UI Hospitals and Clinics Emergency Department plays a very important role for the state of Iowa. "We are not only available 24 hours a day, but we see patients from across the state," says Roy Werner, M.D., medical director of the UI Emergency Medical Services Learning Resource Center. "We are the initial point of contact for many individuals, many who have no other way to obtain health care.

"Resident-trained emergency medicine specialists are available to assess each case and initiate treatment. In addition, we are trained in the initial assessment and treatment of injuries and illnesses that may not require emergency care, but could potentially develop into serious health consequences for the patient".

Emergency medical issues and trauma can happen everywhere and it takes time for emergency medical services to respond and begin treatments. When long distances and extremely ill patients are combined, rapid transport and immediate intervention is important. "AirCare is instrumental in providing rapid transport and advanced training that the staff has can mean the difference between possible long-term disability or the return to normalcy," Werner says. "AirCare staff can begin therapies and treatments that would otherwise have to wait for a physician."

Access to initial medical assistance may take a significant amount of time Werner says. "The first responder may have to come a great distance to get to the scene, and in bad weather this can be even longer. In emergency medical conditions like head injury, stroke, cardiac events, trauma, etc.; we talk about the Ôgolden-hour' - that first hour from onset of injury or illness to intervention. It is that critical time emergency medical specialists train to take full advantage of to improve survival rates."

Werner said having specially trained paramedics in the field acting as a direct extension of the emergency medicine specialist, allows therapy and treatment to start when they will have the greatest impact on patient outcome. "Iowa paramedics have a great opportunity to influence patient care," Werner says. "In large cities a patient is picked-up and delivered to a hospital in less than 15 minutes, the paramedic does very basic things. In a rural community, that paramedic works to keep the patient alive for 30 to 60 minutes to reach a hospital. They do the basic things and often are the eyes and ears of the emergency medicine specialist, performing advanced procedures to begin to stabilize critically ill patients."

Should you drive yourself to the emergency room or call 911? Werner says anytime someone has a true emergency, early intervention is important. Paramedics, EMTs, and first responders are trained to identify emergency medical conditions and assist in the initial interventions and specialized transport. "These professionals are trained to know when and how to safely drive fast, and when to pull over and perform interventions," he says. "A person can be much sicker than he thinks. A person with shortness of breath may have pneumonia, asthma, or blood clots in their lungs, or may be having a massive heart attack. You don't know. If that person tries to drive himself to the local emergency room, he may not make it. Worse, they may accidentally injure someone else or worsen their own outcome in the process".

When should you call 911? "This is difficult question. I never want to tell someone not to call 911 because until I see him face to face, I don't know what is wrong," Werner says. "Emergency medicine-trained physicians assume the worst and then prove it is not." At the same time, he says, calling 911 for a cough that you have had for three months is not appropriate because it may take a highly skilled ambulance crew away from a patient they can potentially save in a true emergency.

As a rule of thumb, Werner says, any illness that comes on suddenly and makes you feel scared, a new onset chest pain or shortness of breath, a new onset one-sided weakness, or any traumatic injury, really should seek emergency medical services. If you've had something for more than a week, you could still come to the emergency department for evaluation, but don't call 911. If there is a question in your mind, call the UI Health Access and speak with a nurse.

University of Iowa offers various training programs for those who want to become part of the emergency team. "The Emergency Medical Services Learning Resource Center offers a nationally accredited paramedic training program allowing the participant to practice nation-wide as a paramedic as well as a paramedic specialist in Iowa. "We also offer courses for the EMT- basic level, the EMT-I99 (Iowa intermediate level 1999 standard) level, and we assist with education of first responders and the public on how to assist the ill patient.

"With the increasing need for Paramedic Specialists in this state increasing every year, I recommend any person with a desire to provide emergency medical care to their community call us and talk to us to see if we have a program to fit your needs," says Werner. "Chances are we do!"

For any program in emergency medical services (from the basic to the physician levels) call 319-356-2597 and one of the Emergency Medical Services Learning Resource Center staff members will discuss the course. The next paramedic specialist course begins in July and is offered every six months."

For more information:

AirCare

Roy Werner, M.D.

UI Health Access

Emergency Medical Services Learning Resource Center