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

The National Association of Emergency Medical Technicians (NAEMT) and EMS World, 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 2012 awards were 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 EMS Service of the Year sponsored by Ferno; Impact Volunteer EMS Service of the Year sponsored by Impact Instrumentation, Inc.; and NEMSMA Executive of the Year sponsored by EMS World.

Award recipients received 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.

The nomination period for the 2014 awards is now open. Visit EMSWorld.com/awards.

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 Dick Ferneau Paid EMS Service of the Year Award, 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 region. 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,” says 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.”