In the first program of its kind in the nation, New York City has launched a pilot program to increase the number of kidneys available for transplantation by dispatching a second ambulance—marked “Organ Preservation Unit”—to medical emergencies in which a person has a high likelihood of death. The second vehicle will contain a specially trained team that will wait in the wings, out of sight of paramedics and EMTs who are working on the patient. The team will only move in if it is determined that the patient cannot be revived, according to a city news release.
The six-month pilot, a partnership between the New York City fire and police departments and Bellevue Hospital, is funded by a $1.5 million grant from the U.S. Department of Health Resources and Services Administration (HRSA). The program will run through May and will initially cover only the borough of Manhattan.
During the pilot, 911 calls in Manhattan will be monitored by an organ preservation team, which will include a family services specialist from the Organ Donation Network, an emergency physician and two EMT-trained organ preservation specialists. The team will respond to situations in which all resuscitation efforts have failed, according to the news release. If there is an organ donor card available, or if the deceased is registered on the New York State Donor Registry, the team will ask the family to honor those wishes by moving the deceased to the organ preservation ambulance. The deceased will then be taken to Bellevue Hospital.
“Everything we do at the New York City Fire Department is focused on a single goal: saving lives …,” Fire Commissioner Salvatore Cassano said in a statement. “The truly wonderful thing about this program is that it not only lets us help those needing organs, it helps us honor the wishes of those who wanted to give the gift of life as organ donors.”
The program will be evaluated after the pilot ends and possibly expanded to other parts of the city, according to the release.
Though this is the first program of its kind in the United States, similar programs have been tried successfully in France and Spain, according to the news release. To alleviate worries that patients wouldn’t be saved in order to harvest their organs, city officials told the New York Times that responders trying to resuscitate a patient will not be told whether the organ preservation unit has been dispatched until a supervisor has given the order to stop rescue efforts.
The program is limited to the hours of 4 p.m. to midnight, adult patients between 18 and 60, and people who die of cardiac arrest at home or another residence. Officials told the New York Times they would not harvest organs from anybody who died at a crime scene. Read more at nyc.gov/html/hhc/html/pressroom/pr-20101201-ny-organ-donor-network.shtml.
DHS Asks EMS to Be Alert for Human Trafficking Victims
She may be the injured girl who shows signs of old bruises and keeps nervously looking over her shoulder or the housekeeper who has no identification and whose “boss” won’t let her be examined alone. She’s a victim of human trafficking, and she needs help.
Some one-fourth of human trafficking victims seek medical care at some point while they are being trafficked, according to the U.S. Department of Homeland Security (DHS). As such, the department is asking EMS providers to keep an eye out for victims, who might be involved in forced prostitution or be working as domestic servants, sweatshop workers, in restaurants or even begging. “There are a number of instances where EMS folks could encounter human tracking victims,” says Bob Davis, a DHS Office of Health Affairs spokesman. “We want them to know how to spot them, how to talk to them and how to report what they are seeing.”
DHS is considering developing resource materials specifically for EMS, but in the meantime, there’s plenty of information on the DHS website for law enforcement and health care providers that EMS managers could share with their staff. Start by going to dhs.gov/files/programs/gc_1265647798662.shtm#3 and scroll down to Law Enforcement. The “Rescue and Restore Campaign Tool Kit” has a wealth of information that applies to EMS, as does the “First Aid Kit for Use by Law Enforcement First Responders in Addressing Human Trafficking.” Or scroll down to Community Organizations and click on the “Rescue and Restore Campaign Tool Kit” link for health care providers and community organizations.
EMS providers should notify law enforcement if they suspect a person is being victimized or call the National Human Trafficking Resource Center at 888-373-7888.
More Cutbacks on Both Coasts
Budget woes continue in the world of public safety. The Los Angeles Fire Department reduced staffing across the city by seven fire companies as of Jan. 2; prior cutbacks reduced the number of engine companies by 15. As a result, 22 of the department’s 153 companies are out of service each day on a rotating basis, according to news reports. (A fire company can either be a four-person engine company or a six-person hook-and-ladder truck accompanied by a pump vehicle.) The cutbacks were enacted to help deal with a $30 million budget shortfall, according to news reports. The fire department has also imposed furloughs and offered early retirement to veteran employees.
On the other side of the country, Camden, N.J., a city with high rates of crime and poverty, recently laid off nearly one-third of its firefighters and nearly half of its police. The police department lost 168 of 365 officers, while the fire department lost 67 of its 220 firefighters due to a budget crisis, according to news reports.
Yoga in the Fire House?
Wellness programs are often looked to as ways of improving employee health, thereby lowering not only health insurance premiums but costs such as overtime to cover for staffers who are out with injuries or illnesses. But for small departments, coming up with the resources to start a comprehensive program can be difficult.
Chief Marty Scheerer of the Edina (Minn.) Fire Department decided not to let that stop him. He started offering a free weekly yoga class at the station and says the results were apparent immediately. “It’s one of the best things we’ve ever done,” Scheerer says. “Yoga stretches and strengthens the back, which is where almost all of our injuries are. Our injuries have dropped, and it’s dramatically improved morale. People are coming in off duty, and the class is packed.”
iPhone App Saves Life
It was the best $1.99 Eric Cooper ever spent. During basketball practice at La Verne Lutheran High School outside Los Angeles last November, Cooper saw one of his students collapse in sudden cardiac arrest. Cooper ran to the teen, pulled his iPhone out of his pocket and opened Phone Aid, a downloadable app that gives step-by-step visual and voice CPR instructions. While assistant coach John Osorno did compressions and rescue breaths, Cooper gave instructions and used the app to keep time and count compressions. “We worked together perfectly that night,” Cooper says.
Within a few minutes, Xavier Jones, a senior who’d been offered a scholarship at a Division I college before his collapse, started breathing again. He was later diagnosed with hypertrophic cardiomyopathy, a thickening of the heart, and received an implanted defibrillator.
Cooper had been trained in CPR, but he credits having just reviewed CPR using the app the previous evening with enabling him to stay cool under pressure. “God wanted us to be prepared, so he prepared me the night before,” Cooper says. Check out a demo of the app at entanke.se/iphone/phoneaid/.
Boston EMS Deploys Hydraulic Lift
To spare the backs and necks of responders, Boston Emergency Medical Services recently deployed an ambulance equipped with a hydraulic lift for morbidly obese patients, the Boston Globe reports. The retrofitted vehicle will be deployed after the first EMS team responds and determines the special vehicle is needed. The 7-foot lift lowers to the ground, allowing responders to simply roll the stretcher onto the lift and raise it. (Of course, responders still have to get the patient onto the stretcher in the first place.) Retrofitting cost about $12,000, according to news reports.
See a video of the lift here: boston.com/lifestyle/health/articles/2011/01/11boston_revamps_ambulance_for_obese_patients/.
