In a coordinated effort with local hospitals Adventist Health Glendale, Glendale Memorial Hospital and USC Verdugo Hills Hospital, the Glendale Fire Department has outfitted its 9 fire engines and 3 fire trucks with specialized ZOLL-brand defibrillators that double as vital signs monitors, according to Captain Andrew Gano, the emergency medical service (EMS) coordinator for Glendale. The first 4 engines received the advanced defibrillators May 1 and the last vehicle received its unit Oct. 11, Gano said.
Gano said most emergency rescues begin when a 911 call arrives in the dispatch center — Verdugo Fire Communications Center. A dispatcher finds the caller’s location and records information provided by the caller. If warranted by the situation, the fire department will make a dispatch. In Glendale, each emergency medical dispatch includes two paramedics, who arrive at the scene in a fire engine, and one or more ambulances, which are staffed by emergency medical technicians (EMTs). If necessary, the EMTs load patients into their ambulance and transport them to the nearest hospital.
“So the paramedics will go to the call, they will do an assessment, they’ll treat the patient on scene, then they’ll load them up in the ambulance if need be and take them over to the closest hospital,” Gano said.
According to Gano, knowledge of local geography is critical to emergency responders.
“In order to be on the fire department, you gotta know the city, you gotta know the streets. We all know all the streets in the city, we get tested on that as we’re getting hired, so that’s something everyone has to study,” Gano said.
Dr. Angelica Loza-Gomez, who has worked at Los Angeles County+USC Medical Center for five years, became the associate medical director for the Glendale Fire Department in 2013. Loza-Gomez, who later became the medical director for the dispatch center that serves Glendale, spoke about the project to install ZOLL defibrillator/monitors as an example of cooperation between hospitals and the city. According to Loza-Gomez, the new defibrillator/monitors, unlike traditional defibrillators that only provide a shock to a patient experiencing cardiac arrest, provide additional readings and feedback.
“We needed these advanced defibrillators, and we didn’t have the money or the funding for it. So our local hospitals, after much asking and requesting from them, were able to come up with the money to help fund these defibrillators, which was phenomenal,” Loza-Gomez said.
According to Loza-Gomez, the upgraded defibrillators will provide hospitals with additional patient information before the ambulance arrives.
“Now we can submit EKGs [electrocardiograms, a test that reads the heart’s electrical activity] to the hospitals, and they can get set up and ready by the time the paramedics arrive,” Loza-Gomez said. “All these medical emergencies are very time-sensitive — you have to act quick or you will lose that window of opportunity to save a life.”
According to Gano, local hospitals Adventist Health Glendale, Glendale Memorial Hospital and USC Verdugo Hills Hospital contributed more than 90 percent of the required funding for the defibrillator/monitor outfitting, each unit costing upwards of $40,000.
“With our older monitors, we’d call in and say, ‘Hey, this is what we see on the monitor,’ then they’d wait until we got to the hospital to activate the surgeons to come down, whether they’re at home or in the hospital, to come into the [catheterization] lab. But now that we can send that over, they’re seeing it before we even transport the patient, so they’re waiting for us now when we get to the hospital,” said Gano. “That’s taking 10, 15 minutes of time of that heart dying [due to] not getting adequate blood supply, so numerous lives have been impacted by this.”
Dr. Lance Lee, head of the neuroscience department at Adventist Health Glendale and medical director of the hospital’s stroke center, said that he has worked for the past 18 years to provide care for stroke patients. In 2008, Glendale Adventist Hospital became the first community hospital in Los Angeles County with a stroke center, and in 2015, the first comprehensive stroke center in Los Angeles County. Lee spoke about the coordination necessary to deal with emergency medical situations.
“LA County has an ambulance system, and all those ambulance personnel — paramedics — have to be educated for this. So, they know where to send a patient after their initial assessment, which are not perfect, of course, they’re only paramedics, but whenever they think the patient had a stroke they know exactly where to bring the patient to. So, there’s a whole county-wide system that delivers patients to the right place,” Lee said.
According to Lee, constantly adapting to new technology and processes is part of the medical field.
“Thus far, what we have done is great, but the problem is, the field is changing every few months. There are new guidelines coming up, there are new recommendations, so we have to be ready for it. You can’t stay complacent about what you’ve done, we just have to keep educating ourselves and be ready for what’s coming,” Lee said.