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NREMT-PTE health - NREMT Paramedic Trauma exam Updated: 2024

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Exam Code: NREMT-PTE NREMT Paramedic Trauma exam health January 2024 by Killexams.com team

NREMT-PTE NREMT Paramedic Trauma Exam

Exam Details:
- Number of Questions: The number of questions in the NREMT Paramedic Trauma exam (NREMT-PTE) can vary, but it typically consists of approximately 80 to 120 multiple-choice questions. The exact number of questions may vary depending on the specific version of the exam.

- Time: Candidates are usually given a specific time limit to complete the NREMT-PTE, which is typically around 2 to 3 hours. It is important to manage time effectively to ensure all questions are answered within the allocated time.

Course Outline:
The NREMT-PTE exam focuses on assessing the knowledge and skills of paramedics in the area of trauma management. While the exact course outline and content may vary, the exam generally covers the following key areas:

1. Trauma Assessment and Management:
- Primary and secondary survey techniques
- Recognition and management of life-threatening injuries
- Identification and management of shock
- Assessment and treatment of head, neck, spine, and chest injuries
- Management of abdominal and pelvic trauma
- Assessment and treatment of musculoskeletal injuries
- Management of burns and thermal injuries

2. Airway Management and Ventilation:
- Airway assessment and maintenance techniques
- Use of airway adjuncts (e.g., oral airway, supraglottic airway devices)
- Bag-mask ventilation techniques
- Endotracheal intubation and advanced airway management
- Management of complications related to airway interventions

3. Cardiac and Cardiovascular Emergencies:
- Recognition and management of cardiac arrest
- Cardiovascular assessment and monitoring
- Use of defibrillation and advanced cardiac life support techniques
- Management of acute coronary syndromes
- Identification and treatment of dysrhythmias
- Hemodynamic monitoring and management

4. Medical Emergencies:
- Assessment and management of respiratory emergencies
- Neurologic emergencies and stroke management
- Allergic reactions and anaphylaxis management
- Endocrine emergencies (e.g., diabetic emergencies, adrenal crisis)
- Management of toxicological emergencies
- Assessment and treatment of psychiatric emergencies

5. Pediatric and Geriatric Trauma:
- Assessment and management of trauma in pediatric and geriatric populations
- Special considerations for pediatric and geriatric patients
- Age-specific assessment techniques and interventions

Exam Objectives:
The objectives of the NREMT-PTE exam typically include:
- Assessing the candidate's knowledge and understanding of trauma assessment and management principles.
- Evaluating the candidate's ability to apply critical thinking skills in the context of trauma scenarios.
- Testing the candidate's knowledge of airway management, ventilation, and cardiac emergencies.
- Assessing the candidate's ability to apply appropriate interventions for medical emergencies.
- Evaluating the candidate's understanding of special considerations for pediatric and geriatric trauma patients.

Exam Syllabus:
The specific exam syllabus for the NREMT-PTE may vary, but it generally includes the following topics:

1. Trauma Assessment and Management:
- Primary and secondary survey
- Life-threatening injuries
- Shock management
- Head, neck, spine, and chest injuries
- Abdominal and pelvic trauma
- Musculoskeletal injuries
- Burns and thermal injuries

2. Airway Management and Ventilation:
- Airway assessment and maintenance
- Airway adjuncts
- Bag-mask ventilation
- Endotracheal intubation
- Advanced airway management
- Airway intervention complications

3. Cardiac and Cardiovascular Emergencies:
- Cardiac arrest management
- Cardiovascular assessment and monitoring


- Defibrillation and advanced cardiac life support
- Acute coronary syndromes
- Dysrhythmia recognition and treatment
- Hemodynamic monitoring

4. Medical Emergencies:
- Respiratory emergencies
- Neurologic emergencies and stroke
- Allergic reactions and anaphylaxis
- Endocrine emergencies
- Toxicological emergencies
- Psychiatric emergencies

5. Pediatric and Geriatric Trauma:
- Pediatric and geriatric trauma assessment and management
- Age-specific considerations

