Hendricks County Flyer, Avon, IN

February 4, 2013

BFT introduces life-saving protocol

By Bart Doan
CNHI

BROWNSBURG — A potentially major life-saving protocol was added to Hendricks County recently that will essentially allow the operating room to come to an emergency scene.

The Brownsburg Fire Territory is the first department in the county to acquire what is called Rapid Sequence Airway protocol, which will allow emergency personnel to use a neuromuscular blocking agent to help facilitate breathing in people with serious head trauma or other maladies that make securing an airway difficult.

"The best way to explain it is that we're moving the operating room method of securing an airway out to the field,"  said Todd Schindler, a paramedic with the department. "When we have somebody who's in dire need of airway management and they're not able to be secured because of a medical problem or injury, we'll be allowed to use medication to paralyze and sedate them and ventilate as we care for them in the field."

Initially, he said, the equipment will only be on the BFT's safety cars.

Schindler said that RSA usage is prominent in northeastern Indiana, where he is from and he's seen it save countless lives.

"For a head injury patient, there are two things you have to ensure to give them the best chance of a good outcome: good oxygenation and managing their blood pressure," he said. "By utilizing this to manage their airway, it allows us to focus on their blood pressure level."

BFT Fire Chief William Brown said it's a pilot program in Brownsburg, but he hopes it can prove useful and expand to other areas within the year.

"Our travel distance from Hendricks County to Methodist or Wishard, which are the level-one trauma centers, is a much greater distance," Brown said. "We'd have to wait until those medics flew in to start the scene. Now we can start while we're waiting for them. If we had a major traffic accident on say, I-74, right now, our guys now have the skills to save lives on the scene."

Brown said air ambulance transport is dependent on weather, sometimes making it impossible for a helicopter to get to the scene. That could mean a matter of life or death in many cases, he added.

"Hopefully, the rest of the county will be able to utilize it as well," said Schindler. "We'll go ahead and use the protocol and transport the patient if they're not pinned in an accident."

Schindler said the procedure probably wouldn't have come to Hendricks County without the help of Dr. James Nossett of Hendricks Regional Health.

"Obviously, our ultimate goal is to deliver the patient to the hospital with the best possible outcome," he said.

Brown added that being proactive makes the difference.

"Having the skills and the knowledge, this is just another chapter, another tool in the tool box to save lives," he said.

Schindler said that the paralytic agent wears off after about 30 minutes, but because patients cannot physically let medics know that they're regaining feeling in their muscles, they continue to be sedated in order to ease discomfort.

To see a demonstration on how the RSA method works, go to Youtube.comand type "Rapid Sequence Airway" into the site's search engine.

bart.doan@flyergroup.com