Sunday, April 8, 2007
Last Modified Saterday, April 7, 2007 11:58 PM MDT

SIERRA VISTA -Thirteen emergency medical technicians who recently completed the paramedic training program at Cochise College are believed to be the first in Arizona to receive hands-on clinical training in a controlled hospital environment.

Part of the first paramedicine class offered by the college in several years, the students practiced everything from delivering babies to endotracheal intubation under the direct supervision of doctors at Sierra Vista Regional Health Center. The 13-month program aims to fill a local need for professionals who are able to provide advanced emergency care in the field. With job growth projections of 36 percent for the next decade, EMTs and paramedics rank in the top 15 percent for job growth in Arizona, according to the state Department of Economic Security.

"It's an important fact that paramedics are responsible during critical moments and that their knowledge and skills can make a difference in the outcome," said Dr. Harvey Zeligman, an emergency room doctor at the Sierra Vista hospital and medical director for the college's emergency medical services programs. "This is a model for the way paramedicine training programs should be."

Zeligman gained hospital support for the hands-on clinicals after recognizing that most paramedicine clinical training is limited to observation of life-saving procedures. Students who observe only must become familiar with critical tasks, such as securing an airway so a patient can breathe, on mannequins or on the job.

"This method is best for people who are going to be working in stressful, life-or-death situations," said Mike Grill, Cochise College's EMS programs coordinator.

As a result, the students collectively scored 98 percent on a practical exam, an all-day test in which they demonstrated their skills in airway management, cardiac care, vascular access, and medication administration. They're also prepared to take the test to obtain certification with the National Registry of Emergency Medical Technicians. The University of Arizona South is one of the few sites in the state that is equipped to offer the recently computerized test.

Student Josh Steinberg, an EMT with the Bisbee Fire Department, said understanding what happens to emergency patients once they reach the hospital will allow for overall improvement of care.

"There is a huge benefit in seeing what happens after the patient is dropped off at the hospital and understanding what I can do in the field to make that go smoothly," he said.

The Fry Fire District, which has lost personnel to other agencies due to higher pay and promotional opportunities, is one of several that covered the cost of putting EMTs through the program. Chief Bill Miller said it put staff members through the program with the intention of providing the best possible service to citizens.

The city of Douglas covered tuition for Armando Higuera and Oscar Elias as an investment in the care of residents of the EMS agency's 1,500-square-mile service area, one of the largest in the state, said Douglas Fire Chief Mario Novoa. Since Douglas is far from a level one trauma center, the city needs to make sure citizens have a fighting chance. The paramedics, Novoa said, can make the difference between life and death.

The biggest challenge for Higuera and Elias has been juggling family, work, and school.

In addition to clinical hours, the program includes three evening classes per week and some Saturdays. Those who pass the certification exams can work as firefighter paramedics or flight paramedics or in hospital emergency departments, as Catherine Buckmire intends to do. While she appreciated the benefits of learning in the field, Buckmire was impressed with the expertise of guest lecturer Dr. Dan Cowan, former chief of anesthesiology at the Sierra Vista Regional Health Center.

"It takes considerable experience to be a guest lecturer and to teach us," Buckmire said. "The textbook is good, but none of us have had a textbook patient."

Most of the students have worked as EMTs for several years and are ready to advance their knowledge and take a step up the career ladder. In addition to intubation, paramedics are qualified to start IVs and administer drugs, interpret EKGs, and understand cardiac problems -tasks that EMTs are not trained to handle.

Fry Fire's Kurt Denney has already seen the difference paramedics can make. On his first ride-along, Denney was part of a crew that saved the life of a jogger in cardiac distress. The patient was flown to Tucson and a few weeks later dropped by the station to say "thanks."

"Watching the captain secure the patient's airway, and then seeing him healthy a few weeks later, gave me a greater appreciation for what paramedics are asked to do," Denney said.

DENISE MERKEL is public information officer for Cochise College.