National Emergency Medical Services (EMS) Week is being observed May 17-23.
This is just one opportunity we as a community can take to express how proud we are to have 23 dedicated individuals who choose to serve the Pagosa area every day of the year. Our local Emergency Medical Technicians (EMTs) operate as the Upper San Juan Health Services District. The District covers a broad area, as the name indicates. To the east our EMTs travel Wolf Creek Pass up to and including the Wolf Creek Ski Area. They respond to emergencies to the west as far as the Archuleta County line on Yellow Jacket Pass. They are responsible for the northern area of the county and part of Hinsdale County around Williams Lake and the southern area as far as the Chromo and the New Mexico border.
Who are these EMTs? They are your neighbors and your friends. But more importantly, they are the men and women who are on the job, well trained and ready to respond to your needs 24 hours a day, seven days a week, every day of the year — including all holidays.
These individuals work as teams on a rotating schedule. Their base of operations is on North Pagosa Boulevard, where they literally “eat and sleep” their jobs. Each team member works on a 48/96 schedule. This means they are at the station for 48 hours (two full days), are off for 96 hours (four days) and back on again for the next shift. During this time, they have their meals at the station, and have sleeping quarters there. They are in constant preparation for that next call.
Whenever an emergency call comes in, whatever the time, an EMS team is prepared for immediate response. The protocol for a daytime call is to be “rolling” within two minutes, and for a nighttime emergency they are in the vehicle within three minutes. Sometimes they are on the road even more quickly. Do keep in mind, however, that the time to reach an individual varies according to distance, weather and road conditions, and how easy it is to find a home or emergency location. The EMTs cannot stress strongly enough how important it is that you clearly display your house number at your driveway and on your house. This simple procedure on your part can shorten response time greatly, and may well save your life or that of a loved one.
Additionally, there are other simple measures you can take to help the responders. Your first step in an emergency is to call 911. A highly trained dispatcher will answer your call. It is important that you try to remain calm and relay your physical location, the age and sex of the sick or injured party, the nature of the emergency, the time of the occurrence, and any pertinent medical data you can provide. It is helpful for the EMTs to know if the individual is diabetic, is using oxygen, has heart disease, is having trouble breathing or is bleeding profusely, for example. The dispatcher promptly relays the information to the EMTs and he or she is trained to stay on the line with you until paramedics arrive. After the 911 call has been made, it is also helpful if there is an individual who can be at the road — with a light if it is a nighttime call — to further direct the responders.
Helping save lives is what the EMTs are trained to do, and they are fully committed to their profession. They are strong patient advocates. Once the patient has been stabilized and the extent of the emergency is determined, a number of options are available to the EMTs. The response vehicles are equipped with a cardiac monitor, a defiibrilator, and basic medications, but there are limitations. The EMTs are not capable of doing x-rays or blood work on site, for example, and transport is often preferable. Patients can be taken to Pagosa Mountain Hospital or Pagosa Family Medical Center for stabilization, non-surgical procedures, and observation, or to be prepared for transport to Mercy Regional Medical Center in Durango. If time is a critical issue, patients can be transported directly to Mercy via ambulance. Other options include transport to locations such as Denver, Albuquerque, Grand Junction or Pueblo depending on the nature of the emergency. While to the casual observer transport may not appear necessary, the EMTs normally prefer to have the patient checked out for possible complications or more extensive injuries at a medical facility.
An EMT team often responds to remote areas. They can travel one half mile up a trailhead for an outdoor accident. Both helicopter and fixed-wing plane options are available for true emergencies, but the public must keep in mind that the cost for a helicopter evacuation is 10 times that of ambulance use, and plane transport costs can be 20 times that of the ambulance. In emergency situations, of course, cost is usually the secondary consideration.
The district maintains three Type 1 ambulances. These are full-box vehicles, equipped for maximum care in the field. There is one Type 2 vehicle that is less fully equipped, thus offering fewer on-site treatment options. The details obtained from the 911 call to dispatch often determine which vehicle is used for response. Ambulance responses generally initiate from the North Pagosa station, but there is also a staff responder with some equipment who is located in the Chromo area.
Vehicles as well as equipment suffer from wear and tear. When the responders are not on a call, they do much more than just sit around waiting for your emergency needs. After each call has been completed the vehicle is checked and re-stocked for the next call. Our EMTs are continually in training. In order to stay current with the latest medical procedures, all the EMTs need to take course work each year to stay certified. There is a national renewal requirement every two years and additional Colorado requirements for recertification every three years. The entire staff attends classes regularly and there is always continuing in-house training.
There are three levels of EMTs. The Basic Responder has a minimum of six months training, including clinical training, ride-alongs, and required certification in a number of areas. The next level, requiring more experience and training, is the Intermediate Responder. The Paramedic is the most advanced level of responder. Pediatric Life Support and Cardiac Life Support are two examples of additional training that is required at the Paramedic level..
All district EMTs are trained as first responders. They serve as emergency medical response for the local search and rescue team. They work closely with the local sheriff, police and fire departments. They recently participated in the MCI (Mass Casualty Incident) drill at the Durango Airport. This particular drill involved a mock terrorist scenario. They do CPR training for agencies and groups in the community. They do as much CPR training as they can. A startling statistic states that mortality rate increases by 10 percent for each moment’s delay in the CPR procedure, so the greater the number of people that can be trained, the better off we all are.
A major way in which the community can help assure that this training continues is to take part in the EMT Association’s second annual, big fall event, Medical Mayhem. This will take place Saturday, Oct. 17, at 7 p.m. It will be a costume party complete with food, fun, a silent auction, and lots of door prizes. Proceeds from this benefit are primarily used for scholarships for the EMTs. The individuals pay for their training, but upon successful completion of a course each EMT can be reimbursed for up to $500 for classes taken.
Some medical equipment may be purchased from the benefit proceeds, but the staff continually seeks grants, donations and other financial opportunities to upgrade equipment. Rural travel places a constant strain on all vehicles. One district ambulance has about 155,000 miles on it and all the department vehicles continually need to be maintained to meet the rigors of the road and weather conditions and the great distances that are traveled in our area. Medical equipment not only wears out, but new equipment that can help save more lives is continually being developed.
Helping save lives is what these people do best. They serve us selflessly, fully understanding the potential risks they face each time they respond to an emergency.
While we hope we never need their professional services personally, we can all take time to express our gratitude for the commitment our Upper San Juan Health Services employees make to all of us.