Talbot County Emergency Services, Emergency Medical Services (EMS) Division has a new tool in its toolbox – an ultrasound machine on each of the ambulances in its fleet. Talbot EMS approached the Talbot Paramedic Foundation about supporting this new and exciting pilot project for the state of Maryland and they agreed. Talbot County paramedics started using the technology in the field in the summer of 2022.
“It’s one more example of us bringing technology out of the hospital and into the field. We don’t use it solely to diagnose conditions. It gives us more insight into what’s going on with our patients, particularly with a patient’s heart and lungs, in addition to our traditional methods. The training for the technicians is significant and ongoing weekly. Every three months, paramedics take ultrasound exams, adding new skills to their repertoire,” comments Matt Watkins, Division Chief of Talbot County EMS.
The cost of the ultrasound units is $2,500 each and the Talbot Paramedic Foundation has funded 10 units for a total of $25,000. The Talbot Paramedic Foundation was formed in the 1980s to support efforts to establish advanced life support throughout Talbot County. As that dream became a reality, the Foundation turned to other projects to support emergency medical services for county citizens. Other projects that the Paramedic Foundation has supported include video laryngoscopes – a tool for improving intubation of patients; automated CPR devices to help free up people on long ambulance transports; electric stretchers and loading units; and within the last few years, Life Pack 15 devices which cost $35,000 apiece and support cardiac events in the field. This year, the Paramedic Foundation is supporting the replacement of outdated AEDs in public places in Talbot County.
“One of the things that I know about the services our paramedics provide is that they’re always out there looking for the newest and brightest equipment that’ll support better patient care in our community. That’s why the Foundation is willing to support them. Everything that they bring us increases the care that they can provide to the citizens of Talbot County.” Wayne Dyott, President of the Talbot Paramedic Foundation comments.
“We’re always looking to innovate, but it needs to be clinically sound. There are lots of gadgets out there these days, but not all of them are worth the money,” adds Watkins.
Dr. Thomas Chiccone, Regional EMS Medical Director for the Region IV Maryland Institute for Emergency Medical Services Systems (MIEMSS) serves on the Protocol Review Committee for MIEMSS that establishes the statewide protocol for the use of ultrasound on ambulances. He states, “I’m from a generation of emergency department physicians, where I was not trained in how to use bedside ultrasound myself. So literally, I am now learning alongside my colleagues and clinicians how to use this new mobile tool. Dr. Steve White, Jurisdictional Medical Director for Dorchester County EMS, has been instrumental in helping with this effort as one of the newer generations of emergency medicine physicians. He is introducing ultrasound at the same time to Dorchester County EMS.”
“The first use of ultrasound on ambulances is to detect whether the heart is contracting during resuscitation in cardiac arrest patients. We’ve also adopted a use where we look at people’s lungs during a traumatic injury to see if air is leaking around the lung. It will also disclose to us pneumonia in the lung in the case of the Coronavirus,” Dr. Chiccone adds.
“We’re about to begin training for clinicians to identify blood vessels for IV sticks. And then the next thing we’ll go to from there is a little more complicated and requires more intensive – looking into the abdomen for signs of bleeding from trauma. This could be bleeding from the liver, the spleen, or bleeding around the kidney.”
According to Watkins and Dr. Chiccone, the use of ultrasound will not interfere with any other life-saving interventions. Instead, it’s meant to be an additional diagnostic tool as opposed to a replacement for a good clinical exam.
“We were so fortunate to have our guardian angel – the Talbot Paramedic Foundation. That’s really what made it possible. It could have been a more delayed rollout of a year or more. We are always grateful for their help. We are also fortunate in this region to have medical directors that are very progressive and we can do things together like this project,” Dr. Chiccone states.
Dr. Chiccone also states that in Maryland there has been a shift through MIEMMS from referring to paramedics as “technicians” to calling them “clinicians,” because they are called upon now to make more sophisticated diagnostic and treatment decisions in the field.
According to Watkins, Talbot County EMS is always staffed with a paid emergency medical technician (EMT) and a paid paramedic on all County ambulances. He states, “Today, Talbot County EMS staffs six full-time paramedic units throughout the County. While most patients are transported by a County EMS unit, we enjoy a great working relationship with the volunteer fire departments. We work together closely to ensure that we can meet the emergency medical needs of our community at all times.”
“We’re extraordinarily fortunate in the Mid-Shore area. It takes a lot of vision and a lot of careful planning to be able to have an EMS system like Talbot County has. And that’s because so many of those involved have a State presence and are involved in the state-wide efforts,” Dr. Chiccone concludes.
“This is one more example of how through community partnerships and support from our County Council and the Talbot County Paramedic Foundation that our highly trained and dedicated EMS personnel can use state-of-the-art technology to save lives,” comments Talbot County Manager Clay Stamp.
“This new cutting-edge technology will undoubtedly allow our EMS clinicians to better serve our community. The Council values the ongoing partnership and support the Talbot Paramedic Foundation has provided for many years,” adds Chuck Callahan, Talbot County Council President and a lifetime member of the Easton Volunteer Fire Department.
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