Urban and rural EMS crews quick to respond: saving lives, limiting injuries, making a huge and positive difference.

• Author: Anderson, Tom
• Position: HEALTHCARE - Emergency Medical Services

It wouldn't be uncommon for a family or adventurer to drive north from Anchorage to Fairbanks along the Glenn and Richardson Highways. Considering the Alaska scenery, wildlife, and well-maintained highway system, it could be the trip of a lifetime. From planes to trains, and everything in between, Alaska has the allure to visit and explore. But what if there is an accident with serious injuries? Who responds to the emergency and from where?

Levels of Care and Transportation

Alaska has myriad treatment levels should an emergency or accident occur. Response comes from the largest urban departments and hospitals to village emergency medical technicians (EMT) and health aides, many of whom are volunteers.

Hospitals in the state range in size and service. The Alaska State Hospital & Nursing Home Association, led by President and CEO Becky Hultquist, lists twenty-eight facilities that handle the gamut of emergencies and treatment, from initial services to major surgery across the state in all regions. The hospitals and acute care facilities are central in hub communities. The surrounding villages and cities depend on the facilities and air transportation therefrom when a higher level of treatment is necessary. The facilities' management includes nonprofit, corporate, military, and Alaska Native.

The Federal Indian Health Service works with Alaska Native tribes to provide medical and emergency services to 143,078 Alaska Natives throughout the state. There are 44 tribal health centers and 160 tribal community health aide clinics, with the Alaska Native Medical Center in Anchorage as the central overseer for outreach and services. Approximately fifteen thousand healthcare professionals staff the hospitals, clinics, and centers, serving exigent and emergency needs of community and visitors. Village residents are well-served.

As part of the commercial transportation component to emergency services, flight service companies offer comprehensive medevac coverage across the state.

Guardian Flight is the largest medevac provider in Alaska, transporting medical, surgical, cardiac, trauma, and other emergency patients from rural facilities to tertiary care facilities throughout the year, 24/7. Guardian has bases in Anchorage, Fairbanks, Ketchikan, Prudhoe Bay, Dutch Harbor, and two in Southeast. The medical staff includes nurses and paramedics, trauma and ICU trained. The company has mutual aid agreements with the US Coast Guard (USCG) and Alaska State Troopers. Its twenty-one fixed-wing aircraft are a mix of Learjets and King Airs, with two new Beach Jets and a Cessna Caravan stationed at the Dillingham Hospital.

LifeMed Alaska also provides 24/7 critical care transportation services across the state. The company has a fleet of Learjets, turboprops, and helicopters, with headquarters in Anchorage and bases in Fairbanks, Soldotna, Bethel, and Palmer. LifeMed's emergency services medical support staff has expertise in critical care, high-risk, and pediatric/neonatal ICU, with advanced and continuing training like Guardian Flight's staff.

In concert, these two critically necessary private carrier services continuously link rural and urban medical facilities to those in the most vulnerable health conditions.

Urban Centers

So, if one could choose a place to get injured or in an accident, Anchorage and Fairbanks remain the best locations because, as Alaska's two largest cities, they have all the emergency and fire personnel and infrastructure to respond to and treat the cases, whether an injury, accident, or fire.

Anchorage has an abundance of hospitals including Providence, Alaska Regional, Alaska Native Medical Center, Joint Base Elmendorf-Richardson Hospital, and the Alaska Veteran's Administration Healthcare facility. With myriad urgent cares and clinics, practitioners, and mental health facilities, the city is primed for nearly any accident or emergency.

The Anchorage Fire Department has a 100 percent record for arrival and mitigation of incidents in the Municipality last year. The department has instituted Criteria Based Dispatching since April 2014 that is designed to rule out cardiac arrest on every call and identify medical compromises in the cardiovascular, respiratory, and nervous systems. The department has thirteen stations dispersed throughout the municipality (1,961 square miles) from Eagle River to Girdwood.

Emergency service hospital facilities in and near Fairbanks include Fairbanks Memorial Hospital, Denali Center, and Bassett Army Community Hospital on Fort Wainwright, as well as numerous urgent cares and practitioners who can assist during scheduled hours.

In Fairbanks, Battalion Chief Brian Davis explains that his department covers the city jurisdiction, with 100 percent career professionals that include five administrators and thirty-nine suppression and firefighting professionals. The force has two fire stations and received 4,500 calls last year. The Fairbanks North Star Borough has fire departments at North Pole, the University of Alaska campus, and Chena Goldstream, as well as volunteer departments at North Star, Ester, and Steese.

The Layers of Emergency Service Infrastructure and Training

Essentially every single community in the state has some level of response and protocol for an emergency.

The state meshes multiple levels of government and private entities to provide timely, productive emergency services to those in harm's way and injured. Volunteers and community members are most involved. The federal government plays a role, local boroughs and cities effectuate action, for-profit and nonprofit associations and corporations provide comprehensive care and treatment, and the State of Alaska's Department of Health and Social Service's Emergency Medical Services Unit oversees the streams of communication and response delivery.

Andy Jones is the acting section chief and manages three units administering multiple programs in emergency management: Public Health Preparedness, Emergency Medical Services (EMS), and Alaska Trauma Data. The programs within these units include development of community health programs to improve primary care, surveillance, and medical services and trauma care in rural and underserved regions.

"My job is more about coordination, control, and supporting our communities. Our section has the necessary resources and capabilities in a time of need, and it's my role to ensure the right personnel are at the emergency scene to complement resolution of the problem," says Jones.

The state has an emergency medical plan and an Emergency Operations Center that Jones oversees, should an incident commander be necessary in a disaster involving mass fatalities and injuries.

If rural emergencies don't have direct support or require heightened attention, the State utilizes its health and public safety departments, Alaska National Guard, Department of Defense branches (particularly USCG), and Alaska Native corporate and nonprofit associations in conjunction with private and public hospitals and municipal/borough fire and paramedic personnel. In concert, the team reduces injuries and saves lives.

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