EMT: How Alaska's emergency experts extend a helping hand.

• Author: Simonelli, Isaac Stone

An updated emergency medical service regulations package in Alaska has further broadened the scope of practice for emergency medical technicians (EMTs) who face some of the most challenging conditions in the United States.

Even prior to the updates, EMTs in the Last Frontier--many working with medevac teams or on ski patrols--were trained to deal with a broader array of medical issues than entry-level EMTs in the Lower 48, explains Todd McDowell, the Emergency Medical Services (EMS) program manager at the Alaska Department of Health and Social Services.

"Our scope of practice was essentially based on scope of practice from the late 1990s, early 2000s." McDowell says, noting that to ensure EMTs are trained using the most modern techniques, they need to take additional training courses with an expanded scope. "It was actually the first major revision of the EMS regulations in about seventeen years. So, it's actually a pretty exciting time right now."

All of the approximately 3,500 trained EMTs in Alaska were certified by the Alaska EMS program to practice in state, explains McDowell. Even those trained Outside are required to take a short transition class to ensure they're ready to take on the expanded scope of duties needed to perform here.

The lack of connectivity between communities and hospitals via road systems in Alaska is unparalleled in the Lower 48. Because of this, Alaskans living in rural communities depend primarily on air transportation--especially in the case of a medical emergency.

"So when you look at the type of patients we fly, they're having to fly because there is no other way for them to travel to where they can get the level of care they need," Guardian Flight Executive Director Jared Sherman says.

"About twenty years ago, the airline industry said you couldn't put a passenger with a tank of oxygen or managing IV medications on a commercial aircraft.

"And that's how, originally, all around Alaska commercial operators operated. So, when the FAA came out and said that you needed to actually operate like a medevac company, it opened up the need for this kind of transport."

Medevac companies, such as Guardian Flight, LifeMed Alaska, and Medevac Alaska, quickly moved in with trained emergency medical personnel to fill that need.

"These services are critical to the people of the state of Alaska. Much of Alaska is remote and underserviced. Many communities exist without a surgeon or specialist. Alaskans are rugged themselves. It just takes time to get to patients," says LifeMed Alaska Director of Clinical Services Erik Lewis. "Often when someone gets injured it takes time to activate the right resources and mobilize assets to get to a patient; then we fly to their location and fly them to the resources they need."

Given the wide variety of...