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Ambulance Service change enhances delivery of care

When a person calls 911 for an ambulance, minutes can seem like hours while waiting for it to arrive. When the ambulance arrives, the team moves into action like a well-oiled machine, knowing that everything they do is critical to the survival of the patient.

With the transition of the New Ulm Medical Center ambulance service from basic life support (BLS) to Allina Medical Transportation ownership and advanced life support (ALS), bystanders will be able to fill those few waiting minutes with actual hands-on assistance to the patient, thanks to pre-arrival instructions from the dispatcher. When the team of paramedic and emergency medical technicians arrive, they’ll be able to provide more life-saving procedures in the field than ever before.

New Ulm Medical Center successfully made the transition to Advanced Life Support on August 1, 2006. The change meant a transfer of ownership to Allina Medical Transportation (AMT). Now, in addition to the excellent group of EMTs that NUMC has always had on-call and ready to respond to emergencies at a moment’s notice, there will be a paramedic on duty 24 hours a day.

Several years ago, NUMC President Lori Wightman began looking at upgrading the ambulance service to ALS.

“Geographically, it’s a need for this area,” Wightman said. “One thing I was hearing from patients was that when they needed to be transferred to another facility by a paramedic, they had to wait for Gold Cross ambulance to come from Mankato and that wait was very difficult for them.”

With the upgrade to the ALS service, transfers will be handled by the Allina Medical Transportation ambulances and the local crew of a paramedic and an EMT.

The decision to transfer ownership of the service to Allina Medical Transportation was based on several factors: they would be able to handle the billing, dispatching, and the education and training of paramedics and EMTs.

“Part-time ALS is the best of both worlds,” said Susan Long, the ALS Ambulance Transition Manager at the medical center. “Part time means there will be one paramedic on duty, but if they are away on another call, the basic life support kicks in and we constantly have coverage.”

While an EMT is able to stabilize a patient in the field and begin many of the life-saving measures necessary while transporting them to the emergency department, a paramedic receives a different level of education and is trained in more advanced procedures. They are able to give more medications, they can intubate and start IV’s and they have more advanced assessment skills.

“Paramedics operate according to protocols that were created by a consortium of ambulance medical directors out of Hennepin County,” said Joan Krikava, MD, an emergency medicine physician and the Medical Director at the New Ulm Medical Center. “The protocols are a very specific set of rules which guides them. They are also working under the supervision of a physician. They maintain close communication with a physician regarding the patient before the patient ever reaches the emergency department.”

With the transition to ALS, dispatching will now by handled by Allina Transportation Service, Long said. The 911 call will go to the Brown County Law Enforcement Center as it always has, but then will be transferred seamlessly to AMT in St. Paul. After AMT has dispatched the ambulance crew, they are then able to give pre-arrival instructions to the caller, such as coaching them to begin CPR.

“It really provides what we call zero response time because they can begin giving care immediately,” said Julie Halvorson, RN, NUMC Emergency Department Manager.

In addition to the pre-arrival instructions and the newly outfitted and re-designed ambulances with the AMT logos, people can expect to see the ambulance crew staying on the scene of the call for a longer period of time, Halvorson said.

“They will stay on the scene longer to stabilize the patient and to start some of that advanced level care that can be life saving,” Halvorson said. “When you transfer a patient, you interrupt care which can sometimes have a detrimental effect on the patient.”

For the New Ulm Police Department this will mean changes, too, Long said. “They are on the scene to assist the EMTs now, so as our paramedics are on the scene longer, the police will be too. It will be a change for them as well.”

Wightman agreed that this improvement is very much about great partnerships.

“We would not be able to do this if not for partnerships with Allina Transportation Services, the city of New Ulm, the Brown County Sheriff and the New Ulm Police Department,” Wightman said. What will remain the same is that the city will continue to help subsidize the ambulance service in some way. “In the past, they have purchased ambulances for us. Going forward we will still have support from them in some way. We are very grateful for the support they have given.”

Along with these continuing partnerships that have always been in place will be new faces and collaborations with the transition to ALS. Five new paramedics and a supervisor (who will also be a paramedic) will be hired over the next few months. In addition to overseeing the day to day operations, the supervisor will be charged with closer involvement with the community, building tighter relationships with the first responders such as police, sheriff and fire departments and providing additional training for them.

New Ulm Medical Center
1324 Fifth St. N.
New Ulm, MN 56073
507-233-1000
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