EMS technology ‘can’t stay stagnant’Written by Michael Nicely Tom Bartley | | Duty@toledofreepress.com
6:40 a.m. You are mentally drifting, waiting for your shift to end in 20 minutes. Your beeper goes off: unconscious person. Hop in the life squad. Dispatch reports CPR in progress. From Engine 16’s fire station you take a left on Detroit off of Dorr Street. By the time you make the Birmingham and Fearing series of curves, a civilian Lucas County car responding to the code 3 pulls into view behind you.
On scene, out of the car hops Brent Parquette, who just “happened to be” monitoring the radio for cardiac arrests. He is scanning for an opportunity to field assess the CirQLator, a device which helps create a vacuum within the body, dispersing oxygenated blood more deeply into the tissue. This is part of his investigation using the most up-to-date research and equipment to improve EMS and EMS outcomes in the field.
A medic in the Lucas County system since 1979, Parquette joined Toledo Fire Department in 1988. He rolled into Lucas County EMS in 2007 where he became the training officer. The patient’s quality of life after the medical emergency is key to Parquette. For decades, we’ve been able to correct heart rhythms with the administration of medicine or electrical shock. Now the goal is to not only to restart the heart, but to increase the oxygen both it and the body receive during cardiac arrest.
Parquette has overhauled the Lucas County EMS protocols one by one. He moved to craft a more “user-friendly flow chart, making it easier for medics to absorb.” He has researched each section and incorporated new techniques and medications reflecting the most current research.
“You can’t stay stagnant,” Parquette said.
Some of the devices and protocols he hopes will shape the future of care in the field include:
n The new protocol for congestive heart failure events no longer calls for the medications lasix and morphine. Nitroglycerin and the CPAP positive-pressure air mask are now used because studies show cardiologists prefer this treatment pre-hospital.
n The Induced Cooling by EMS (ICE protocol) sedates and cools a patient after being revived from a cardiac event. It helps stabilize a patient by limiting inflammation and the need for oxygen.
n Lucas County has incorporated the EZ-IO. Derived from the military, this is a Dremel-like drill that bores instant IV access into the bone of the arm or shin.
The technology aspect of his investigations led Parquette to Advanced Circulatory Systems. This company provided research to help. After some time, a relationship developed that prompted field evaluations of some of the new technologies. Parquette’s answer to the offer was an unequivocal: “Yes, because we want to stay on the cutting edge of things.”
This association brought the medical technology known as ResQPOD to Lucas County. Used in conjunction with the airway, this grenade-size device creates a negative pressure or vacuum within the body during cardiac arrest scenarios. This effectively increases cardiac output and the circulation of drugs.
Lucas County now stands in the top 10 percent of progressive protocols in the United States. A patient with a cardiac event stands a better chance of a positive outcome than ever before because of these new techniques. Prior to 2005, our recovery rate was at best 15 percent; recent stats put us at nearly 40 percent. Although he was unable to assess the CirQLator because of the successful revival of the patient prior to the device being used, Parquette remains undaunted: “The bottom line is to increase the probability of having a positive outcome and an improved quality of life after the incident.”
Michael Nicely has been a firefighter for 18 years. He is a paramedic and certified in confined-space rescue. Tom Bartley has been a firefighter for 10 years. He is an EMT, registered nurse, rescue diver and is certified in confined space rescue.