Honoring the Best in EMS

The National Association of Emergency Medical Technicians (NAEMT) and EMS World Magazine, in conjunction with the National EMS Management Association (NEMSMA) and the National Association of EMS Educators (NAEMSE), established the National EMS Awards of Excellence program to recognize outstanding achievement in the EMS profession. The nomination period for next year's awards will open in February 2013. Visit EMSWorld.com/awards

The 2012 awards will be presented on Tuesday, October 30, at the NAEMT Annual Meeting in New Orleans, held in conjunction with EMS World Expo 2012, and at the EMS World Expo Opening Keynote on October 31. We would like to thank the following sponsors of this year's awards: NAEMT Paramedic of the Year Award sponsored by Nasco; NAEMT EMT of the Year Award sponsored by Braun Industries; Dick Ferneau Paid Service of the Year sponsored by Ferno; Impact Volunteer EMS Service of the Year sponsored by Impact Instrumentation; and NEMSMA Executive of the Year sponsored by EMS World.

Award recipients receive a $1,000 award stipend, a three-day core program registration to EMS World Expo, plus $1,000 for travel and lodging to attend EMS World Expo and the NAEMT Annual Meeting.

NAEMT Paramedic of the Year: Kenneth Davenport, Paramedic, Marion, KY

Davenport is a paramedic with Lyon County (Ky.) EMS, and has worked in EMS since 1988. He was nominated by Adam Lyons, his director, who says that Davenport helped him adjust to the area as a new director to the service. He says that Davenport works for multiple agencies not for the money, but because he loves the job and wants to help as many patients as possible. Lyons said that Davenport is always willing to step in and help coworkers, and “his patient care is superb. He is intrigued by the patient's condition and what is causing their current symptoms or illness. He gets down to the root of the problem and treats patients and their family members with dignity and respect.”

Brent White, the son of a patient Davenport treated, relays how his disabled father had fallen at home. While the family believed this fall to be no worse than others he had taken, and the patient assured paramedics he was all right, Davenport asked him a few key questions before leaving the home and discovered the patient was experiencing pain behind his ear. “Without hesitation,” White says, “Mr. Davenport instinctively changed course and said it was imperative to get my father to the hospital as quickly as possible. Over the next several hours my family would learn that my father had a subdural hematoma and other significant damage to his brain that required immediate surgery.” The surgeon said Davenport's quick diagnosis and action saved White's father's life.

G. Allen Jones, EMT-P, his director at Trigg Co. Hospital EMS, says that “Every patient Kenneth encounters is treated with the utmost respect and care. Kenneth shows compassion and empathy for his patients and their families. He has touched so many lives.”

In addition, Davenport “is a leading force for continuing education for our organization,” says Lyons. “He is always trying to help keep himself and other members current on state and national standards.”

In his everyday work, “he has continued to impress me with his dedication,” says Jones. “Kenneth not only performs his duties above and beyond but he encourages everyone to do the same. He is constantly sharing and enlightening us with the continuous knowledge he possesses.”

Jones adds, “There are no words or amount of money that could compare to the compassion, time and selflessness that Kenneth has so graciously given to EMS. He constantly looks for the good in people and brings out the best in those around him.”

“Kenneth Davenport is an exceptional person and a paramedic who is highly regarded in the EMS community and truly deserves this award,” says Lyons.

NAEMT EMT of the Year: Dean Darling, EMT-I, Sauk City, WI

Darling is a EMT-I with Sauk City (WI) Prairie Ambulance Association, serving with the agency since 1982. He was nominated by his coworker, Joe Welsch. Welsch relates that Darling once responded to a pager call while off duty, and saved a pulseless, non-breathing man's life by starting CPR quickly before the ambulance could arrive. That man he saved was Welsch's father—and Darling was the reason Welsch became an EMT. “Dean is the best EMT I have ever known,” Welsch says.

