2 | MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011
Maine Emergency Medical Services: Available and ready to help Maine Emergency Medical Services Director: Jay Bradshaw Address: 152 State House Station Augusta, ME 04333-0152 Phone: (207) 626-3860 Fax: (207) 287-6251 Email: MEMS@maine.gov State EMS Medical Director: Matt Sholl, MD, Maine ACEP Assistant State EMS Medical Director: Steve Diaz, MD
May 15 to May 21, 2011 From dispatchers to first responders, firefighters to emergency medical service professionals, Maineâ€™s communities are safer because neighbors are caring for neighbors.
Region 1: Southern Maine EMS Online: www.smems.org Address: 474 Riverside Industrial Parkway Portland ME 04103 Phone: (207) 741-2790 Fax: (207) 741-2158 Email: email@example.com Medical Director: Marlene Cormier, MD Coordinator: Donnell Carroll
Region 2: Tri County EMS Online: www.tricountyems.org Address: 300 Main Street Lewiston, ME 04240 Phone: (207) 795-2880 Fax: (207) 795-2883 Email: firstname.lastname@example.org or email@example.com Medical Director: Rebecca Chagrasulis MD Coordinator: Joanne LeBrun
Region 3: Kennebec Valley EMS Online: www.kvems.org Address: 71 Halifax Street Winslow, ME 04901 Phone: (207) 877-0936 Fax: (207) 872-2753 Email: firstname.lastname@example.org Medical Director: Timothy Pieh MD Coordinator: Rick Petrie
Region 4: Northeastern Maine EMS Online: www.northeastems.org Address: 354 Hogan Road Bangor, ME 04401 Phone: (207) 974-4880 Fax: (207) 974-4879 Email: email@example.com Medical Director: Jonathan Busko MD Coordinator: Rick Petrie
Region 5: Aroostook EMS Online: www.reg5ems.org Address: 111 High Street, Suite 1 Caribou, ME 04736 Phone: (207) 492-1624 Fax: (207) 492-1624 Email: firstname.lastname@example.org Medical Director: Dr. Peter Goth Coordinator: Steven D. Corbin, EMT-B
Region 6: Mid-Coast EMS Online: www.midcoastems.org Address: Thompson Community Center, P.O. Box 610, Union, ME 04862 Phone: (207) 785-5000 Fax: (207) 785-5002 E-Mail: email@example.com Medical Director: Whitney Randolph DO Coordinator: Bill Zito
Large Cover photo: Anne Jordan, former commissioner of the Department of Public Safety, presents the American flag to the family of Allan Parsons, a paramedic killed in the line of duty on July 5, 2007 (Photo provided by Maine EMS).
This special section was produced for Maine EMS by the following Bangor Daily News staff: Cover Design: Chris Quimby; Advertising sales: Linda Hayes; Editorial and Layout: Debra Bell, Sheila Grant, Bangor Daily News file reports and HeartSafe Communities; Photography: Debra Bell, Brian Swartz, Bangor Daily News file photos, as well as provided images. If you have a non-profit organization or business with a special message to share, please contact Michael Kearney at the Bangor Daily News, (207) 990-8212.
MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011 | 3
When minutes count, Maine EMS is on scene to help By Sheila Grant FOR THE BANGOR DAILY NEWS
The Maine EMS trauma system includes everyone from the dispatcher receiving the 9-1-1 call to the surgeon at the high-level trauma center who treats a life-threatening injury. “That’s the beauty of the trauma system in Maine,” said Rick Petrie, regional director of Northeast Maine EMS in Bangor and Kennebec Valley EMS in Waterville. “It’s everybody working together to get the patient to where they can get the care they need.” Local non-transporting first responders are often first on scene, providing stabilizing care while awaiting an ambulance. Ambulance crews bring more resources to the scene, and must decide how to treat patients, where to take them, and how to transport them. Depending upon the location of the nearest local hospital or trauma center and the condition of the patient, transport could be via ground ambulance or helicopter. “Sometimes they don’t have any choices about how to go because of weather or location, so they are all trained to manage and stabilize trauma patients to the best of their ability,” said Petrie. “We have very comprehensive pre-hospital trauma training that dovetails nicely into the overall Maine Trauma System.” To become certified, first responders must take a
BDN FILE PHOTO BY GABOR DEGRE
Capitol ambulance and Holden rescue personnel attend to the female driver of a motorcycle that crashed at the corner of Fisher Road and Mann Hill Road in Holden. 60-hour course. The basic EMT course is 120 hours, and to reach the paramedic level requires more than 1,000 hours. There’s also a 16-hour course focused solely on trauma care: patient assessment, decisionmaking, a skills review, and specific treatments for
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head or chest injuries and internal bleeding. To remain certified requires between 24 and 54 continuing education credits every three years. LifeFlight of Maine has been providing healthcare by air since the late 1990s. “From the beginning
is has been our goal to change the playing field for the people of rural Maine, so that if someone is injured on Main Street, Jackman, to the extent that we possibly can, we give them access to the same healthcare as if they lived on State Street in Bangor or Congress Street in Portland,” said Tom Judge, director of LifeFlight. LifeFlight is more than a fast ride. In addition to highly-skilled providers on board, overseen by specialist physicians, LifeFlight helicopters carry blood, hospital-level ventilators, multiple-infusion pumps, a portable laboratory, and “a pharmacy that looks like an ICU.” Soon, ultrasound equipment will be added. “We have some unique capabilities, but we are just one part of the trauma system,” said Judge. “From the minute the call goes in to 9-1-1, everyone in that whole chain of survival has to work together to do the right thing at the right moment. When we do that, we create the best possible chance for the patient to have a good outcome.” “Trauma centers are only the last stop,” said Prett Bjorn, who chairs the state trauma advisory committee for Maine EMS and is the regional trauma nurse at the Eastern Maine Medical Center trauma center. “You don’t judge the train ride by the destination. You have to look at the whole system.” Bjorn said much has been done to maximize relationships between first responders, ambulance personnel, local hospitals, LifeFlight and the three
See TRAUMA, Page 4
4 | MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011
Trained staff are behind the scenes at emergencies By Sheila Grant
and the time a surgeon intervenes to repair that injury. “That doesn’t always mean 60 minutes,” McGinnis said. “What it means is that for a major injury, if it goes two, three, four hours, you are running into a much greater chance of the patient dying from it eventually. Chemical imbalance in the body is created and other major complications will set in and kill you. The goal is to, as quickly as possible from the time of injury to surgical intervention, fix the problem and straighten out the chemical imbalance in the body. You don’t have an hour to wait to be discovered, in the case of a car crash, for example, and two hours to spend at a small hospital getting all sorts of diagnostic, radiological and blood tests. You don’t always have an hour or two for a ground ambulance.” A system had to be established so that EMS could respond quickly with first responders to stop bleed-
FOR THE BANGOR DAILY NEWS
Operating behind the scenes when a patient is critically injured or ill is a statewide system of medical response which includes medical first responders, ambulance crews, local hospitals, trauma centers and LifeFlight working together to shorten the time between incident and high-level treatment. “We started organizing the trauma system in 1992,” said Kevin McGinnis, MPS, EMT-P, the Maine EMS trauma system manager. “The point of creating a trauma system was that typically, the way a person with major injuries that would kill them if they were not treated was handled was that the patient would go to the closest hospital, where he would be assessed, injuries would be diagnosed, and typically the patient would die unless he was able to be transferred to a major center with sophisticated surgical capabilities. Most general surgeons at smaller hospitals 20 years ago did not see a volume of major surgically-treatable injuries, nor have the facilities or support staff to manage them effectively. It was not uncommon for the patient to die en route to a bigger hospital.”
