Venice EMS Bike Unit: A Pedal-Powered Solution for Enhanced Emergency Response

Venice, Florida is an active biking community, recently recognized as a Silver Bicycle Friendly Community by the League of American Bicyclists.

The city government hosts monthly community bike rides, with one ride led by its mayor, Nick Pachota, who has a background as an EMT, paramedic, firefighter, and SWAT medic.

It only made sense to have an EMS bike unit to not only service the biking community but to be able to have mobility during events attracting large crowds where otherwise an ambulance has more restricted access, notes Venice Fire Department Chief Frank Giddens.

Established earlier this year, the Venice EMS bike unit’s four mountain bikes are equipped with full ALS life support services.

“In looking at all of the resources we provide for our community, we want to be the responders for our community and make sure we get our services to them as quickly as possible,” says Assistant Chief of EMS Nathan McManus.

“Anywhere where there is a narrow corridor packed with people and it’s hard to move vehicles around in that area, that’s where the bikes come into play,” McManus notes.

Bikes in Place of Ambulances

One of Sarasota County’s central bike trails is the Legacy Trail, an 18.5-mile multi-use recreational rail trail connecting Sarasota and Venice that is set apart from vehicular roadways.

“Putting an ambulance on that bike trail is impossible,” says Giddens. “Because of the long span, we are able to deploy the EMS bikes up and down the trail. It gives us a better access point and geographic location where that person is and then we can meet up with an ambulance and have a rendezvous if patient transport is needed.”

As the bikes aren’t primary response units, they are securely stored at the main fire station in Venice. When they are needed for deployment, if the event is close enough, the medic rides the bike to the event.

“We have a means of putting them on a bike rack on the back of our SUVs so they can be taken to wherever they need to be and then deploy from that site,” says Giddens.

In the future, the bike unit may be doing patrolling as the department gets more information on high-traffic areas, says McManus.

Providing Emergency Care on the Trail

Shortly after the EMS bike unit was established, it proved its worth when a female cyclist dislocated her hip on a community ride.

“Fortunately, we were there and crews were able to administer patient care right there and then in record time,” Giddens says, adding McManus was involved in the response

The response included using ice packs, taking vital signs, and using Zofran for anti-vomiting.

McManus, who came up with the idea of the bike unit, sourced information from the International Police Mountain Bike Association (IPMBA), using its guidelines to make bike choices that fit into the department’s budget.

“They recommend certain sized bikes, certain sized tires, different types of transmissions, and drive trains that are a little bit more sturdy for this type of use – it’s a little more wear and tear,” McManus says. “Anytime you look at doing an EMS bike program, you should have something sturdy enough, but also able to take some wear and tear. So we went with a mountain bike, but got some less aggressive off-roading tires – we got hybrid tires on it,” says McManus.

When the bike program rolled out, some crew members wondered what it entailed, McManus says. But the program isn’t new, says McManus.

According to an IPMBA website posting by Maureen Becker, IPMBA executive director, it is likely the first EMS bikes were bike-powered ambulances used by the military during World War II.

While it is not uncommon to see bike medics in developing nations, in the U.S., EMS services now deploy bikes in tourist areas, during special events, in amusement parks and sports arenas, on college campuses, and in airports, train stations, and other transportation hubs.

McManus notes adjacent Manatee County has had a bike team for years.

“We talked to them about some of the trials and tribulations they went through. There are a lot of younger people who never rode a bike before. We explained to them what it's about and how it helps out the community,” he says.

“We now have five people who are the core members of the bike team who are interested, willing to do it, and have done some practicing with it,” says McManus, who also serves on the bike unit.

Initial & Ongoing Challenges

Staying under budget was one initial challenge.

“We set a budget of about $4,000 for this project. The first biggest investment is the bikes themselves,” says McManus, adding the financing came from a Sarasota County Department of Health EMS grant. “Trying to find a bike that meets our needs, but also meets our budget was a little challenging at first,” says McManus.

McManus and his team consulted with law enforcement on what they liked and did not like about their bikes to home on what would be best for EMS use.

“I spent about 50 percent on the bike,” he explains. “The rest went to the equipment. We landed on the Trek brand. I went to our local dealer and talked to them about the program and what we're looking to do to get their input. They helped me dial into which model of Trek would work for us for this program.”

McManus says the department bought a few different sizes of bikes to pair the riders to bikes. The bikes are marked with Venice Fire Rescue lettering. Each can hold a water bottle and has aftermarket lights from Amazon.

“We looked at the ability to change different strobe patterns. We looked at what was the best for brightness and rechargeability. Knowing these bikes aren't always going to be on the road, we went with lights that we could recharge instead of having them battery-powered,” says McManus.

The department also bought radio chest harnesses as a result of learning that riding on a bicycle with something hanging off the side of the medics’ bodies was not an ideal situation.

“Now they can wear it on their chest so it's up and out of the way and still have that easy access to communication,” McManus says.

Another challenge was finding bags to carry the medical equipment and figuring out what equipment would be needed for what would most likely be encountered while out riding and answering calls, McManus says.

While that includes responding to injuries, people falling off their bikes, or people in an area where there are a lot of trips and falls, the unit crew also wanted to be equipped for higher acuity calls requiring more intervention.

The bikes also carry equipment for checking vital signs, blood pressure, and blood sugar. They also carry an AED, an emergency airway kit, an IV kit, and an IO gun and needle. The crews also carry Narcan for opioid overdoses.

Invasive & Noninvasive Medication

Since Venice is home to a significantly older population more likely to have chest pain or heart attacks, McManus notes, the bikes carry a chest pain kit with cardiac medications as well as a bag valve mask to help those in cardiac arrest. On top of that, a medication pack carries less invasive medications.

“If our patients have low blood sugar, we can hook them up to a bag of the Dextrose and start giving them medication to raise their blood sugar. We also have oral glucose,” says McManus.

The crews also carry an allergic reaction kit with Benadryl and an anaphylaxis kit with epinephrine.

McManus says he’s a proponent of using technology in EMS, so his department uses a third-party telehealth service – Tele911 – that provides access to board-certified emergency room physicians.

“A lot of the times, we can get recommendations to transport or not transport, treat in place,” he says.

Presently, if bikes respond to a call and start treating the patient, at the minimum they still need the transport unit to come to do the electronic report and finish out the rest of it, says McManus.

The department also seeks to add a gurney to attach to the bike.

“Whoever is assigned to the call, we could meet that crew in a more open area,” says McManus. “I can take them out of a heavily dense area where there's a lot of people and then ride them out to an area to meet the ambulance and get them put onto the stretcher so they can be transported to the hospital.”

The EMS bike unit meets monthly.

“We take them off-road, do a couple different maneuvers just to make sure they’re able to feel how the bike feels underneath them,” McManus says. “We show them a couple of scenarios. We make sure we know where our equipment is, check our equipment at that time to make sure it's still within date and that we have everything we need.”