As training director for the Sauk City Prairie Ambulance Association, Darling has trained every EMT with the service and is highly respected throughout the area for his knowledge of patient care.

“Many nights and weekends you can find Dean helping new and veteran EMTs review skills or teaching new procedures. He is a great teacher, mentor, and role model for all of us; his skills as an EMT are unsurpassed and respected by all,” says Kevin Weber, his director at Sauk Prairie Ambulance. “On calls, Dean’s priority is to give quality care and advocate for patients' health and well-being. He will accept nothing less than the absolute best patient care and treatment. Evidence of this is the numerous hours he spends reading articles and texts to continue to educate himself in the latest trends and techniques, continually practicing his advanced skills and afterwards imparting his knowledge and skills to the members of the service.”

“Dean is always looking for new ways to move the service forward,” says Welsch. Darling has introduced several new programs, including:

• A program to fund and place defibrillators in all ambulances. As part of this program, Darling established a field response program: When defibrillators are replaced in ambulances, EMTs now carry the still-useful defibrillators and a medical kit in their personal vehicles in case they need to quickly respond to a cardiac arrest.
• The area's first-ever bike medic program, which allows EMTs on bicycles to respond quickly to patients in very crowded areas during events. This program has cost-effectively saved lives.
• Upgrading Sauk City Ambulance from a basic level volunteer service to intermediate IV level. Although all members had to undergo additional training, Darling convinced them that it would be best for the community.
• Working with law enforcement to form a search and rescue team, prompted by the lack of one to find a missing child. Darling has met with the county sheriff to gain support, and is fundraising.

James Anderson, Village President of Sauk City, says that “Dean has worked well above and beyond expectations as a volunteer to keep SPAA a quality service. He has incorporated a number of techniques that give SPAA the ability to deal with more serious traumas as well as routine EMS services. Dean started Combat Applied Tourniquet (CAT) to help with the more extensive injuries and spent a considerable amount of time to make this a quality project. He spoke with local military personnel to learn how CAT was used on the combat field so he could teach the proper application.” Darling also introduced intraosseous (IO), Anderson says, spending a good deal of his own time in learning the process before he taught the other members of SPAA.

“Without his dedication, this service would not have survived,” says Weber.“I have never met and probably never will meet a person who is as dedicated and giving of his life and who puts his whole heart into EMS as Dean Darling. I would trust my life to him.”

“The work he has done and continues to do for the community is absolutely amazing. Dean is the backbone of the Sauk Prairie Ambulance Service and does a phenomenal job,” says Welsch.

Dick Ferneau Paid Service of the Year Award: New Orleans EMS, New Orleans, LA

No one would diminish the epic tragedy of Hurricane Katrina, which in 2005 led to the deaths of more than 1,800 Americans and shattered an entire region of the country, including the beloved institution of New Orleans. But if any good can come from such a calamity, it’s the premier prehospital care the Big Easy receives today.

At the forefront of that is New Orleans EMS, whose rise from the floodwaters earns it the 2012 Dick Ferneau Paid Service of the Year Award, presented by EMS World and the NAEMT and sponsored by Ferno.

Katrina still shapes NOEMS’ circumstances in countless ways, from the temporary quarters that house its crews to the number of hospitals that can take its patients. The city’s still poor and struggles in many areas. Further storms and other events continually buffet the Gulf area. But with a little federal help, a lot of individual dedication and a forced starting-over, New Orleans EMS has emerged a stronger, more capable service marked by innovation and quality care.

“Our people know they could go work someplace else where it’s not as busy,” says Jeffrey Elder, MD, the service’s director and medical director. “A lot are here because they value the experience. We have a lot of sick medical patients. We have a good amount of trauma. As a paramedic, you get a good clinical experience here seeing a lot of different patients.”