Trauma Continued from Page 3 trauma centers: Eastern Maine Medical Center, Central Maine Medical Center, and Maine Medical Center so that patients can receive critical care quickly. Every hospital in Maine voluntarily participates in the trauma system. The Maine EMS system provides technical assistance team visits to hospitals to keep them current on trauma protocols and Maine EMS members consult with hospitals about trauma cases. Telemedicine is playing an increasingly important role in trauma treatment, as well. Via cameras, a virtual ICU staff or trauma surgeon can be with providers at local hospitals as critical decisions on patient care are being made. “I think of all of us as one huge hospital with really long corridors,” Bjorn said.
Trauma system in action For one Maine family, having a trauma system in place was the difference between life and death. On March 23, Louise Boudreau-Bouchard of Searsport was
WE SALUTE OUR TEAMMATES IN EMERGENCY MEDICINE! Acadia Hospital, Bagaduce Ambulance Corps, County Ambulance, Eastern Maine Medical Center, G& H Ambulance, Hancock County Sheriff’s Department, Lifeﬂight of Maine, Maine State Police, Memorial Ambulance Corps, Peninsula Ambulance Corps, Spectrum Radiology, and ﬁrst responders throughout the peninsula.
ing, position a patient so broken bones aren’t causing further damage, provide oxygen and fluids, and get the patient routed to the nearest hospital. In turn, this allows EMS to stabilize the patient for transport and get him on the way to a facility with the necessary surgical capabilities. Maine has three trauma centers: Eastern Maine Medical Center in Bangor, Central Maine Medical Center in Lewiston, and Maine Medical Center in Portland. “There may be intervention from a local surgeon, but under the trauma system, care at the local hospital is minimal,” McGinnis said. “They stabilize the patient — open him up and clamp off bleeding in the abdomen or wherever and pack it to do the job for transport, and get a helicopter in with a sophisticated crew and get the patient to a trauma center. That just turned three to five hours into an hour. That’s our goal.”
AP PHOTO/SUN JOURNAL, RUSS DILLINGHAM
Firefighter Don Therrien gives oxygen to Kasey, a 10-year-old Lab mix at the scene of a fire in Auburn in February of 2008. Giving comfort is his owner Rena Wilkins and her daughter Anna. McGinnis said there is a “golden hour,” the time between receiving an injury that can kill if not treated
driving on Route 1A in Frankfort when she was struck head on by the vehicle driven by William Hinkle of Frankfort as he attempted to pass another vehicle. She was trapped in her vehicle until first responders arrived. First responders from the Frankfort Fire Department, Winterport Fire and Rescue, Hampden Rescue and the Waldo County Sheriff ’s Office responded to the accident and used the Jaws of Life to rip off the top of the Subaru to remove her. EMTs and LifeFlight evacuated Boudreau-Bouchard from the scene and worked to stabilize her condition. Her son David has been keeping friends and family updated on her accident and status through a blog. “I think of the people there to greet her — without shock, without reservation, without hesitation; waiting on the helipad to take her to a room where they would give her 11 units of blood (the average body has 15), and start the repairing,” he writes. “They, the members of a Trauma Team at EMMC, repair bones, fix organs, mend tissue and restore vessels. They read charts, use tools and know medicine. They have experience and our faith. And they joined the fight to keep Louise breathing, pumping, living.” Boudreau-Bouchard remains at EMMC as she continues to heal from her accident.
Maine EMS at work: Mid-Coast Interceptor brings paramedics to scene When time is of the essence, Intercept. Mid-Coast Hospital’s Interceptor brings paramedics to the patient when advanced life support is needed, or when volunteer EMS departments need assistance. This unique medical service benefits residents from Wiscasset to Freeport and includes assistance to Georgetown, Brunswick, Phippsburg, Orr’s and Bailey Islands, Cundy’s Harbor, and Harpswell neck. According to Lois Skillings and David Hudson, both from the Mid-Coast Hospital Interceptor program, the paramedic interceptor program was started in 1997. MC1 — as it’s known — is essentially a “virtual emergency room”. However, no patients are transported in MC1. Instead it is there to stabilize patients and provide assistance to volunteer EMS departments. There are nine paramedic-level staff members in the program, Skillings said. When called in, they stabilize the patient and once the ambulance arrives, the paramedic rides with the patient to the hospital of their choice. “When you have a paramedic in the ambulance, it turns into an emergency room,” Skillings said. “Our staff provide critical, lifesaving care by bringing the equipment to the patient. That means faster response when seconds matter.”
