Busy and better than ever
May 18, 2015
EUREKA – Next week is Emergency Medical Services Week, and Randy Wolfe, Emergency Medical Services Chief of the Eureka-Goodfield Fire Protection District, wants people to know that this area has a lot to celebrate, as the ambulance service has undergone some dramatic changes over the last few years.
“We’ve done some great improvements,” Wolfe, EMS Chief since February 2011, said.
The fire side of the Eureka-Goodfield Fire Protection District covers 84 square miles and a population of around 9,500 people. The medical side covers over 110,000 square miles and more than 10,000 people, providing service to everyone in the Eureka-Goodfield fire district, as well as the Secor fire district. They also have a separate contract with Germantown Hills to provide a paramedic and run that village’s ambulance service.
Decades ago, small town ambulances were run by local funeral homes, and Eureka was no exception. In the late 1960’s, local ambulances went to an all-volunteer service, and that worked for awhile, Wolfe said.
Many small town ambulance squads are run by volunteers, but dedicated volunteers have gotten harder to come by. Most volunteer departments are losing an average of 19 percent of volunteers yearly, Wolfe said, with no new influx of volunteers to replace them.
“Small town volunteerism, overall, has dropped dramatically,” he said, leading, unfortunately, to many rural areas similar in size to Eureka and Goodfield doing away with their ambulance service all together.”
This area, Wolfe said, is “so, so very lucky to have this type of service available to them. Most towns this size don’t even have an ambulance. They’ve had to close their ambulance down because they had nobody to run it.”
More stringent training requirements complicate the situation, as does the ever growing call volume.
In the mid-1990’s the Eureka ambulance service went from basic life support to intermediate life support and hired three full-time ambulance personnel. One paramedic was there 24/7 and assisted by scheduled volunteers.
This system worked well for awhile, but the call numbers kept increasing, and sometimes, volunteers did not show up, and the paramedic would have to wait, as state law required two people to answer a call.
“Keep in mind, if you’re in cardiac arrest or you’re not breathing, you have a 4-6 minute window, max, to be able to do something,” he said.
A mutual aid ambulance would have to be called, he said, meaning tax-paying citizens in medical crisis were waiting for out-of-town ambulances to come and help them.
“It was a black eye for the district,” he said. The Board of Trustees recognized things had to change. They hired Wolfe to be a full-time administrator, and his first task was to hire several part-time people so EMS could have two paid ambulance personnel around the clock.
“April 1, 2011, this ambulance went full-staff, 24/7, 365,” Wolfe said. “And it’s been that way ever since.”
Before last December, Eureka-Goodfield had two ambulances, the primary one a 2008 vehicle.
“We run a lot of second calls,” Wolfe said. When they had only two older vehicles, answering all the calls could often be problematic.
They now have four ambulances. The 2008 ambulance that used to be the primary Eureka ambulance was re-purposed and is now a rescue truck and transporting ambulance at the Goodfield station. The two new ambulances will be rotated, so they should last longer and spread the mileage. Each cost about $160,000, while normally brand new ambulances cost about $250,000 with an extra $100,000 in equipment. They were able to use a lot of the equipment they already had, Wolfe said, thus saving money.
One of these ambulances is equipped with specialized bariatric equipment to help with the transport of large patients, and it is one of the few ambulances in the tri-county area with this equipment.
Wolfe drives a four-wheel drive vehicle that also can be used to transport patients.
The additional vehicles will be helpful during high school and college football season, as they have a crew and ambulance at each game. In the past, if a second call came in, they would have to leave.
Last fall they also started using some new technology that has made a huge difference in how calls get answered, Wolfe said.
Before they had this application, when second calls came in, Wolfe said, “nobody knew who was coming up to the station at any given time. One time you could have a dozen guys here, the next time you’d have one guy standing here, all by himself.”
The application lets people know which people are in town and available. When they answer a call, they can punch a button on their smart phone to instantly let the team know they are on their way. This information is also displayed on a television at the station.
Having this technology and the additional ambulances has proven to be very helpful, as the call volume continues to increase.
“We keep getting busier,” Wolfe noted.
Last year the district received 1,040 calls, 881 of which were medically related. Wolfe added that Eureka in particular has a very high call volume due to the two large elderly communities in town.
He said that in the future they might need to hire a second crew to help handle the call volume. The first 12 hours of the day, Monday through Friday, tend to be the busiest times. They have an average of 100 calls a month, and they are usually out the door in under two minutes, even in the middle of the night.
