Rimsie McConiga
Special to the Citizen
Scott Roy has been executive director of the Northland Regional Ambulance District (NRAD) since 2012 and his top priority throughout his career as a paramedic, supervisor and director has been to keep his co-workers and patients safe. The recent introduction of a new ambulance in the district has given Roy and his staff confidence that safety has been enhanced.
NRAD has a fleet of seven ambulances that cover about 350 square miles and includes Platte City, Smithville, Camden Point, Dearborn and Tracy. Four are used regularly and three are on hand in case of extra demands and vehicular failures.
The fleet will travel about 130,000 miles annually, so one new ambulance is purchased each year to replace the ones with heavy mileage.
“Our new ambulance started its career off here two months ago in Platte City,” Roy said.
“It’s best for the employees, the people that work on the ambulances, to have a voice in what they need in the new vehicles that they work in every day. So we started early last year engaging with them as far as their ideas on how to make the vehicle safer and more ergonomically friendly for them to do their job. We looked at it like what’s the best thing for the employees, the taxpayers and the patients.”
Most ambulances have rotating chains on the vehicles year-round, but the staff at NRAD decided to try the four-wheel drive ambulance and Roy said since the ambulance is a six-wheel vehicle anyway it will do pretty well on the road and it will only be a few days a year when they need extra traction due to bad weather.
The new vehicle also has a liquid springs suspension system which will provide a smoother ride.
“Anybody that’s ever ridden in the back of an ambulance will usually agree on one point,” Roy said. “It looks like it’s a smooth ride but in reality it’s not, it’s a very rough ride. I’ve been a paramedic for 25 years and it’s horrible. It’s sometimes embarrassing how rough the ride is but there have been some changes in the industry that have made it better over time.”
Satisfaction surveys that NRAD has sent out have already shown an improvement on scores for patient comfort and Roy is looking forward to seeing the scores at the end of the year for the new ambulance’s performance.
“It was a big enough change of vehicles that we had to do some training on it and the crew and I noticed a difference with the liquid springs,” Roy said. ”I had the opportunity to drive it a couple of times and it seems smoother.”
The new ambulance also provides extra space that allows the comfortable transfer of an extra patient, which can be dangerous if not done correctly.
The extra patient space is now on the driver, or street side of the ambulance.
“It forces the providers to actually use the stretcher to get that patient in and out so it’s all done with that mechanical stretcher instead of manually,” Roy said. “It makes it a lot easier and a lot safer.”
The lead caregiver’s seat is now on the curbside which helps to keep them in a position with restraints and safer in the case of accident. The clinical measurements such as cardiac monitors and defibrillators are on a monitor within reaching distance of the paramedic’s seat, as is the radio they use to communicate with the hospital, so they are rarely required to come out of the restraints.
The hydraulic lift stretchers provide added safety features for the patient and also the paramedic. Roy said with traditional ambulance stretchers paramedics would often experience serious bodily injuries from lifting after about five years.
“Most of the treatments and medications are within reach of the paramedic,” Roy said. “For instance, usually an airway problem can be managed successfully before the patient would leave for the hospital. But if the patient would have a rapid decline in their condition where they needed airway management a paramedic would obviously have to get out of their seat. The best thing about the new ambulance is it really helps to keep everyone restrained in their seats.”
Roy said the team’s mission is taking care of sick people and the safety of the patient, but it is also important to ensure the safety of the people who serve those patients. He said that vehicles and equipment can be replaced and while it’s important to take care of these taxpayer-funded resources, patients and staff come first.
“Employees are very important,” Roy said. “Let’s just say if they’re out of their restraints and the vehicle takes a sharp turn and they injure their backs and they miss work for a couple of weeks or for an extended period, we might have to hire another employee, which would also be costly. My job as an employer, and I take it very seriously, is to return these people home to their families every day safely in the same condition they were given to us. That’s the one thing that keeps me awake at night.”
A telemetrics driving system that was implemented five years ago has helped the team be more cautious in driving behavior.
“It lets me know where all the ambulances are and if they’re moving it will give me their speed and how they’re performing,” Roy said. “It tells me the amount of miles they’ve driven and they have only traveled 4% of those miles with lights and sirens on. I want that number to be as low as possible so that’s why we measure it. I only want to use those lights and sirens when it makes a difference. It’s a lot of risk when you turn them on. When we implemented the system it wasn’t uncommon to get some complaints from the community about the speed of the ambulances and driving behavior. So this has really helped take care of the complaints and it gives some feedback on their driving. If they’re driving too fast it sends a report out and helps correct their behavior.”
Although Roy said there would be issues since these are emergency vehicles, the telemetrics driving system has been a success and helps protect the person driving the ambulance. “When there is an issue and a citizen will say, ‘Hey this is happening,’ we’re able to pull up that data and the citizen can come and see it for themselves. I can show them the speed they were driving; the lights they had on, or didn’t have on, the blinkers and make sure they had seat belts on. I can look at all those numbers and say this is what the data says. Fortunately they do a really good job.”
Two paramedics are sent on calls at a minimum. Additional paramedics are sent in cases of respiratory distress or cardiac arrest. If a patient is combative or paramedics need help with restraints they take a law enforcement official or firefighter with them.
The maximum amount of transportable patients if they sit upright is about three or four.
The cost of the new ambulance (not counting equipment) was $220,000, but Roy said the new safety features are important since the ambulance will travel over a wide area and what could begin as a transport of two patients could easily turn into four patients and a very long wait time if the ambulance is involved in an accident in an isolated area and the paramedics are seriously injured.
With school shootings on the rise, the team has undergone training and Roy said they would move quickly, help evacuate the kids and increase the occupancy in the ambulances.
“We have a great system in the metro area where we share and collaborate resources,” Roy said. “We can activate a system that would get us more resources in a hurry. We continue to learn from past mistakes in the U.S. and try to get the best practices we can have if we have an event like that and implement them. So the key is increasing the occupancy of one ambulance and delivering them quickly. We have a good system of triage where we pick and sort the priority of patients that are survivable and make those the first patients that leave the scene.”
For Roy and his staff the new ambulance continues to provide many safety nets for themselves and patients alike.