Council Bluffs Fire Department Paramedic Matt Nurton
May 17-23 is National EMS Week
National Emergency Medical Services Week brings together local communities and medical personnel to honor those who save lives every day on medicine's "front line."
The man’s hand was wrapped when EMTs arrived; he told them he’d lost two, maybe three, fingers in a workplace accident.
Paramedic Matt Nurton did some quick thinking, recalling a previous serious injury he’d seen from a lawnmower accident. He remembered that CHI Health Mercy Council Bluffs had a physician who specialized in hand surgery.
“I contacted them (Mercy) to see if they would accept the patient for an initial review,” Nurton said, “Or to see if they would like us to transport him to Omaha (to a Level I Trauma Center).”
The hospital tech wasted no time. After checking with the emergency department physician, she directed the rescue squad to Mercy. When the patient and medics arrived, the doctor --Robert Graham, MD -- met them at the door. He’d alerted the hand surgeon and she was on her way.
Nurton was thrilled to see the patient get the best –and fastest -- possible care following what could have been a devastating accident.
“The surgeon was in the patient’s ER room before I finished getting a new drug box (to replace medications that had been used in the squad) and finalizing my paperwork,” Nurton said. “I know the ER staff likes to see patients with their own eyes before making such big moves, such as contacting surgeons. Their doing this based on my report shows great rapport between Council Bluffs Fire Department (CBFD) medics and the ER nurses and doctors.”
The cooperation didn’t end there. “The city was busy and all the squads were out of service on calls,” Nurton said. “The nursing staff made my job of getting back in service easy by providing me, for example, with signatures needed.”
Nurton said the call couldn’t have gone better: “All parties involved worked like a well-oiled machine to provide the patient the best end result for his care.”
“Having a strong relationship with EMS can truly expedite treatment because of the trust we have with pre-hospital providers,” said Mercy Trauma and EMS Nurse Coordinator Katie Pierce. “Patients can always pick up on both teamwork and conflict. I believe the sense of camaraderie goes a long way to reducing patient anxiety.”
The relationship continues to get better and better, said Fire Department EMS Division Chief Rick Benson. “It used to be the hospital and EMS each doing their own thing,” he said. “Now it’s more of a system. We’ve developed rapport. The trust has developed over the years.”
More extensive education today helps EMTs and paramedics make better decisions in the field, he said. Newer technology also helps. For example, 12-lead EKGs mean the heart’s electrical activity can be recorded from the field to determine if a patient is having a heart attack. The chest pain center will be alerted if he is and medical staff can stand ready when the patient is brought in.
EMS also gets great feedback from the hospital, Chief Benson said. “They’re never afraid to tell us what we could have done different or better.” Mercy’s Pierce also lets them know what happens to a patient once he or she is transported to Mercy by EMS. “So we can learn if there’s anything we should have done differently.”
“In medicine, you need to see the ‘whole picture,’” said Pierce. “What the initial presentation is,what treatments to do and what the outcomes are. The more you connect a group of symptoms with the ‘rest of the story,’ the better prepared you are for the next patient.”
Nurton, who’s been a paramedic for three years, said he likes working with Mercy staff “because they’re always ahead of the game.”
He said “stroke alerts” are another good example of hospital-EMS partnering for the good of the patient. Medics at the scene assess the patient to see if he or she is suffering from a stroke. “We do the initial assessment and take vitals,” he said. “Right away we give them (the hospital) the notification as to whether it’s a stroke alert or not.” The alert saves valuable time. Medics can take the patient directly to the CT scan room, bypassing the emergency department, based on the medic’s call.
“When we wanted to streamline stroke care by taking the patient straight to CT, we asked the Council Bluffs Fire Department to collaborate with us,” said Pierce. “This had never been tried in the metro area, so there was no precedent for us to follow. The process as we set it up is very dependent on the medic’s determination that a patient meets criteria. It has been an amazing success, thanks to the medics at CBFD.”
“They let us make big decisions in the field,” Nurton said.
Traditionally, hospital staff would see the patient in the emergency department before any decision was made, he explained.
“Not having to wait benefits the patient immensely.”
The teamwork results in a familiarity that also benefits the patient, said Pierce. “Many times we know exactly who the medic or EMT is just from hearing their voice. When you know people that well, you can hear cues in their rate, tone or intensity as to how serious a situation is going to be.”
Great EMS-hospital relationships are a good reason to call 911, instead of driving yourself or having someone drive you to the emergency department, Chief Benson said. “Matt (or the EMT) starts the ball rolling. This is especially important if you’re having a stroke or heart attack. He’ll give you the aspirin, start the IVs, obtain the EKG. In some cases the patient can bypass the ER and go directly to the Cat scan or cardiac catheterization lab. That means treatment sooner.”
And that potentially can save a life. “Time is everything,” Chief Benson said.
The Council Bluffs Fire Department is being honored with the American Heart Association Mission: Lifeline EMS Recognition for its vital role in providing timely treatment for STEMI (the deadliest form of heart attack) and cardiac resuscitation patients.