Friday, March 16, 2018

Joni Haug and her son, Mason, got familiar with ALS services when Mason suffered a seizure.Harold Houghton survived a serious stroke in 2014, which he largely credits to the ALS care of the Columbus Fire Rescue ambulance crew.
Chuck and Carolyn Egan both have found themselves in the hands of paramedics

What's your life worth?

For the price of a steak dinner, a very small bag of groceries, a partial fill up of gas, etc., we can ensure the continued high level emergency care for ourselves, spouses, children, grandchildren, neighbors and friends.” -Dr. David Kane

•This is the second story in a 3-part series about the upcoming Stillwater Ambulance District mail ballot.

Count Columbus Elementary School teacher and mother of three Joni Haug in as a supporter of the proposed Stillwater Ambulance District.
“You think it’s never going to happen to you,” said Haug last week, sitting at her kitchen counter, recalling the day she thought her youngest child had died.
Haug was awakened early one morning in July 2011 by her 6-year-old son, Mason, asking if the Tooth Fairy had left him anything during the night.
Haug told him to go check and she fell back asleep. When she awoke again, Mason was next to her having a seizure. The First Aid certified teacher did not know what was happening and immediately called 911 and waited in terror for help to arrive.
Mason stopped seizing, and fell silent.
“I thought I had lost him,” said Haug. “It was the scariest point in my life…it happened so fast.”
The ambulance crew arrived and EMT Jacob Ward headed straight for Joni, who was carrying Mason toward him. She immediately felt a sense of relief as the crew took over and transported them both to the hospital. From there, Mason was sent on to Billings, diagnosed with a form of epilepsy and sent home. They made it to Park City before a second seizure struck, landing Mason in the hospital for two days.
“I cannot imagine not having this service,” said Haug.

Harold Houghton echoes that sentiment.
In June 2014, the longtime Columbus City councilman and businessman sat down for a glass of lemonade and dumped it down the front of his shirt. Unable to speak, he knew he needed medical help. A call to 911 by a family member brought an ambulance crew to his living room within two minutes. In short order, he was transported to a waiting team at the Stillwater Billings Clinic to be treated for a suspected stroke and then on to a Billings hospital.
Although he suffered a serious stroke, Houghton suffered no permanent issues and side effects — something he said his Billings’ doctor largely attributed to the fast and quality care he received in Columbus.
“That ambulance crew is A1,” said Houghton said this week from his custom cabinetry building shop in Columbus. “I support Rich Cowger…I think he is trying to improve the system for everyone.”
For Houghton, the increase in taxes that will be required if the ballot passes are not a factor to him.
“What’s your life worth?” he asked.

Chuck and Carolyn Egan agree with that statement.
“I actually think it’s very inexpensive,” said Egan.
Like Haug and Houghton, part of the Egan’s support for the proposed district is based on personal experience.
In the 2012, Carolyn suffered a near-fatal stroke in their home located across from the Columbus Middle School.
Egan recalls that he knew something was seriously wrong the minute Carolyn collapsed on the floor. He called 911 “and they (the ambulance crew) were there immediately,” said Chuck.
From there, Carolyn was quickly taken to the Stillwater Billings Clinic where doctors were waiting and had already contacted Billings doctors.
“They were ready,” said Chuck. “It seemed like every one was a step ahead of us the entire way.”
In addition to the expert medical care, Egan said he was struck by the respect the crew showed toward the patient and the home.
In 2015, Egan got a first hand ride with the system when he suffered a heart attack, drove himself to the hospital and was then whisked away to Billings for a pacemaker and 5-bypas surgery that he now refers to as “kind of an oil change.”
“I can’t say enough good about the system,” said Egan, who served as the county extension agent for 27 years and a commissioner for 10 years.
The former volunteer firefighter marvels at how far fire and medical services have come. He also said the tax increase that would come with the proposed ambulance district is reasonable.

