WOONSOCKET – Area EMTs have a new set of tools to assist them in responding to medical emergencies, following a round of training sessions on the latest protocols and standards issued recently by the Department of Health.
The new state guidelines that went into effect Nov. 1 allow trained and certified EMS Cardiac responders to apply higher level life support techniques when assisting patients with difficulty breathing, heart attack and other life-threatening medical conditions, according to Woonsocket Fire Department EMS Coordinator Steven Encarnation.
The new techniques now available to area first responders include the use of continuous positive airway pressure (CPAP) apparatus and a bone cavity infusion technique providing an alternative to traditional intravenous administration of medications. The changes also allow rescue personnel to administer some of the newer medications developed to treat breathing difficulty resulting from Chronic Obstructive Pulmonary Disorder or Emphysema.
Although EMT paramedics have held certification in those techniques in the past, the state’s new protocols expand their administration to EMT-C certifications held by rescue personnel in Woonsocket and surrounding several surround communities. Rescue personnel are required to update their certifications every three years under a requirements ensuring they attend training in the new standards regularly issued by the state.
“The state has improved our level of response and our ability to provide a higher level of treatment than we were able to provide in the past,” Encarnation said.
The new response techniques should allow rescue personnel to improve the outlook for patients experiencing a medical crisis requiring stay in the hospital, according to Encarnation.
The case of CPAP respiration assistance, the positive pressure mask equipment now available to rescue personnel can reduce the need to intubate a distressed patient, Encarnation said.
“Many times when we show up at a call, the patient is in such oxygen distress they can’t breathe,” he said. “This equipment allows us to force oxygen into their lungs and oxygenate their circulatory system to help bring down their respiration rate and their heart rate,” Encarnation said.
The added infusion technique can be useful in a cardiac arrest case where a patient’s circulatory system has collapsed, denying responders a suitable blood vessel as a pathway for administering potentially lifesaving medications.
The intraosseous access method provides rescue personnel with the apparatus needed to bore into the patient’s bone marrow cavity to infuse medication through that location.
In addition to requiring state certification of the responding personnel, Encarnation said the Fire Department needed to acquire expensive equipment for a local rescue to be able to offer it. With the help of Landmark Medical Center and funding from a city Community Development Block Grant, the Fire Department was able to acquire EZ-IO units that are considered to be the best offered, he said.
The move to conduct the training update in conjunction with the towns of North Smithfield and Blackstone also lowered the financial cost of adopting the new standards, he noted.
“Working with the Fire Departments in North Smithfield and Blackstone was a very cost effective way to get our personnel trained,” Encarnation said. The joint sessions also provided an opportunity for the area firefighters to work on a project outside their routine duties, he said. Encarnation and the department’s certified instructor coordinators, Capt. Roger Perreault, Capt. Timothy Walsh and Rescue Capt. Robert Cahill helped run the training sessions.
Rescue personnel in Cumberland already hold qualifications to offer the techniques due to their certifications as paramedics and the training of the Woonsocket, North Smithfield and Blackstone responders has expanded the new services throughout the Northern Rhode Island area. “Everybody will now be providing the same level of service,” Encarnation said.
North Smithfield Fire Chief Joel D. Jillson said his department has already had a chance to use its EZ-IO equipment on an elderly patient suffering a fatal cardiac incident. The patient’s condition prevented the responders from setting up an intravenous line but the intraosseous technique gave the rescue crew an alternative to attempt assistance, he said.
“It is very new in Rhode Island for EMT Cardiac techs so we are pleased to come on board early,” Jillson said.
Jillson also pointed to the joint training sessions as an opportunity to expand mutual assistance relationships between the area departments.
The area rescues frequently meet up at emergency scenes and assist each other with mutual aid coverage in their communities, he noted.
“It behooves us to work together and coordinate our training together,” Jillson said. “It helps us tremendously.”
The joint training session allowed the rescue personnel to hear the same presentations on how to use the new equipment, he noted. The intraosseous access presentation was given by flight nurse who had personally used it to help patients many times, Jillson said.
“The basic premise is that if we training together, when we really have to work together there is going to be a lot more cooperation,” Chief Jillson said.