Defibrillator donated by ambulance crew

Understanding the read-outs … Steve Millage orients himself to the new ambulance quipment as Esther Oldenberg waits her turn and discusses the machinery.

The Haakon County Ambulance Service has two new state-of-the-art defibrillators. A more basic unit was donated from the ambulance department to the Haakon County Sheriff’s Office to equip their second vehicle.

Each of the new defibrillators costs $20,000; one purchased from the Ambulance Service’s expenditures and one received by way of a grant. Jim Sobesta, Emergency Medical Services territory manager, delivered the two units and presented an in-service training to the ambulance personnel. Though based in Boston, Sobesta said that he still personally does the in-service “because it is that important.”

A defibrillator is used by the Philip crews to monitor patients on almost every ambulance run. The actual shock aspect has only been required by the Haakon County Ambulance crew an estimated three times per year. The pacing aspect (for controlling heart rate) has only been needed a couple of times per year. Last year the crews were called out 288 times. At present, there are three defibrillators at the fire/ambulance hall, one at the hospital, one at the Philip school, and two with the sheriff’s department. Dusty Pelle, who will be driving the second sheriff’s department vehicle, is also a basic EMT (emergency medical technician).

The machines can only monitor the electrical impulses of the heart. Trained people must monitor ‘signs of life’. These signs include such things as consciousness, pulse, breathing, color, movement and talking (moaning). A defibrillator monitors when a heart’s electrical data is within specific parameters, then the machine prompts the personnel that a shockable rhythm exists. If such a shockable rhythm does not exist, the machine can not be made to deliver a shock. No accidental shocks can happen.

A defibrillator does not ‘jump-start’ a heart. It stops a heart that is misfiring and beating “like a jello thing” so the organ can then “reorganize, regroup its electrical impulses, so it can start itself again.” according to Dody Weller the only fully-ranked paramedic on the ambulance crew. If a heart does not restart controllably after three shocks, then a minute of CPR is applied before another possible three shocks are applied. If the heart still does not respond, no more are to be given. Every minutes counts; to the point that if a defibrillator is not used within ten minutes of being needed, then the case is often beyond hope.

The Haakon County Ambulance Service, led by Don Weller, has 21 members. Of these, 15 are trained as basics, which means they each have had over 110 hours of time put into training and first-hand experiences. A basic may not break the skin of a patient, such as give shots or IVs. Five of the crew are intermediates who have had an additional 70 hours of training and experience. Intermediates may start IVs, but may not intravenously administer drugs. Esther Oldenberg is very close to qualifying and testing to be a paramedic. Dody Weller has trained the additional 1,600 hours and tested to earn the rank of paramedic. She works in Philip and for the Eagle Butte Indian Health Services. Beyond training, so many hours are required in ride-time and in the emergency room, lab and obstetrics.

Don Weller tries to always have three members on rotation at any given time. He stated, “They do a good job. I have a good crew. They follow protocol and stay out of trouble. If any of us are in doubt, we are to call the hospital.”

Sometimes a more advanced member or a whole ambulance crew from one location will intercept another ambulance on its way to a hospital. The greater experience and training could save the patient’s life. Ambulance services in surrounding towns are back-ups for other ambulance services.

People who want to train for ambulance work can do so for around $100 for books and testing, to earn a place on the national registry. Such EMS training and experiences are often a gateway into the medical profession for many individuals.

The Haakon County Ambulance Service also will be acquiring a new ambulance in three to four months. The finances for it have been consistently set aside for the last seven years. The old 1997 vehicle, which has just under 120,000 miles on it, will be sold. The other vehicle is a 2000 model with around 52,000 miles and more interior room. The new one will have even more room, better gas mileage, and will be custom-fit for Philip’s requirements. Philip often needs long distance transport for Rapid City runs.