(soft acoustic guitar music)
- As a paramedic, as a firefighter,
we get into this profession because we wanna help people.
And when you're a paramedic and a firefighter
in a rural environment, you're helping people
with fewer resources and more austere environment
than you would in a larger city.
So, when we get a call for a chest pain patient,
on the way we're thinking,
"Okay, this is an AzREADI-type call."
And when we get on scene, we'll start our assessment.
We'll usually run a 12-lead
'cause that's really important diagnostic information.
- Hello, ma'am. - (panting) Hi.
- My name's Emma, I'm a paramedic.
That's Peter.
He's my EMT today.
What's your name? - I'm Joanne.
- [Emma] So, why are we here, Joanne?
- [Joanne] My chest started hurting
and it got hard for me to breathe.
- [Emma] Yeah, okay.
If it's okay with you,
why don't we just get a really quick set of vitals on you
and take a look at your heart
and then see what we wanna do from there, okay?
- Okay. - All right.
And I'm gonna go ahead and call a doctor
and kinda get their opinion too.
Does that sound all right?
- [Joanne] Yeah, anything to get feeling better.
- [Emma] Yeah, okay.
- [Joanne] I'm scared 'cause this has never happened before.
- Hey, Dr. Gaither. - Hello!
Hello, can you hear me okay?
- [Emma] Yeah, can you hear me?
- Good. - Perfect, all right.
- So, AzREADI, A-Z-R-E-A-D-I, is a grant-funded project
that's run outta the University of Arizona
Center for Rural Health.
What the grant is aimed to do
is to bring telemedicine services
to our rural EMS communities.
It really brings physician-level care
to communities that might not have good access to that care.
In the last four or five years,
a new service has become available
across the United States called FirstNet.
That FirstNet service is a wireless communication service
that's dedicated to first responders.
With that new innovation,
we thought this was a great opportunity
to try out this program
and see if it really did improve care
for our rural communities.
For the AzREADI project,
what we really focus on is providing care,
for example, for patients with chest pain.
Before this program,
if you developed horrible crushing chest pain,
the paramedic would just call the helicopter
and transport you to the hospital as quickly as possible.
With this program, the paramedic can get an EKG,
send that EKG to our physicians.
We'll take a look at the EKG, talk with the patient,
and help come up with a decision.
Is this patient okay to be transported by ground
by an ambulance or can they even go by their own vehicle,
saving that individual money
and allowing the paramedic to stay in the community
to provide the services that community needs.
(garage door whirring)
- So, as operations chief at Sonoita-Elgin Fire District,
my job is really to oversee
the day-to-day running of the department,
so making sure that our crews are scheduled
and they have what they need.
Also responsible for the stuff around here,
so making sure that our vehicles
are on the road and running correctly.
And then, really, anything else that the fire chief
needs me to do to make sure
that we're basically mission-ready every single day.
Being in a rural community, and by ambulance
we're roughly 45 to 90 minutes away from a hospital,
depending on where we pick the patient up
and which hospital we go to,
Sonoita-Elgin Fire serves a fire district
of 350 square miles.
We also are responsible for ambulance transports
for 725 square miles.
- No stoplights.
We have, well, a Dollar General now,
which makes us a little bit bigger,
but before it was just a corner market store,
one gas station, very spread out.
Rural EMS is a whole different animal.
You really have to kinda cowboy up
and just do what you can with what you have.
As a provider, I like it in that way
'cause it really tests you and makes you grow,
whether you like it or not sometimes.
You definitely learn from every call that you get,
spending an hour in the back of the rig with a patient.
You're either really busy doing stuff
or you're having a nice conversation with them
and getting to learn about them
and getting to learn about their family.
And at least for this hour,
I'm gonna get you to the hospital safely
and I'm gonna kinda comfort you
and make you feel a little bit better on your way there.
- [Marc] We're less than 15 minutes out.
- [Peter] Cool, thank you.
- The way in which this program makes my job easier,
frankly, but also more fulfilling
is that between myself and my patient
and the ER physician I'm bringing this patient to,
I don't have to wait until I get to the hospital
to actually link all of the parties together.
I can do it from the point of our initial encounter
with the patient.
Now that we've been running the program for several months,
we've entered into refresher trainings.
And refresher trainings is kinda what it sounds like.
It's going back and make sure we remember,
"How do we use this phone?"
- Hi, thank you for coming.
My name is Aileen Hardcastle.
I am the project manager for the AzREADI program
out of the University of Arizona-
- [Emma] The refresher trainings,
especially for this AzREADI program, I think,
will be really helpful for us.
- So, AzREADI is the Arizona Rural Advanced
Telemedicine Demonstration Initiative.
- [Emma] It'll help what are some things
that we need to be doing different or what are some things
we could be doing different to help the situation.
- A lotta people in a lotta places
are looking at what we're doing
and specifically what you guys are doing.
- And hopefully expand it beyond just chest pains
and we can make it into
that more of a use-me-whenever-for-whatever kinda tool.
- So, Dr. Gaither is the person who's on call today,
and he's ready to accept test calls at any point.
- [Josh] Hello!
- [Peter] Hello.
- Can you guys hear me okay? - Yep.
- My goal throughout my entire career
has been to really help these talented healthcare providers
utilize their skills and resources as best as they can,
so this project really does allow them to do that.
The striking thing about medicine
is I as a physician rarely save a life.
The paramedics and EMTs in our community
are the real heroes.
They're the real lifesavers.
One of the great things about this program
is that it allows those individuals
to get a doctor on a phone to do a telemedicine consult
during those really high-stress, life-critical times.
If they have a question,
this allows them to get ahold of us and we can help them
through those really challenging situations.
- Frankly, if this makes a difference for one patient,
it's made a huge difference.
I would love it if more agencies that we interacted with
and more fire districts in rural communities
were able to participate in that,
'cause we've seen the difference it makes for us.
And if it's helping us and it's helping our patients,
then I know it's gonna help
other rural patients in other districts.
- It's kinda my life goal, I suppose,
is to do whatever I can to build myself so that I can be,
I like to think of it as like a servant to other people.
I really do genuinely get that enjoyment
of if I'm able to make that personal connection
with somebody in the ambulance for an hour
and just talk to them about their day
or talking about their life.
Being able to be there and be the person
that somebody needs in that moment,
I just wanna be able to look back
and say that I made some kind of impact in their lives.
If it was for an hour or two hours or 20 minutes,
it doesn't matter, but as long as I can do whatever I could
to be able to be there and be the best person
that they needed in that moment.