Basic Life Support service is considered to be the backbone of the EMS industry.
Transports, non-invasive procedures and the general monitoring of a patient fall under BLS service.
Advanced Life Support (ALS) service brings a higher skill set that includes administering medications, starting IVs, monitoring airways and when necessary establishing airways, and cardiac monitoring. Paramedics are ALS providers.
With stroke patients, paramedics typically are able to recognize the symptoms more quickly due to more training. They employ cardiac and blood monitoring to watch for signs of the heart “throwing” a clot and potentially causing a second stroke.
With heart attack patients, ALS care is needed to administer appropriate drugs and to be ready should the heart stop beating completely.
With seizure patients, ALS care is needed to stop the seizure with medication before brain damage occurs. Cardiac and airway monitoring are also important.
ALS providers in the field are also able to provide doctors with more specific information about an incoming patient.
Columbus Fire Rescue currently has three paramedics and three advanced EMTs.

Longtime community doctor David Kane says keeping Advanced Life Support (ALS) service in Stillwater County is not a luxury, but rather a necessity.
“Especially if you are the one in the back of that ambulance,” said Kane.
Simply put, ALS service provided by Columbus Fire Rescue paramedics in the field is giving patients better quality care.
“ALS care saves lives literally. Sometimes at the scene, sometimes by preventing significant problems that occur later. Our ALS service is very dedicated and is very good,” said Kane.
There are two parts to ALS service in Stillwater County — in the field and transports.
In the field, ALS care can prevent significant problems that occur later, said Kane.
On the other side of that are transports to Billings hospitals which involve getting the sickest patients to a higher level of care or specialty care.
“Many patients are just too sick to safely transport by BLS or basic service,” said Kane.
Prior to ALS in Stillwater County, the hospital was forced to rely on AMR out of Yellowstone County or the HELP flight for these transfers that would often involve wait times of four to five hours.
“Now, if we lost our ALS service, those wait times would be even worse as AMR does not have the extra resources to reliably come to Columbus for transport and the helicopter is very weather dependent,” said Kane. “The hours (and) even the minutes wasted waiting, often delay vital specialty care that is needed and can put a patients life at risk.”
Trauma patients, for example, often have bleeding that can only be controlled in the operating room, said Kane.
“The Columbus Fire/Rescue paramedics are on scene quickly. They bring us Absarokee and Columbus patients while doing advanced care on scene or enroute and they are available immediately to transport those patients that need specialized care,” said Pam Prideaux-Leak, Stillwater Billings Clinic RN and trauma coordinator.
Stillwater Billings Clinic is designated by the state as a Trauma Receiving Facility. In 2016, the trauma system was activated for 61 patients. Of those, 31 patients were brought to the emergency department by Columbus Fire Rescue ALS. In 2016, 115 patients needed ALS transport from Stillwater Billings Clinic to a Billings hospital for medical and trauma reasons, according to Prideaux-Leak.
“ALS is a critical partner in providing this vital service to our community,” said Prideaux –Leak.
SBC physician assistant Sue Ivankovich says when life, death or serious disability incidents occur, time is of the essence in getting patients from the field to the hospital.
“Time is critical and the clock is ticking,” said Ivankovich. “Paramedics are trained to identify critical situations and can provide life saving interventions in the pre hospital setting. When minutes matter, they can start care when patients may still be miles from the nearest hospital,” said Ivankovich.
That care often continues when patients are transferred to Billings hospitals.
The cost of the service is well worth it.
“For the price of a steak dinner, a very small bag of groceries, a partial fill up of gas, etc., we can ensure the continued high level emergency care for ourselves, spouses, children, grandchildren, neighbors and friends,” said Kane. “From a financial stand point this may be the best investment a household will make if, God forbid, they have an emergency such as a heart attack, stroke, severe asthma or breathing problem, diabetic emergency, car, horse, or ATV accident, etc.”
Kane also touted the quality of the ALS in Stillwater County.
“Columbus and Stillwater County are very fortunate and lucky to have such good prehospital and post-hospital transfer care available,” said Kane. “I am so proud of and grateful for Chief Cowger, Nick Jacobs and all the paramedics and the volunteers that make up this excellent department.”