 On that, we'll call to order the committee the whole meeting for this evening, and we'll start with roll call. Bauman, he's excused, I do expect him I didn't talk to him on the phone. Berg? Here. Moni? Here. Doyle? Here. Graf? Here. Manny? Here. Montemayor? Here. Moody? Here. Perez is excused, Rineflesh, Steffen? Van Akron? Here. Van Derwele? Here. Longerman? Here. Ann Weninger? Here. We have a quorum. And on that, I'll ask for approval of the minutes from our July 21st, 2003 meeting. I have a motion and a second. Are there any additions or subtractions? Hearing none, all those in favor of the motion as stated, signify by saying aye. Aye. Chair votes aye. Motion passes. Start all with a brief opening statement and then we'll turn it over to the fire department. First, I'd like to say good evening to everyone and welcome to our committee the whole meeting this evening. Tonight's presentation by the Sheboygan Fire Department will give us a sense of what it takes to be a first responder and the importance of the role our firefighters have in providing life-saving emergency medical services. It's been over 10 years since the Sheboygan Fire Department established fire-based emergency response as first responders. Working together with the Sheboygan Police Department and Orange Cross Ambulance, our fire department's first responders have saved countless lives. At this time, I would like to introduce Chief Mark Zair of the Sheboygan Fire Department, Chief. Thank you Chairman Werner. I'm our Mayor Sram, members of the committee whole and common council members. I bring to you a thank you from the members of the Sheboygan Fire Department for inviting us to show you a part of our job, our profession that we serve every day of our life. 365 days a year, 24 hours a day. 115 years ago, in 1888 is when this fire department became a paid department and I know Alderman Longman is a historian but I dug up a little something also. The then Mayor James Bell delivered an address to the city fathers in 1888 and this is what he said. This fire department has within the past year undergone a wonderful change for the better with stationary, paid firemen, well-trained horses, accompanied with all the necessary equipment which has proven to be an unqualified success. And I'm here to echo that with a lot of updated means of providing services to this community. Now in 2003 our services include firefighting, rescue of victims from homes, trapped vehicles, mechanical equipment in factories, autos, we also have a great fire prevention program, a public education program for the school kids, trench rescue, marine safety and tonight's topic EMS in the fire service and first responders. Yes, tonight almost 115 years later, I'm here to tell you that I am proud of the members of the Cheboygan fire department who 10 years ago took the step into making Cheboygan a safer place by being first responders. And I am excited about the next step that the Cheboygan fire department is about to take to make this city of Cheboygan a safer place to live. It is my pleasure at this time to introduce Jaylas Dustin, Deputy Chief of the Cheboygan fire department for the presentation tonight of fire department first responders serving to save life. There'll be questions and answers later, thank you. Jay? Thank you Chief, sir. Tonight we're gonna talk a little bit about the first responder service in the fire department. I don't wanna leave out the fact that the police department also provides that same service and we work cooperatively very well together and have done so for almost 10 years now. I will focus on the fire department because that's what we're here tonight about. But what we're gonna do tonight is I'm gonna give you a little history and background of how we got started in the first responder. Some facts and figures on run numbers and types of calls we go on. And then we're gonna have a demonstration regarding a simulated code call and this would be typical of what we could go on if there's a cardiac arrest and we wanna show you how our firefighters would work a call like that and we're gonna have somebody kind of explaining to you what's going on as we do that simulation. I guess probably for you to visualize this best after our firefighters come in here we're gonna do this right up in front of the council chambers here. Maybe all the persons might wanna stand up and kind of gather around where they'll get a better view and we're gonna be using the camera off to the south here for TV audience. I'd like to introduce a few people that are here to help us tonight and maybe I could ask you to stand when I read off your name. They're gonna be involved in the simulation and first off, firefighter paramedic Blaine Warner. He's also our EMS instructor through Lakeland Technical College and does a lot of our training for us. Firefighter paramedic Brad Brighton-Gross. He's fairly new with us. Came from the final act fire department. Firefighter paramedic Matt Polzen and firefighter paramedic Brent Adamson. And we also have our administrative assistant Lisa Horn who's gonna be helping us out tonight as well. So I'd like to thank them for