In 2006, the Merrill Fire Department upgraded their ambulance service to EMT-Paramedic which is the highest level of pre-hospital emergency care, but starting July 1st, they will add to their paramedic skills with the addition of RSI, or Rapid Sequential Intubation. RSI is an advanced procedure that requires a minimum of two paramedics on scene to complete. The procedure entails administration of a potent sedative and a paralytic medication. Through the use of those medications, paramedics are able to insert a breathing tube into the patient which allows them to ventilate the patient. This procedure is necessary in critically injured or ill patients who need assistance breathing properly. By breathing for the patient, Merrill paramedics predict a better outcome for patients who meet the criteria.
Adding this life-saving procedure for Merrill Fire Department firefighter/paramedics would not be possible without the leadership of Dr. Michael Clark. All EMS providers must work under the medical direction and supervision of a licensed physician. Dr. Clark is the medical director for MFD and other ambulance services in northcentral Wisconsin. He is also heavily involved with EMS issues across the state including serving on the Wisconsin EMS Advisory Board and Physician Advisory Committee. Dr. Clark has also been actively supporting his ambulance services through the COVID pandemic with creation of protocols and guidelines for EMS providers.
Also new with the RSI upgrade is the purchase of video laryngoscopes. These devices allow paramedics to better visualize the vocal cords when placing the breathing tube into the patient. The advantage is a higher success rate of intubations and less irritation and possible tissue damage to the patient. The new laryngoscopes also make the process of intubation safer for paramedics since this is an aerosol generating procedure, something that requires extra personal protection with the ongoing coronavirus pandemic.
“We are excited to finally add RSI to our EMS protocols,” added Battalion Chief Scott Krause. Krause also serves as the EMS Division Chief and was one of the original paramedics on the department. “We’ve known for years that we had patients who would have benefited from this procedure and now we are finally making it happen,” said BC Krause.
Training was completed in the end of June under the direction of Dr. Clark. The additional, required medications were also purchased. The Merrill Fire Department currently has 21 of their 23 full-time members cross trained as paramedics and have an annual ambulance call volume of approximately 1,800 calls.
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