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Last Word



From the October 2008 Issue | Wednesday, October 8, 2008

Seamless System, Spectacular Save

Robert Ozarski was on his weekly hike up Iron Mountain in San Diego County, Calif., when the best of EMS inter-agency cooperation and public education converged to save his life. Ozarski and three friends had just started down the mountain and were about an hour from the trailhead, when he suddenly felt ill. He sat on a boulder and then rolled onto the ground. He recalls saying to his friends, "This is serious. I need help."

His friends immediately mobilized. One went to find cell phone reception and call 9-1-1. Another went to the trailhead to meet the ambulance when it arrived. Rosemary Blascettaƒwho Ozarski says had been teased about carrying a heavy pack so she_d be ready for anythingƒpulled an aspirin out of her pack and told him to swallow it.

The San Diego Fire-Rescue (SDFR) dispatch center received the call at 7:51 p.m., and at 7:52 dispatched ground units from the Poway Fire Department (PFD) and a chopper from the San Diego Regional Fire and Rescue Helicopter Program.

Back on the mountain, Ozarski felt his heart fibrillate and assumed he was going to die. "I knew it would take too long for people to get to me," he says. At almost that same moment, he heard the helicopter. "I thought, Maybe I have a chance after all," he says.

According to Ozarski, the helicopter landed about 30 yards away on "the only level spot on the mountain."

PFD Division Chief Kevin Hitchcock arrived at the trailhead with an ambulance and engine. He says SDFR paramedics on the helicopter reported Ozarski was stable and they were going to fly him back to San Diego. But then Ozarski crashed, going into full cardiac arrest.

The SDFR paramedics began CPR while the helicopter flew to the trailhead, picked up two PFD paramedics and delivered them to the mountaintop. The four paramedics performed CPR and defibrillated Ozarski in flight to Sharp Hospital in San Diego, nine minutes away. Five days later, after angioplasty and the insertion of five stents, Ozarski left the hospital.

Ozarski says he_s usually "cynical" about how cities and counties work together. "It_s generally dismal," he says. But not this time.

Hitchcock says, "Inter-agency cooperation and training played a valuable role in this rescue." PFD trains with SDFR flight crews 10 times a year and had done so about three weeks earlier. Because they train together, the crews know how to work well together.

The bystanders did the right thing, the paramedics did their jobs well and San Diego County_s regional EMS system performed seamlessly, creating the perfect chain of survival. Thumbs up to everyone involved!

Rural Services OvercomeStruggle to Survive

Rural and small town ambulance services never have an easy time of it. Usually staffed largely by an ever-dwindling supply of volunteers, they deal with inadequate payments from Medicare, Medicaid and private insurers and now from incredible fuel bills.

For example, Community Ambulance in Dixmont, Maine, which serves four communities and runs about 350 calls a year, has struggled from its beginning in 1992. Community grapples with rising costs from upgrading to paramedic-level care, and the local hospital no longer restocks their drug boxes for free. Although fuel costs have risen from $800 to $2,000 a month, Community_s reimbursement has hardly risen at all.

To keep Community_s two ambulances on the road, owners Ginny and Butch Cole (both paramedics) recently mortgaged their homeƒfor the fourth time.

"EMS has its trials and tribulations; rural EMS is even worse," says Ginny Cole.

JEMSoffers a Thumbs Up to the Coles and to all the other foundering rural ambulance services that go to extraordinary lengths to keep providing critical services to their communities.

CE Free for Ailing Medic

A paramedic in Kansas City, Mo., recently lost his employment because of a serious illness that destroyed his liver. Fortunately, his wife_s liver is a donor match for him. Unfortunately, he faces the loss of his National Registry certification next March if he doesn_t have the necessary continuing education (CE) hours. Because he can_t work, he can_t afford the high prices charged for non-employees for CE in his area. (As any EMS educator can tell you, good CE is expensive to produce.) He could take the challenge exam, but would risk needing to take a refresher course if he didn_t pass it on the first try.

One of our columnists contacted the clinical services staff at Kansas City_s 9-1-1 provider, MAST, and offered to write a Thumbs Up piece forJEMSif the agency would agree to provide the medic with enough free CE to meet his re-certification needs. MAST promptly agreedƒbut declined the offer of an article. It wasn_t necessary, theysaid. Maybe not. But we think MAST showed class.JEMS

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