MC1 also benefits the communities it’s available to. “Small communities are not always equipped with enough paramedics,” Hudson said. “We really provide a supplement to their services.” That supplement is even more important to departments — and residents of those communities —that have volunteer rescue departments. “We’re able to [work with the local providers to] ensure high quality access to care when it’s needed most,” Skillings said. “Our services ensure [additional] quality, safety, licensure, and provides a single standard of care within our state. The EMS system over the past 40 years has been a critical part of improving timely access to medical care. Local services are key, and we’re there to support and supplement them.”
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Is your community HeartSafe? HeartSafe training saves man during heart attack
By Debra Bell BANGOR DAILY NEWS
What does it mean to be HeartSafe? In Maine, it means that 57 designated EMS services raise awareness about the risk factors for cardiovascular disease, provide CPR and automated external defibrillation training, and provide rapid emergency response for cardiovascular events. Not only do these services support early detection and care for cardiac arrest, heart attack and stroke, but also provide important education and resources to improve the chances of survival associated with these cardiovascular events in their communities. And Maine is leading the nation. “Over half of the population of the state is covered by HeartSafe Communities,” said Danielle Louder, Project Manager with the Maine CDC/DHHS Cardiovascular Health Program.“In 2005, seven EMS services from all over the state, stepped up to become the first HeartSafe designees: Ashland Ambulance, Brooklin Volunteer Fire, Delta Ambulance, Lebanon Rescue Squad, Med-Care Ambulance, Standish Fire-EMS, and the University of Maine at Orono’s Volunteer Ambulance Corps. And in 2009, Region 5 — Aroostook EMS — became the first HeartSafe Region in the state, with 100 percent of their 11 services having achieved HeartSafe designation. They have some of the highest cardiovascular burden in both the state and the nation, and collectively they are working to reduce it,” added Louder. “In the last six years to go from zero HeartSafe commu-
Story courtesy Maine HeartSafe communities
nities to 57 covering 265 communities and one college campus [the University of Maine’s Orono Volunteer Ambulance Corps] is spectacular,” said Troy Fullmer, Program Manager with the Maine CDC/DHHS Cardiovascular Health and Diabetes Prevention and Control Programs.
See HEARTSAFE, Page 8
Maine EMS at work: Minot FD volunteers have “best hobby in the world” First responders make the difference in patient care while the ambulance is on its way. And according to Chief of Services Jim Allen, Minot Fire Department’s first responders make a difference daily. Minot Fire Department primarily serves the town of Minot, as well as providing mutual aid to surrounding cities of Auburn, Poland, Hebron, Turner, and Mechanic Falls. “As an EMS first responder service, we don’t transport patients, but we hope to arrive before the ambulance shows up — depending on where we are in town,” Allen said. “As first responders, we are called to provide basic response and stabilize the patient until transport arrives.”
The 25 firefighters that make up the volunteer squad are trained and licensed. Allen noted that three-quarters of the squad also have EMS training. “These [responders] are our neighbors,” he said. “Day and night they come out in the worst weather to help their neighbors. And they don’t ask anything in return for it.” Allen’s squad also contains many people who are already involved in the health-care profession.“For them, it’s an extension of their career,” Allen said.Allen works a day job as a nurse. “If you want an adventure with rewards, it’s not something you’d normally think about,” he said. “I’ve been doing this for 35 years and it’s the best hobby in the world.”
It was March, 2010. Jim Merry started out his morning much like any other. He went out in the garage with a torch to remove some old paint from a piece of equipment, and in the process, accidentally started a small fire with some leaves and a puddle of chemicals that were sitting at the base of the machinery. Jim went to get the fire extinguisher that he kept nearby, but it had already been used up. So he went out to his truck, but couldn’t find another extinguisher. Meanwhile the fire was progressing, and smoke was filling up his garage. He opened the door, and started to shovel snow from outside onto the fire. It turns out that snow doesn’t work well on a chemical fire. As the smoke got thicker, it got harder for him to breathe. Merry states “After a few minutes, I decided to swallow my pride, and called the Scarborough Fire Department. “Lucky for me, they are right across the road, and they arrived very quickly,” he said. He remembers answering some questions about how the fire started, but then while he was talking to one of the firefighters, he lost consciousness. His son told him later on that as soon as he became unconscious, someone hollered “Man Down!” and everyone on the scene went into another mode, just like that… They had all the equipment they needed to help him. They not only brought the fire truck, but a defibrillator, and all of the various tools they would need to revive him from the heart attack that he had just experienced. Jim doesn’t remember waking up in the ambulance, but was later told by the paramedics involved that he woke up wondering where he was and what happened. He was told that his heart had stopped, he was not breathing, and he did not have a pulse. His heart had been restarted for him with electricity and he had received artificial respirations and chest compressions. He asked those questions several times. Then his
sense of humor started to shine through when he was asked his age. His reply was, “Well, how old do you want me to be?” When asked his last name, his reply was, “Merry, like Merry Christmas, Ho-Ho-Ho!” Once he was in the hospital he continued to improve and even shook hands and thanked the EMS personnel when they went in to check on him before leaving. Jim recalls, “I’d been huffing and puffing for a whole year, and funny thing is, I was supposed to go in for a stress test the following week. Who knows how and when my heart attack would have come about if the fire hadn’t happened. I might have been out somewhere alone, fallen down and no one would have found me in time. I asked the doctor how this was going to affect my life, and he said, ‘We changed your plumbing around, so you’re going to be around for another 30 years, Jim!’ Someone was looking out for me — if I hadn’t called, even though it was a small fire to begin with, I would have really been in trouble. That is why calling 911 fast is so important — the sooner you get emergency services there, the better your chance of survival and recovery.” Jim and his wife have been married for 50 years, and have eight children. Jim says that his wife has had four bypasses over the past two years, but they are both on the mend. They scuba dive every Sunday, and try to watch their diets closely. Jim shares, “The wife, she’s a nurse, and has been telling me about my diet for a long time. And now I listen. No salt, cut out the fatty foods… It’s pretty hard to eat right, but you don’t usually get a second chance. And you are what you eat, so I try hard to eat well.” Jim says that he’s not worried about his exercise. He’s been moving houses for 60 years. He retired once, for two weeks, but got bored pretty quickly. Jim laughs and says, “What keeps my mind at 45 is working with my kids — I have two sons who are engineers and they have it going on upstairs.”
