 2) the need for intensive medical
oversight of the entire continuum
of care we called the "Chain of
Survival/Recovery" (concepts later
published in scientific papers). I
advocated that on-scene interventions
were not only critical to the patient's
continuum of care, but could even
drive better in-hospital management
by early identification and initiation
of the required level of interventions
and by doing the research that
determines what works and what
doesn't.
How has the field changed since
you've been in it?
Tremendously! Full-time medical
direction is found in many large EMS
systems, and EMTs, paramedics
and first responders have become
very sophisticated about quality
assurance, patient safety and even
research, largely because we now
have technological advances that
demonstrate better what we needed to
improve upon-and what we haven't
been doing so well (e.g., CPR quality
issues and outcome data tracking).
Is there a particular moment or
call that stands out?
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Texas. Department of State Health Services. Texas EMS Magazine, Volume 33, Number 6, November/December 2012, periodical, November 2012; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth541925/m1/26/: accessed July 18, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.