City of Lincoln
Fire & Rescue Department
Paramedic Engine Program - ALS Services
Classroom sessions were conducted for eight hour days, twice a week. Clinical work was completed at the three Lincoln hospitals and agreements were signed with the local ambulance company for students to ride-along for field encounters. Students also rode with fire department paramedic ambulance crews in nearby Des Moines, Iowa for field training.
Classes 2 and 3 followed in the subsequent two years. In addition to those firefighters trained as paramedics from within the department, paramedics were hired from outside the department to fulfill our requirements to 48 paramedics (one per each of the city's fourteen engine companies plus two "floaters" per shift).
Beginning in July 1997, LFR became a fully staffed paramedic engine department. Each Advanced Life Support (ALS), engine is equipped with a Physio-Control/Life Pack 12 monitor/defibrillator, advanced airway management devices, materials needed for IV administration and a drug bag containing medications required by our medical director. Medical protocols have been recently revised to include intraosseous infusions, use of paralytics and cardiac pacing. Direct communications with physicians at all the Lincoln's hospitals is provided via 800 megahertz portable radios with telephone interlock back up.
With the advent of paramedic engine companies, the Lincoln Fire & Rescue provides ALS response to all 911 medical calls. Average response time within the city is 3.2 minutes from dispatch.
The concept of providing paramedic care with the quick response team continues to prove it's effectiveness each day. Not only is ALS care initiated sooner from paramedic engine crews but the continium of care is complete from initial assessment to delivery to the emergency department.
In 1997 when the fire department completed adding a paramedic to all engine companies, the number of cardiac arrest saves within the City was 10 in 1998 the "saves" doubled to 20. A "save" in our system is defined as a patient who was in cardiac and/or respiratory arrest being revived in the field and eventually be discharged from the hospital to go home. During 1999, the second full year for paramedic engine's in Lincoln, the cardiac arrest "saves" numbered 16.
Many changes have improved prehospital care since the advent of the paramedic engines. Additional equipment and capabilities have been added (pulse oximetry, external cardiac pacing, rapid sequence intubation, cricothyrotomy, and interosseous infusions). Future innovations being considered include 12 - lead EKG's, CO2 monitors and nitrous oxide for relief of pain. New medications for heart patients are on the horizen and training for our paramedics to provide specialized care to patients who have received implanted mechanical hearts began this year in Lincoln.
Lincoln Fire & Rescue Bike*Medic program is another spin-off of the paramedic engine program. Bike*Medic crews of one paramedic and one EMT provided with advanced life support equipment and an AED mounted on special "mountain bikes" are assigned to large crowd events such as Nebraska home football games, the Star City Parade and the Holmes Lake July Fourth festival.