As a former relief care provider at the Rural Health Center and as an island property owner (Peane Twp), I am saddened by the recent discussions that involve implementing a backward movement in EMS care for residents and visitors of this remote island. I cannot support the loss of paramedics on this island because with them comes a higher level of care that is under control of the Charlevoix Medical Authority. This is evidenced based practice level of care that is standard and provided by highly trained individuals. Why would the board and community consider discarding this higher level of care in order to have BLS only providers that move a sick or injured patient to the Rural Health Center? The health center is a clinic, not an ER, and therefore is a delay in getting the patient to a definitive care setting-ie Munson Charlevoix ER.
Most of you probably don't know my background so I will fill you in. I have been part of this island's health care on a regular basis from 1998-2008 when I filled in for the regular care providers. I have been involved in numerous emergent care situations where a patient needed quick evacuation from the island, and in most cases, bringing them to the medical center was a delay in critical care treatment, so I was happy to have the paramedics (Mr. Joe Moore) there to help facilitate a rapid and safe departure on Island Airways to Charlevoix Hospital.
We did call North Flight Air from time to time but there is always a delay in getting them here because the crew has an hour to respond for the fixed wing flights if they are not at base. The fixed wing (King Air) may be needed in the UP or Alpena or any where else in Northern Michigan and just not available. Also, perhaps North Flight cannot make it in due to low minimums on the approach to the island airport and they may not be able to land. I understand this because I am a licensed pilot with instrument landing endorsement. I have flown over on Island Airways medical transport with patients who could not have waited for Northflight because they were too critically ill. The patients received excellent care from the time of intercept until handoff in Charlevoix and the care was not delayed until the patient arrived in Charlevoix.
The medical center NPs do a great job caring for patients but paramedics who are current in their skills and protocols are a different aspect of medical care and their role is absolutely essential to a good outcome in most medical emergencies. The evidence is there if you look at the stats for emergency outcomes in ACLS and the Journal of Emergency Medicine.
I know that the cost for the fixed wing is, I believe, be around $10,000 for a flight to and from the island. This may not be true now and all insurances do not cover this cost. Island Airways can deliver faster transport at a lower cost. Paul Welke has worked hard and spend a lot of money on the air medical certification for his air ambulance service. That certification is hard to earn and he does keep to the standards of that certification. Island Airways emergency air transport is here and the pilots know the intracacies of this crazy island weather. Utilize them and our amazingly talented and caring paramedics (if we can keep some!-that is for another discussion on failure to put a paramedic on the Peane Twp ballot.)
I also am an EMT-S and a former flight nurse with North Flight Air from 1988-2004. I know how medical control can help guide our standardized care. I also worked at Munson ER as a nurse from 1987-1998 so I saw numerous transports from all over the state, including Beaver Island. Coast Guard and NorthFlight transfers were lengthy. NorthFlight provides excellent care but it takes so long to transfer.
I am currently practicing at Munson Urgent Care in Traverse City as an NP.
Jo Hendrix, EMT-S, FNP-C
nppilot@charter.net
NP's view of the recent proposed changes in EMS care.
Moderator: Gillespie