It is important to note that the specific content and emphasis of the NREMT-PTE may vary depending on the NREMT's guidelines and updates. Candidates should refer to the official study materials and resources provided by the NREMT for the most accurate and up-to-date information regarding the exam syllabus and content.
NREMT Paramedic Trauma Exam
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Question: 41
Which of the following most accurately describes the finding of jugular venous
distension in pneumothorax?
A. It is an early finding of even minor pneumothoraxes
B. It indicates relative hypovolemia in the thorax due to hemorrhage
C. It is indicative of high intrathoracic pressure
D. Pneumothorax is more likely to cause jugular vein flattening
Answer: C
JVD is typically a sign of increased intrathoracic pressure, but can be a very late
finding. It presents when increased pressure on the great vessels in the thorax
cause a backup of blood returning from the head. This typically presents in
serious tension pneumothoraxes and does not appear in minor cases.
Question: 42
Becks triad is a combination of increased JVD, hypotension and muffled heart
tones and occurs in which of the following?
A. Hemothorax
B. Cardiac tamponade
C. Aortic dissection
D. Traumatic brain injury
Answer: B
Becks triad is observed in cases of cardiac tamponade and is caused by the
increase in pressure in the pericardial sac, which, in turn, causes the inability of
the ventricles to expand fully. This results in hypotension systemically and a
backup of blood in the jugular veins.
Question: 43
Upon arrival to the scene of a stabbing, you find a patient with a stab wound to
the left chest, midclavicular, 4th intercostal space. The patient is in peri-arrest,
hypotensive, with a rapid, thready pulse and jugular venous distension. The
patients GCS score is 3. You perform bilateral needle decompression, but there is
no rush of air or improvement in patients condition. The patient no longer has a
pulse and now presents in PEA. Which of the following is suspected in assessing
the patient?
A. Cardiac rupture
B. Diaphragmatic rupture
C. Hemopneumothorax
D. Pericardial tamponade
Answer: D -Hypotension presenting with JVD and clear mechanism of
traumatic injury is highly suspect for pericardial tamponade. Consideration for a
hemothorax, pneumothorax, or hemopneumothorax should be made and can be
differentiated by considering location of penetrating trauma, presence of Becks
triad and clinical suspicion. Cardiac rupture is almost entirely caused by blunt
force trauma, particularly in MVAs.
Question: 44
Other than rapid transport to a trauma center, which of the following is most
helpful for a patient suffering from pericardial tamponade?
A. Needle thoracostomy
B. Positive pressure ventilation therapy
C. Aggressive IV fluid administration
D. Remote ischemic conditioning
Answer: C
The best prehospital treatment for patients with pericardial tamponade is to
maintain vital signs and keep perfusion up. Oxygenation is typically not a
problem for these patients, but the increase in pressure around the heart requires
that adequate preload be maintained.
Question: 45
Which type of mechanism of injury is not likely in patients with posterior rib
fractures of the second and third ribs?
A. Frontal strike
B. Compression of the ribcage from the side
C. Relatively high force impact
D. All of the above.
Answer: A
Frontal impacts are more likely to cause lateral fractures, not posterior fractures.
Posterior second and third rib fractures are usually a result of high velocity side
impact to the chest. The first, second, and third ribs in healthy adults are strong
and require a high degree of force to fracture. When posterior fractures do occur,
it is usually from side impact.
Question: 46
You are called to the scene of an elderly patient female who slipped and fell,
landing on her chest. She complains of dyspnea and chest pain that increases with
inspiration and palpation. She states that her symptoms are much better when she
holds pressure on her left side. What is the most likely cause of her symptoms?
A. Hypovolemia from hip fracture