You will be busy, though: Still a bit stretched for resources, NOEMS fields only 10–12 ambulances at peak hours (when the service population can grow to 700,000) and as few as six overnight. Then there are 20-plus special events each year, including bacchanals like Mardi Gras and sporting events. The service’s UHU runs around 0.75; crews handle it with occasional assists from the fire department, private services and neighboring systems.

Those connections are stronger now horizontally, through mechanisms like common protocols and a council of metro EMS leaders, and vertically, with an increased presence in emergency management circles and access to big federal funding sources (MMRS, UASI, etc.). That’s helped NOEMS bring state-of-the-art tools and capabilities to the field even while it lacks a permanent base. “We have all the equipment now, we just don’t have the home,” notes Carl Flores, the service’s deputy director and chief of EMS. “Hopefully, once our new building is ready in early 2014, that’ll complete the circle and allow us to ultimately heal.”

Here are some of the reasons why this year’s panel of EMS experts selected New Orleans:

• NOEMS implemented therapeutic hypothermia for cardiac arrest patients and told local hospitals they’d have to continue it to receive them. “That really jump-started the whole region to get policies in place,” says Elder. It’s similarly helped promote rapid assessment and intervention for time-sensitive STEMI and stroke patients.

• In the field, it’s equipped crews with tools like ResQPODs and LUCAS devices, CPAP, tourniquets, hemostatics, video laryngoscopes and IO systems, as well as powered cots and reflective apparel. New disaster resources include trailers, shelters, boats and a mass-casualty bus.

• Through a partnership with LSU, EM residents work in the field alongside medics. “The medical control doctors know who the paramedics are, the paramedics know who the doctors are,” Elder says. “It benefits communications.”

• NOEMS has the city’s primary extrication and rescue responsibilities. “Paramedics understand the science behind what’s going on with the patient and vehicle,” says Flores, “and how manipulating the vehicle might cause further damage.” Personnel train and work closely with firefighters on such scenes.

• A dedicated education/training division now oversees employees’ orientation, training and CE. Training encompasses NIMS/ICS, the range of “alphabet” courses, defensive driving, hazmat, rescue fields and more.

• Under the VIGOR program (Volunteers in Government of Responsibility), more than 100 volunteer EMTs and paramedics join crews to help provide care during peak times and major events.

• NOEMS is a rare system that uses prehospital ultrasound. That’s currently restricted to physicians, but should soon extend to medics.

• Working many unique special events requires expert planning based on historical data and use of a full array of Gators, bikes, sprint cars and extra ambulances.

• A paramedic/RN is devoted to identifying frequent nonemergency 9-1-1 users and connecting them with resources to meet their needs.

• Ambulances have rear-view, driver- and passenger-side cameras, LED lighting and Howler sirens. Around half, including all new vehicles, have DriveCams. Specs also include the Kelderman Air Ride suspension system, which lowers the rear of the ambulance for patient loading.

“The main thing people should know,” Elder says, “is that none of this would have happened if not for our people working the streets every day. We know it gets hard out there, and without them we wouldn’t be anywhere. That’s the key to the success of this whole operation.”

“It’s not a perfect system,” adds Flores. “We wish we had more budgetary support and could have more units out there. But as a group I think we’ve been able, through the dedication of the people running the calls, to achieve a great amount of success. So hats off to them for sure.”

Impact Volunteer EMS Service of the Year: Friendswood Volunteer Fire Department Emergency Medical Service, Friendswood, TX

Founded in 1972, Friendswood Volunteer Fire Department Emergency Medical Service has, from its beginning, been a true community enterprise.

Local “Father of EMS” Van Williams convinced the city council an ambulance was needed and a used Ford Fairlane station wagon was purchased and outfitted to take over transport calls from the local funeral home. In 1974, with trained EMT volunteers working shifts on evenings and weekends, the ambulance was sitting idle by day. So the women of Friendswood—mainly the wives of volunteer firefighters—went to school, got trained and took over the day shift until the husbands came back from work in the evenings to take over the night shifts, says EMS Chief Lisa Camp.

