[WEMSI Letterhead]

July 13, 1994

Attn: Representative Richardson
Pennsylvania House of Representatives
Health and Welfare Committee
Harrisburg, Pennsylvania

Dear Representative Richardson:

SUBJECT: Wilderness EMS

Attachments to this letter explain and document a small but important percentage of Pennsylvanians whose medical needs are not met by our present EMS system: those in backcountry or wilderness situations. WEMSI is attempting to meet their needs outside the EMS system. We are now operating through the generic "delegated practice" provisions of the Medical Practice Act. This, however, leaves regulation and quality assurance entirely up to WEMSI, or other organizations that develop similar programs. It also does not provide the liability protection afforded by a state-mandated EMS system. We believe that the Commonwealth regulating and supporting wilderness emergency medical services would improve patient care.

Existing EMS regulations do not allow EMS providers to care for wilderness patients according to standards set by national medical organizations (Wilderness Medical Society and National Association of EMS Physicians). According to Kenneth Brody, Assistant Counsel for the Department of Health, Act 45's language does not allow the Department to regulate or support emergency medical services in wilderness or backcountry situations.

Legislation that charged the Division of EMS Systems with developing and implementing a system for patients in backcountry and wilderness situations need not be expensive. Considerable volunteer resources are already at work on the problem, and they could be incorporated into the state EMS system. The number of wilderness-specific providers and services need not be large for the patient load, and require little financial support.

The number of patients who need specialized wilderness or backcountry care are not large. However, the need is acute to the those involved: the victims, the hundreds of search and rescue and EMS personnel, the family and friends, and the press.

Thank you for your consideration of this problem.

Yours truly,

Keith Conover, M.D., Medical Director
Clinical Assistant Professor, Division of Emergency Medicine, University of Pittsburgh

encl: Typed Testimony; WEMSI Brochure; article on cave rescue from June JEMS Magazine;
       Conover, K. Wilderness. in Kuehl, AE, ed. National Association of EMS Physicians
       Prehospital Systems & Medical Oversight, 2E. St. Louis: Mosby Lifeline, 1994: 47-58.

cc: PEHSC, Mr. Flinn

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