“I feel more confident in working on research projects and I am even more interested in working in a rural community in the future,” reports Paige Titak, a Medical College of Wisconsin-Milwaukee student and recipient of a Wisconsin Medical Society Foundation fellowship sponsored by Winnebago County Medical Society. Paige’s research looked at the time of defibrillation by EMS for out-of-hospital cardiac arrest patients in Wisconsin based on population size.
Along with mentor, Leslie Ruffalo, PhD, Mario Colella, DO, MPH, DHS, and the Wisconsin Office of Rural Health, Paige learned about EMS staffing models and challenges EMS agencies are facing in Wisconsin. She shared the following regarding her research:
In Wisconsin, 41% of EMS agencies report having periods of time where a legal ambulance crew was not available to staff an ambulance. Agencies that rely on volunteers are more likely to have gaps in service due to insufficient staffing and most volunteer-based agencies serve rural areas. Staffing shortages can lead to delays in patient care if a call is received when there is no staff available to keep an ambulance in service. Act 113 passed in 2015 addresses these staffing issues by allowing a legal crew to be defined as an Emergency Medical Responder (EMR) driver and Emergency Medical Technician (EMT) in agencies that serve municipalities with populations less than 20,000 people instead of requiring two EMTs. EMR is the first level of certification offered by the National Registry of Emergency Medical Technicians (NREMT). An EMR course is an average of 65 hours compared to an EMT course which is typically 120 hours of training. While the scope of practice of an EMR is more limited when compared to that of an EMT, they may help to meet staffing needs that can result in less delays when responding to 911 calls.
Since the passing of this Act, there have been no studies in Wisconsin to determine if allowing EMR drivers has decreased response times. We sought to study this by looking at patients who experience an out-of-hospital cardiac arrest and compare mortality outcomes between communities with EMR drivers versus EMTs as quick EMS response is associated with improved survival. There is a sharp increase in patient mortality if a first responder with a defibrillator does not arrive on scene in less than five minutes.
At present, the research team is working with the Wisconsin Office of Rural Health and the Wisconsin Department of Health Services to identify all variables that need to be included in the Wisconsin Ambulance Run Data System Elite data pull. Next steps include expanding the study to include calls that result in stroke alerts or trauma alerts.
The Wisconsin Medical Society Foundation is pleased to offer medical students these important research opportunities. The number of Fellowships we are able to award is completely dependent on yearly donations to our Fellowship Program. Please consider supporting important medical research of Wisconsin physicians and students with the Wisconsin Medical Society Foundation Fellowship Fund. If you are interested in becoming a mentor or applying for a fellowship, please contact Jaime Craig at firstname.lastname@example.org.
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