B. Tension pneumothorax
C. Rib fracture
D. Traumatic asphyxiation
Answer: C
This patient likely has a fractured rib. Elderly patients are more vulnerable to rib
fractures due to their bones becoming more brittle with age. The presentation of
mild dyspnea with improvement in symptoms when being held is very typical of
rib fractures.
Question: 47
You are called to the scene of an elderly patient female who is displaying classic
symptoms of a fractured rib. The patients GCS level is 15, oxygen saturation on
room air is 93%. Heart rate is 112, blood pressure is 142/102. What is the most
appropriate course of treatment for this patient?
A. Use rib binders for comfort, apply high flow O2, transport to a trauma center
B. Apply supplemental O2 via nasal cannula, monitor for ventilatory changes,
transport to a trauma center
C. Bind the ribs for comfort, apply nebulized albuterol for dyspnea, provide 324mg
aspirin for chest pain, transport to a trauma center
D. provide nitroglycerine 0.4mg sublingual for chest pain, apply high flow O2,
transport to a cardiac center
Answer: B
The optimal treatment for patients with broken ribs includes supplemental O2 as
needed and monitor for changes during transport to trauma center. C-spine
precautions should be considered per protocol. The use of chest binders is
contraindicated as it can result in hypoventilation. This patient should receive an
assessment for cardiac chest pain, but this etiology is unlikely given the
mechanism of injury and nature of complaints.
Question: 48
Flail chest occurs when a segment of the rib cage is broken and detached
following trauma. This typically presents as a section of the rib cage moving out
of sync and independent of from breathing motions. What is this phenomenon
called?
A. Pulsus paradoxus
B. Rib contusion
C. Paradoxic chest wall movement
D. Traumatic pneumonia
Answer: C
This pattern of chest wall movement is called paradoxic chest wall movement.
This paradoxical movement causes significant pain and dyspnea and is usually
accompanied by a pulmonary contusion, the latter of which and can lead to
respiratory compromise.
Question: 49
What is the best management for a patient with flail chest who is deteriorating
and developing severe respiratory distress?
A. Analgesia to reduce the pain of respiration
B. Needle thoracostomy to reduce internal pressure
C. Encouragement to hold their breath to increase the internal pressure
D. CPAP or positive pressure by BVM to internally splint the injury
Answer: D
Patients that are starting to develop severe respiratory distress require ventilation
assistance in order to avoid complete respiratory compromise. By applying
positive airway pressure carefully, the flail segment can become splinted
internally, allowing for better ventilation. Analgesics would have been more
applicable before a patient reaches this point. Needle thoracostomy would not
help this patient.
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Medical Paramedic health - BingNews https://killexams.com/pass4sure/exam-detail/NREMT-PTE Search results Medical Paramedic health - BingNews https://killexams.com/pass4sure/exam-detail/NREMT-PTE https://killexams.com/exam_list/Medical Ex-Paramedic Pleads Guilty to Burglary at 90-Year-Old’s Rancho Bernardo Home No result found, try new keyword!A former paramedic pleaded guilty this week to burglary and other charges for breaking into a 90-year-old woman's Rancho Bernardo home after responding there to a medical emergency the previous night. Thu, 04 Jan 2024 12:24:00 -0600 en-us text/html https://www.msn.com/ I’m An Ex-Paramedic, This Is What To Do If A Body Part Is Cut Off No result found, try new keyword!Instead of keeping oily rags for a rainy day, it's best to discard them. Lay them flat (not in a pile) outside to dry, then submerge them in detergent and water in a container with a tight-fitting lid ... Thu, 04 Jan 2024 01:11:13 -0600 en-us text/html https://www.msn.com/ Brattleboro’s municipal EMS takeover plan may face state review
The Brattleboro Fire Department is scheduled to take over local emergency medical services on July 1. File photo by Kevin O’Connor/VTDigger

