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Guilderland Archives — The Altamont Enterprise, April 16, 2009

Civilians and pros team up for $1M EMS system in Guilderland

By Anne Hayden

GUILDERLAND — Emergency Medical Services Supervisor Richard Hughes deftly handles two calls on Tuesday morning — one for an old man with dementia suffering from a urinary tract infection, and the other an elderly woman with a foot infection. He asks if they are in pain, reassures them that they will soon get the relief they need, and even cracks jokes with them as he oversees their transfer into the ambulances that will transport them to the hospital.

Back in the truck, Hughes remarks, “Well, we’re not saving lives this morning, but we’re helping out and comforting, and that’s what we’re here for.”

Moments later, a call comes in for an old man having trouble breathing. The dispatcher tells Hughes it’s priority one, prompting him to turn on the lights and siren.

By the time the EMS vehicle arrives at the house, the patient is a shade of white bordering on blue, and barely breathing. Hughes sets to work immediately, laying the man out on the floor, simultaneously radioing the ambulance and the other EMTs on call. He asks the patient’s son, the one who called for help, for background information, while checking for a pulse and heart rate.

The two EMTs also on call that day arrive as backup, and the three staff members work with the paramedics from the ambulance to put a tube down the patient’s trachea and get him oxygen, as he stops breathing.

It is a harrowing experience, and everyone in the room is completely focused on working together to help the man and reassure his family members. Each person has a task, and, within 20 to 30 minutes, the patient is stable enough to be rushed to St. Peter’s Hospital’s emergency room.

Once there, the technicians accompany the patient into the ER, where they fill in the doctor on what procedures they have already done, and the medications they have administered. When the doctors at the hospital are able to take over, the technicians leave good wishes with the family, go back to their trucks, and get ready for the next call.

“What had I just been saying earlier about saving lives?” remarks Hughes in the truck, leaving St. Peter’s.

Hughes, who has been an EMT since 1990, and a Guilderland EMT since 2000, wants the residents to understand how the Emergency Medical Services actually work.

“I think there is often a misconception about what happens when you place a 911 call,” said Hughes. “Everyone just thinks the ambulance is going to show up and whisk you to the hospital.”

Actually, explained Hughes, the town has a tier system in place. There are two categories of EMTs — the technicians in one category go through 130 hours of training, and those in the other take over 1,200 hours of classroom, clinical, and field training. The difference between the two means some EMTs provide basic life support, and others are qualified to provide advanced life support.

When a call comes in, EMTs in quick-response sports utility vehicles drive to the scene, in addition to the ambulance. Often the quick response vehicles get there first, and the EMT evaluates the injured or ill person. They can provide basic life support, which includes monitoring vital signs, or advanced life support, which includes pain relief, intubation, and even defibrillation.

If a patient needs advanced life support, the technician will accompany the ambulance paramedics to the hospital of the patient’s choice.

Residents might be surprised to learn everything that Guilderland EMS encompasses, according to Hughes. There is a civilian division of the police department that goes to every EMS and fire department call in the town. That division is made up of 20 state or nationally certified paramedics, and a number of volunteer paramedics. Most of the staff work three 12-hour shifts per week.

Hughes wants to make sure residents understand the service, because although ambulance services are funded through the billing of insurance companies, the paramedics are funded through the town’s budget, which relies on taxes.

Guilderland spends close to $1 million annually on its paramedics. The preliminary budget for 2009 showed $968,042 for paramedics, the lion’s share for salaries, and showed $12,500 for “paramedic instruction,” nothing the total for volunteers.

“The department is a leader in the region in implementing new, cutting-edge procedures,” said Hughes. “We’re the first ground-only agency to have anesthesia kits,” he said, giving an example.

People do appreciate the service, he said. “With very few exceptions,” he said “people are glad to see you when you show up.”

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