Darien EMS – Post 53
Encyclopedia
Darien EMS – Post 53 is a nationally recognized ambulance service staffed mostly by teenagers in the town of Darien, Connecticut
Darien, Connecticut
Darien is a town in Fairfield County, Connecticut, United States. A relatively small community on Connecticut's "Gold Coast", the population was 20,732 at the 2010 census. Darien was listed at #9 at CNN Money's list of "top-earning towns" in the United States as of 2011...

.

It operates with the cooperation of local police, hospitals and the high school. In any single year, there are about 50 participating teenagers in the program who are trained as emergency medical technicians.(In 2006, there were 58.) Post 53 also has about 25 adult volunteers.

Post 53 is an Explorer post, a part of the Boy Scouts of America
Boy Scouts of America
The Boy Scouts of America is one of the largest youth organizations in the United States, with over 4.5 million youth members in its age-related divisions...

, Connecticut Yankee Council
Connecticut Yankee Council
The Connecticut Yankee Council of the Boy Scouts of America is located in Milford, Connecticut. The present council was formed in 1998 when Quinnipiac Council and Fairfield County Council merged....

.

Operations

The teenage volunteers are certified by the state as emergency medical technicians and operate the service in shifts 24 hours a day, 365 days a year, sleeping overnight in dormitory rooms in the Post 53 headquarters at 0 Ledge Road. The teenagers drive the post's three $100,000 ambulances, staff the radio room that responds to calls, and help run an operation with an annual budget of $200,000. Post 53 was responding to about 1,400 calls a year as of 2006. According to one news account, they "live by a rigid set of rules they set and enforce themselves. To be part of Post 53 is an honor; fewer than one in 10 who apply are accepted."

Fondly referred to as "day ladies," a group of adult advisors (consisting of both men and women) staff the first responding ambulance during school hours. These volunteers may serve as crew chief during the evening, and are the Advanced-EMT's that respond with the fly car on calls.

Teenage volunteers, called "Posties" (or "young adults" on the organization's Web site), serve at least two 24-hour shifts a month. All get mandatory EMT training of more than 150 hours before a member reaches 16. The volunteer work includes time maintaining the ambulances and the building, raising money and doing other chores. The group also offers first-aid training.

Mandatory training begins the day a teenager is invited to join (usually at age 14), and continues throughout the volunteer's membership. After 120 hours of classroom study and more than 20 hours of practical training, 16-year-old volunteers take the Connecticut state examinations for basic level EMT certification. Adult volunteers take the same training. Adults can also get EMT intermediate level certification, which includes invasive advanced life support procedures.
Dispatching

Darien Emergency Medical Services
Emergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...

 (DEMS) utilizes three fully equipped ambulances, and has more EMS resources per capita than the area's surrounding towns, resulting in DEMS rarely needing to call for back-up from out of town. The organization operates under strict medical direction and protocols set forth by Stamford Hospital
Stamford Hospital
Stamford Hospital is a private, nonprofit, community and teaching hospital in Stamford, Connecticut, with 440 affiliated doctors.The hospital has 305 inpatient beds in medicine, surgery, obstetrics/gynecology, psychiatry, and medical and surgical critical care units.As of 2005, Stamford Hospital...

, DEMS's medical control. Each call is reviewed for quality assurance
Quality Assurance
Quality assurance, or QA for short, is the systematic monitoring and evaluation of the various aspects of a project, service or facility to maximize the probability that minimum standards of quality are being attained by the production process...

 (QA) by an assigned Director from Stamford Hospital. The QA Director analyzes both patient care and response times for every run Darien EMS has. DEMS utilizes a well-established stair-step response system by dispaching first responders (police), an Advanced-EMT in a fly-car, a unit from an area fire department, a Post 53 ambulance, and paramedics from Stamford or Norwalk Hospital EMS if necessary.

After a call to 9-1-1 has been placed from a landline telephone in Darien, it will be automatically routed to Darien Police, whereas a cellular phone is first routed to the Connecticut State Dispatcher. The Police dispatcher will proceed with the stair-step response by paging out the closest police officer (the Darien Police Department is the town's first responder agency, and is trained by DEMS as First Responders
Certified first responder
A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. They have more skill than someone who is trained in basic first aid but they are not a substitute for advanced medical care rendered by emergency...

), followed by a fly-car
Fly-car
An ambulance emergency response vehicle is a vehicle operated by an emergency medical service to respond to medical emergencies either in addition to, or in place of, an ambulance capable of transporting patients....

 staffed by an Advanced-EMT from DEMS, one of three area fire departments, and shortly thereafter, by the DEMS ambulance. This is done while simultaneously transferring the call over to a certified emergency medical dispatcher when warranted, and advanced life support (ALS
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...

