Pre-EMS Care: Filling the Gap
All those defibrillators, and who's using them? All that talk about CPR, and who's doing it?
In both cases, too darned few people, says Frank Poliafico.
"The EMS system has a major gap in it, and that gap is what can be called pre-EMS," says Poliafico, a longtime RN and advocate for out-of-hospital emergency care. "When EMS shows up on scene, rarely is anybody doing anything for a patient in a life-threatening emergency."
That's the dilemma that faces even communities heavily invested in efforts like CPR education and public-access defibrillation programs. They can place AEDs and offer emergency-care classes, and still few people will act when they witness an arrest or collapse.
People just aren't comfortable, says Poliafico. Making them more so is a goal of the Initial Life Support Foundation (formerly the AED Instructor Foundation), of which he is executive director. The ILSF works for the development of onsite emergency-care preparedness programs as effective components of community EMS systems. It partners with local EMS agencies, CPR/AED instructors and emergency-care trainers and consultants to help create and maintain effective programs to prepare civilian "first detectors."
The key is the verb prepare. To work optimally, Poliafico says, such programs must go beyond simple training. "Training's a one-time event; preparation's an ongoing process," he says. "Training is a part of preparation, but without ongoing learning, management and supervision, there is no preparation."
It's not enough, in other words, to impart the skills and move on. The skills need to be regularly refreshed. To be performed smoothly under duress, they must be practiced. They must be supported and promoted and reinforced.
"There has to be ongoing learning," says Poliafico. "There has to be management, supervision. Not in a big, bureaucratic way; you don't necessarily need the outside expert to come in every month and drill you. But somebody should be bringing it up in safety meetings. You ought to be showing videos throughout the year."
This can inculcate the comfort that's so important to acting in an emergency. People must have enough familiarity with and faith in their knowledge and abilities to overcome natural reservations and leap to a stranger's aid.
EMS folks can relate, and that's what makes them uniquely suited for involvement in these types of programs.
"EMTs don't finish school and go out by themselves on day one," Poliafico notes. "They have mentors, they have supervisors, they have preceptors. Somebody's helping them develop a comfort level. And without that comfort level, without that emergency mind-set, there is no response--that's human nature."
Where EMS is involved in community preparation programs, the results have often been good. And beyond the obvious medical benefits, there are nonmedical advantages as well.
"No. 1, you build constituency in your community--you begin to identify to the public who EMS is," Poliafico says. "No. 2, you recruit. Once I train someone and they're comfortable with it, a lot of times they'll get the bug and want to do more. And No. 3, it generates revenue. There are just phenomenal benefits."
For more, see www.ilsf.info.
FRIENDSWOOD: 'MORE WAYS TO HELP PEOPLE'
Volunteers exemplify community service by their nature. If you're willing to give of your time and talents when those in your community are hurting, it's not a big leap to doing it at other times as well.
"Our whole theme is neighbors helping neighbors--that's what we come in committed to do," says Friendswood EMS Chief Lisa Camp. "And when you start helping people, then you see other things you want to change, and you start realizing more ways to help people."
For Friendswood, that's meant a steady stream of efforts aimed at improving constituents' safety. Many of these focus on kids--a sure way to win hearts and minds.