New Program Advances Ill. Firefighters' Medical Training
The State Journal-Register, Springfield, Ill.
Dec. 13—Laying on the floor of his home Tuesday afternoon, 6-year-old Junior was unresponsive after suffering a heart attack. A crew from Springfield's Fire Station No. 6 rushed in, took their positions and started chest compressions.
A tube was put in his airway. A defibrillator sent a shock to his heart. Because Junior's vessels were limp from a lack of blood, a firefighter drilled a hole into Junior's knee and injected cardiac medication into his bone marrow.
The firefighters were using what was called the "pit crew method," in which CPR was continuous and every firefighter knew what his job was.
Though Junior wasn't breathing, he was declared saved. Then again, Junior never breathed. He is a training mannequin. The dog next to Junior was a stuffed animal named Mcli, named after the Memorial Center for Learning and Innovation, 228 W. Miller St., where Junior's "heart attack" was happening.
The scene was all part of a simulation to improve Springfield firefighters' knowledge of life-saving medical techniques.
In the last year, the Springfield Fire Department, in partnership with Memorial Medical Center, has carried out a new initiative in which firefighters have upped their medical training so they are licensed to administer more life-saving drugs in emergency situations.
In the last year, about 11 people suffering from heart attacks made full recoveries and left the hospital after a firefighter administered aid, and two more are in the hospital recovering, Fire Chief Barry Helmerichs said. Before 2016, the department averaged about two cardiac saves a year out of 200.
"We've changed 11 people's lives," Helmerichs said. "We've changed 11 families' lives."
In order to save someone from a heart attack, many conditions need to align perfectly, from a family member seeing the heart attack happen to the firefighters getting there in time, Helmerichs said. After four minutes without oxygen, the brain dies.
"Time is brain cells," Helmerichs said. "Time is heart cells."
A vast majority of the Springfield Fire Department's calls for service are for medical help. In 2016, 10,317 of the department's 17,641 calls were for medical emergencies. Only 507 of the calls were for fires.
So far this year, firefighters have responded to 10,272 medical calls.
The new training initiative allows more firefighters to do more for those patients.
In 2015, only 27 Springfield firefighters had advanced medical training as full paramedics. All other firefighters had basic EMS training, which allowed them to help paramedics but not administer drugs.
Helmerichs said in order to have more paramedics, each firefighter would need 954 hours of training, which was expensive and time-consuming. The intermediate level of training, in which firefighters are licensed to administer two-thirds of the drugs paramedics can, is 278 hours of training.
Starting in the summer of 2016, all new fire department recruits spent an additional three months in training to be certified at the intermediate level. In the last year and half, 15 existing firefighters came off their shifts to train to get intermediate training as well.
"This was an economically efficient way to increase our capabilities," Helmerichs said.
By the end of 2017, the Springfield Fire Department will have about 100 firefighters–about half of the force—trained above the basic level. Not only have there been more saves, Helmerichs said, there have been more people delivered to the hospital with beating hearts.
"It's made a big difference in patient care," Helmerichs said. "It's a gamechanger."
Helmerichs said it has also made a difference in morale.
"For years and years, you would work and work and you would see a bad outcome," Helmerichs said of firefighters who had basic training. "You would deliver a dead person to the hospital."
Though the fire department operates many of the training seminars, it receives assistance from Memorial Medical Center. Within the hospital's MCLI, firefighters have access to rooms simulating family homes and an open-back ambulance that mimics driving over bumpy streets.
Much of the training was taken from King County in Washington state—which is considered to have some of the country's most progressive techniques for emergency medical training—but personalized to how Springfield firefighters work, according to Sara Brown, Memorial's emergency medical services coordinator.
When firefighters first come in for training, they are videotaped administering CPR. Each moment of their response is evaluated and corrected if necessary, Brown said.
"Those first seconds, those first minutes—how those are handled will define how the rest of that emergency is going to go," Brown said. "(Firefighters) are the first ones there."
Brown said she has kept track of the patients that were helped. One who had recovered from a heart attack asked for the name of the firefighters and EMTs who responded to thank them, Brown said.
On Tuesday, Springfield Fire Capt. Jason McMillan, who has been a paramedic since 1992, led a handful of veteran firefighters through where to put diagnostic leads on a chest, using cues like "salt, pepper, ketchup, pickles and mustard" to help them remember the locations.
Firefighters also were shown how to inject epinephrine into an arm.
"What should we do with an alcohol swab before we do this?" one firefighter asked.
"They say if you pop the top fresh, you're good," another paramedic answered.
Firefighter Jim Holt, who was helping teach Tuesday's class, received his intermediary training in 2002, much earlier than when the initiative was started. He said he wanted the additional training after seeing what two firefighters with advanced skills could do.
"There's a higher level of responsibility," Holt said. "You feel like everyone looks to you for the answers."
The first time Holt was leading a crew during a medical call, the patient died.
"I walked away from it knowing I did everything I could," Holt said.