The Times-Independent

EMS looks to expand services

New program will focus on helping ground fall victims stay upright


Ground-level falls are one of the most common 911 calls for Grand County EMS. It is an issue that has concerned local paramedics, EMTS, and health care providers at Moab Regional Hospital for years, and now, thanks to a casual conversation that took place during a hike, there is an effort afoot to minimize those calls by helping people, when they can, mitigate the risks that led to the fall.

Grand County EMS recently responded to a ground-level fall in Spanish Valley. The patient was assessed and transported to Moab Regional Hospital, and also was tagged for follow-up through the now-under-development Mobile Integrated Health program. Photo courtesy of Grand County EMS

EMS Captains Will Barnhardt and Chris Canning in interviews with The Times-Independent said the now-under-development Mobile Integrated Health program would provide follow-up service to certain patients who fall at home.

They would perform a range of analyses, such as the person’s environment: Is the carpet loose and a tripping hazard? Are hand railings needed? Is it nutritional? Is it a bad to reaction to medicine or a lack of medicine?

“There are a lot or reasons people fall at home,” said Canning. “It can be a mobility issue, dizziness, vision, they could have stumbled and even have a broken leg, a heart attack or they just got up too fast. There are lots of reasons people are falling.”

And for older residents, such falls can lead to death. Canning said progress has been made and “a lot of good people” are involved in the effort, but a launch date is a few months away.

“The hope is to identify patients who refuse transport to MRH, that are high-risk,” he said. “We would do an assessment.” This is where the carpet and other home factors are inspected, and the patient also is examined to determine, among other things, if they are even strong enough to hold themselves in a standing position.

The idea isn’t new, but no two programs are alike. In a nutshell, such programs allow paramedics and EMTS “to operate in expanded roles by assisting with public health and primary healthcare and preventive services to underserved populations in the community,” according to the National Association of Emergency Medical Technicians.

Clearly, this isn’t a one-size fits all program and nascent attempts to implement them have been mixed, with some being successful and some not successful, said Canning.

“We’re focused on, ‘What does our community need?’ We want to tailor the program to meet the needs of the 10,000 or so residents of Grand County.”

While no two communities share the same exact needs, all communities have segments of the population that “fall through the health care cracks,” as Canning puts it, which is something else EMS wants to address.

To the rescue came MRH Dr. Whitney Mack. “She’s been integral to this working group,” said Canning. “It’s all so new and we have a lot of good people helping.”

“We think this program has a lot of promise,” said Barnhardt, whom Canning credited as the de facto leader of the effort. “There’s still a lot of moving parts, but we think we’ll be ready to announce a launch date in May.”

Barnhardt said EMS is trying to do what the Moab Valley and other fire departments have done for years with fire prevention education at the school level, as well as inside homes.

“We want to help people avoid 911 calls,” he said. “Fifty percent of the time people get back up, but the other half of them are unable to get up on their own.” And 2% of them will ultimately die as a result of that fall, he added.

Barnhardt said EMS will move from being reactive to preventative. No more will they simply help them off the floor and move on to the next call. “We’ll set up visits for the next day or two and evaluate their medical condition and environment. We’ll put in railings if that’s what’s needed,” he said. “It’s the little things that help.”

Barnhardt also singled out Dr. Mack for praise, saying she was a key to the program. “As [EMS] we’re used to walking into unknown circumstances,” he said, but with a doctor trained as a primary care physician on board, they can identify patients who require weekly help for the long-term or home health nursing, or whatever the need is — it most likely could be addressed.

Barnhardt said using the resources available would make for a “win-win” as vulnerable patients would be identified. He also appreciated the mobile aspect of the program as people are more comfortable at home and would be more communicative in discussing their issues, both medically and environmentally. “They feel safe and we want to make sure we discover thoroughly what their issues are and talk to them about their health.”

He singled out those with diabetes for an example. They could have an episode of acute hypoglycemia when their blood sugar drops, sometimes to the point they are unresponsive. Barnhardt said EMS crews can help the patient quickly recover, but what about the next time?

“Health care access is a huge issue,” he said. “It’s one of the biggest issues in the community surveys. We can teach them about their diabetes, about nutrition, how to check their blood pressure and how some of the things they do hurts them rather than helps. We can really make a difference in a person’s health.”

Barnhardt said EMS will seek out people skilled in building railings, or carpet repair or other handy skills. This work could be voluntary or supplemented through grants, but that’s a decision that will be made down the road.