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The Tomahawk Leader is a state and national prize-winning weekly newspaper serving the scenic Northwoods area in and around Tomahawk, WI.

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PostPosted: Thu Jul 17, 2003 11:38 pm 
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I heard a rumor that the ambulance department in Tomahawk is going to be a Paramedic service. Aren't they that allready? How much is it going to raise taxes? $$$


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PostPosted: Fri Jul 18, 2003 9:09 pm 
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Mark,
Actually Lincoln County EMS - Tomahawk Division is not currently paramedic level. LCEMS is licensed as an EMT-IV level service. This level of certrification allows the EMTs to start IV lines as well as give certain kinds of medications that are more advanced then the EMT-Basic level. Included in this list is IV dextrose to reverse diabetic coma, narcan for opiate overdoses, and certain repiriatory drugs to help with asthma.

This is certainly a progressive step in professionally delivered emergency healthcare, but, and there is always a but, there is another step to what LCEMS could be doing to improve thier pateint care and that is advancing thier skills to the Paramedic Level. Paramedics are the highest level of pre-hospital emergency service providers. Basically it is the scope of practice of a paramedic to bring emergency department level care directly to the patient.

Paramedics can place tracheal tubes and other advanced airways for respiratory emergencies as well as administer advanced cardaic medications and to aid those in cardiac compromise. The skill level of a paramedic is quite high - the classroom school time alone is 1000 hours as opposed to the 60 or so that EMT-Basics must complete. This level of training gives the paramedic an incredible knowledge base from wich to draw upon - from anatomy and physiology, to currrent therapies for trauma and medical emergencies, to child birth, and advanced pharmocological interventions.

Another interesting point is that a review of the types of emergency calls that LCEMS currently respond to shows that nearly a third or so would benefit from some type of paraemdic intervention, be it advanced skills like cardiac care, or the simple intervention of administration of pain control medicines. This really represents a significant number of the emergency patients seen by the ambulance. Certainly the other 2/3 benefit indirectly from this advanced knowledge as well because Paramedics have the skills to better diagnose medical emergencies then before.

So, should LCEMS strive to become paramedic - I say absolutely! We owe it to our patients and our community.

<small>[ July 18, 2003, 11:20 PM: Message edited by: MedicDVG ]</small>

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PostPosted: Fri Jul 18, 2003 11:33 pm 
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Originally posted by MedicDVG:
Paramedics can place tracheal tubes and other advanced airways for respiratory emergencies
They do tracheostomies? Or are you talking intubation and inserting an endotracheal tube? I think it must be the latter. I agree Tomahawk should have paramedics, especially given the large area the hospital serves.

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PostPosted: Sat Jul 19, 2003 9:25 am 
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Nell,
Paramedics are trained to perform Needle Chrichotyrotomy, Surgical Chrichothyrotmy, and Retrogrdade intubations. Not all of these procedures are allowed by state laws at this time, but suffice it to say Paramedics have a large toolbox to work from including many advanced airways.

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