Crown Ambulance Making a Difference Every Day Celebrating and honoring Crown Ambulance EMTs and paramedics who heroically provide care to those in need, often under difficult circumstances.
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MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011 | 7
First on the scene
Know your local EMS! Licensed Provider Levels • First Responder: Patient assessment, oxygen administration, bandaging, simple splinting, CPR administration, use of an Automatic External Defibrillator. • Emergency Medical Technician (EMT): Above plus basic emergency medical treatment and assisting a patient in self-administration of their own medications. • EMT-Intermediate: Above plus advanced airway management, IV therapy, cardiac monitoring/defibrillation, administration of certain medications. • Paramedic: Above plus additional medication administration, chest decompression, advanced airway maintenance skills. • Scene Response Air Ambulance Service: Flight crew with Paramedic and RN, both with specialty training in air operations and advanced medical skills.
A Home Safety Guide
1. Call Emergency Medical Services (EMS). If you are using a cellular phone in Maine you can call 9-1-1 in an emergency. Never assume that someone else has called already. EMS would rather get 10 calls than miss one because everyone on the scene thought someone else called.
Tell the dispatcher about the accident: Where it is (including directions), how many people are injured, how badly they appear to be hurt, and give the phone number you are calling from.
3. Unless they are in danger from fire or traffic, patients should not move or be moved particularly if they are seriously injured.
When the ambulance arrives, give as many details about the accident as possible.
What to expect when you call EMS Think an ambulance might be needed? Don’t guess... call EMS When you call, you may first be asked the nature of the emergency: police, fire, or medical. Then you will asked specific questions about the problem and where you are located. The emergency medical dispatcher will guide you through this, so remain as calm as possible and listen to the questions. If the patient is injured, do not move them unless they are in immediate danger where they lie and encourage them not to move. Depending on where you live, you may be serviced by a first responder service that will treat life-threatening and other problems until the ambulance arrives. The ambulance crew will provide at least basic life support and in many areas, advanced life support. A basic life support service may request an advanced life support service to meet them while they are enroute to the hospital, and ALS personnel will enter the ambulance to assist during the remainder of the transport. In all cases, life-threatening problems are dealt with immediately. Serious injuries are treated rapidly at the scene, and the patient is transported quickly to the hospital. The patient may be immobilized using a neck brace and body-length board stretcher to prevent worsening of the injury. Heart attack and other life-threatening illnesses may
be treated quickly at the scene with oxygen, intravenous medications, and cardiac monitoring (if advanced life support personnel are available). When the EMS personnel arrive, pulse, blood pressure, and other vital signs are taken. At the scene or en route to the hospital, the EMT or paramedic will call the hospital and confer with the emergency department staff. This is so the hospital will be ready for the patient and also to obtain orders and advice for certain treatment. When the patient is ready for transport, they will be carried to the ambulance on a stretcher and ride lengthwise in the ambulance with their head towards the front. The EMS crew can usually sit on either side or at the head of the patient. Someone accompanying the patient may be allowed to ride up front with the driver at the crew’s discretion. Lights and sirens are seldom used en route to the hospital usually less than 10 percent of the time. At the hospital, the staff will know the patients up-to-date condition and will be ready to take prompt action. In some cases, a patient may be flown by medical helicopter either from the scene to a hospital, or between two hospitals, for specialty care.
Heart attack and stroke: Learn the signs Heart attack warning signs
Warning signs of a stroke: FAST
• Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. • Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach. • Shortness of breath: May occur with or without chest discomfort. • Other signs: These may include breaking out in a cold sweat, nausea, or lightheadedness • Act quickly: If you experience any of these warning signs, it is imperative you act quickly: Call 9-1-1.
The FAST acronym can help you diagnose a stroke. • FACE: Ask the person to smile. Does one side of their face droop? • ARMS: Ask the person to raise both arms. Does one arm drift downward? • SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange? • TIME: If you observe any of these signs, call 9-1-1 immediately.
Learn CPR now! To find out how, contact: • American Heart Association: (800) 242-8721 • American Red Cross: (800) 482-0743 • Or call your local EMS service (see page 2)
Keep these instructions handy Say your type of emergency: __ Medical __ Fire __ Police Say your name: ________________________________________________________________ Say your phone number: ______________________________________________________ Give directions: ______________________________________________________________ My town:_____________________________________________________________________ My street/road/fire road/camp road is: ____________________________________________ House/apartment number: __________________________________________________ Nearest road that intersects: __________________________________________________________ Any well-known landmarks nearby: ______________________________________________ Color of building: ____________________________________________________________ Type of building:______________________________________________________________
PROUD to SUPPORT Maine Emergency Medical Services
Insurance products are: not a deposit; not FDIC insured;not insured by any federal government agency; and, not guaranteed by TD Bank, N.A. or any of its affiliates. Insurance products are offered through TD Insurance, Inc. TD Insurance is a service mark of the Toronto-Dominion Bank. Used with permission.
Note the time that symptoms first appear. It matters when treating a stroke patient.
Stroke symptoms include: • SUDDEN numbness or weakness of face, arm or leg, especially on one side of the body. • SUDDEN confusion, trouble speaking or understanding. • SUDDEN trouble seeing in one or both eyes. • SUDDEN trouble walking, dizziness, loss of balance or coordination. • SUDDEN severe headache with no known cause.
8 | Friday | May 13, 2011 | MAINE EMS: EVERYDAY HEROES PHOTO COURTESY OF BARBY PRENTISS
Four Bangor firefighters who on Sunday saved the life of their friend and co-worker, Capt. John Prentiss (center), stopped by his house on Wednesday to see how he is doing. Pictured (from left) are Joe Wellman, firefighter-paramedic; Melinda Caldwell, firefighter-paramedic; Bruce Johnson, firefighter-intermediate; and Nate Snyder, firefighter-paramedic.