BRATTLEBORO — Health care regulators have told municipal officials here that a pending $1.37 million fire department takeover of emergency medical services may require state review and approval.

The Brattleboro Selectboard voted unanimously last fall for the town to drop its nearly 60-year contract with the private nonprofit Rescue Inc. — Windham County’s largest and longest-serving EMS provider — and instead buy and operate its own ambulances starting July 1.

At the time, local leaders said the selectboard vote was the last step in their year-and-a-half-long effort to launch the plan. But after ordering three vehicles and hiring an EMS supervisor, they recently learned that a longtime Vermont law gives regulators from the Green Mountain Care Board the right to decide whether “a new health care project” must obtain a state certificate of need, or CON.

“The CON process,” regulators note on their website, “is intended to prevent unnecessary duplication of health care facilities and services, guide their establishment in order to best serve public needs, promote cost containment, and ensure the provision and equitable allocation.”

Under state statute, new projects require a certificate of need if the Green Mountain Care Board determines they exceed a series of thresholds involving costs and size of proposed changes.

Since the law’s adoption in 1979, regulators have reviewed several transport applications submitted in the past to the Vermont Department of Health and then to the former Health Care Authority, the former Public Oversight Commission and now to the Green Mountain Care Board.

The state, for example, granted a certificate of need in 1996 to Dartmouth Hitchcock Medical Center’s DHART helicopter and, most recently, one in 2021 for a Maryland company’s $2.5 million acquisition of Franklin County’s privately owned AmCare Ambulance Service.

Brattleboro leaders expect to outline their plans to the state “in the next week or so,” Town Manager John Potter said. The Green Mountain Care Board then will decide within 30 days whether the project is within its jurisdiction and, if so, schedule a review that could take 90 days.

A state review would reopen a Brattleboro EMS debate that first sparked in April 2022, when the selectboard voted with little notice or public debate for a transition plan to study if the fire department should pick up ambulance coverage.

At the time, then-Town Manager Yoshi Manale claimed the proposal not only would cost less than Rescue’s $285,600 annual fee but also collect “a $500,000 to $700,000 net gain in revenue.”

Manale’s assertions haven’t proven true, and he abruptly resigned eight weeks later. But local leaders didn’t provide up on the proposal, even after a feasibility study found that a takeover would bolster the town’s understaffed system of crisis response yet increase costs.

Just before approving the plan last September, the selectboard received a petition signed by more than 400 residents seeking a return to Rescue. Robert Oeser, a vocal takeover critic and one of nearly 90 people who wrote the town’s public feedback page in support of the past ambulance provider, said this week that any new review would provide people another chance to comment.

The Brattleboro news comes as the Vermont Legislature is set to consider a bill to create a task force to develop a more coordinated EMS system for a state where some communities are debating various options while others have few.

“We all expect an ambulance to come if we call 911 — it’s a critical part of our health care delivery system,” said the bill’s lead sponsor, Rep. Katherine Sims, D-Craftsbury. “We need to ensure it’s more coordinated, more efficient and more effective, as well as has adequate oversight and accountability.”

In the same vein, Vermont’s congressional delegation has introduced a bill in Washington to require the federal government to reimburse providers for all EMS services, and not just if a person needs an ambulance ride to a hospital.

“Rural communities depend on these critical services to close care gaps,” U.S. Rep. Becca Balint, D-Vt., said in a statement. “This bill will mean commonsense change to ensure EMS get properly reimbursed for their lifesaving work.”

Thu, 04 Jan 2024 20:02:00 -0600 en-US text/html https://vtdigger.org/2024/01/05/brattleboros-municipal-ems-takeover-plan-may-face-state-review/
Crozer Health changing EMS delivery model

Crozer Health President Tony Esposito said on Friday that while the health system is changing its emergency medical services delivery model, Crozer Health is not reducing any advanced life saving or basic life saving services in Delaware County in the coming year.

“Our recruitment efforts over the past few months have been very successful and we are going to be fully staffed going into 2024,” Esposito said in a statement Friday.

Historically underpaid and overworked, there has been a shortage of paramedics nationally in exact years.

Esposito said changes to the EMS delivery model will better serve the residents of Delaware County.

Esposito said the model change will expand on the longstanding system of using ALS paramedic chase cars to rendezvous with BLS ambulances.

Currently Crozer provides multiple ambulances both ALS and BLS in Delaware County as well as multiple chase cars.

That includes two ALS units in Upper Darby and two in Chester.