They also stay busy with intercept calls, Wolfe said. He said sometimes neighboring EMT-basic ambulance services need a paramedic to offer a more advanced level of care while they are transporting a patient to a larger hospital. They will call Eureka-Goodfield EMS for an intercept and one of the medics will drive out to meet them.
“Our medic hops into their ambulance and starts giving advanced care to that patient all the way to Peoria,” He said. “We run a lot of those types of calls.”
They also do inter-facility calls, transporting patients from Advocate Eureka to larger hospitals in Peoria or Bloomington.
In the past, the Board of Trustees had gotten complaints about why Eureka ambulances couldn’t transport Advocate Eureka patients.
“They would commonly wait four or five hours,” he said, for an ambulance from out of town to come pick them up.
The ambulance service, with expanded scope paramedics, is fully equipped now to do inter-facility transfers and will gladly do so if called.
“We can go over and take those critically ill and injured patients to Peoria, to Bloomington, if needed, and help decrease that delay of specialized care,” Wolfe said. “We are fully capable of doing whatever is needed.”
The fire side and the medical side work very well together, Wolfe noted. Out of the 27 fire personnel, 23 are medically trained, with the training ranging from first responders to registered nurses.
“We have a very wide variety of experiences and training and education here,” Wolfe said.
As of May 1, all fire personnel are required to be trained as emergency medical responders and will need to stay certified for the duration of their time with the fire department.
“That’s a huge commitment,” Wolfe said. He said that the district pays for the training, but the people still are volunteering their time to take the classes.
“We are very, very fortunate on both sides,” he said, of the fire and medical people’s dedication.
Wolfe also spoke highly of the Board of Trustees.
“We’ve got a great Board of Trustees that support us. They listen to both Chiefs,” he said. “They’re a great group of people.”
The ambulance service is tax-supported, with 65 percent of the ambulance budget being covered by the fees generated by calls.
“We are less than half dependent on tax dollars,” Wolfe said.
He said that the ambulance side can levy up to 40 cents, but they just now were at 20 cents. He also said that Medicare reimbursement has not gone up since 1995, and two years ago, it even was cut by 3 percent.
“We write off a huge amount of money every year,” he said. “That’s why it is so important to have that tax support. The taxes you pay just help offset the overall cost.”
Offering cutting edge medical services costs money, and often there are behind-the- scenes costs that people don’t think of, such as insurance and equipment costs.
Wolfe said he and Fire Chief Craig Neal are always looking for ways they can improve, but not at the expense of taxpayer dollars.
Wolfe pointed out that Neal was able to get grant money to drastically reduce the cost of new cardiac monitors. The district was able to get three cardiac monitors, the same kind used in hospitals that usually cost $40,000 each, for $6,000 each.
Health care reform
Wolfe said the passing of the health care reform means that many changes to the ambulance service are on the horizon. Community paramedics will be crucial to implementing the reforms, with paramedics making home visits and writing prescriptions in the future. Ambulances, which are now only allowed to transport to a hospital, will be able to take patients to Prompt Care.
Wolfe does not know when these changes will occur, but EMS will be ready to face them when they do.
Heartfelt: Donation allows ambulance service to improve service
Sep 21, 2015
CHERYL WOLFE, The Pantagraph
Eureka-Goodfield Fire Protection District Paramedics Kyle Walder and Obed Fritz demonstrate the use of the newly acquired Lucas Chest Compression System on a mannequin.
EUREKA — When the Eureka-Goodfield ambulance service recently received a $10,000 donation, members knew they had to do something special with the money.
“That was a big chunk of money,” said Randy Wolfe, emergency medical services chief for the Eureka-Goodfield Fire Protection District. “We were very surprised to get it. We decided we needed to spend it on something that would benefit the residents of the district the most.”
The decision? A Lucas Chest Compression Cystem, which helps patients who suffer cardiac arrest. The device is strapped around a patient's chest, providing continuous compressions for cardiopulmonary resuscitation.
“It just goes; it doesn’t stop,” Wolfe said. “It allows the medics to concentrate on giving medication and managing the airway.”
Sudden cardiac arrest is a leading cause of death, especially among people over 70, but it can happen at any age.
Many of of the ambulance service's calls involve elderly patients or accidents. The more quickly emergency medical technicians can perform a number of lifesaving tasks, the better the chance is for survival.
“The first week after we put it in service, we used it twice, and it made a huge difference,” Wolfe said.
The device cost $14,000, with the department supplementing the difference from its own budget to cover the cost.