Continued from Page 5 “It is really an opportunity have meaningful partnerships with these agencies and it’s a two-way street. We’re able to support them and help them improve their outcomes and vice versa.” According to the Maine Center for Disease Control and Prevention, heart disease and stroke account for one in three Maine deaths and are collectively the leading cause of death in Maine. HeartSafe communities provide needed education and opportunities for training. The reason: “Patient delay is the number one barrier to early treatment,” Louder said. “Many people don’t recognize the symptoms, delay getting care or deny that they’re having an event.” Those barriers, coupled with the estimate that 95 percent of cardiac arrest victims die before reaching the hospital, provide striking evidence that early care is crucial. According to information provided by the American Heart Association, in places where defibrillation is provided within five to seven minutes, survival from sudden cardiac arrest can be as high as 49 percent. For stroke vicitims, early care is crucial to survival as well; time lost is brain lost. Maine has already led the way when it comes to training for professionals in the field of emergency response. In 2007, a law was passed that required training and licensure for every emergency medical dispatcher, including protocols for cardiac arrest,
heart attack and stroke. Louder said that this licensure is of vital importance, for example, it allows dispatchers to instruct a caller how to provide CPR to a cardiac arrest victim while emergency responders are en route. Education empowers the community as well, Louder said. “Community CPR and AED training [is crucial],” she noted. “We know that our EMS [professionals] have training, but if there’s traffic in Portland or you’re 50 minutes out in Allagash, it is impossible for even the quickest of EMS services to arrive within 3-5 minutes, which is the short timeframe we have to begin CPR and defibrillation for the best chances for survival and recovery. By
Maine EMS at work: Gardiner’s Fire-based EMS benefits community Fire-based EMS transport is the use of an established fire department to respond to emergencies and transport patients to medical facilities. According to Fire and Rescue Chief Rick Cody of the Gardiner Fire Department, this type of emergency medical service can do a lot to keep a bad situation from getting worse. The Gardiner Fire Department is a community-based department with a home base in downtown Gardiner. His staff consists of firefighters and paramedics. “As firefighters, there isn’t much that we don’t do,” Cody said. According to Cody, his staff is ready to do everything from gaining access to patients in difficult places to transporting them in our ambulance.” The Fire Department is part of the Gardiner Public Safety Department that provides ambulance
service and mutual fire aid to the communities of Gardiner, Chelsea, Farmingdale, Litchfield, Pittston, Randolph and West Gardiner — an area of about 240 square miles and serves over 24,000 people. Part of the benefit to a Public Safety Department is the level of assistance that can be provided.“When someone reaches for the phone and has a problem, we can usually provide everything they need.” “A firefighter/paramedic is a special breed [of EMS professional],” Cody said. “They’re knowledgeable in both roles.” Cody estimates that last year his department responded to about 2,300 fire and EMS calls. And, he said, it gives the community comfort knowing that no matter what their issue is — safety-, medical-, or fire-related — that Cody’s department will be able to help.
increasing the number of lay people who can do CPR and [use a] defibrillator, we’re significantly increasing the number of folks who may survive from cardiac events.” HeartSafe Community distinction also helps create a bond between the community and the EMS responders. “Having worked with EMS providers all over the state for the past six years, both locally and regionally, I can’t say enough about their dedication to saving and improving the lives of those in the communities they serve,” Louder said. “They do this quietly however, and are often under recognized for what they do for the community and the state. These people are on call 24/7 and go into dangerous and difficult situations on a regular basis. HeartSafe
recognition gives us an opportunity to highlight that dedication to Maine residents and the influx of visitors that these services also care for during Maine’s year-round tourist and recreational seasons, especially for cardiovascular events that are time sensitive.”
What does a community have to do to be designated HeartSafe?
To be designated as a Maine HeartSafe Community, an EMS service and community partners must meet the following criteria: • Offer cardiopulmonary resuscitation (CPR) training to the community • Offer cardiovascular-related education and/or awareness activities in the community, such as symptom recognition and the importance of calling 911 immediately for cardiovascular events • Equip at least one emergency response designated vehicle with an Automated External Defibrillator • Place at least one permanent AED with AEDtrained personnel in public or private areas where many people are likely to congregate or be at higher risk for cardiac arrest • Provide advanced cardiac life support to all priority medical emergencies, as primary responders, or as ALS backup on-scene, en-route, or at the hospital • Have an ongoing process to evaluate and improve the “Chain of Survival” in the community
For more information, including program contacts, visit www.mainehearthealth.org and click on “HeartSafe Communities”
HeartSafe Community ensures survival for stroke victim Story Courtesy Maine HeartSafe Communities; BDN Photo by Debra Bell In March of 2009, Christine Burke Worthen gave birth to her second child, Zachary. Despite suffering some nagging headaches, the 36-year-old left the hospital looking forward to resuming her life as a mother and attorney. Over the course of the next week, the headaches became worse, so Christine called her doctor for advice. The doctor thought that spinal anesthesia given during her labor might be the cause. She was told to drink more caffeine and lie down. She followed the instructions, but the headaches continued. Eventually the pain became so bad it made her cry. On the morning of April 2, 2009, she went to the emergency room. Her doctors intended to treat her for leaking fluid in her spine, which they believed to be the cause of her headaches. While in the examining room, Christine suddenly lost function of the right side of her body. Her speech was slurred and she had trouble communicating. She did not understand what was happening, nor did her doctors. She was sent to another part of the hospital for further diagnosis. Although she exhibited classic stroke symptoms, no one thought she was having a stroke. The ER doctor encouraged her to stay the night for a brain scan in the morning. The next day, tests confirmed the unthinkable: She had suffered a stroke. She cried at the news, thinking that her 4-yearold and newborn might lose their mother. Although doctors could not pinpoint the cause of the stroke, they believed it was related to the childbirth. As a result, she can have no more chil-
dren. Over time, however, her life returned to normal. She regained use of her right arm. An avid runner, she has started to run again. She still feels some residual weakness, and sometimes slurs her speech, but says, “Those are small prices to pay for a second chance at life.” Thinking about her experience, Christine says, “It’s important for folks to understand the signs of stroke since time is so precious: prompt medical attention is a must.”
MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011 | 9
Oakland woman gets into EMS after her own emergency By Debra Bell BANGOR DAILY NEWS
Potential tragedy turned into passion for one EMS professional. Oakland resident Allyson Moore was helping her neighbor clear an obstruction from a snowblower on March 2, 2007. Her hands were covered with thick snowmobiling gloves and she went to swipe ice out of the snowblower’s chute. And then her hand got stuck. Her neighbor called Oakland Fire and Rescue — conveniently located across the street — and EMS responder David Groder was first on the scene. “We got my hand out using a crowbar,” she said. “We took the glove off to look at my hand. The outside looked fine, but the [palm side] looked like hamburger.” Groder continued to care for Moore while rescue was dispatched, including Delta Ambulance. “During the ride to the hospital, Dave had hold of one of my hands and the paramedic had the other hand,” Moore said. “At that moment, I decided that [emergency medical care] was really cool.”