From there, Camp says, the small service has continued to innovate and stay at the forefront of emergency medicine.

Friendswood VFD EMS provides service to the city of Friendswood and its approximately 38,000 residents. The service responds to between 2,500–2,600 primarily medical calls per year in 27.5 mile service area. Out of about 105 total fire department volunteers, there are 58 volunteers EMS providers, as well as approximately 10–12 paid part-time staff who help cover day shifts while the regular volunteers are at work. Friendswood functions as a mobile intensive care unit (MICU) with BLS capabilities and operates three Chevy C-4500 ambulances—one on duty 24 hours per day—made for the service by Frazer, Ltd. in Houston.

Camp credits the high level of community spirit among volunteers for the service’s continued success. “All of the medics believe they’re neighbors helping neighbors, that’s kind of our motto,” she says. “You look at the group of volunteers we have—FBI agents, nurses, educators, licensed paramedics, even one guy with a double master’s degree who builds medical equipment. This unique grouping of people has an interest in EMS, but they do it because they want to help their neighbors. It’s a unique camaraderie that holds us together, because everyone around us is paid or partially paid. We’re kind of an anomaly in the Houston area.”

Friendswood VFD EMS receives the majority of its funding from the city. Camp says an approximately $2 million annual operating budget covers fire, EMS and part-time salaries, with EMS receiving about $800,000 in annual funding. As a 501(c)(3) corporation, the service also receives a fair portion of its funding through donations, though the public funding through the city covers all of the department’s daily operating costs. Since the early 1980s, a bi-monthly voluntary $6 donation on city water bills—paid by about 44% of the city’s population—has also enabled the service to cover the cost of replacing all of its rolling stock on its fire and EMS vehicles. Grant funding also helps with larger equipment purchases, such as ventilators and cardiac monitors. And, Camp says, she often works with other area chiefs to determine shared needs and purchase supplies in bulk at a discount.

Always trying to stay ahead of the curve, Friendswood VFD EMS recently entered into a research study with Houston-area Christus St. John Hospital for lactic acid monitoring and also put an excited delirium protocol in place with local police. Recognizing a rise in excited delirium cases, Friendswood worked with law enforcement to establish a protocol of sedation for patients exhibiting excited delirium, as recent studies have shown sedation is saving these patients’ lives. “We’re able to get these patients sedated in the field and transported safely,” says Camp. “That’s been a real higher standard of care for us. We’re a small bedroom community and unfortunately we do have drugs. And the police are really good at recognizing it.”

Friendswood was the first agency in its area to get ZOLL AutoPulses in 2007 and it’s in the process of switching to the LUCAS Chest Compression System from Physio Control. Additionally, Friendswood providers have offered hypothermic post cardiac resuscitation since 2007 and the agency started using CPAP as a standard of care in 1997 or 1998.

“A lot of the things we’ve been doing for a long time are becoming the standard of care now around the nation,” Camp says. “Once something comes to the forefront, we research it to find out what’s best for our service and patients, so that we are giving the best care to increase the survivability of these people.”

Visit Friendswood VFD EMS online at www.friendswoodvfd.com.

NEMSMA Executive of the Year: Tim Hearn

When Tim Hearn became executive director of Ft. Smith EMS, the service was on the verge of bankruptcy. It was understaffed, according to a colleague who nominated Hearn as America’s top EMS boss, had obsolete equipment, owned no real property and, despite serving the second-largest city in Arkansas, was valued at less than $500,000.

Four years later, the turnaround Hearn’s overseen has earned him honors as the National EMS Management Association’s 2012 EMS Executive of the Year. He was to receive the honor on October 31 at the official opening of EMS World Expo in New Orleans.

“Our citizens deserve to have the very best, and we won’t settle until we have it for them,” says Hearn, who was an ER paramedic and educator at a local hospital before assuming control of the EMS service in 2008. “That’s what we’ve pushed for four years, and I think that’s where we are now.”