“We have been very fortunate as far as getting items and equipment we need,” Wolfe said. “We do everything we can to be responsible with tax money and looking for grants. We want to provide the best service possible for the lowest cost. We are very fiscally responsible while trying to better our service.”
The ambulance service responded to 1,040 calls last year, and Wolfe said the department is well ahead of that number this year. He expects the numbers to continue to go up.
PEORIA — A serious accident gave EMTs from the Eureka-Goodfield Fire Protection District their first opportunity to use Twiage on March 1, the first day online with the new mobile application.
Twiage is designed to foster better communication between emergency responders in the field and personnel in the hospital emergency room. OSF HealthCare Saint Francis Medical Center is the first hospital in Illinois to try out the new technology. They began a year-long pilot of the app with the help of Eureka-Goodfield and six other EMS providers in central Illinois.
“We were the first ones to use it,” said Randy Wolfe, EMS chief at Eureka-Goodfield. “We had a multiple vehicle accident on I-74.”
Though he wasn’t on the call, Wolfe was able to watch the EMT response playout live on the computer of the Twiage representative who was in town for the initial rollout.
“They took pictures and they were talking back and forth with the ER,” said Wolfe. “It was awesome.”
LESLIE RENKEN/JOURNAL STAR Randy Wolfe, EMS chief at Eureka-Goodfield Fire Protection District, displays one screen in the new mobile app Twiage, which is designed to improve communications between the emergency room and EMTs in the field. Eureka Goodfield is one of seven area EMS providers participating in a pilot program of the app with OSF HealthCare Saint Francis Medical Center.
With a 32-year career in the EMS field, Wolfe is excited about the new app. It will not only speed communications — the old system employed an operator to relay messages to the emergency room — it will also greatly improve communications with options like texting, video clips and photographs.
“A photo is worth a million words when it comes to describing a scene,” said Wolfe, who recognized the importance of photographs back in the 1980s and ’90s and put Polaroid cameras in ambulances when he worked in East Peoria. Photos help emergency room doctors understand the scope of the trauma and pinpoint where to look for internal injuries.
“Pictures can give us a lot of useful information on the mechanisms of trauma,” said Dr. Matthew Jackson, emergency room physician with St. Francis Medical Center and Emergency Medical Services medical director for Peoria EMS. “Is there intrusion into the vehicle? Did they have to be extricated? It’s very useful in determining the level of need once they get here.”
Photos or video clips can also be helpful in relating symptoms — a sagging face or slurred speech in a stroke victim, for example. A photograph of an EKG can immediately relate key information that was cumbersome to transmit over the phone.
“Taking a picture of an EKG allows us to easily ID heart issues early on,” said Jackson.
Photographs can also speed the admissions process. EMTs send a picture of the patient’s driver’s license, allowing the hospital to start paperwork before the patient reaches the hospital.
All information comes directly into the hospital emergency room on a computer which employs a loud alarm to announce a transmission from an EMT. Most verbal communications will likely be done by text, although a phone call is also possible. Texting is a great way to communicate on the accident scene which is often very noisy, said Wolf.
For Jackson the app gives him the ability to jump in and help wherever he is, day or night.
“I have a companion app on my phone, so all the information from inbound patients can come to my phone. I can just pick it up and start interfacing with the EMTs,” he said.
Another feature popular with the emergency room staff is the GPS which tracks the ambulance in real time.
“People are really liking the ability to track the unit inbound,” said Jackson.
A favorite feature with EMTs is how the app eases the burden of paperwork required after each call. Information sent through the app is printed and submitted to document what happened.
All patient information collected on Twiage is stored in a way which is HIPAA compliant. Everything, including photos, becomes part of the patient’s medical record.
Both Jackson and Wolf said the app is more than likely here to stay. More area EMS departments will be brought into the program during the course of the year-long pilot, and at the end, results will be assessed and changes will be made in the app as needed.
“Part of the pilot is to see if it is a good fit for our workflow, and what we can do to make it a better fit,” said Jackson. “The great thing about Twiage is they can customize the app to our needs. What we need might be different than what they need in Boston. We have the ability to change that.”
Beginning on Monday September 3rd at 6 am, EGFPD is proud to announce that we are relocating a staffed ambulance to our Goodfield Station on Monday thru Friday, 6 am to 6 pm. This relocation will allow for a quicker response time to calls in our southern portion of the ambulance district during our heavier call volume times. This is the first time in the history of the District that there has been a paid staffed ambulance housed at the Goodfield Station.