RRFR EMS teams learn advanced procedures

RIO RANCHO — Rio Rancho Fire and Rescue has made several big advancements in the EMS field.

The measures paramedics learned Jan. 20 at the department's headquarters on Jackie Road will take them to the hospital level when it comes to saving lives. 

RRFR Public Information Officer Sean Gerdemann talked about the advances RRFR is making and why they are necessary.

"Within our paramedic scope of practice, this is what state medical directors are saying we can do, these particular skills, as a paramedic," he said.

Each level of licensed paramedic is allowed a certain set of skills, and depending on need in a given community, a department can learn new skills to meet that need, according to Gerdemann. This can prolong the process of getting certain training within the department, he added.

Rio Rancho was in need of the medical advances learned on Tuesday, according to Gerdemann.

"Rio Rancho really spans the gap of that urban and rural environment, especially within the west side of the city," he said. "The only level one trauma center in the state of New Mexico is UNM, which is fantastic for us, but that's still a 20-minute drive on a good day."

The team learned a procedure to help in severe cases of collapsed lungs Tuesday. Pneumothorax, or a collapsed lung, is common, according to Dr. Darren Braude, professor of emergency medicine and RRFR trainer .

Now, RRFR paramedics have received approval to perform the finger thoracostomy procedure, a rapid, life-saving emergency procedure for severe chest injuries.

According to Braude, the thoracostomy is performed when air or blood becomes trapped in the chest and collapses a lung. Pressure can prevent lung and heart function. Braude said the procedure involves making a small incision between the ribs to release trapped air or blood. While the method is faster and more effective than a needle method previously used, Braude recommended using the needle first before going to this method.

As general practice, paramedics start with the least-invasive procedures and work their way up as needed, according to Gerdemann. However, the thoracostomy is necessary in the most critical trauma situations, such as a blunt force trauma to the chest, and if the needle doesn't work, it is the next best option, according to Braude.

Gerdemann said this particular procedure will allow paramedics to maintain the patient after a trauma and take them to Sandoval Regional Medical Center for stabilization rather that UNM downtown, giving the example of traumas caused by ATV or four-wheeler accidents, which he said are some of the most significant traumas RRFR handles.

RRFR is also now the only ground service in the state for frozen plasma, which an RRFR release states has been shown to reduce deaths within 30 days for trauma patients with major blood loss when administered early.  Braude said only 1–2% of ground EMS agencies nationwide currently carry and administer plasma, despite strong evidence supporting its life-saving potential in trauma cases.

The release stated it helps prevent dangerous clotting problems that can occur after severe trauma, improves outcomes for patients with traumatic brain injuries and, when administered early, can reduce the amount of blood transfusions needed later at the hospital. RRFR partnered with Vitalant to properly rotate blood supply.

Additionally, RRFR has implemented medication-facilitated airway management (MFAM), also known as RSI (rapid sSequence intubation), allowing specially trained paramedic supervisors to secure a patient’s airway using medications when it cannot safely be done otherwise.

EMS Battalion Chief Chris Mandeville, who participated in the training, said all of these measures are so paramedics can prevent "loss of life."

"I think everybody is genuinely excited about (the training). We have tried to keep our EMS skills progressive, and being able to continue to keep the interest of our paramedics and challenge them helps everyone grow and get a little bit better," he said.

One of Mandeville's goals is to not have to rely on another agency for care to patients in the community. "The more that we have that we can provide to our community, the better we can stabilize and care for them," he said.