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Paramedic’s Corner: Looking Forward to 2009
Paramedic’s Corner: Looking Forward to 2009

Gary Carmack
The New Year is a time to think about the future, make resolutions, and reflect on the past. This article will be to tell the readers about the Pulaski County Ambulance District (PCAD) plans for 2009.

2008 has been a busy year with the district EMTs/paramedics responding to over 4777 patients so far this year. A total report will be submitted in a future article on 2008 statistics after all the December information is in and the 2008 records are complete.

Plans for 2009 include a lot of education. PCAD is very forward looking regarding continuing education as PCAD has a strong belief that continuous improvement is accomplished by continuing education. Additionally, there are many new federal laws and Medicare changes that require continuous education for the EMTs/paramedics. Some of these new Medicare requirements will be covered in future articles to assist the readers in understanding some of the new paperwork the paramedics will be required to do and required Medicare signatures and so forth.

PCAD is planning on teaching a paramedic course starting Feb. 10. The class will require one year of classroom and laboratory sessions; plus hospital clinical requirements and a field internship. The class will cost approximately $3000. After graduation the student may take state boards to be a licensed paramedic. Those who are interested may contact PCAD at (573) 774-5413, or stop by for an application. Requirements to enter the program include having a high school diploma or GED, having an EMT, anatomy and physiology (A&P) class or taking A&P during the course, and good math, reading and writing skills. The class and laboratory sessions will meet Tuesday and Thursday evenings. A&P must be done at a college or approved on-line course.

The district will continue a strong focus on 12-lead EKG transmission to hospitals as part of the new state STEMI legislation passed in 2008 regarding heart attacks. STEMI stands for ST segment elevated myocardial infarction, which merely means signs of an obvious heart attack based on 12-lead EKG findings. This 12-lead technology is part of the cardiac machines and data systems to send the information to hospitals in a dependable manner. What this does is prepare the hospital for the arrival of a cardiac patient as time is critical. The hospital can notify their cardiology team and prepare for fibrinolytic therapy or door-to-balloon inflation therapy. This modern model of emergency cardiac care is to save lives and cardiac muscle so as to help the patient have a better quality of life following a heart attack. Chest pain is the number one cause of medical calls for PCAD, and we believe it is important to provide the optimal state-of-the-art pre-hospital emergency treatment. Each new cardiac monitor/defibrillator cost about $30,000 and then requires special batteries at $450 each. The AutoPulse chest compression system costs 17,000 each. This is expensive, but worth every-single penny to the cardiac patient and their loved ones. PCAD is particularly dedicated to optimal cardiac and stroke emergency care.

PCAD is continuing the longtime plan of ambulance replacement by taking the oldest ambulance off-line and placing a new one on emergency calls. The district has purchased two 2009 Chevy C-4500 ambulances with ambulance boxes from Osage Ambulance Manufacturing in Linn, Missouri. These ambulances cost $139,000 each and that does not include any of the equipment.

Staffing is always a large concern. Keeping enough EMTs and paramedics remains a challenge each year and overtime costs are sky-high. This year we are told Fort Leonard Wood Ambulance is hiring six or more paramedics at GS7 positions and six or so EMTs at GS6s. So, this will remain a challenge to maintain employees. The district’s health insurance went up and will cost us about $195,000 in 2009. The district changed our IRA retirement plan to a 401 A and 457 plan which allows a higher percent of matching funds than the IRA. The employee must vest at least five years for the entire retirement benefit. Workers' compensation will cost us about $70,000. This is awful, in my opinion, but nation-wide, ambulance personnel are classified as a very high risk job and in the top percent for on-the-job injury. Therefore, rates are ridiculously high.

One optional item we are looking at, depending on how the economy does, is an Emergency Multi Utility Response Vehicle, which is a Gator-type vehicle fixed to hold a cot and spineboard to transport patients from the woods, or off the football field. The vehicle can also be used at the many community functions PCAD covers. We provide coverage at rodeos, fairs, truck pulls, Railroad Days, Old Settlers Day, etc. The vehicle would be used to check on people and provide emergency care. A big use would be at the many football games we cover to get the player off the field without driving on the school’s track and artificial field. PCAD has applied to get one of these several years by grants, but haven’t had success.

A reminder for the community: please feel free to stop by our bases for a free blood pressure check, glucose check, and vital signs check at anytime. This year alone we have had walk-in patients with myocardial infarction (heart attack), hypertension, diabetes and hidden internal bleeding problems. Remember, cardiovascular disease is the number one cause of death in America. Many times these are hidden killers. PCAD strongly encourage regular checkups with your family physician. If you develop sudden chest pain call 911 and get the paramedics there as soon as possible. Same with sudden stroke symptoms: stroke is the third most common cause of death. Stroke is a “brain attack” and symptoms to be concerned about include sudden severe headache, sudden vision problems, facial drooping, difficulty in talking, weakness, numbness, tingling or paralysis on one side; dizziness, problems with moving your tongue — any of these if sudden and unexplained call 911 immediately and tell the paramedics you want to go to a hospital that can provide acute stroke care.

The number one trauma killer (non-medical) in America is motor vehicle crashes. Encourage family and people you know to slow down when driving, wear seatbelts, and do not drink and drive. Just slowing down driving will save many lives. This includes our police/fire brothers and sisters and our ambulance folks as well. If you crash en-route you haven’t helped any person. In 2009 PCAD is encouraging a new culture of emergency people slowing down and living, and not endangering citizens.

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