Prehospital Profiles: When Medics Need Assistance

For volunteers at East Amherst Fire Department, their emotional well being is an important part of the care they provide their patients. With that thought in mind, the East Amherst Fire Department, which serves the cities of East Amherst and Clarence, New York, implemented the Firefighter Assistance Program in 2006. The program focuses on ensuring its member firefighters are in the best possible condition, both emotionally and physically.

"There are a lot of stressors that come with this job, as well as those outside of what we do," says Mike Morris, EMS coordinator with the department. "We are a 100% volunteer department and we found that some of our members weren't able to get this type of assistance through their employers. In addition to doing everything possible to provide the best service to our community, we also work hard to provide great services to our members."

EMS World recently spoke with Morris about the Firefighter Assistance Program and how it encourages emotional and physical well being of its department members.

What types of services are offered through the Firefighter Assistance Program?

The program provides assistance related to addictions (including drugs, alcohol and gambling); financial counseling; emotional/psychological problems (including depression, anxiety, eating disorders, etc.); and personal relationships (including those related to spouses/significant others and the workplace).

In 2009, the department added a physical fitness aspect to the program when it contracted with an athletic trainer who focuses on the physical well being of the department members. Since its inclusion, a number of members have lost significant amounts of weight and have drastically improved their health.

We offer up to six face-to-face sessions free of charge to our members. If additional sessions are needed, we try to work with insurance companies to obtain coverage.

How is the program implemented?

An outside vendor manages the program for us. This allows us to maintain confidentially, which is very important. In a small town, everyone knows everything about everybody. A lot of these services are related to personal issues, and it's important for us to maintain the integrity of the program. The administrator may know who goes through the program, but they may not know necessarily for what.

Are programs such as this more important now than in years past?

There are so many outside stressors affecting our members today. And we're asking them to do more at the department. Our call volume continues to increase as more people utilize the EMS system. In my district, we have a number of adult residence homes, so we answer a huge number of cardiac arrest calls from our aging residents.

Also, because we're a volunteer department, we have a neighbors-helping-neighbors concept. The good part of that is you get to help your neighbor. The bad part is that you usually know that neighbor. Sometimes when you put a name and face to the person you're helping, it can be more difficult to deal with the situation.

Another example is the aftereffects of catastrophes such as Flight 3407. The commuter airplane crashed in 2009 less than four miles from us. We were on scene within 10 minutes. While there wasn't an emergency medical request for passengers, we knew we were dealing with a catastrophic event and the thought that we might know someone who was on the flight. While we participate in a county-wide program for stress debriefing, some people may be more comfortable with individual counseling rather than talking in groups. That's where our program comes in and provides benefits.

Each year we evaluate its effectiveness, and it's difficult to put a dollar value on it, but we know we are helping people. We know we've had members utilize the program, and we've had more successes than failures. As long as we can continue to provide assistance, we deem the program a success. It's just one more thing we can offer to our members for doing the job they do.

DEPARTMENT PROFILE: EAST AMHERST (NY) FIRE DEPARTMENT

Type of department: 100% volunteer

Number of employees: 56 firefighters (28 New York State-certified as EMT-basic, 4 as EMT-intermediate, 6 as EMT-paramedic; remaining members are CPR certified on an annual basis)

Service area: Seven square miles within the towns of Amherst and Clarence, New York

Call volume: About 900 calls per year, including fire/rescue and EMS response (which accounts for about 70% of call volume). Within our district there are three nursing homes, four independent/assisted senior housing facilities, an array of commercial structures, 6,500 residents and a hospital. We partner with a commercial ambulance service, Twin City Ambulance, which has allowed us to build a tiered response system to ensure the residents of our district receive the best ALS care possible 24/7. It's a win-win for everyone, including our residents. We can also provide ALS service to neighboring fire departments if requested.

What makes your service different or unique: We are the only fire department providing ALS service in the Amherst/Clarence communities, which covers almost 100 square miles. Our EMS services started in the late 1980s when a district resident donated a defibrillator. That donation triggered a wave of enthusiasm that brought about our enrollment in New York State's pilot defibrillation training program. At one point we were the only fire department with defibrillation capabilities in Amherst and Clarence. Through mutual aid, we made ourselves available to our neighboring departments.

We are proud we've been able to advance and move to the next levels -- from EMT-basic in the 1980s to EMT-intermediate in the 1990s. Like our defibrillation program years earlier, we were the first department in our area to provide intermediate life support service. In the mid-2000s, with the help of our new medical director, Dr. Joseph Takats, we became a paramedic-level agency. In just five years, we've implemented a comprehensive 12-lead program with Bluetooth transmission capabilities; implemented the EZ-IOs and absorbent hemostatic agents; and introduced a therapeutic hypothermia protocol. We've also added a continuous positive airway pressure device as an advanced airway adjunct. We now operate with six paramedics who participate in an education-based recertification program and also complete training in CPR, PALS, ACLS and PHTLS.

While our background is in firefighting, we're getting fewer fire calls (due in large part to better construction) and more emergency medical requests. For example, we had one fire call last month, but we had three EMS calls yesterday. The bottom line is, if we're going to answer an EMS call and help someone, we should be able to do the best possible job for that person. We feel our commitment to emergency medicine and to serving our community and members is unmatched. We are unwaveringly committed to providing first-rate service to our community while simultaneously fulfilling the needs of our members.

Recent technology or equipment upgrades: We've instituted and gone online with 12-leads and CPAP. We also recently switched to the EZ-IO drill for treating some cardiac patients and trauma patients. As new products are introduced, we continue to evaluate those which can provide benefits.

Any new or unusual protocols: One new protocol we're performing is therapeutic hypothermia for post cardiac arrest patients. We also want to include tactical training for our members. We have one high school, two middle schools and two elementary schools within our fire district. One 12-year-old student at a school in our town, but outside of our district, was recently arrested for making a bomb threat. While it was just a threat, we need to be ready should it become reality. We're looking to train our members for these types of tactical situations, which isn't offered in a normal curriculum.

How do you reduce costs or maximize limited funding: We have an exchange program with Twin City ambulance, a commercial ambulance service we partner with. If we both respond to the call and we start an IV with our equipment but they transport the patient, they'll give us an IV set in return. They also provide us with some training as well.

Website: www.eafd.org.