Getting there began with a plan so ambitious it initially prompted laughter from the city board. Hearn sought an accelerated replacement schedule for trucks and to replace every piece of the service’s outdated equipment. He wanted to bolster staffing, upgrade education, improve technology, and build a new corporate headquarters and comms center.

And he wanted some good leaders around him. For nearly three decades, Ft. Smith’s executive director had been its only “suit.” As his first order of business, Hearn hired a business manager to work on improving collections and cash flow. An operations manager followed, then a 9-1-1 center manager who doubled as a grants administrator.

“I knew I had to assemble a good management team first so we could start working on changing things,” Hearn says. “We had good personnel; we just didn’t have everything else we needed. For the size of our town, we were behind. We had to strive for excellence.”

The payoff came quickly in the form of better collections, trained account representatives and successful grant applications. In one fiscal year, Ft. Smith EMS went from losing $180,000 to turning a profit.

Equipment posed the next challenge. While Ft. Smith met all its requirements for state licensure and operation, much of its inventory was old, dated and needed upgrading. Over the next few years, Ft. Smith undertook to replace every single piece: cots, stair chairs, monitors, ventilators, pumps, LUCAS devices, EZ-IOs, laryngoscopes and more. They also put EMS units on a two-year replacement cycle.

With newer tools came newer technologies: state-of-the-art cardiac monitors and 12-lead transmissions, ePCRs, vehicle data recorders, automatic vehicle location, computer-aided dispatch, Toughbooks, even two different models of video laryngoscope. This year Ft. Smith becomes the first service in Arkansas with Stryker’s Power-LOAD to automate cot lifting and lowering.

“That’ll save backs,” says Hearn. “Every time I talk to a vendor, I tell them, if it’s out there and it’s better for our citizens and paramedics, whether it’s a treatment or a safety measure, I want it. I want our paramedics to have the best equipment to work with they can.”

The service has worked closely with local hospitals on stroke and STEMI care, slashing times to intervention. It’s cut response times and improved 9-1-1 call processing. Educational offerings for providers have been expanded, and work is ongoing to bring an accredited paramedic program to Ft. Smith. With the help of grants, it’s procured resources like a trauma trailer that will serve five counties. In turn it’s been recognized as Arkansas’ ALS Service of the Year and with the 2012 Horizon Award from APCO International.

Across the community, Ft. Smith EMS has sought relationships with local nonprofits and health advocates and promoted activities like biking and after-school physical fitness. It distributes food to locals in need. It buys up unsold PTA memberships. That civic spirit reflects in its employees, who have responded to the renaissance with record volunteering of their time and efforts.

“What we invest in our employees, they more than pay back,” Hearn says. “Volunteerism is at an all-time high. Our bike team’s an example of that. It’s completely volunteer-based, and that trailer’s gone every weekend working events. Four years ago you wouldn’t have seen that. I believe it’s because our employees believe in our company now. They feel part of it, they feel ownership, and they know the company’s doing everything it can to take care of them.”

In January 2011 Ft. Smith EMS broke ground on a new 12,500-square-foot home to replace the 2,000-square-foot retired fire station into which it’d previously been crammed. The new digs, occupied that June, include offices, crew quarters, training facilities, records housing, a supply warehouse, and indoor parking for EMS vehicles. By this summer the building was paid off; the service is now procuring more property for further growth.

There’s no magic formula for rebirth, but for leaders of similar struggling services seeking turnarounds, Hearn has some tips.

“No. 1, and some people chuckle at me, is you need to pray,” he says. “You need to listen to your people, their wants and needs and what they see in the community. I share information with my employees, including finances—I let them know where we stand. As the director, I make sure I’m surrounded by people who can do the job, both in the field and in management. And if you want to be blessed, get involved in community efforts. Get plugged back into your community, and your community plugs back into you, and will support you in everything you do.”