2017-02-16 / Front Page

State changes protocol for cardiac aid

BY TIM RIEL

Howie Tighe, Jamestown Fire Department’s deputy chiefHowie Tighe, Jamestown Fire Department’s deputy chief
Rushing to the emergency room is no longer the top priority for rescue workers dispatched to patients suffering from heart attacks.

For the first time in roughly three decades, the state of Rhode Island has completely revised its protocols for emergency medical services. While revisions are prolific, including stricter rules on whether ambulance drivers can deploy lights and sirens, there’s one policy shift Deputy Fire Chief Howie Tighe wants to emphasize — the extended time first-responders must remain on-scene while treating patients for cardiac arrest.

“We’re required to conduct CPR and resuscitation measures on-scene, wherever the patient lies, for a minimum 30 minutes,” Tighe said.

According to Ron Barber, training captain for the town’s ambulance division, the new protocols go into effect March 1. Because each fire department and ambulance service in Rhode Island is expected to adopt the policies, emergency medical technicians in Jamestown already have started studying the new guidelines with their on-shift paramedic.

Tighe is stressing the new policy because of its impact on crowd control. With rescue workers on-scene for a half-hour resuscitating a patient, there could be confusion about why the victim isn’t being transported to the hospital.

“Family members and bystanders get quite upset when care seems like it’s taking a long time,” he said.

In a tight-knit community like Jamestown, he said, it can be especially difficult because many residents are familiar with one another.

According to Tighe, the strategy of rushing patients to the emergency room is not necessarily the best course of action.

“Data and statistics prove that if we’re able to remain on-scene providing those resuscitative measures, there’s about a 40 percent increase in the survival rate,” he said.

Moreover, a doctor may direct EMTs to perform 15 additional minutes of CPR. After the initial half-hour, Tighe said, an on-scene worker notifies Newport Hospital. The doctor then decides on the next measure using information from the scene.

“The potential of being on-scene for 45 minutes is pretty daunting,” Tighe said.

While the new policy will have no direct financial impact, Tighe said it will change the way EMS does business. A fire truck with additional workers will be deployed because patients won’t be immediately transported to the hospital.

“Cardiac arrest calls are very labor intensive,” he said. “It takes more than two people on the ambulance. There is a high possibility that eight or nine people will need to respond. That will let us do what we need to do to raise that survival rate.”

Since the police also will have a bigger role with crowd control, Tighe has met with Police Chief Ed Mello about the changes.

“Police are really going to be needed to keep bystanders and family members at bay,” Tighe said.

While the new policy may be scary for family, friends and bystanders who are watching a suffering victim lying on the ground, Tighe said the goal is to save lives, and this measure is best.

“At the end of the day, it’s a good thing,” he said.

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