When it comes to emergency medical services, reliability saves lives. Working from this axiom, Katherine Tetrault, PA-C, Medical Director for the Ruby Valley Emergency Medical Services, embarked on a two year project to obtain a new 4WD ambulance with financial assistance from the Ruby Valley Healthcare Foundation and the Montana Department of Motor Vehicles Emergency Medical Services. The new 4WD ambulance, which arrived in Sheridan on July 7th, will not only provide more reliable transportation for the emergency services teams but it will also improve safety and comfort for the EMTs and patients, and enhance the pre-hospital delivery of healthcare.
To support the needs of a rural community with many miles of rugged roads, the Ruby Valley EMS has long needed to enhance the segment of their fleet equipped with 4WD. These vehicles are the lifeline for backcountry and deep winter emergency care. In 2018, Tetrault determined that the primary source for financing a 4WD ambulance could be a grant program from the Montana Department of Motor Vehicles Emergency Medical Services (MDOT-EMS) which was set up by the 2009 legislature. Having no experience with grant writing, Tetrault turned to Nondi Harrington, Fundraising Manager with the Ruby Valley Healthcare Foundation, who applied her extensive experience in grant writing to the project. Unfortunately, the grant application would have to wait a year as the MDOT-EMS grant program requires that applicants must be in service for over a year. The Ruby Valley EMS had only been in operation since late 2017, following a transition from the Ruby Valley Ambulance Service.
In 2019, Tetrault and Harrington were successful in obtaining the grant for a $225,000 4WD Ford F-450 power stroke diesel ambulance. “There is a lot of competition for these grants, so it’s remarkable that the Ruby Valley EMS received the grant the first year it was eligible to apply,” said Tetrault. She added that the Ruby Valley EMS won’t be able to apply for another grant for a long time. The Ruby Valley EMS was one of three 2019 ambulance grant recipients. The other two recipients are located in Superior and Lakeside.
A 10% matching donation is required to obtain the MDOT-EMS grant, so Harrington fired-up the resources of the Ruby Valley Healthcare Foundation to raise $22,500 needed for the match. Additional funds would also be needed to purchase ancillary equipment and supplies for the new ambulance. The Ruby Valley Healthcare Foundation raised $21,000 at the annual Round Barn fundraiser in August, 2019 with all funds designated specifically for the new ambulance expenses. An additional $50,000 had been donated to the Healthcare Foundation in December, 2018, by the Ruby Valley Ambulance Service, designated for ambulance procurement matching funds. These funds had previously been donated to the volunteer service by the residents of the Ruby Valley. Opportunity Bank also donated $4,000 toward the cost of acquiring the new ambulance.
Billie Jo Rowberry, President of the Ruby Valley Healthcare Foundation’s Board of Directors, is elated with the outpouring of financial support for the ambulance funding project. “Once again, the Ruby Valley community has shown their dedication to supporting local healthcare and ensuring that we have the necessary resources when our neighbors need medical care,” said Rowberry. “On behalf of the board of directors, I want to express our gratitude for the extraordinary generosity of our community.”
After the Ruby Valley EMS was notified of the grant award, several meetings were held to discuss customizations for the ambulance. While a number of features were important to support the EMS teams, Tetrault’s primary concern was ensuring that the ambulance would have a power cot/power load feature. This feature is costly but particularly important for RV-EMS’ two person teams. The power load feature has a maximum capacity of 870 lbs. and greatly reduces the risk of back injury when loading patients to and from the ambulance.
Paramedic Chris Laukant and EMT Kali Currier with the new ambulance
Kelsey Cooksey, Paramedic Operations Manager, was involved in the customization discussions and provided information about the features of the new ambulance.
The in-line fluid warmer is an established treatment for delivering warmed intravenous (IV) fluids and is essential to prevent hypothermia in patients with trauma. This piece of equipment is very expensive and difficult to incorporate into an ambulance. The new ambulance comes with the fluid warmer in a built-in location in the patient area.
Older model ambulances have seat belts but no safety harnesses in the patient area. The new ambulance has safety harnesses.
Federally regulated substances must be carried in a safe. Cooksey noted that it’s difficult to find and install a safe in older ambulances that meet requirements for federally regulated substances. The federally regulated substances safe is built into the new ambulance.
The oxygen system is more accessible from multiple areas of the patient area.
LED spotlights are installed to help EMTs locate injured parties in the backcountry.
The sirens are controllable through the steering wheel controls, reducing driver distraction when the sirens need to be turned up or down.
Adjustable pedals are a godsend for vertically challenged drivers, allowing them to keep a comfortable distance from the steering wheel.
The new ambulance has a clocking system to document events such as the time when specific interventions are made with a patient.
“The new ambulance will become the first response 911 ambulance,” said Cooksey. A 2015 ambulance will become the primary ambulance for back-up calls and patient transports.
Cooksey is working with Ruby Valley Medical Center’s CEO, Landon Dybdal, to determine which additional equipment and supplies will be purchased for the new ambulance. The major items to be purchased include –
Life Pack Monitor to treat cardiac dysrhythmias
Scoop stretcher which is used to get patients out of precarious situations
Two traction splints for femur fractures
I/O kit to deliver medication via the bone
Roadside safety equipment
New safety vests and helmets
Electric suction unit
If there are sufficient funds, Cooksey would also like to obtain a stair chair to facilitate patient transport down steep staircases and a pediatric safety security system. “We are hoping to maximize our emergency healthcare services with the additional funds that have been donated by the Ruby Valley community,” said Dybdal. Cooksey expects that the new ambulance will be fully outfitted within the next two weeks.
Katherine Tetrault is pleased that the new ambulance has arrived and will soon be ready for operations in the Ruby Valley community. “This is huge for us!” said Tetrault. “We have an aging fleet in general with higher mileage. The new ambulance gives us the opportunity to update our fleet and reduce repair costs.” She added that the high volume of patient transfers ages the current fleet of ambulances very quickly, especially given the distances needed to transfer patients to specialized healthcare facilities in Montana and neighboring states.
The Ruby Valley Emergency Medical Services serve the emergency medical needs of Madison County and parts of Jefferson, Silver Bow, and Beaverhead counties. The organization also provides patient transports for Ruby Valley Medical Center, Madison Valley Medical Center, and Barrett Hospital.