) may be dispatched if the call meets certain criteria set forth by the Southwest EMS Council. Within two to four minutes after the time the call is received, police will be on scene and able to provide basic life support, with the fly-car arriving soon after. As mentioned above, a Stamford EMS Paramedic (or a Norwalk Hospital
Norwalk Hospital
Norwalk Hospital is a nonprofit, acute-care, community hospital in the Spring Hill section of Norwalk, Connecticut. It is also a teaching hospital....

 EMS Paramedic if Stamford EMS is unavailable) will be en route, if not yet on scene if the nature of the call falls under the listed criteria or they are requested by personnel on scene. Together, with the combined efforts of area fire departments, Darien Police, area paramedic services, and local hospitals, DEMS works to ensure that the citizens of Darien are provided with a rapid response to medical emergencies and injuries, and that they are provided with state-of-the-art emergency medical care around the clock.
Stamford Emergency Medical Services Paramedic Coverage


Darien EMS-Post 53 entered into a contract with Stamford Emergency Medical Services (SEMS) to provide paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...

 coverage for certain medical emergencies. Stamford Emergency Medical Services provides paramdeic coverage for the entire city of Stamford, Connecticut
Stamford, Connecticut
Stamford is a city in Fairfield County, Connecticut, United States. According to the 2010 census, the population of the city is 122,643, making it the fourth largest city in the state and the eighth largest city in New England...

. Stamford's close proxmity to Darien makes this coordinaiton possible.
The protocols for types of calls that require a paramedic are set by The Stamford Hospital and are in alignment with national protocols for paramedic responses. According to Ron Hammer Director of Post 53, “because of the close proximity of SEMS paramedics, they are able to respond very quickly if the call warrants a paramedic.

When a patient requires paramedic interventions, a Stamford paramedic is immediately dispatched by Post 53 personnel. The following are the criteria mandated by the Southwest EMS Council, in which a Paramedic will be called to assist the Post 53 crew:

-Cardiac Arrest
Cardiac Arrest
Cardiac Arrest is a 1980 horror/thriller-film written and directed by Murray Mintz.-Plot:The city of San Francisco is pushed into a state of terror and fear as a deranged murderer stalks the city. The police are baffled by the case and are lead to extremes by a lunatic whose victims all have...



-Unconsciousness
Unconsciousness
Unconsciousness is the condition of being not conscious—in a mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is a type of unconsciousness. Fainting due to a drop in blood pressure and a...



-Difficulty Breathing/Shortness of Breath

-Trauma Patients involving extensive extrication

-Chest Pain

-Diabetic emergency

-Patients with unstable or deteriorating vital signs

-Seizure
Seizure
An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...



-Syncope
Syncope
In phonology, syncope is the loss of one or more sounds from the interior of a word; especially, the loss of an unstressed vowel. It is found bothin Synchronic analysis of languages and Diachronics .-Found synchronically:...

 (Fainting)

Trauma incidents with one or more critical patients

Any situation determined by Darien EMS

Stamford Emergency Paramedics provide the highest level of pre-hospital care available in the State of Connecticut. Paramedics are certified by the State to administer life saving medications, advanced airway techniques and cardiac life support. A Stamford Emergency Paramedic must complete 1200 hours of classroom training, usually over a two year period, in addition to hundreds of hours of hospital rotations.

Paramedic Response.

Paramedic System.
Funding & Patient Billing

While Darien EMS does not charge citizens for the services or transport they may provide (they rely on private donations, fundraising/outreach, occasional grants, and some operational support from the Town of Darien), if a Stamford or Norwalk Paramedic attends the call, the patient will receive a bill from Post 53. Because they are the transporting service, DEMS is responsible for collecting the fees for advanced life support care rendered by a third party agency. All fees collected are given to the agency providing the paramedic, as these agencies are staffed by paid professionals.

A Postie's Career

First Aid Class

All students wishing to become members of Post 53 must take the initiative to enroll in a basic but comprehensive CPR and First Aid class, taught by fully certified Post 53 EMTs. These classes are mainly offered during the summer before a student's freshman year of high school, although there are additional opportunities for freshmen to enroll in the course the following Fall, or occasionally in the Spring. Over the course of the one-month period, each student will complete 25 hours of class time. Those who show promise and demonstrated ability in the skills required to be an EMT are chosen by the instructors and officers and are invited to become a member of Post 53.

Through the Ranks

Candidate

Once the student has been invited to join and has accepted, he or she spends the next three months attending business and training meetings to familiarize themselves with the organization and how it operates. This time is also spent cleaning the Post 53 building for an hour each day. Each candidate is assigned to a sponsor, a high schooler who is already an active member of Post 53. This sponsor monitors his or her candidate's progress and gives feedback to the membership. After three months (90 days) of candidacy, each candidate is voted on for full membership and must gain a majority approval by all of the young adult members of Post 53. The candidate may then be accepted for immediate initiation into the membership, be denied from membership, or be granted an extension on his or her candidacy if further review is needed. Post 53 does not have any predetermined size limits; the organization accepts as many or as few students as it deems worthy. On average, approximately 18 candidates are chosen each year.

