By Nelson Espinal
San Bernardino County Sun
SAN BERNARDINO COUNTY, Calif. — John Commander, a longtime emergency medical services training officer and coordinator at the San Bernardino County Fire Department, has been awarded a state Distinguished Service Medal for extraordinary contributions to the EMS field.
Commander was among 43 EMS professionals statewide honored in May by the California Emergency Medical Services Authority for significant contributions to the EMS field.
“Commander demonstrates heart and soul in everything he does and his commitment to procedures and protocols,” the state agency said in announcing the honor.
Among those also receiving the Distinguished Service Medal were Jennifer Antonucci of Murrieta Fire & Rescue and Phong Nguyen of the Redlands Fire Department.
Commander, a veteran of 47 years in the field, got his start in EMS by passing a first aid class as a Boy Scout and soon became an instructor for the scouts and eventually for the Red Cross and the American Heart Association. He went on to become an EMT and a paramedic, eventually joining San Bernardino County Fire in 1990.
Besides his work for San Bernardino County Fire, Commander is a member of and training officer for the San Bernardino County-based CA-2 Disaster Medical Assistance Team, which deploys to disasters as part of the National Disaster Medical System in coordination with the U.S. Department of Health & Human Services.
He’s taught at the state’s California Specialized Training Institute; and at FEMA’s National Fire Academy and its Center for Domestic Preparedness. Commander is also an EMS/Fire Technology adjunct instructor at Crafton Hills College in Yucaipa, and an adjunct faculty member in Fire Technology at the College of the Desert in Palm Desert.
Commander has seen changes over the decades in the field, some related to new technology. For instance, the practice of airway management involves inserting a tube down a patient’s throat or through their nose. If performed incorrectly, there may be problems maintaining the airway. Newer techniques employ a device to see the exchange of air through the tube.
“So we now confirm placement as far as respiratory rate and volume,” he said. “We can actually see what’s happening with the patient, where in the past it was hit-and-miss.”
Recommendations on how people should perform CPR during emergencies, while emergency help is on the way, have also changed over the years.
“We try to encourage you to sing various songs that basically keep you there (at the correct rate of compression),” Commander said. “A couple of songs come to mind, obviously the Bee Gees’ song (Stayin’ Alive), which is about 100 beats per minute. But then again, we’re also teaching kids. So the Baby Shark song, it’s 108 beats per minute.”
We recently asked Commander about his dedication to emergency medical services and about two issues facing the field: drug overdoses and homelessness.
Question: Why is emergency medical services so important to you?
I’m just one of many that make up the collective and the thing is I’m going to make sure I pass on what I have learned over the years to help people become better paramedics (and) first responders.
A lot of programs will teach you how to do things, but they don’t teach you the why or the reason behind it. So I’m the one that fills in the gap of the why. And that way they have a comprehension. And what’s nice about that is when I see students get the concept, the imaginary light bulb goes on or there’s the “aha” moment. That’s the key for me. Yeah. It’s like, “Oh my God, they got it!”
Question: How has the emergency medical services system dealt with and helped with the surge of drug overdoses?
We’ve seen some changes as far as how we deal with that.
We have a couple of programs now available. Number one is that our dosage of Narcan has increased. (For that) fentanyl is the biggest one that we’re dealing with. Also, now when we go on calls that we have an overdose, either accidental or intentional, we now have a program that’s been authorized by the state. A grant was provided allows basically law enforcement, fire and EMS people to leave Narcan behind.
After we care for the person, for relatives or friends of this individual who just overdosed, we leave them a box of Narcan with just-in-time training. So it helps a little bit because the whole purpose of why we’re giving Narcan is to buy time and to reverse the adverse effects of the narcotic that they’ve taken.
Because what usually happens is when we get called to 911, there’s a time frame anywhere between 8 to 10 minutes or so before we get there and during that time, no one’s doing anything. And if we don’t reverse that drug quickly, they will die. So if we can get someone there, a first responder, or even a citizen can give Narcan and if necessary, follow up with a hands-on CPR.
Question: How has the emergency medical services community dealt with the rise in homelessness?
It has increased over the last couple of years. As you can tell, each city has their own little encampments per se, especially near the highways and freeways and things like that or abandoned buildings. Obviously that poses a health risk in certain areas and obviously a health risk to those people in these encampments because this is where disease and and things can spread among them because (of a lack of good hygiene).
So that’s one issue. The other is overdoses because now you have people who go and find their favorite narcotic wherever they may get it from, come back and overdose. And then we’re called in. And then the other thing is a safety hazard. In some of these encampments, obviously, they build warming fires or cooking fires and sometimes those get out of hand and things get burnt, such as wildland areas, trees and parks as well as homes.
Our agency has a program for the homeless to check on them (with law enforcement) such as the Sheriff’s Department and Fontana PD.
They have a person who’s sort of like a social worker, but is obviously a police officer from the law enforcement aspect. And we have personnel from our department that are trained and also carrying medical bags. So they do spot checks or health wellness checks on these homeless encampments to see how they’re doing (and check on their needs).
So then that information is shared with various organizations. For example, sanitation, food resources, finance, you know to plug them in. So basically they kind of spend some time with these people to offer them potential assistance. Now, unfortunately, you can lead them to water, but you can’t force them to drink. So they have information that they pass out and share. They actually have (needle) sharps containers that they give them. So that way they can put them there and if they have any sharps for whatever reason, put it in there and then leave it at a designated location where they can be picked at. So no one can accidentally get stuck. But it is unfortunate that we still have this in our society. It is a universal problem and it’s actually everyone’s problem, not just fire, EMS and law enforcement — it’s actually the cities, the counties and how they deal with it.
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