Additional medics include Clifton Heights, Marcus Hook, Aston and Norwood. A unit in Bethel is also operated by Crozer, though it is reported to often be out of service due to staff shortages.

“We are concentrating on proper resource utilization by sending the appropriate EMS unit to the type of emergency indicated,” Esposito said.

Sat, 23 Dec 2023 21:35:00 -0600 Pete Bannan en-US text/html https://www.delcotimes.com/2023/12/24/crozer-health-changing-ems-delivery-model/
‘Honorable but Broken’: Spotlighting EMS in crisis

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.



“Honorable but Broken: EMS in Crisis” is a documentary film exploring the world of EMTs and paramedics, the collapse of the EMS system, and what needs to be done to save it. Narrated by six-time Golden Globe and two-time Primetime Emmy award winning actress, Sarah Jessica Parker, “Honorable but Broken” raises awareness of the systemic collapse of EMS and advocates for change.

In this episode of the EMS One-Stop podcast, host Rob Lawrence chats with producer Bryony Gilbey about the documentary that is now completed and available for streaming. Gilbey hopes the impactful, hard-hitting documentary will serve as a briefing and education tool for our elected officials and members of the general public.

As Gilbey notes, “It’s no good any longer just throwing up your hands and saying that’s just the way EMS is; it’s no good saying it’s someone else’s problem; it’s something we all need to work on, as a civilized society we need to address this issue and we need to do it quickly.”

The 60-minute documentary is now available on demand, streamed by Prodigy EMS and it is hoped that it will be used at local, state and national levels to bring attention to the issues we are facing.

Top quotes from this episode

“I expected to tell a story; I did not think that it would have quite this reaction” — Bryony Gilbey

“We now all have not many degrees of separation to somebody who has had some sort of PTSD, who has had to leave the job because of the pressures of work and dare I say ultimately taken their lives and that is incredibly sad.” — Rob Lawrence

“It all comes down to three words – all in favor – if we don’t get the vote, we don’t get the money, we don’t get the change.” — Rob Lawrence

Listen now

Episode contents

00:48 – Documentary teaser

01:18 – Introduction/Bryony Gilbey

02:16 – The “Honorable but Broken” back story

05:46 – How did Gilbey view EMS and its issues

08:15 – The finished product and how can we view it

10:24 – A federal screening on Capitol Hill

11:30 – Reaction from elected officials

13:16 – John Mondello/emotional trauma

14:00 – Eileen Mondello – John’s mother

15:25 – Reaction to Eileen Mondello – “It never gets easier’

17:00 – He wasn’t the first, he isn’t the only and sadly he won’t be the last

22:00 – Other featured speakers in the documentary and their powerful messages

22:30 – Recruitment, retention and retirement

24:35 – What is the cost of a human life to a politician?

26:25 – Educating the legislators and the public

28:00 – The cost of readiness

29:05 – Reimbursement doesn’t add up

31:00 – The hospital side of things – Beckers Review on Hospital closures and adding to ambulance and hospital deserts

31:30 – Call to action and the legislative agenda

35:30 – Sarah Jessica Parker

39:00 – How and where to view via Prodigy EMS

39:50 – Final thoughts

About our guest

Bryony Gilbey

With a prolific career spanning several decades, Bryony Gilbey is a seasoned director, producer and freelance writer/editor, distinguished for crafting compelling narratives across various media platforms. As the director/producer for the impactful EMS documentary, “Honorable but Broken: EMS in Crisis,” Gilbey has showcased an unparalleled ability to guide projects from inception to completion.

Gilbey previously worked with the Nexstar Media Group, Inc. as a freelance writer/editor. Here, she demonstrated versatility by producing feature pieces on health and lifestyle courses for Tribune Publishing and contributing to BestReviews.com.

Gilbey also served as an associate producer at Mary Murphy & Co. from 2005 to 2012. During this period, she played a pivotal role in the production of the PBS American Masters documentary “Hey Boo,” centered around Harper Lee. In the early 2000s, Bryony worked as a Producer/AP at ABC News Productions, where she produced documentaries on medical breakthroughs in neonatal care for Discovery Health.

