Mobile Intensive Care Unit Offers Training for EMS Providers in Geriatric Care

     With the coming of age of the Baby Boomers and improved technology and healthcare extending the lives of the elderly, there's a new awareness that this senior population has special needs that will require a new approach to medical care. New Jersey-based Virtua Health's Mobile Intensive Care Unit is meeting this challenge with a training program for EMTs and paramedics on how to attend to the special needs of senior citizens in the critical time before they arrive at a hospital.

     "Most EMT programs only spend about 1% of the time talking about geriatric patients, yet 33% of 9-1-1 calls relate to the older population," says Dorothy Engel, Virtua's EMS education coordinator. "In our classes, we spend a lot of time talking about how the older patient differs from younger patients and some of the challenges dealing with them. We go through sensitivity exercises where students put on glasses that restrict their vision and try to look up a number in a phone book, or they try to pick different colored pills out of a pile with glasses that restrict or change their color perception. They attempt to pick up things with gloves that simulate arthritic hands or open bottles while wearing those gloves. We ask students questions in a normal voice when they're wearing ear plugs, so they understand the frustration older patients feel when they can't hear."

     In New Jersey, the special attention to seniors doesn't stop at the emergency department door.

     "One of the weaknesses of the EMS system nationally is that many agencies bring their patients to the ED or deliver them to the receiving floor of the hospital, say good-bye and go on to the next call," says Scott Kasper, MS, NREMT-P, MICP, corporate director of Virtua Health's emergency medical services. "One of our advantages of being a hospital-based paramedic service is that we don't stop at the ED. Our EMS service is well integrated with all of the clinical services departments, so it becomes more a continuum of care than it is just teaching EMTs and paramedics how to take care of the elderly for the 15 minutes they have them. After Dorothy began to educate folks about geriatrics for EMS, some of the paramedics started to inquire about how to plug patients into the appropriate social services, whether it was Meals on Wheels or other types of services. When it became part of their thinking, they became more proactive about dealing with it."

     Since the program just started last December, only three classes have been run, but they have been very well received, says Engel.

     "The other interesting thing is that a number of other people, like hospital administrators, nurses and even one individual from a long-term-care facility, have attended the classes," she says. In addition to EMTs and paramedics, police and fire personnel are also encouraged to participate.

     The training program offered through Virtua MICU was developed by the American Geriatric Society. For more information on Virtua's geriatric care program, visit www.virtua.org, or call 888/VIRTUA-3 (888/847-8823).

In other EMS News

Report Faults Response To London Bombs
     An official report from the London Assembly's July 7 Review Committee determined the city's emergency services could have been better prepared for last year's terrorist bombing attacks.

     Areas of failure included a lack of communications between the emergency services, the way survivors were treated and a lack of basic medical supplies, the report said.

     The committee made 54 recommendations for improving future efforts, and will review actions taken by the city's response entities this November.

     "No one is hung out to dry or blamed," investigation leader Richard Barnes said, "but we have been asking what needs to be put right."-Daily Post

NENA Marks E9-1-1 Progress
     More than three-quarters of the U.S. population now have their phone number and location automatically provided to 9-1-1 call-takers, the National Emergency Number Association (NENA) reported in June, representing an 8% increase in the number of Phase II deployments since last December.

     Over half the nation's counties, however-primarily those in rural areas-are still unable to provide the service. A report this year from the Government Accountability Office, entitled Telecommunications: States' Collection and Use of Funds for Wireless, warned that five states may never achieve full Phase II compliance, and in seven others, it was expected to take at least four more years.-NENA