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City of Lincoln
Fire & Rescue Department

We Care for Your Heart

 

firefighters learning to use defibrillators Lincoln Fire & Rescue began offering a new and very important technique called cardiac defibrillation in August 1984. This capability was added to the list of services offered to the Lincoln community for a number of important reasons. First, because of the number of locations of Lincoln's fire stations, a quick response time to the patients' side could be ensured. Rapid delivery of defibrillation shocks is essential to enhance survivability chances for victims of cardiac arrest. Second, all Lincoln Firefighters are trained and certified as Emergency Medical Technicians (EMT), and this was a logical and sequential step in upgrading and expanding their training and life-saving capabilities for the community.

Through training and certification, Lincoln firefighters became adept at administering defibrillation in the course of responding to medical emergencies. What is defibrillation? In many heart attacks, the patient's heart initially goes into "ventricular fibrillation," a life-threatening condition where the heart quivers uncontrollably, thus stopping the heart's ability to pump blood through the body. If the heart can be converted back to normal rhythm of pumping blood within the first four to six minutes, irreversible brain and heart damage can be minimized. This conversion can be achieved by a trained technician delivering an electrical shock to the patient's chest using a portable defibrillator.

These defibrillators are carried on all fire department engine and truck companies. When defibrillation is used in conjunction with cardio-pulmonary resuscitation (CPR), endotracheal intubation, and cariac drugs, the patient's chances of survival are increased dramatically. Defibrillation has been used to re-start patients' hearts in emergency rooms since 1960. However, by the time the patient reached the emergency room, the success rate of bringing the patient's heart back to a normal rhythm was seriously compromised because of the time spent transporting the patient. By reversing the order of events and bringing the defibrillator to the patient's side, rather than moving the patient to the defibrillator, many heart attack victims have been able to recover and lead productive lives.

In 1984, the Emergency Medical Technicians - Defibrillation (EMT-D) program was started by training firefighters in a defibrillator course specifically designed for Emergency Medical Technicians (EMT). The initial project manager was Dr. Chris Maasdam, an emergency room physician.

In 1995, with the advent of the new Automatic External Defibrillator (AEDs), all of Lincoln's firefighters attended a new defibrillator course to certify them to use the automatic machines. All EMT's are now certified by the State of Nebraska.

All firefighters frequently re-certify with the AED's by attending courses emphasizing the practical aspects of defibrillation. CPR and airway management skills are also examined at these re-certification sessions using state-of-the-art manniquin's and heart rhythm generators.

In July 1997 Lincoln Fire & Rescue became one of the nations first fire departments to staff all engines with paramedics. Today a duel role/cross trained firefighter/paramedic responds to all alarms. Paramedic engine response time to medical emergencies in the City of Lincoln averages about four minutes.

In 1998 the department added external transcutaneous cardiac pace making to our medical capabilities. Phyio Control Life Pak 12 defibrillators with pacemakers are now carried on all engines. EMT's generally operate the AED's while fire paramedics provide advanced life support care as required. These defibrillators were upgraded in 2001 to the new bi-phasic defibrillation technology. Pulse oximetry and end-tidal CO2 monitoring capability was also added to ambulance defibrillators.

In 2001 Lincoln Fire & Rescue assumed responsibility for emergency and non-emergency ambulance transportation for Lincoln's 225,000 residents. Eleven ambulances were purchased and are housed at the city's fire stations. Ambulances are staffed by one EMT and one paramedic. An engine responds to all medical calls along with the ambulance providing at least two paramedics at the scene of each emergency. Ambulance staffing varies by time of day and day of the week. Two units are staffed each week day to handle routine, non-emergency transfers. Off-duty crews are called back to staff various medical stand-by events in the city. Paramedic ambulances also respond to assist rural providers in and around Lancaster County.


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