The foundation of Bryony’s career was laid during her time as an associate producer at “60 Minutes,” CBS News, from 1995 to 2000. Working closely with producers and correspondents, she contributed to the creation of original news stories.

Throughout her extensive and diverse career, Bryony Gilbey has consistently demonstrated a passion for storytelling, a desparate journalistic instinct, and an unwavering commitment to delivering content that informs and resonates with audiences worldwide.

Resources


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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

Thu, 04 Jan 2024 03:08:00 -0600 en-US text/html https://www.ems1.com/ems-advocacy/honorable-but-broken-spotlighting-ems-in-crisis
Mitchell EMS enters into partnership with Iowa college, providing paramedic internships

Jan. 4—MITCHELL — A newly formed partnership between the city of Mitchell and an Iowa community college could help recruit paramedics to the Mitchell Emergency Medical Service (EMS) Division.

The Mitchell City Council approved an internship agreement on Tuesday with Northwest Iowa Community College that will allow students to intern at the Mitchell Fire and EMS Division.

Dan Pollreisz, the chief of Mitchell's Fire and EMS Division, said an internship is required to become a paramedic.

"We actually have two of our (staff) who are going to be doing internships starting in February. They have to be done at an advanced life support service, which would be us," Pollreisz said.

The partnership with the community college would serve as another recruiting tool for Mitchell's Fire and EMS Division, Pollreisz said.

"In the past, we've been able to bring people who have interned with us on board," he said.

In addition to the Iowa community college, Mitchell's Fire and EMS Division has similar agreements with Sanford Health and Lake Area Technical College that allow aspiring paramedics to become licensed.

Although Pollreisz said the division is fully staffed as of now, there have been staffing shortages in the past. A fully staffed team equips the division with eight firefighters and EMTs on hand for each shift.

As Mitchell Mayor Bob Everson put it, a fully staffed Fire and EMS Division is "kind of fluid."

If future staffing shortages emerge, the agreement with Northwest Iowa Community College adds another tool to recruit crew members to the team.

The partnership is a one-year agreement with the option to renew on an annual basis.

Thu, 04 Jan 2024 10:49:00 -0600 en-US text/html https://news.yahoo.com/mitchell-ems-enters-partnership-iowa-004900683.html
Province to train up to 200 new emergency medical responders

Nova Scotia will train up to 200 emergency medical responders – a new role that will help Excellerate emergency care in the province – over the next two years.

These healthcare professionals will keep more ambulances available, reducing wait times, and allow paramedics more time to focus on emergency calls.

“The demands on our system and paramedics continue to grow and with emergency medical responders we are taking another step toward transforming emergency health services for Nova Scotians,” said Health and Wellness Minister Michelle Thompson. “We have a world-class system in our province and the addition of these new team members will allow us to enhance the care Nova Scotians have come to expect.”

Emergency medical responders working on ambulances can assess, stabilize and transport patients to hospital. Each will be partnered with a paramedic to expand the number of teams available to respond to an emergency call.

They may also work in teams of two to transfer low-risk patients who have been assessed and do not require medical care during transport, or in emergency department offload areas, freeing up paramedics to focus on and respond to emergency calls faster.

Emergency medical responders will receive three months of training, be licensed and regulated by the College of Paramedics of Nova Scotia and must pass a national exam administered by the Canadian Organization of Paramedic Regulators.

To increase the number of paramedics working in Nova Scotia, a bridging program will be developed for emergency medical responders who want to become paramedics.


“In the evolution of emergency medical services systems, the incorporation of the emergency medical responder role provides relief and support to our paramedics. With a proven track record in numerous emergency medical services systems nationwide, this role will help enhance service delivery to communities throughout Nova Scotia.”
– Charbel J. Daniel, Executive Director, Provincial Operations, Emergency Medical Care Inc.

