Dallas Does Community Paramedicine
Community practice paramedicine is viewed by many as the latest prehospital healthcare initiative that improves EMS response patterns while, at the same time, maximizes resources, improves service delivery, reduces unnecessary use of engine and ambulance units that can be better utilized for true emergencies, prevents patients from readmission to hospitals, or detects and corrects conditions early (in a person’s place of residence) before they worsen, all while adding a new revenue stream for cities.
With its Mobile Community Healthcare Program, the city of Dallas becomes the first large municipal fire department in the United States to implement community practice paramedicine. The Dallas program has a two-pronged approach: It will focus on chronically ill people and patients recently discharged from a local hospital in addition to targeting 253 “frequent flyers” who used EMS 12 times or more in a year.
Dallas Fire-Rescue has allocated four paramedics and one lieutenant to the new program. For the identified patients, the dedicated staff will assist in the patient’s recovery by evaluating medical needs, teaching patients to manage their own health, ensuring medications are being taken and referring patients to services they might need. The idea is to make sure the patient doesn’t require readmission to a hospital or call 9-1-1 for medical needs. The overall goal of the program is to stabilize a steady increase in EMS calls.
We applaud the medical team of Paul Pepe, MD, MPH, MACP, FACEP, FCCM, Ray Fowler, MD, FACEP, and S. Marshal Isaacs, MD, FACEP; EMS Bureau Assistant Chief Norman Seals and the visionary staff of Dallas Fire-Rescue; and the city of Dallas elected officials for leading the way in fire service implementation of this innovative program that will improve services to the Dallas population and improve the efficiency and effectiveness of Dallas Fire-Rescue EMS resources.
Boston Detects CO
After receiving a FEMA/Department of Homeland Security grant, Boston EMS Captain Jose Archila distributed Drager Pac3500 carbon monoxide (CO) monitors to all its units. The device is adhered by a key ring and security tag onto the oxygen bag assigned to all ambulances. The oxygen bag is required to be brought to every patient requiring 9-1-1 emergency medical assistance.
On Dec. 3, Ambulance 5 responded to a call at an assisted-living facility for a woman who had fallen. When the crew from A5 entered the facility, the CO detector indicated elevated readings. They requested the Boston Fire Department (BFD) respond. The BFD arrived and confirmed elevated CO levels on several floors of the building and ordered an evacuation.
On the evening of Dec. 20, Ambulance 3 and Division 2 responded to a multi-family home for a minor illness. While the crew was evaluating the patient, the CO monitor attached to the oxygen bag sounded an alarm and showed elevated levels of the potentially deadly gas. The residents had been using their oven as a heating source. Though only slightly elevated, continued build-up could have proved much more serious. The apartment was ventilated and the landlord arrived to assess the heating system.
In both these instances, the detector was able to alert personnel to the dangerous levels of CO prior to any illnesses. We applaud Boston EMS for using grant money to provide crews with a tool that keeps both providers and patients safe.
ELSA on the Slopes
When a visitor to the U.S. from another country is on the slopes during a ski vacation and gets injured there are no interpreters on skis or snowboards who can rapidly get to them and assist in translating their chief complaints and past medical history. But recently, the National Ski Patrol (NSP) and RTT Mobile Interpretation announced a partnership to send “ELSA” (Enabling Language Service Everywhere)—RTT’s innovative mobile, real-time language interpretation system—to injured parties on the slopes.
NSP members will now wear ELSA, a lightweight, hands-free, body-worn device, and with the press of a button be able to access RTT’s network operating center to have the call connected to a live bilingual interpreter in one of 180 supported languages within seconds. “The ELSA technology will help frontline patrollers establish trust and make fast and accurate assessments by eliminating language barriers with non-English speaking guests,” says NSP Managing Director Darcy Hanley.
The ability to communicate with the injured in remote areas is essential. This remarkable partnership between the NSP and RTT will now ensure consistent care and improved customer service to non-English-speaking visitors. We salute the NSP and RTT for putting ELSA on the slopes to enhance the capabilities of the NSP and the care rendered to the sick and injured.