How things work: Ambulances

Tammie Martin, left, a NREMT-P and supervisor/public relations coordinator, works with paramedic student Cody Floyd and paramedic LaCrisha Sample. They are packing up in the ambulance as part of a daily checklist that ensures all equipment is properly working before each shift starts. (Adam Robison)

Tammie Martin, left, a NREMT-P and supervisor/public
relations coordinator, works with paramedic student Cody Floyd and paramedic LaCrisha Sample. They are
packing up in the ambulance as part of a daily checklist that ensures all equipment is properly working before each shift starts. (Adam Robison)

EDITOR’S NOTE: Today continues a summer series by Daily Journal reporters called “Teach Me Something” where we show how to do a variety of things and how things work.

By Riley Manning
Daily Journal

TUPELO – North Mississippi Medical Center’s Ambulance Services respond to around 1,000 emergency 911 calls and an additional 600 non-emergency calls each month.

So to effectively manage such a high volume of work, the ambulance service system must be a well-oiled machine.

“We operate as many as 12 ambulances during the day, and seven at night, and they cover Lee, Pontotoc and Itawamba counties,” said Josh Wenzel, administrative director of placement and transportation. “We’ve got our operation down to a science.”

According to Wenzel, each ambulance is captained by one emergency medical technician and one paramedic, who work in 12-hour shifts.

“EMTs are equipped to administer basic life support, first aid, resuscitation, while the paramedics are capable with much more technical things like IVs, medications and defibrillators,” Wenzel said.

In over two decades of work in emergency medical services, Wenzel said the ambulances themselves have come a long way.

“Until about 15 years ago, an ambulance was just a taxi cab with lights on top,” he said. “We basically bring the emergency room to the patient.”

Ambulances now come equipped with top-notch hydraulic stretchers, and a dizzying amount of equipment and monitors. Wenzel said a bare bones ambulance costs about $130,000. With everything it needs, the costs is double.

But all the bells and whistles amount to nothing without a strategy.

“It’s not the population that makes it tricky, it’s covering such a big area, so we are very intentional about where we place our ambulances,” Wenzel said.

In addition to the four or five ambulances stationed at the Medical Center, ambulances are also placed at the Baldwyn Medical Clinic as well as at the Barnes Crossing Family Medical Clinic. Two are stationed at the Fulton Medical Clinic and two at the Medical Center in Pontotoc.

When ambulances get called to a certain end of the coverage area, uncalled ambulances are placed near the other end of the area.

“For instance, if our ambulances are tied up in, say Fulton, we’ll place one on the Pontotoc county line to be ready to react to a call from that area,” Wenzel said.

The odds are astronomical for all ambulances to be called at the same time. If the ambulances are all occupied and another emergency occurs, one of the ambulances is usually dropping a patient off and is able to quickly head straight to the next emergency.

All the while, back at ambulance services, each vehicle is meticulously tracked on a flat screen television by an employee.

The screen shows each where each ambulance is, where calls are placed from, how fast the ambulances are going, and even the weather in the area. If a check engine light comes on in an ambulance, it sends a signal to supervisor Tammie Martin.

Behind it all
Wenzel first came to the emergency medical field 22 years ago as a lifeguard, and from there, volunteered on a local rescue squad in his native Kentucky. Initially attending Western Kentucky University as a music major, he made the switch to EMT school midway through, and never looked back.

“The biggest advance in the emergency medical field for us has been synching the ambulances, emergency, and [catheterization] lab,” Wenzel said. “With the technology especially, now we can provide the hospital with more information on the patient before we even get there, so when they arrive, the cath lab knows what to expect and can be prepared.”

This improvement is measured by “door to balloon time,” that is, the time between when the patient arrives in the emergency room and when the catheter (the balloon) is administered to the patient.

“We are constantly trying to improve,” Wenzel said. “Currently our average door-to-balloon time is under 90 minutes, and as low as 34 minutes. In the past it has been as long as three hours.”

Wenzel said in the case of a heart attack, the clock starts ticking. For the record, he said, when an ambulance is coming, please stop and pull to the right to let them through.

riley.manning@journalinc.com