For most every trauma that has occurred in the past 24 years in Jackson County, an emergency medical technician or paramedic with Jackson County Emergency Medical Services has showed up.
From traffic accidents to seizures, emergency personnel rush to the scene by ambulance to assess and treat the victim as needed before being transported to the hospital.
“We do a lot in such a small area in the back of an ambulance that can completely make a difference in either their life or quality of life,” said paramedic Nate Bryant, who has been with Jackson County EMS for about nine years.
Bryant, a Seymour resident, said there is a common misconception that EMTs and paramedics arrive on scene and load the person in the back of an ambulance and go.
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But he said that’s not that way it works anymore as the duties and responsibilities of emergency medical providers have increased over time.
“There are a lot of things that we do on scene and prior to and en route to the emergency room,” Bryant said.
Not to mention, EMTs and paramedics now must have a lot more training before they start and take continuing education courses each year.
“Medicine is always changing,” Bryant said.
Bryant and other health officials said they hope the next few days will give them greater public recognition and awareness for the work of emergency personnel during National Emergency Medical Services Week.
With the theme “EMS Strong,” the week brings together local communities and medical personnel to publicize safety and honor the dedication of those who provide the day-to-day lifesaving services of medicine’s “front line.”
Changes over time
In 1991, the county ambulance service or Jackson County EMS began, replacing private ambulance service. The service relies on user fees to pay for most operating costs; although in the past, the service received some property tax money. This year’s $2,274,373 budget includes no property tax dollars for the first time.
Dennis Brasher, the only director in the service’s history, said the county council has always set aside some property tax funds for the service each year, but it’s never been much.
“Maybe $125,000,” he said. The state board of tax examiners, however, cut that out of this year’s budget.
There are ambulance stations in Seymour, Crothersville and Brownstown. There is a plan to add a fourth station on the east side of Seymour to deal with an increase in train traffic on the Louisville & Indiana Railroad line.
The 29 full-time and 12 part-time EMTs and paramedics work in three shifts and keep busy with daily chores on the trucks and in the building until emergency calls come in, which can be at any moment. When the service started, there were 20 staffers.
There are two administrators — Brasher, who ran the ambulance service in Bedford before helping start Jackson County EMS, and training officer Hugh Garner, who also helps out on runs at times.
A particular tone will sound from the dispatch center at the Jackson County Jail in Brownstown calling for the appropriate truck depending on the location of the emergency. Each truck has two people on it — one EMT and one paramedic.
The decision on who drives depends on the severity of the call or how sick or injured a person is, Bryant said.
An emergency that needs advanced life support will need the assistance of a paramedic. Basic life support would rely on the assistance of an EMT. The difference in the position is based on the number of training hours — a paramedic has a minimum of 452 hours, and an EMT has 151 to 159.
On occasions, patients will be transferred by ambulance outside the county to another hospital besides Schneck Medical Center in Seymour or they have to be flown to Indianapolis or Louisville, Kentucky.
Bryant said that on the scene the initial job is to assess to make the next decision.
“You can’t treat if you don’t know,” he said.
For example, if a call comes in for a person complaining of chest pain, emergency personnel can perform an electrocardiogram or EKG, which is a test that checks for problems with the electrical activity of one’s heart.
“From that, we can determine whether or not the person is actively having a heart attack or something not as critical,” Bryant said. “If it is a heart attack, then we will need to start IVs, give medication and help with the heart muscle itself.”
The plan for heart attack patients has changed due to an agreement with Jackson County EMS, Schneck Medical Center and Columbus Regional Hospital.
Now, if patients have an ST elevation seen on an EKG, EMS will be in contact with an ER doctor, who will direct them on what to do next. Sometimes, it means going to the Columbus hospital, where the patient will undergo a cardiac catheterization and possibly receive a stent.
Before, the patient would be taken to St. Vincent Hospital in Indianapolis, more than 80 miles away.
“And now we’re at 23 (miles),” Brasher said of Columbus Regional. “Because time is of the essence.”
Numbers of runs rising
Another change Brasher has seen is the state-of-the-art equipment and how the patient is maneuvered on scene.
Years ago, even if there were no signs or symptoms of a spinal injury, the person had to be put on a board, which can be uncomfortable and time-consuming.
“It used to be that anything that was involving a motor vehicle accident, we had to use a board. They would be strapped down,” Brasher said. “But the educational aspect and the trust that the physicians have, it can now be cleared in the field.”
The biggest change the department has seen is the significant increase in runs. In 1991, there were about 3,500 runs. In 2012, there were 6,290. Last year, there were 6,037. This year, Brasher said, he’s confident his staff will reach 7,000 runs, which would be the most ever.
“I never fathomed that many runs. It’s wild,” he said.
The reason for the increase is the aging baby boomer generation.
“That will probably continue to increase for the next 10 years,” Brasher said.
There are also more industrial calls in Seymour, drug overdoses and farm accidents.
EMS responds to any trauma event, including some fires and fights, where they are called to stand by. They also make some runs that are nonemergency, such as kidney dialysis transports.
Bryant said it’s hard to pinpoint why the service is called more, but it could be attributed to billboards and advertisements that have increased awareness of signs or symptoms of a medical emergency telling a person when to call 911.
The uptick in runs is one of the reasons the department has expanded and most likely will continue to grow.
“We started out in 1991 with four ambulances, and now, we have seven plus one supervisor nontransport vehicle,” he said. “The way things are going, we are probably going to have to request eight.”
‘You miss a lot’
Despite the changes and transformations, Brasher said he hopes to make another change in the near future that he calls long overdue: Increasing wages.
Currently, EMTs starting out make a little less than $10 an hour.
“We really have a long way to go on our wages,” Brasher said. “And we’re really going to tackle that hard during the summer budget hearings.”
Staff members work 24-hour shifts. On their days off, most work other jobs.
“I’d say 90 percent of them have part-time jobs,” Brasher said.
They also miss out on some holidays and moments with loved ones.
“You miss a lot,” said Bryant, who has a 3-year-old son. “It’s just a lifestyle now. Christmas may not be Christmas Day, but it may be the day after.”
‘Pretty much family’
However, there’s the other side of the job that many of EMTs and paramedics wouldn’t trade for anything: The feeling of keeping the community safe.
“It’s the satisfaction of helping people,” said Valleri Curry, a supervisor paramedic who lives in Medora. “It makes you feel good that you truly help someone.”
Bryant, who said he enjoys a job that leads him outdoors on occasion, agrees.
“I enjoy being able to use critical-thinking skills to make on-the-spot decisions that could mean the matter of life or death sometimes,” he said. “That’s always exciting.”
Many of the emergency personnel also have formed a bond, particularly during intense or stressful moments.
“There are days where nobody should see what we do,” Bryant said.
That’s when they rely on their peers to help them get through.
“We talk among each other after a run that’s really bothering us, and some of us get together outside of work and do things. We’re pretty much family,” Curry said.
Bryant also said working in a smaller community is easier for him. It’s a risk to see someone you know or love out on a run, but he said he knows Jackson County EMS will do everything it can to help save a person’s life.
“I know they had everything done that’s possible,” he said. “It’s self-satisfying.”
The American College of Emergency Physicians was instrumental in establishing EMS Week when President Gerald Ford declared Nov. 3 to 10, 1974, as the first National Emergency Medical Services Week. This annual observance continued for four more years and was then reinstituted by ACEP in 1982.
“We do a lot in such a small area in the back of an ambulance that can completely make a difference in either their life or quality of life.”
Paramedic Nate Bryant