Quick Facts:
— several Canadian provinces license and employ emergency medical responders
— emergency medical responders in Nova Scotia will receive training that exceeds national standards
— the emergency medical responder role is a nationally recognized role with pan-Canadian essential regulatory requirements including a competency framework, regulatory practice standards and a national exam
— training will be offered in Nova Scotia by Medavie HealthEd starting in March, with the first graduating class working by summer

Via NS Health

Fri, 05 Jan 2024 00:16:00 -0600 en-CA text/html https://haligonia.ca/province-to-train-200-new-emergency-medical-responders-297429/
Nationwide data breach impacts Northern Nevada Medical Center: What we know Your browser is not supported | usatoday.com
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Tue, 02 Jan 2024 22:50:00 -0600 en-US text/html https://www.usatoday.com/story/news/money/business/2024/01/03/eso-data-breach-impacts-northern-nevada-medical-center-sparks-reno/72088950007/
Crisis grips emergency medical service providers in rural Minnesota

Rural emergency medical service workers are sounding the alarm about a system in a financial and worker crisis that can lead — and in some cases has already led — to increased response times for Minnesotans in a medical emergency.

“This has not been a trend that has really surprised people that have been paying attention,” said Becca Huebsch, director of Emergency Medical Services and Emergency Preparedness for Perham Health in western Minnesota. “But now it’s really coming to a breaking point where systems have been underpaid for so long, now they’ve used up their cash stores and they put off big purchases.”

For the seven ambulance services that cover Otter Tail County, where Perham is located, ambulance providers are losing $181 per call, according to Huebsch.

“Every time the pager goes off and we respond to an emergency, we’re digging ourselves deeper into the hole,” Huebsch said. “We don’t want to stop responding but we do need to address this because there’s only so long that we can sustain that.”

In response to this call, legislators have set up an Emergency Medical Service Task Force to address the state of EMS services in Minnesota. Legislators plan to travel around the state to hear from the public about what is needed to keep the system afloat.

In addition to the cash-flow issues, the state is currently facing a shortage of almost 3,000 EMS workers, which is impacting greater Minnesota at higher rates due to lack of pay, leadership and culture issues, job burnout and time commitments in outstate Minnesota, Dylan Ferguson, executive director for the Emergency Medical Services Regulatory Board, told the task force during its first meeting in early December.

In addition to the shortage of EMS workers, there is a particular shortage of emergency medical technicians because they are often assigned to do hospital work as opposed to running an ambulance, Ferguson said.

EMS is largely financed through billing to patient insurance or the patients themselves. This type of funding model no longer works, Huebsch said, and even when it did, it has been just enough to cover costs.

“The challenge is, as our costs have increased, reimbursement has not changed or not kept up,” she said.

Even if an EMS increases its charges, it doesn’t matter, according to Huebsch, because the insurance rates are set by the insurance providers. For example, Medicare and Medicaid only pay about 35% of the cost when it comes to ambulance transportation.

In Perham, a town about 25 minutes from Detroit Lakes with a population of just slightly over 3,500, a projected $200,000 loss for 2023 is expected, according to Huebsch.

Response times

Beyond further stretching medical personnel in an already strained system that largely relies on volunteers outside metro areas, the cash and worker shortage has led to response times that lie entirely outside the bounds required for effective medical care.

In Mountain Iron, a town of fewer than 3,000 people in St. Louis County, EMS response times have extended to up to 90 minutes.

Thankfully, these lengthy response times haven’t hit Perham EMS, but if something doesn’t change soon, the possibility is there.

“It’s not a problem. It’s not a challenge. It’s a crisis,” Sen. Grant Hauschild, DFL-Hermantown, told the task force during its meeting.

Hauschild, who represents Minnesota Senate District 3, which covers most of northern and northeast Minnesota, including Mountain Iron, said towns are going bankrupt trying to provide these services.

“Your health care, your livelihood shouldn’t be determined by your ZIP code,” he said.

Ely, an Iron Range town with a population of around 3,200, has about two months of money available before they have to shut down, Hauschild said.