Radio Roomie

During his or her candidacy, the candidate serves time in the Radio Room. Here, he or she is responsible for answering telephones, responding to pages from the Darien Police Dispatcher regarding accidents requiring medical attention, and keeping record of all calls made during the shift. Achieving the rank of "radio roomie" during candidacy is required for membership.

Rider

To become a Rider in one of the three ambulances, the member must study and know the location and function of every piece of equipment in the ambulance and demonstrate this knowledge through a series of written and practical tests. If proven able, the rider will accompany the EMS crew on ambulance calls and assist when needed. Once adequate skill is shown, and the rider becomes a sophomore, he or she is recommended to begin training to become an EMT.

Emergency Medical Technician (EMT)

EMT training is done through a 140-hour training course taken over a period of six months, which involves classroom work, shifts in hospital Emergency Rooms, and concludes with the passing of the State EMT test. Upon receiving the official EMT certification, the EMT is responsible for all patient care at the basic level and for acquiring radio communication with the receiving hospital to where the patient will be brought for further care if needed.

Ambulance Driver

Once a member has had his or her license for at least six months and has a clean driving record, the member is eligible to undergo ambulance driving training, which consists of driving hours, a written test and a final driving test. If the test is passed and the member shows complete understanding of the material and demonstrates proficient driving skills, he or she is trusted with the responsibility of driving the ambulance to the scene and safely transporting the patient and crew to the hospital.

Crew Chief

This is the most prestigious level a member can reach and is usually achieved during the member's senior year of high school. He or she must be an EMT and be selected by the Post 53 adult Officers based on skills in patient care, maturity and leadership.

History

Post 53 was conceived in 1969 and began offering service in 1970.

John "Bud" Doble, founded Post 53 in 1970 with several other Darien fathers who wanted to find something useful for their teenage children to do. "Doble and other concerned parents wanted to teach their children about the devastating effects of drug and alcohol abuse," according to the Post 53 Web site. "They felt there was no better way to learn about drugs and alcohol then through direct care, by teenagers, to the victims themselves."

In the 1970s, the service provided back-up support to Cornerstone (a drug out-reach and overdose clinic in Norwalk, CT) and for Norwalk Hospital. It also responded to all working fires in the city of Norwalk. In the mid 70's it began to provide back up to the town's regular ambulance service, then run by Darien police. With 40 volunteer teenagers, the first crews used a converted telephone truck for transportation and Doble's basement for a headquarters. In the first year they responded to 100 emergency calls and the budget totaled $150.
In 1972, the organization moved into the former Noroton Heights train station (now occupied by The Depot youth center). By the late 70s it was providing first-response coverage to the Town of Darien from 6:00PM until midnight. By 1985, the police decided to drop their own service and Post 53 became the town's first responder.

In 1976, Post 53 received its first new ambulance, a donation from a local businessman. At that time, the annual budget was $12,000 and crews were responding to 250 emergency calls a year. By 1985, the town made Post 53 its 24-hour first responder throughout the year and the town's only regular emergency ambulance service. In 1989, when it was handling about 1,000 calls a year, the Post moved into a new headquarters, across the train tracks.

Through 2004, about 325 Darien High School students have been volunteers in the organization.

The Post does not receive town funding, instead relying on fund-raising at its annual art show and at its Memorial Day Food Fair, held at Tilly Park after the town's Memorial Day parade. Individual residents of the wealthy town occasionally donate $100,000 for a new ambulance.

In mid-2009, the Post announced Dennis Cummings had been made the sixth director of the organization, taking over from Susan Warren, who had held the volunteer job for five years. The director oversees the entire organization, including personnel, training, fund-raising, operations and community relations. Warren was to continue serving Post 53 as a member of its governing board.

Recognition

"The Oxford and Cambridge of the youthful emergency volunteers' universe can be found almost four exits up I-95, in Darien, in a rambling two-story building just off the southbound entrance ramp that houses what is almost certainly the most remarkable outfit of its kind in the country," wrote Peter Applebom in a 2006 article in The New York Times
The New York Times
The New York Times is an American daily newspaper founded and continuously published in New York City since 1851. The New York Times has won 106 Pulitzer Prizes, the most of any news organization...

. "In other communities, youths help adults staff the volunteer ambulance corps. At Darien Emergency Services Post 53, they pretty much are the volunteer ambulance corps."

The Post was awarded the 822nd Point of Light by former President George H.W. Bush in 1990. In 2002 Post 53 was featured on the Canadian Television CTV program, "The 21st Century", or "21C", and in 2001 and 2002 the post was also covered on featured on Bryant Gumbel's "Early Show" on CBS and on Channel One Educational TV from Los Angeles. The American Medical Association has called the Post one of the “top ten volunteer organizations” in the country.
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