Kimball Ambulance approved as EMS Advanced Services Transport

The Kimball County Ambulance crew's hard work since Carla Goranson's appointment as director has paid off in a big way. Recently, the ambulance has been approved to run as a State of Nebraska EMS Advanced Services Transport.

There is a lot of work that goes into being approved to operated as an advanced services transport. Not only must they be in compliance with certain regulations they must be able to show a history of compliance as well.

"We had to develop and get approved protocols. We had to show that we were taking care of our equipment so we had to show a history of weekly inspections that are done on our electronic equipment. We also had to show a history of inspecting the ambulances themselves once a month, and so we had to do a lot of maintenance to get the ambulances ready for the inspection," Goranson said.

The lights in the ambulances had to be working and other mechanical maintenance had to be taken care of to make sure that the ambulances were in working order. Not only that but certain medical equipment and medications kept on board must be properly contained and in a secure area. All of these things a must for those seeking an advanced license. While equipment is a large part of the things being inspected, it wasn't all there was to getting this advanced licensing.

The personnel that are working with the ambulance are also a large part of getting the license.

"They checked into our personnel to make sure that each member of our crew had the proper credentials. They also had to look at training records because we are responsible for providing certain types of training to the crew every three years, so we had to get that done and then have a record of it. Each crew member has to have certain training every two years and we have to be able to show that," Goranson said.

Along with the personnel being trained properly and having up to date training they must also make sure that they are taking records that are accurate. It is crucial that the personnel on the ambulance take down proper information regarding the patients that they are assisting while out in the field.

"They looked at the patient care records to be sure we were documenting patient care properly, probably the biggest part of it were the state protocols," Goranson said.

With all of the aforementioned being under consideration the Kimball County Ambulance was approved with flying colors. They were inspected by Karen Bowlin and Jackie Larrington, a Panhandle EMS Specialist. The ambulance passed in every category, a must in order to obtain an advanced license.

"This service has developed policies and procedures above and beyond what is required. EMS personnel affiliated with it have definite direction. Expectations of behavior and patient care are well defined. There has been thought to the future as well as making sure current procedures are well taken care of. There are interagency policies to assist with the overall care of the region. I recommend licensure of this service to ALS transport," Bowlin said in the inspection report.

Now that the ambulance is licensed they can act as an advanced service transport when they have either their paramedic, Dawn Maier or their Advanced Emergency Technician (AEMT), Heather Gawith, on a call. This allows them to provide services to patients that before they had to wait to administer at the hospital.

"What it changes is the type of care we can give to the patient. Before, we were a basic life support service, so, for instance , we could defibrillate, and we could only help administer the patient medicine they were already taking. If we have an advanced person on a call and the call warrants advanced care, that person can now use their advanced skills to the fullest ability. They can start and administer IVs and help get certain treatments started. Them being able to do this in the field allows them to really help out the hospital and the patient," Goranson said.

Being able to start IVs out in the field puts the patient at a very big advantage. Since veins can collapse or become difficult to locate during times of significant blood loss, it is beneficial to be able to start an IV in the field when the veins are still viable. Not only that but they can offer other types of care to assist patients that may have had a severe accident with pain management.

Goranson has several plans for the ambulance to advance. Soon she will have a fully licensed crew, either all will be Emergency Medical Responders (EMR) or a higher level. In the past, Goranson had drivers that were just that, they were not licensed. However, she soon plans to have them all able to administer at least a basic level of care.