January 26, 1998
Photo by Deborah Stone
Steve Richardson (back) and Jim Duren
by Deborah Stone
Making informed decisions on ballot measures is an important responsibility. Obtaining the objective knowledge required to do this, however, can be a frustrating process. One often has to wade through the convoluted rhetoric of the dozens of propositions whose fates lie in the hands of the public.
On Feb. 3rd, voters in King County will be asked to vote on Proposition 1, the continued funding of the Medic One program, through a three year tax levy. Last November, this ballot issue failed to pass with the required sixty percent super majority needed for approval. This program has been consistently funded by a levy since the late 1970s so it came as a surprise to proponents when the levy failed to receive its traditionally strong support. It appeared that many voters, including myself, were confused about Medic One, its various components and the services it provides.
To clarify much of this confusion, I set out to do some hands-on, face-to-face research. At Medic Unit 47 in Bothell, Jim Duren, Medical Services Officer and fellow paramedic Steve Richardson allowed me to spend the day with them to learn about the Medic One program. Evergreen Medic One is one of five providers in the King County Medic One system and it serves the communities of Bothell, Woodinville, Kirkland, Redmond, Duvall and Carnation, covering over 140 square miles of area. There are four paramedic units or stations for Evergreen Medic One and twenty one paramedics who work within this system. Last year they answered 5500 calls, ranging from problems such as chest pain and shortness of breath, to drug overdose and trauma.
To understand how Medic One operates, one must have an overview of the complete Emergency Services System for King County. The county has a tiered response system, comprised of Basic Life Support (BLS) on the first tier, followed by Advanced Life Support (ALS) on the second tier. When a 911 call comes in, the dispatcher immediately sends out a fire department aid car staffed by Emergency Medical Technicians (EMTs). EMTs, skilled in advanced first aid and automatic defibrillation, are the first responders and arrive within four to six minutes to begin assessing and treating the patient. When the dispatcher determines that the emergency is urgent or life-threatening, ALS units are then sent. Medic One units, staffed with physician-trained paramedics, bring a "mobile emergency room" to the accident or illness.
ALS units arrive within ten minutes of being dispatched and treat and stabilize the patient, before transporting him to the hospital if necessary. According to Duren, the system works because it's flexible and matches resources to patients' needs. He says, "The success depends on a good BLS system that provides help until the ALS arrives. EMTs allow the paramedics to have a viable patient and thus increase survivability chances. Our resuscitation rate is the highest in the nation."
The Medic One program is a national and international model for emergency services. Its success is due primarily to the high level and consistency of training among its paramedics. All King County Medic One paramedics must go through an intensive training program, which is based at Harborview Medical Center and under the auspices of the University of Washington School of Medicine. This highly reputable and rigorous program involves a commitment of 3000 plus hours over a ten month period of time.
The training includes classes and experiential learning at the hospital and on the streets. Prospective paramedics who apply to the program must have a minimum of three years as an active EMT, take a written entrance exam, a physical fitness test and go through a series of oral boards. Those chosen are then considered to be paramedic students for the ten month training period. King County pays their tuition and a living stipend.
As Medical Services Officer, Duren does the hiring for Evergreen Medic One paramedics. He says, "It is very competitive because our standards are so high. I usually have about a hundred applicants per position, and a position might only become available once every year or every two years. "
To keep their status current, all paramedics must attend fifty hours of continuing medical education classes a year, test for recertification every two years and do twelve endotrachial procedures each year. The national average career of a paramedic is between three and five years, due to burnout and stress-related factors.
However, Evergreen Medic One paramedics don't conform to that statistic. "Our paramedics have been here on the average of five plus years because they treat what they do as a profession, not a job," explains Duren. He goes on to explain that the Medic One system uses state of the art equipment, emphasizes continued learning and involves its paramedics in break-through research and innovation. "There's also a high level of trust and respect in the system," says Richardson. "We are the eyes, ears and mouths of the doctors out in the field and great trust is put in our judgment and actions. It's a privilege to work in such an environment."
Both Duren and Richardson agree on the qualities of a good paramedic, "Being humble and not arrogantly assuming you know it all," is essential says Duren. Richardson adds, "You need to be mature, possess confidence in your skills and also be diplomatic, because you deal with all kinds of people in a wide variety of situations. Communicating with people effectively is ninety eight percent of the job. First and foremost though, you need to have a strong motivation to help others."
Paramedics have to be able to handle numerous tasks at one time, all while maintaining their composure. They're like detectives who, within minutes, must determine what's wrong and set about solving the problem Duren and Richardson communicated wordlessly at times, appearing to know what the other was thinking. One would gather the necessary background information while the other was assessing the patient and monitoring his/her vital signs. "We are all trained the same and that's where the consistency factor really helps," explains Duren. "Working with a partner also gives us the opportunity to bounce things off each other." Duren and Richardson each had their own reasons for becoming paramedics.
As a young boy, Richardson witnessed his father having a cardiac arrest on a ferry. He saw him successfully resuscitated by an EMT and knew from that point on that he wanted to pursue a career in this realm. "I decided I wanted to someday return that favor to another young child," says Richardson. "I have a high compassion factor and really love taking care of people. It's an honor for me to be invited into someone's home, an honor to have that trust."
Duren finds the profession deeply satisfying. He says, "Talking to people and caring for them is very rewarding. I also thrive on the challenge of putting the puzzle pieces together and using the skills I have to help others." "We're always a phone call away," says Richardson, "and when you need us, you can be assured that you'll be getting the best pre-hospital care in the country." Duren adds, "Many people may never be in need of our services, but knowing that we're here twenty four hours a day to help if and when the time arises, provides a true sense of security and comfort. You don't know what you have until you don't have it anymore." For more information regarding Evergreen Medic One, including scheduling a tour or speaker, call 425-488-4954.