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HomeMy WebLinkAboutHandouts_Special Meeting_Tab 07_05/01/2012 Tequesta's Paramount EMS System You are five times more likely to survive Cardiac Arrest in Tequesta than the average in this country. That is a very significant figure, but it doesn't happen easily. It takes quick response times, advanced training, expensive equipment and advanced treatment guidelines to achieve what we refer to as a Paramount EMS System. The provision of Emergency Medical Services (EMS) is one of the most important roles a government can take to safeguard their residents and visitors. EMS is provided in a number of different ways around the United States but every community strives to provide the finest service they can afford. In 1993, the Village of Tequesta established their own Fire Department, and contracted with the local private ambulance company for EMS. After identifying weakness in the EMS care, the Village hired their own Paramedics and took over EMS in 1994 to improve patient care and treatment. During the presentation to the Village Council on the pros and cons of starting their own EMS, Chief James Weinand advised them that "they could go a lifetime without needing fire suppression forces but chances are someone in your family will utilize EMS and they should never settle for second best when it comes to pre-hospital care for their families." In the ensuing 18 years the Fire-Rescue Department has developed a state-of-the-art, Paramount EMS system that is second to none. Using a combination of rapid response, intensive training, advanced equipment and cutting edge medical guidelines Tequesta Fire-Rescue has risen to one of the areas elite teams in Pre-hospital medicine. But, just what does it take to become a Paramount EMS Agency? What separates Tequesta Fire-Rescue from other departments? Continuously striving for excellence, Tequesta Fire-Rescue has identified the greatest risks to their population and intensified the training and equipment for those risks. As with many South Florida communities, cardiac issues including Congestive Heart Failure, Heart Attacks and sudden Cardiac Arrest are life threatening ailments that early intervention can help to reverse or improve. Tequesta Paramedics have worked relentlessly over the years to develop advanced guidelines and acquire equipment that greatly improves a patient's chances of survival. Response Time One of the ways that we measure our performance is our response time; that is the time from notification until we arrive at the patient's location. The American Heart Association states that the chance of a successful resuscitation from Cardiac Arrest decreases by 7- 10% for every minute that goes by without CPR. While the geographic size of Tequesta is a factor, so is the speed with which a 911 call is processed and dispatched and the time that the crew takes to get into their vehicles to respond. According to response time statistics provided by Palm Beach County Department of Public Safety, in 2011 Tequesta Fire-Rescue had the fastest response time of any EMS agency in Palm Beach County, with an average of 4 minutes 39 seconds between 911 call to arrival at the scene. The next closest was the Town of Palm Beach at 5:02 and the longest response time was Palm Beach County Fire-Rescue, who covers a very large area, at 6:18. The County-wide average, including all EMS agencies, was 5:31. Response time is a critical I� � � component in any EMS Agency and Tequesta has always prided itself on being the quickest in the county. Training All Paramedics in the State of Florida are required to maintain their Paramedic License and remain certified in CPR and Advanced Cardiac Life Support (ACLS). In Tequesta those requirements are extended to include training in trauma care, advanced pediatric care, burn care, diabetes, stroke, advanced EKG interpretation and much more. At least one hour of every day is spent training on the latest medical advances. Additionally, all Paramedics attend EMS Training taught by the Medical Director every other month and participate in a Quality Assurance Program that reviews every EMS call for accuracy and quality of care. This constant focus on daily training and quality improvement keeps our Paramedics fresh and up-to-date with the latest trends and techniques. Equipment Medicine in general, but Pre-Hospital medicine in particular, is a rapidly evolving and advancing science. New techniques are being discovered and studied all the time. One of the advantages of a small Fire-Rescue Department is that it can quickly adopt new techniques and incorporate cutting-edge technology into its operation. With fewer Paramedics to train and fewer vehicles to equip, a smaller agency is well positioned to embrace life-saving advancements. Tequesta Fire-Rescue was the second department in Palm Beach County to perform 12-Lead EKG's in the field. 