Moore received 35 stiches and had five broken finger bones. Her thick gloves protected the tendons and nerves in her hand. The accident happened on a Friday night and she had to wait until Monday to undergo surgery on her right hand. Moore, the mother of two sons, was working at Thomas College as the assistant director for finance. But her EMS experience left an impact. Two months later, Moore decided to sign up to take an EMT class at Kennebec Valley Community College. “I still had bandages on at my first class,” she said. “I took the class, got my basic license and decided that I wanted to work for Delta Ambulance.” In the meantime, after gentle prodding from Oakland’s fire chief, Moore took a firefighter training block and became certified as a firefighter 1 and 2 for the town of Oakland. “I wanted to do more as far as patient care goes,” she said. “I went and got my intermediate license which allows me to do IVs, intubation, and administer medications.” She now works per diem with Delta Ambulance working one 12-hour shift per week, and on call for for additional shifts. She’s also
BDN PHOTO BY BRIAN SWARTZ
Ally Moore was inspired to go into EMS after a snowblower accident injured her hand.
currently working on a nursing degree from Kennebec Valley Community College. “I started this whole thing at age 35,” she said. “I knew that I would eventually go into nursing, but I absolutely fell in love with EMS. When you go and help a patient, when you walk into their house and they see you — especially if it’s a patient you frequent a lot, you can look in their eyes and see that they are so grateful. Just holding their hand can help them get through the situation.” And Moore isn’t new to the EMS world. “I have a lot of family in EMS,” she said. “There’s something about the EMS world; It’s as close to the Army as I’m going to get. I love my guys at the fire department. We all take care of each other.” Today, Moore never thought that her bizarre accident would bring her into the world of EMS, but in a way, she’s glad it did. It’s given her an opportunity to give back to her community when they need help most.
Maine EMS at work: First response services in Holden and Eddington
Maine EMS at work: Crown Ambulance service helps County residents In Aroostook County, Crown Ambulance service has 49 staff members as well as four critical care staffers. Those professionals provide ambulatory care to 16 communities including: Caswell, Limestone, Fort Fairfield, Easton, Presque Isle, Mapleton, Castle Hill, Mars Hill, Westfield, E Plantation, Bridgewater, Monticello, Washburn, Wade, Blaine, and Chapman. “Being in Aroostook County — a super rural community — is challenging,” said Crown Ambulance Manager Perry Jackson. “The nearest trauma center is 160 miles away so we have to provide really great care, which we do.” As a testament to the care they provide, Crown Ambulance received the EMS Service of the Year award from Mid-Coast EMS in 2008. “It’s a challenge, but 99 percent of our staff are from here,” Jackson said. “We’re very accustomed to living and working in Aroostook County. Our bases are spread out in four offices.” While their bases may be spread out, Jackson said, the network of first responding agencies is expansive. “Our response time to the
scene can be 20-30 minutes, so it’s important to establish a first response network,” Jackson said. “Typically volunteer firefighters respond to the scene ahead of us. They have AEDs [automated external defibrillators] and basic first aid skills.” Crown Ambulance also has a flight program to help facilitate quick extractions. The program uses a fixed-wing aircraft that is staffed with critical care paramedics and critical care nurses to transport patients to Eastern Maine Medical Center as well as to Boston hospitals. The flight program has a staff of 13 critical care paramedics and four critical care nurses. According to Jackson, they fly about 150 missions a year. In contrast, Crown Ambulance answers about 4,000 ambulance calls per year. “Just because we make the choice to live in a remote area, that doesn’t mean that we shouldn’t be afforded the best care available,” Jackson said. “It’s a comfort to me to know that my family and friends in the community receive the absolute best in care if they need it. It’s peace of mind.”
First response emergency services are critical to ensuring good patient outcomes. And at the Holden Public Safety and Eddington Public Safety departments, the 31 licensed first responders make a difference in the life of their neighbors. “Our role as first responders is to respond and provide emergency medical care and stabilization if we can until ambulance gets there,” said Public Safety Director James Ellis. “Our on-scene time with patients is between four minutes and 30 minutes and the first few minutes of a medical emergency can be very critical.” Ellis said that the Holden and Eddington departments have an in-house response time goal of six minutes between being dispatched and being at the patient’s side. These departments serve the people of Eddington, Holden, and Clifton and provide mutual aid to Dedham, Orrington, Mariaville, Brewer, Bradley, Amherst, Hampden, Bangor, and Veazie. In 2010, the Holden Fire Department responded to a total of 456 fire and EMS calls while the Eddington Fire Department responded to 317 fire and EMS
calls. The geography of the towns the fire departments serve can pose challenges, but Ellis said they strive to be at the sides of those in need quickly. While the firefighters and EMS professionals work to stabilize and treat people, they also provide comfort while waiting for the ambulance to arrive. “An ambulance arrival can exceed 10-20 minutes, so we rely heavily on our on-call volunteers,” Ellis said. These people join the fire department, usually, to make a difference. And because of their commitment, the departments rely heavily on them. “When joining fire department it’s a 24-hour-aday, 7-days-a-week commitment; it’s a huge commitment,” he said. “One the neat things with a small town is it’s often your neighbor who is coming to help. There’s a connection. It’s rewarding and moving too.” The type of person who would join Ellis’ departments is someone looking to make a difference. “Anybody who has sense community and wants to donate time [will be rewarded by] a great opportunity,” he said.
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10 | MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011
Dispatchers are first line of defense in emergencies By Debra Bell
“People [here are] doing it because of the love of the job, the challenge, the fast pace and dealing with people. They truly are the ‘unsung heroes’ of public safety.”
