EMS docket: Tech, training, recruitment

The Shelter Island Emergency Medical Services team takes pride in quickly responding to medical emergencies and rapidly getting patients to the area hospital that best suits their needs — despite being surrounded on all sides by water.

But many of the problems facing the EMS team also confront mainland agencies: Rising costs for equipment and supplies; keeping pace with technology; and recruiting, training and retaining qualified volunteer personnel.

So says Detective Sergeant Jack Thilberg of the Shelter Island Police Department, who also serves as the Town’s director of emergency medical services, a part-time, paid position. He met with the Reporter last week to review the activities of the 26-member all volunteer squad, which made 276 emergency calls in 2016.

Most notably, the non-profit Shelter Island Ambulance Foundation has donated $85,000 toward the purchase of an ambulance.

A 2015 vehicle, now the primary ambulance in the fleet of three, cost over $200,000 and is expected to last at least 15 years. The latest donation — from funds raised in events like the annual Shelter Island Cricket Club match — keeps the corps on schedule to buy a new rig about every five years, he said.

A digital radio system, long in the works, is now in use; an educational fund was set up to support additional training for EMS providers; the corps purchased video laryngoscopes to assist with intubation; a pilot project is underway to replace expensive ephinephrene auto-injectors; and basic EMS personnel are being trained to use 12-lead ECGs that enable remote assessment of cardiac patients.

Importantly, the new radio system connects EMS personnel to other town departments, has clear coverage Island-wide, and means volunteers no longer have to carry a pager and a radio.

“In wintertime, we might need a highway truck to plow the ambulance to a call,” Mr. Thilberg said. “Now the driver of the highway truck will be able to talk directly to the ambulance,”

The educational fund augments the publicly-funded budget for training.

“If you come to me and say ‘I want to be a paramedic’ and I don’t have the full $10,000 for training in my budget, we would use the education fund for that,” Mr. Thilberg said.

A video laryngoscope costs about $2,500 and uses a fiber optic camera to give a direct view of the larynx, reducing risk of error.

“There is nothing better than it in EMS,” he said.

Basic EMS responders are also learning how to use a 12-lead electrocardiogram that transmits data to Stony Brook University Hospital and enables a change of course to a specialized facility if a serious issue is detected.

“This is critical in the identification of STEMI,” Mr. Thilberg said, using an acronym that stands for ST Elevated Myocardial Infarcation and refers to that segment in a ECG where evidence of life-threatening conditions may be spotted.

With the price of EpiPens surging to $400, the squad joined a pilot program to evaluate the effectiveness of allowing basic EMS personnel to use a $75 kit that enables doses of epinephrene ­— used to combat anaphylactic shock — to be administered by syringe.

With each ambulance carrying four EpiPens, which have a limited shelf life, he said, “we may end up throwing away $4,000 to $5,000 of expired EpiPens a year.”

Critical to the success of the corps is the recruitment of new volunteers, Mr. Thilberg said. Anyone age 18 or over who has a drivers license is welcome to join. Initial training takes about 135 hours spread out over six months, and continuing education for recertification takes place in classes that can be attended in person or, in some cases, online.

Once certified in basic EMS protocols, volunteers are expected to take part in 10 percent of calls and attend monthly meetings and training sessions. Not all volunteers are involved in patient care; some prefer to drive or handle other non-medical tasks.

There are perks, Mr. Thilberg said. Those who serve 20 years may be eligible for the town’s longevity of service award, which provides a pension. After five years of service, volunteers may qualify for a property tax abatement.

In towns around the Island, EMS agencies struggling with recruitment are turning to part-time, paid employees to augment their volunteer squads.

“We are still able to carry this agency as a volunteer agency,” Mr. Thilberg said. “In five years, I don’t know that I’ll be able to say that.”