By Glenn Rolfe

GEORGETOWN — For the third consecutive year, Sussex County Emergency Medical Services attained the American Heart Association’s Mission: Lifeline Gold Plus Award.

The honor recognizes the county paramedic program for its success in implementing a high standard of prehospital care “by ensuring that every patient receives treatment according to national accepted recommendations and standards.”

“I think a lot of people don’t realize that, when the paramedics show up, it’s almost like you are at the emergency room already — to a limited degree,” said Sussex County Councilman John Rieley during mention of the award at an August council meeting. “We’ve made huge strides in improving that service over the years. It’s a great thing.”

The three straight golds followed a silver in Sussex EMS’ first submission to the program.
“And the only reason we got silver our first year is because it is not possible to get gold the first year,” said Rob Mauch, Sussex County EMS deputy director. “The very first time you apply for recognition, the best you can do is the silver. Then, you get the gold by meeting the same high standard for consecutive years. You have to do it for at least two consecutive years to get the gold.

“We have met that same high standard since the first we applied for the recognition. We got silver the first time and maintained gold ever since,” he added.

The award process is based on information supplied to AHA.

“A lot of it is an honor system, that we are supplying them with truthful and accurate information — which I can attest that we are because I am the one that submits it,” Mr. Mauch said. “They don’t necessarily do a follow-up to say, ‘Well, show us the documentation.’”

He said there are a number of reports he runs, “some on a daily basis, some on a weekly basis, looking at some of the indicators and some of the performance levels, so I can make sure we are meeting them on a daily basis. So if I see something starting to trend in maybe the wrong direction, we can catch it almost immediately.”

Among the indicators for chest pains, for example, are administering aspirin to the patients relatively quickly.

“Because that initial dose of aspirin has been shown to be very beneficial and, in some cases, lifesaving,” Mr. Mauch said. “Now, if the patient reports they have an allergy to aspirin, then, well, we don’t want to cause another problem by giving them aspirin.”

Quickness in performing an electrocardiogram is another indicator measured. “The standard is to complete that EKG within 10 minutes. I think we’re like high 90% compliant with cardiac-type patients with EKG,” he said.

Sussex EMS also compiles data on stroke protocol.

“AHA is working very closely with the stroke folks to make sure we are treating stroke patients appropriately. We have, for a number of years, reported stroke data, as well. It has been an optional item to submit,” Mr. Mauch said. “This past year, the stroke data was supposed to be a mandatory reporting field. However, a little thing called COVID changed a lot of people’s plans. So they didn’t think that was the right year to change the metrics, if you will.

“My assumption is, for the 2022 award cycle, they probably will mandate the stroke info,” he added. “We are already meeting that standard.”

Currently, Sussex County EMS has 10 full-time paramedic stations throughout the county, plus the East and West districts’ supervisor bases. Over summer months, there is extra staffing for coverage along the Del. 54 corridor.

“When we build new stations, … we are looking at where current, past and future call volume are expected, what the growth is going to be and how we can geographically get the closest to the national standard of response time of eight minutes,” said Sussex EMS public information officer and special operations manager Glenn Marshall. “Sometimes, it’s a simple move. These things are what we look at when we relocate stations.”

Funding for EMS is reflected in the county’s annual budget. For this fiscal year, the operating expense of Sussex EMS is $17.4 million. Of that, approximately 30%, or $5.1 million, is supported by the state of Delaware, according to Sussex County Finance Director Gina Jennings. The bulk is provided by the county.

Sussex EMS currently has 107 uniformed staffers, plus 10 nonuniformed personnel.

Education for paramedics, for the most part, is a two-year process.

“Most programs, not all, are going toward a two-year associate degree program,” Mr. Mauch said.

Years ago, you could attend paramedic training at a firehouse or community college, but “those days pretty much are gone just because of the level of expertise required, the level of knowledge,” he said. “So most paramedics are coming out with a couple classes in biology and chemistry, in addition to actually learning the actual medical side of treating an injury or an illness.”

Learning is ongoing, with full-day classes — some virtual — eight months out of the year.
“We do continuing education pretty much year-round with all of our staff. We focus on new things, new equipment to train, or refresh on skills that we do every day … to make sure we have them ingrained in our brains, as far as how to do them and the knowledge behind it and why it’s important,” Mr. Mauch said.

Outreach also has evolved as a key EMS component.

“We started going to these different events, these festivals, with the initial intent of being there to provide care if somebody has a medical emergency,” said Mr. Mauch. “While we are there for those reasons, we realized that that is an excellent opportunity to really engage with the public, to spread important messages: how to call 911, how to recognize a stroke, a heart attack.

“That led down to the road of hands-on CPR, teaching CPR, the ‘Stop the Bleed’ campaign and even how to recognize possible opiate overdose and how to administer Narcan, if that is something that’s available to a family member or in a public setting.”

Over the years, Sussex County EMS has fared exceptionally well in the Journal of Emergency Services Games, garnering medals in Olympic-style competition that attracts teams from around the world.

“We have won the gold a number of times,” Mr. Mauch said. “I believe we are still the most decorated team in the Games’ history, with a series of gold, silver and bronze awards.”

Due to a surge in COVID-19, JEMS Games in 2021 were canceled. Next year’s games are set for the National Harbor, near Washington, D.C.

“We’re ready to go next year and bring home that gold again,” he said.