BANGOR DAILY NEWS
The moment 9-1-1 is dialed, a Maine emergency dispatcher is on the other end of the line, ready to help. According to Jim Ryan, communications center director for Penobscot Regional Communications Center, that role is part comfort, part education, and part emergency response. And it’s the people on the other end of the line, who benefit. In 2010, PRCC responded to 38,368 91-1 calls, 23,513 EMS calls, 6,034 fire calls, and 69,487 law enforcement calls. But according to Ryan, PRCC handles approximately 648 calls per day, Emergency Medical Dispatched 11,955 calls for 2010 (996 a month) and is responsible for 4,000 warrants in Penobscot County. PRCC dispatchers work shift work, as well as on weekends and holidays and are the first line of assistance when there is a disaster or an emergency. Currently Ryan has 30 employees working at PRCC. “In Penobscot County we do the dispatching for all the fire, EMS and law enforcement calls, except for the City of
JIM RYAN, PENOBSCOT REGIONAL COMMUNICATIONS CENTER
computer system that runs a program called ProQA used for Emergency Medical Dispatching. This program guides the dispatchers through the potential medical emergency by prompting them with questions to ask and in what order. The software enables the dispatchers provide pre arrival medical instruction to the caller until — fire, police, or EMS arrive. “They can do an [emergency medical dispatch] for everything from ‘I cut my finger’ to ‘someone’s not breathing’ and [guide the caller on] how to do CPR to childbirth,” Ryan said. “There’s just a whole gamut of things they do.” PRCC dispatchers undergo training on the computer software system as well
BDN FILE PHOTO BY JOHN CLARKE RUSS
Communications specialist Will Lovejoy (standing) of Dexter and senior supervisor Tracy Hall of Hermon pull up radio logs on the center's computer system at the Penobscot Regional Communications Center. Bangor and the University of Maine. We also do the fire emergency dispatching for Penobscot Nation, Old Town” Ryan said.
But, according to Ryan, it’s more than just answering the phone. His highly trained dispatchers utilize a
as annual training on CPR, first aid and telecommunications in order to renew their certification every two years. In addition, there is in-house quality control on the calls dispatchers respond to. Each dispatcher has one EMD, Fire and Law call QA’d each week by a supervisor. The calls are then reviewed by the operator and their supervisor. New employees are required to go through a monitored in-house orientation training which lasts about 20 weeks. “It’s not [quality assurance on the calls] so much to see if the dispatcher did good or bad,” Ryan said. “The big reason is that 99 times out of 100 they did a great job, we want to reassure them
See DISPATCH, Page 11
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MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011 | 11
Maine EMS at work:
Island EMS services provide full spectrum of care and comfort
Continued from Page 10 that they did everything they could do. They may take a call on a critical incident where there is a death involved and the moment they hang up they’ll be right into another call.” Dispatchers are important in the EMS process, Ryan said, and many of his dispatchers are also involved in EMS when not on the job. In fact, he said, many dispatchers are department chiefs or members of their local public safety departments. That provides the dispatcher with insight into what might be happening on the scene. “They are the first ones to have contact with anyone about anything and they set the tone,” he said. “If the dispatcher is curt or winds the caller up, it’s the responder — whether they are a paramedic, a firefighter, or a law enforcement officer —who are the ones to bear the brunt on the scene. The way a dispatcher deescalates the situation is extremely important.” PRCC also handles the 9-1-1 landline call taking for Aroostook County. That means they’ll answer the phones when there’s an emergency in northern Maine, but local EMS will be dispatched based on the needs of the caller. “People [here are] doing it because of the love of the job, the challenge, the fast pace and dealing with people,” Ryan said. “They truly are the ‘unsung heroes’ of public safety. They take calls from people who are intoxicated; from people who don’t like police; and then they take calls from people who are having very traumatic events in life. They’re very good at what do and they are saving lives every day.”
When you live on an island, you accept that things will be done a little differently. When it comes to responding to an emergency, island life can pose some complex logistical challenges. According to Service Director of Vinalhaven Ambulance Burke Lynch, responding to emergencies on the island takes strategy and timing. “We’re responsible for providing coverage for everything from first aid to life threatening emergencies.,” Lynch said. “We work closely with our medical professionals to treat, stabilize, and transport the patient. We evacuate about 30 percent of our patients to the mainland” Patients who do not need to be evacuated are usually seen at the Islands Community Medical Center in addi-
tion to receiving on-site care. For those patients requiring hospitalization, there are multiple transport options. The Vinalhaven Ferry, operated by the Maine State Ferry Service, can take an ambulance on board if the need coincides with a regularly scheduled ferry run. Nighttime emergency ferry transports are utilized when air transport is not available. The weather can dictate the evacuation mode. Weather permitting, Penobscot Island Air’s fixed-wing aircraft is an ideal option, as is the LifeFlight helicopter. “Logistically, it can be severely challenging,” Lynch said. “The length of time that we spend with a patient far exceeds the norm.” Remote locations on the island also pose challenges
for Lynch’s 14-member EMS team. The team contains Intermediate Emergency Medical Technicians, Basic EMTs, and drivers — all volunteers. The volunteers are compensated when they take on calls and receive on-going training to stay current and licensed. “We provide the full spectrum of care,” Lynch said. And that spectrum of care relies heavily on assets outside the EMS structure. “It’s like psychological first aid,” he said. “In remote communities especially, when you’re ill it’s a psychologically traumatic event to go to the mainland. To be escorted off the island by someone who lives there provides some degree of comfort. We’re proud that we can be a source of comfort.”
