EMT/EMR Shortages Can Hinder Response
Nationwide there is a shortage of Emergency Medical personnel, especially in rural areas. This results in delays in transfers and the inability to sometimes provide transfer service at all. Madelia Health offers free online or conventional training for individuals who are interested in becoming an Emergency Medical Technician (EMT) or Emergency Medical Responder (EMR) in exchange for two years of service to the Madelia Health Ambulance Service.
“Volunteering for the Madelia Ambulance squad isn’t what it used to be. Members are paid to be on call,” said Madelia Health CEO Jeff Mengenhausen. “Even though we have the ambulances and the building, we sometimes can’t provide the long transfer services to Rochester or the Metro without people to staff the rigs.”
The Madelia Health Ambulance Service has two rigs that are housed at the new Ambulance Base across from the main Madelia Health facility. At this time, Madelia Health offers Advanced Life Support (ALS) transfers part time, Monday through Friday from 8 a.m. to 6 p.m. The rest of the time Basic Life Support (BLS) is available, including nights and weekends. So, we can run two ambulances during the day-time hours, but struggle in the evenings and on weekends. Patients are transported to a facility of their choice. If the patient is incapacitated and cannot request a specific facility they will be transported to the nearest facility for care.
ALS transfers are needed for patients that require a higher level of medical monitoring and include those who need continuous IV drips, those on a chronic ventilator and those who require cardiac monitoring. An ALS rig has a Paramedic on board along with an EMT or EMR. ALS procedures include: manual defibrillation/cardioversion, endotracheal intubation, central venus line, cardiac pacing, chest decompression, and surgical airways. The ambulance is equipped with air-way support equipment, cardiac life support, cardiac monitors and a glucose testing device. An ALS ambulance also carries medication on board, including medication for pain management.
BLS transfers are typically staffed by EMT and EMRs, and is for patients who have lower extremity fractures, are being transferred to sub-acute care facilities or who are discharged to home care, psychiatric patients and other non-emergency medical transports. The personnel in a basic life support ambulance can provide cardio pulmonary resuscitation (CPR), automated external defibrillation, mechanical ventilation, placement of air way adjuncts to open airways, pulse oximetry, glucose testing, splinting, and suctioning. In addition, EMTs are trained to assist patients with administration of certain prescribed medications, including nitroglycerin, inhalers, and EpiPens. EMTs can typically also administer certain non-prescribed drugs including oxygen and oral glucose. In response to the opioid overdose epidemic, EMT are allowed to administer naloxone.
Since Madelia Health has taken over the management of the Ambulance Service in 2020, we have increased the number of transfers to other facilities by 25%, and our response time is much better for 911 calls. Because other agencies also struggle with staffing, we help each other out. We have done transfers from Mayo Clinic in St. James when they have been short staffed. We also have done several transfers to the metro area, Sioux Falls and Rochester, which takes a rig and staffing out for five hours. We still have to have a rig and staffing in Madelia for 911 calls.
The new ambulance base was fully funded by Madelia Health and did not affect any local taxes. Most construction on the facility was done by local contractors and businesses whenever feasible.