12-Lead EKG's allow Paramedics to recognize the difference between chest pain and a heart attack. That early recognition allows Paramedics to transport the patient to the nearest Cardiac Specialty Hospital, one that is capable of life saving Cardiac Catheterization, the current "gold standard" of heart attack care. Without 12-Lead EKG Paramedics would transport the patient having a heart attack to the nearest hospital, who would then have to diagnose the heart attack and transfer the patient to a Cardiac Specialty Hospital, resulting in a time delay that could result in a less desirable outcome. Today, 12-Lead EKG is the standard in all departments. Tequesta was also one of the first agencies in Palm Beach County to use the AutopulseT"", a device that provides mechanical CPR and has been associated with excellent resuscitation rates in numerous clinical studies. Tequesta was an early adopter of the use of CPAP (Continuous Positive Airway Pressure) to alleviate fluid backup in the lungs caused by Congestive Heart Failure. Most recently Tequesta has acquired GlidescopesT"", a color video scope that allows placement of an emergency airway device in difficult patients. When a patient stops breathing the insertion of a tube into the trachea can be a lifesaving, but difficult, procedure to perform. Patients with unusual anatomy can be a challenge, but the GlidescopeT"" allows for video scope observation of the tube placement and greatly improves success rates and minimizes complications. Until now the Glidescope was used only in the Emergency Room, but recently EMS agencies have begun to place these scopes in the field with great results. Medical Guidelines Medical Guidelines, or protocols, are written directives given to Tequesta Paramedics from their Medical Director, Dr. Don Tanabe, a Board Certified Emergency Medicine Physician and Emergency Room Physician at Jupiter Medical Center. The guidelines set the level of care that the Paramedics are allowed to provide, and in this case Dr. Tanabe has set that standard as high as it goes. By incorporating the latest cutting edge technologies, by adopting the latest advancements in pre-hospital care and by holding the Paramedics to that standard Dr. Tanabe sets the tone for a Paramount EMS system. Several years ago Tequesta was one of the first agencies to incorporate paralytics into their treatment guidelines. Paralytics are medications that allow the Paramedics to sedate and then temporarily paralyze their patients. Some patient's injuries are so severe that their own movements, either intentional or unintentional actually obstruct their care. Others need airway interventions that they simply cannot tolerate, while head injured patients can become combative, eliminating the option of flying them to a Trauma Center. By temporarily paralyzing these patients we can provide the lifesaving care that they need. Most recently Dr. Tanabe has instituted a cutting-edge technique to reduce brain injury in Cardiac Arrest patients called Hypothermic Resuscitation. Once a patient is successfully resuscitated Paramedics can cool the patient down using chilled IV solutions. This helps to reduce swelling of the brain. Jupiter Medical Center is also participating in the program and is prepared to continue that treatment once the patient is delivered to the Emergency Room. Working hand-in-hand with our local hospitals Tequesta Fire-Rescue Paramedics incorporate the latest advancements in technology and techniques to provide the highest level of care possible and continue that level of care though the hospital to discharge. "The Village of Tequesta can be very proud of the level of care that has been provided. I believe that it as good as anywhere in the country. And while the care is excellent, the best part is that the people who work in the department truly care. They work hard to provide the best medicine and the best experience in difficult situations." - Dr. Don Tanabe, Medical Director Cardiac Arrest Statistics While many aspects of a high performance EMS agency are difficult to quantify, response times and cardiac arrest save rates are not. We have already determined that Tequesta Fire-Rescue has the fastest response time in Palm Beach County, now let's look at the chances for surviving an episode of sudden cardiac arrest in the Village. Patients who experience sudden Cardiac Arrest usually have very serious medical issues that lead up to the arrest and in many cases survival is simply not possible. It should be understood that the chances of surviving sudden Cardiac Arrest are slim. According to the American Heart Association the national average Cardiac Arrest survival rate is 5%. In Tequesta, over the last six years the survival rate for patients in Cardiac Arrest is 26.47%. Tequesta Fire-Rescue patients deserve nothing less than the absolute best.