“It is multiple communities, it’s everybody, and we are acutely hit by it on the Range and northern Minnesota because of the rural isolation we have and the distances it takes to transport,” he said. “The reimbursement rates are so out of whack at the federal level and are just not keeping up with the services that we need to provide.”

The task force was formed following an Office of Legislative Auditor report that highlighted issues with a system that has not changed since the 1980s despite changes in demographics and health care in general.

“The increasing cost of medical supplies, labor and equipment has greatly outpaced reimbursement from state, federal and commercial payers,” Huebsch wrote the task force in a submitted statement. “This comes at a time when we are seeing an aging and medically needy population and increasing requests for ambulance services.”

The task force is slated to visit areas outside the metro area to receive testimony from the public and stakeholders about the state of EMS in Minnesota’s more rural regions.

A report that includes recommendations is expected to be submitted by the task force by Aug. 15.

“We’re an action-oriented unit of government,” task force member Sen. Andrew Lang, R-Olivia, told the group during their initial meeting. “Hopefully, in not too long of time, this task force will have a plan in place that will keep those small ambulances in rural Minnesota functioning.”

Several task force members are employed in the health care field, including co-chairs Rep. John Huot, DFL-Rosemount, and Sen. Judy Seeberger, DFL-Afton. Both serve as emergency medical technicians.

“This is overdue,” Sen. Tina Liebling, DFL-Rochester, said, adding that while Rochester may not face these issues because Mayo Clinic runs emergency services in the city, everyone deserves medical care. “When you make that call, the need is great and you need somebody to respond.”

Lack of staffing

Rural EMS services largely rely on volunteers, and those are getting harder to come by.

Altura, in southeastern Minnesota, may have an ambulance service that dates back to the 1960s, but they’re in danger of losing their basic lifesaver license because they have been unable to staff on-call shifts for more than 12 consecutive hours on several occasions in exact months.

Jason Passow, a volunteer EMT in Altura, said he joined because he wanted to help his neighbors, and if the service goes away, that’s akin to telling people in the community they need to wait for lifesaving medical response care.

Because the service area only generates about 80 to 90 calls a year, Passow said it would not be financially feasible to hire a full-time EMT to cover shifts.

A solution put forward during an October public meeting at Altura City Hall suggested recruiting more emergency medical responders, though those are in short supply as well.

During a similar October meeting in Baxter, near Brainerd, stakeholders pointed to outdated thinking from policymakers.

“Our current reality is that we lack people, not jobs, yet our current policies, still, I think, favor 1970s thinking,” Kelly Asche, senior researcher at the Center for Rural Policy and Development said during the meeting. “Policies are still developed around the idea that we should build more jobs, not (find) more people. … We still have politicians or policymakers, doing their campaigning on, ‘I’m gonna bring good jobs to the region.’ That’s really the last thing we need. And it’s that old style of thinking that’s going to keep us stuck.”

Fri, 29 Dec 2023 21:47:00 -0600 Mark Wasson en-US text/html https://www.twincities.com/2023/12/30/crisis-grips-emergency-medical-service-providers-in-rural-minnesota/
Spirit EMS record

Spirit Emergency Medical Services weekly log

Dec. 24-30

According to Brian K. Hathaway, Spirit EMS president/CEO, Spirit EMS was called to five emergency medical dispatches in Shelby County. That’s four more calls than the week prior.

Two patients were transported from the scene. Two other patients refused transport after an evaluation by EMS personnel. Spirit EMS, along with troopers from the Piqua post of the Ohio State Patrol and firefighters from Lockington were called to an injury crash on the night of Christmas Eve, but were never able to locate the driver or the vehicle involved as it fled the scene prior to emergency personnel arriving. Spirit EMS was assisted at two other medical scenes last week by Russia Fire personnel.

Of the patients transported last week, one was taken to Upper Valley Medical Center in Troy and the other to Wilson Health in Sidney.

Spirit EMS responded to 100% of its dispatched calls this week.

Sun, 31 Dec 2023 21:00:00 -0600 en-US text/html https://www.sidneydailynews.com/2024/01/01/spirit-ems-record-90/




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