Off-Road EMS Hits the Mark

What would you do if your area of service included a thousand-acre wood with over a hundred miles of dirt bike trails through it? A lot of places like this have a sign on a post warning, "Enter at your own risk." But Georgia EMT-Is Lewis McClain and Josh Wheelis had another idea: EMS ATVs. "My brother was into motocross," says McClain, "and we were at a track one day when somebody got hurt. It took an ambulance 30 minutes to get there and another 15 minutes to find them in the woods. That's not a good level of care." So he and his EMS partner came up with the idea of taking an all-terrain vehicle and refitting it "like a miniature ambulance."

     Now their state-licensed Trauma Care Emergency Services, Inc., located an hour and a half east of Atlanta, operates an EMS service that averages three minutes response time at one of the biggest outdoor sporting venues in the country, he says. Their off-road fleet includes two Polaris Ranger utility vehicles (MEDCARTs), equipped with a backboard for transport; two smaller quick-response vehicles (QRVs) with BLS equipment and two Ford Rangers--certified mini trucks by the state of Georgia for first responder vehicles. These are regulated by the same body that regulates ambulance services.

Utilizing Every Inch of Space
     McClain says their ATVs are all Polaris, but any number of makes would work as well. These mini ambulances have lights and siren and can carry everything you'd find in an ordinary ambulance. "We just had to use lots of space-saving methods. We carry spare oxygen tanks mounted under the front hood. There's a bench seat-type box in the back--it came out of a boat--and inside it are oxygen supplies, spare gauze, cold packs and hot packs," says McClain. "We carry an AED or a cardiac monitor--depending on if we have a paramedic or not on site for the day--backboards, traction splints, MAST pants, KEDs. We've got suction units, IV kits, a blanket, sheets. And then we also have a bag with more oxygen, an intubation kit, splints and collars.

     "If you look at the requirements for an ambulance in Georgia, we may not carry large volumes, but we have some of everything required." He explains: "We use adjustable C-collars instead of having a different one for every size patient. So with two C-collars, we've got 18 different sizes. Instead of normal head-immobilization blocks, we use these cervical immobilization devices that store flat, but pop up into place. We use corrugated plastic splints that also store flat."

     McClain and Wheelis employ 15 EMT-Intermediates and three paramedics, and contract with special events and outdoor sporting facilities, including the family-oriented Durhamtown Plantation Sportsman's Resort that is 8,000 acres of more than 130 miles of off-road trails, five tracks for ATVs and motorcycles, camping, lodging and RV hookups. Proprietor Mike McCommons says they help business, offering a "security blanket" families like knowing they have. "You cannot imagine the impact and the lives saved," he says. "These guys know more about ATV and bike injuries than anyone in the country and they respect my riders rather than condemning them."

     Providing emergency response on ATVs for a population that ranges from 500 folks on a slow weekend to 1,500 on a busy one can't be easy, but McClain says, "We've been able to maintain an airway and do adequate CPR on these things. We're mostly set up for trauma--which is what you expect with motorcycles--but we also handle medical calls. Just recently, we've had three cardiac arrests and had a good outcome with two of those."

     Patients get two responders with each vehicle--the second attends from the bench seat in the back. They treat and package patients out on the trail where the accidents occur, calling a Wilkes County EMS ambulance by radio if hospital transport is needed. The ambulance will get there in 22 minutes or so, says McClain, which allows their ATV to take it slow coming out of the woods, C-spine precautions and other treatments in place.

     For more information, visit www.traumacareems.com, or call 404/379-2246.