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LAFD Emergency Medical Calls On The Rise

on August 24, 2017 - 8:01am

LAFD EMS Division Chief Benjamin Stone stands next to a machine that dispenses medication to LAFD personnel to replenish those administered during their shift. Photo by Maire O'Neill/ladailypost.com

 

By MAIRE O’NEILL
Los Alamos Daily Post

The Los Alamos Fire Department has responded to 1,046 calls for emergency medical services (EMS) so far this year, up 144 from the same period last year.

EMS Division Chief Benjamin Stone said he has carefully documented each one of those calls and is proud of LAFD’s response to them. In 2015, the Department responded to 1,270 calls and in 2016 the number rose to 1,377.

“Our travel time last year was six minutes or less 92 percent of the time. Our total response time from when we are dispatched to the scene to an effective response is 12 minutes 20 seconds or less 98 percent of the time,” Stone said.

When the Consolidated Dispatch Center inside the Los Alamos Police Department receives an EMS call, dispatchers go through a set protocol, which involves a 100 percent accurate reading of questions to the caller. This allows the dispatcher to decide the appropriate response and dispatch the LAFD responders.

Stone said calls are given a different level of response according to their severity. For example, an Alpha response would involve something like a fall requiring assistance to get up and a Bravo response would also be non-life threatening but a little more serious. A Charlie response could be for new onset chest pain with no symptoms to match but could be potentially life-threatening.

Delta responses could be something like chest pains with symptoms indicating a heart attack until proven otherwise. Echo responses  would be if someone was in cardiac arrest where their heart had stopped beating. A typical response to an Echo call would be an engine, a mobile intensive care ambulance and a rescue truck with a minimum of two paramedics, Stone said.

“We have at least two paramedics at each station on all shifts. We have a total of 47 paramedics in the Department – nearly half the staff. Five of them are command staff,” Stone said.

Sometimes EMS personnel administer pain medication to people they are transporting. Advanced emergency medical technicians can call ahead to the hospital for directions from the doctor. A paramedic can administer pain medication working off a strict protocol based on the presentation of the patient.

“We use a pain scale of 1 to 10 based on what the patient says. The patient gives a subjective rating and we make an objective review taking into account heart rate, blood pressure, oxygen saturation and physical findings to make a decision,” Stone said. “If there are physical signs such as chest pain and the patient is obviously in distress, these help us to decide. The hard ones are people with no signs or symptoms who are complaining of Level 10 pain.”

Stone said LAFD responders err on the side of giving pain medication because it is very difficult to determine if they are drug seekers or if they are in need of the medication. He said there are often no objective findings they can use to prove that patients don’t need medication.

In the last month, 100 percent of chest pain patients received pain management. Nitroglycerin is often administered for suspected heart attacks as it opensthe arteries allowing an increase of blood flow, which reduces pain. Patients have the right to refuse pain management and this accounts for the majority of patients who do not receive pain medications from paramedics. There also are instances in which the patient's vital signs do not allow for pain medication to be administered because they would do more harm than good.

In 2016, LAFD administered 196 doses of Fentanyl, an opioid medication with rapid onset and short duration of action. They administered 79 doses of Zofran, which is used to prevent nausea or vomiting.

All LAFD ambulances and rescue vehicles carry about 10 milligrams of Narcan, which is used to block the effects of opioids and reverse an overdose. So far this year, 24 doses have been administered, Stone said.

Stone joined LAFD as a firefighter in 2003 and has been active in emergency services since then. He was promoted to Captain in 2010 and to Battalion Chief in 2013. Since 2014 he has been the EMS Division Chief.

Stone holds Associates of Applied Science degrees in Fire Science and Paramedicine as well as a Bachelor of Science degree in Paramedicine with a Fire Science Minor. He will also be graduating with his Master's in Leadership and Domestic Preparedness in February. He is one very few fire professionals to hold the Chief Emergency Medical Services Officer and Chief Fire Officer designations. He serves in several organizations such as the Los Alamos Medical Center Advisory Board, International Association of EMS Chiefs, the International Association of Fire Chiefs, the Northern Regional Trauma Advisory Council and the Los Alamos Public Safety Association. He currently serves in leadership positions on the New Mexico EMS Educators Association and the Los Alamos Health Council.

Stone’s qualifications include being a National Registry Representative, Certified Instructor for the University of New Mexico, Safety Officer and Hazardous Materials Technician.


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