Maine EMS in the community Did you know that Maine EMS professionals can: • Provide child passenger safety seat checks • Properly fit a bike helmet to your child’s head • Oversee bike rodeos and outreach events • Provide tours and educational talks to scout groups and schools • Provide training to the public on first aid and CPR
Maine EMS at work: Dispatchers talk Newport mom through childbirth By Christopher Cousins BDN STAFF
Four times Sheila Davis and James Farnham, went to Eastern Maine Medical Center in Bangor to have a baby, and four times Sheila’s contractions faded, and they went home. Tired of false alarms, Sheila was unsure what to think when she began to feel contractions again on the morning of Jan. 26. “We were tired of being sent home from the hospital,” she said. “I wanted to be sure.” Then she felt a sharp pain, so she lay on her living room floor and rocked back and forth to relieve the pressure. “It’s time,” she told Farnham, who busied himself packing up two of their other children for the trip to Bangor. “With the other [babies, the doctors] had to break my water for me,” said Davis. “My water hadn’t broken yet so I thought I was OK.” But a flurry of nausea came and went — a familiar sign for this mother of
five — and Davis knew her unborn daughter wouldn’t wait for the trip to Bangor. “I told [him] to call 911,” she said. About the time Penobscot County dispatcher David King asked Farnham whether Davis’ water had broken, her water broke. She moved to the linoleum kitchen floor and, with Farnham’s help, prepared to give birth. “I just started pushing,” she said, “because I knew she was coming regardless of whether I pushed or not.” Farnham, still on the phone with the dispatcher, found himself being talked through delivering a baby. It took three Newport Fire Department personnel — Emergency Medical Technician Amanda Chretien, Lt. Adam Noyes and Lt. Tom Snowman — seven minutes to reach the home. The emergency call came in as Farnham suspected Davis was going into labor, but just seven minutes later little Kylee Lauren was making her debut in the world. Chretien, the department’s emergency medical services director, took over with
Noyes and Snowman backing her up. “I started yelling to Adam to get me this and get me that,” said Chretien, herself a mother of two sons. “It was a great team effort.” The first priority was clearing the baby’s breathing passage and wrapping her in warm towels. With her mouth and nose cleared, Kylee started screaming — a welcome sound that told Chretien the baby was breathing. Chretien handed Kylee over to Davis. With mother and baby doing well, the beauty of what just happened flooded Chretien and she couldn’t stop tears of joy. “It was just so beautiful,” she said. “It’s not every day you get to bring life into the world.” Others in the department also were struck with emotion, said Assistant Chief Rick Turner. “We’re all just doing our job, but something like this is just a good thing for all of us,” said Turner. “I think we’ll kind of adopt this one.” Snowman, Noyes and Chretien
BDN FILE PHOTO BY BRIDGET BROWN
Newport Emergency Medical Technician Amanda Chretien (above, right) greets Kylee Farnham with a kiss as the baby's mother, Sheila Davis, holds her at their Newport home. returned to Davis and Farnham’s home Thursday toting gifts for Kylee. “We’re planning on this being our last child, and I think she wanted to make sure she was memorable,” said Davis, a
medical aide who works in Ellsworth. “She sure accomplished that.”
Note: this article originally appeared in the Bangor Daily News on February 6, 2010
12 | MAINE EMS: EVERYDAY HEROES | Friday | May 13, 2011
Maine EMS Memorial will honor past and present EMS staff “This isn’t just a tribute to those who died in the line of duty — it’s for every [EMS responder].”
By Debra Bell SPECIAL SECTIONS WRITER
When minutes count, members of the Maine EMS community are there. And, if organizers have their way, Maine’s responders will get the recognition they’re due — and that they never ask for. It’ll come in the form of a memorial celebrating the people who keep their neighbors — and complete strangers — safe. According to Rick Petrie, a regional coordinator for Maine EMS, this memorial really isn’t a “memorial”; instead, it’s a tangible testimonial to Maine EMS professionals. “An overwhelming majority of the [EMS professionals in Maine are] volunteers,” Petrie said. “It’s the nature of our state. This memorial will highlight the fact that there are full-time firefighters, EMTs and that there are also volunteers who carry a pager seven days a week. These volunteers feel a responsibility to take care of their neighbors.” The memorial, dedicated to Maine’s emergency medical service providers, would create a trifecta of memorials celebrating Maine first responders. Petrie said the memorial has been proposed to fill the space between the firefighters memorial and the law enforcement memorial. “This monument will remind us to remember every sacrifice, honor every contribution, and show
ILLUSTRATION COURTESY OF RICHARDSON & ASSOCIATES
This illustration shows the proposed design of the Maine EMS memorial. The EMS Memorial celebrates present and past EMS professionals and will be located between the fire and law enforcement memorials by the Capital in Augusta. that everyone plays a major role,” Petrie said. “This isn’t just a tribute to those who died in the line of duty — it’s for every [EMS responder].” Saco-based Richardson & Associates, a landscape architectural firm designed the memorial with input from Maine EMS Memorial Committee chair Kevin McGinnis and Petrie. The “monument” will be far from a granite marker honoring those who have passed. Instead, it’ll be interactive.
The memorial, McGinnis said, will be an educational site as well. “When you think ‘memorial’ you think of a granite commemorative site that lists all the folks who gave their lives in the line duty,” McGinnis said.“That’s part of this. But the bigger thing that we want to do with this is to tell the public the story of EMS in Maine. Who does it, where it’s done, and how it’s done.” The design of the memorial incorporates a glass
wall with a description about the EMS system as well as a toll-free phone number for the visitor to call. The call will provide an up-to-date story of the Maine EMS system and how it works in Maine. Then throughout the rest of the memorial site, granite pillars ranging in height from a couple feet to four feet high. Each pillar will contain the name of a person being memorialized or recognize a part of the Maine EMS system. Using toll-free phone numbers, visitors will hear the story of a real person who worked in Maine EMS. Other columns would contain a simple phrase, such as “dispatcher” or “emergency responder”. “This memorial is absolutely unique in the United States,” McGinnis said. This memorial will not be paid for using taxpayer dollars. Instead, Maine EMS is fundraising the $300,000 that it will cost to construct the memorial. To date, over $65,000 has been raised, Petrie said. That means that only $235,000 remains. McGinnis said that a recent donation from Harris Corporation included a matching grant of $5,000. “[They gave us a] straight donation of $10,000 and also said they’d give a matching grant of $5,000 if we were able to raise $5,000 by next year,” McGinnis said. Anyone can donate to the EMS Memorial fund, McGinnis and Petrie said.
To donate towards the memorial, visit www.kvems.org or call (207) 877-0936. Donations are tax-deductible.
RFGH Celebrates EMS Week! Thank you to the RFGH EMS Team for providing lifesaving care, 24 hours a day, seven days a week.
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Caring for the Community!
Maine's local EMS professionals are the front line when it comes to keeping communities safe. These professionals are firefighters, EMTs, am...
Published on May 13, 2011
Maine's local EMS professionals are the front line when it comes to keeping communities safe. These professionals are firefighters, EMTs, am...