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• 911 process – We took a bold step and tweaked the way we handle incoming life-threatening emergency calls. Utilizing a quick-launch call-processing procedure we were able to double the number of cardiac arrest calls in which we arrive on scene in less than four minutes. The idea and process on how we did this came directly from the 911 dispatchers themselves. They thought of the idea and were asked to create the solution and they did. It has helped us decrease total response times and save lives. We took serious steps to measure, track and improve on dispatch-aided CPR rates and identify obstacles to starting dispatcher-assisted CPR.
• CPR – Using historical data from our computer-aided dispatch system and our electronic patient care reporting system we have been able to plot out where bystander CPR is being done (or not being done) and cross reference that with survival rates. Where bystander CPR is lacking we saturate the area with a community Save-A-Life Program that teaches compression-only CPR and AED (automated external defibrillator).
• AED – Everything starts at your home. Here in the City of Las Vegas we have been strengthening our city’s Public Access Defibrillation Program by teaching city employees compression-only CPR and AED use. Additionally, all City of Las Vegas facilities have an AED on campus.
• Advanced care – We focus on high-quality, uninterrupted chest compressions; measure and feedback CPR fraction; avoidance of hyperventilation; aggressive first strike; safe transport with continuous chest compressions using the Auto-Pulse hands-off CPR device. Together with high-performance response times we are making a positive difference in people’s lives.
• Post-resuscitation care – We were the first agency in southern Nevada to provide therapeutic hypothermia; careful monitoring and care of ETCO2 (end tidal CO2, the level of carbon dioxide released at the end of expiration), temperature, blood pressure management and a healthy partnership with community hospitals. Our cardiac arrest survival started at 5%, peaked at 48% and currently sits at 30%.
Firehouse: Please describe how LVFR has designed new EMS units for safety and better operations.
Myers: We have an excellent medical services division and in my opinion of course, are the best in the business. Led by Deputy Chief Dr. David Slattery, we put a technical specification team together to design an ambulance unit that was the safest available for both the crew and the patient. Our new rescues have numerous new safety features. These include: three strategically placed captain-style seats; every item is secured in case of an accident; eliminated head-strike areas; keeping our providers seated and restrained; placement of medical/airway equipment on both sides of the unit; controls that are reachable from both sides of rescue; protected and redundant sharps containers accessible from both sides; increased visibility of our units; improved overhead lighting; yellow assist rails on the ceiling; increased emergency lighting for coverage and visibility; and Reflexite graphics on the rear of the unit.
Firehouse: How are you able to open and plan to build new fire stations with a reduced budget?
Myers: Building the fire stations are one thing; staffing and then opening is a whole other issue. We used capital money from a bond to fund the construction of three new fire stations that fill in coverage gaps within the city. Cost advantages were gained by the fact that land cost and construction service costs are currently less expensive due to the recovering economy. We capitalized on the market situation.
Staffing and opening the firehouse has been interesting. As a fire chief, you must balance strategic unit placement (operational interest), ISO and accreditation needs (administrative interest), what does the community you are serving expect to be in the fire station (community interest), what does the bargaining unit leadership expect (political interest), what was already promised years ago prior to the station construction (moral interest), current salary and benefit budget allowance (fiscal interest) and a whole host of other special considerations.