ALS pumper program ‘true benefit to community,’ chief says


The Mehlville Fire Protection District has improved its emergency response times and lifesaving capabilities since launching its advanced life support pumper program last fall, according to district officials.

The hiring of 10 new employees as firefighter/paramedics allowed the district in October to launch the program in which the district’s pumpers now provide ad-vanced life support, or ALS, instead of just basic life support for medical emergencies.

“It’s a true benefit to the community,” Chief Jim Silver-nail said of the district’s ALS pumper program.

Assistant Chief Steve Mossotti said, “What the main difference was is we have two levels of care — basic life support and advanced life support. Over the years on the pumpers, we’ve been providing the basic life support with EMTs (emergency medical technicians). They would come in and could do some basic stabilization, control bleeding, provide CPR — the essentials to keep a person going until the paramedics would arrive and start to provide the more definitive care like putting airways in, the drug therapies, things like that.

“What we’ve done now is we’ve put equipment on the pumpers so that the paramedics who are on the pumpers can start to provide some of that advanced care …,” he added.

Besides the equipment, the change in-volves personnel, said Phil Minnella, assistant chief of emergency medical services.

“More than the equipment, we’ve put personnel who are licensed and capable of doing advanced care,” he explained. “You have different licensing levels and we’ve just changed from the basic licensing level to the advanced paramedic licensing lev-el.”

The fire district currently boasts more than 50 paramedics, including the 10 new employees, 10 firefighters who have their paramedic certification and more than 30 existing paramedics.

District policy now calls for hiring only firefighter/paramedics, and over time, through attrition, the district will completely eliminate the two divisions it traditionally has had — a Fire Division and an EMS Division.

“In the past, we ran two very separate divisions. We had the Fire Division and we had the EMS Division. The Fire Division, if you were hired there you had to have just been through the academy and be an EMT, basic level. To be in the EMS Division, you had to be a paramedic,” Mossotti said.

“So what we’ve essentially done is eliminate the idea of divisions. We still have people that are assigned to particular trucks and will always just stay on one or the other, but we have a new group that will work on whichever truck or type of vehicle we need that day,” he added.

A big factor in being able to launch the ALS pumper program was the generosity of St. Anthony’s Medical Center, Minnella noted.

“They helped us coordinate this, helped us get our SOPs (standard operating procedures) and our guidelines down and our protocols,” he said. “And they also donated six LifePak 12s (cardiac monitors) this last year, which allowed us to take the cardiac monitors that we were using on our life support vehicles and put them on the pumpers. So they saved us a tremendous amount of money to change to this program.”

Noting those cardiac monitors would have cost the district more than $100,000, Minnella said, “They allowed us to be able to do it within our budget …”

Mossotti said, “The original thought was to take just one truck and make it an ALS pumper. But after we looked at it, we decided that if we only make the one truck an ALS pumper, it may only run two or three medical calls that day. Whereas if we equip all of the trucks and we have all of these different personnel who are qualified, on any given day now we can have anywhere from three to five trucks that are ALS now …”

Minnella said, “At present, we don’t have enough paramedic/firefighters to have every truck as an advanced life support unit. Through attrition as we replace people with paramedic/firefighters, it’ll be available more and more. But at present, if there’s a paramedic assigned to that pumper that day, it will be an ALS pumper.”

Silvernail said, “The big advantage of this program is that if an ambulance is out — or we had all five out — at least our fire equipment now can get on the scene and perform advanced life support … Instead of having five life support units in service during the day, we can have up to 12.”

The net effect, Mossotti said, is improved emergency response times and enhanced lifesaving abilities.

For example, in the case of a multi-vehicle accident with multiple patients on the interstate, Mossotti said, “The ambulance and a pumper arrive at the same time. Now we’ve got another group on those pumpers with some equipment that can start to provide more treatment quicker while we’re waiting for additional ambulances to arrive. So it’s going to be an enhancement.”

Silvernail said, “The real beauty part of it is if all five of our ambulances are out, this guarantees you have life support vehicles still in the district … This leaves you with advanced life support vehicles still in the district.”