taking the time to do that. Upon completion of that demonstration one of the things we're talking about is a little bit history tight and a little bit of what we're looking to do in the future. And as some of you remember when we went through the ambulance process about a year ago, some of the things we talked about were upgrading the skills of our first responders. And as we go through this you're gonna see kind of why we wanna do that. But at the conclusion of our demonstration we're gonna give you an idea of some of the processes that we use now and some of life saving techniques that we propose to use down the road. Basically, as Chief Sire said, 1994 we got started in the first responder business but prior to that our department worked and trained in rescue and firefighting. And we also did CPR and first aid training and that was less of a focus of our operations until 1994. In late 1993 our entire department received first responder training and we were a licensed first responder group with defibrillation in the city of Sheboygan. At that time in our department there were several firefighters that on the side job worked for ambulance companies and were volunteer fire departments and were EMTs but there was a limited amount of those at the time. Since 1994 and some of our requirements for employment changed we've added a higher level of EMS training to our department, a higher level of individuals who were trained to those levels. And we've integrated that EMS training into our on-duty regular training program every year. And we integrate it with our rescue services as Chief Sire talked about. A lot of these things that we deal with extrication, trench rescues, water rescue, whatever it may be, it kind of is a flowing situation where it goes from being a fire or rescue situation right into a medical situation. So to have that continuity there is real helpful. Since 1994 our department has responded to over 15,400 first responder calls. So we've really accumulated a lot of experience and background in the process through those years. The picture you see up on top there is a recent training session that was a joint training session with the school system, Orange Cross Ambulance, the police department, and the fire department conducted down at Longfellow School and that was done to test the response of not only the first responders but the individuals helping out the school system as well. We respond to our first responders from all four of our fire stations and they're strategically located and I think I'll show you a little later in our response times what those are and what areas are best served. But basically we have a station north, south, east, west and in most of those stations or all of them in fact, there are two first line vehicles. Southside fire station on South 18th Street, we have a ladder company, a platform ladder truck that responds as a first responder as well as an engine. Downtown here a rescue unit and an engine response. Northside fire station, we have a ladder and engine company and out of the headquarters station we have a engine company and the shift commander also can respond as a first responder. All of our first line vehicles are equipped with automatic external defibrillators and a medical supply kit. Our best asset is not our stations or our vehicles or our equipment but it's our trained personnel and I'm real proud of the group that we have. They're very dedicated, they're looking to get involved as much as they possibly can because they see the benefits of what they do for our community. Like I said, since we started with just first responders and a handful of EMTs, now we've evolved into a department where we have eight licensed EMT paramedics, 41 EMT basics and EMT basic RN and 27 people trained to the first responder level. So we have a great pool of resources to help our community and when we talk about all the potential bad things that are on the horizon with terrorism and mass disasters and those type of things to have a pool of people like this that are dedicated long-term employees is just a super asset to the city. So I just think I'm very thankful that we have those kind of people involved. I'd like to recognize several of our individuals who received special awards within this last year and the first one is Blaine Werner and he was introduced earlier. Blaine has just been extremely active in EMS not only in the city of Sheboygan but in the county for many, many years. He was one of the founders and got the project jumpstart program going and in tune with local 43 of the firefighters in town here worked and put together a program with support of the community that provided defib units in all of the middle schools and high schools in Sheboygan County and Blaine continued on in that program and worked with area businesses and still continues to do that to work to get defibrillation units in the area of businesses. And I believe per capita we have the most defibrillators in our county of any county in the United States. So it's a real tribute to the people who are dedicated and push these programs because as you see, we'll see in some of the information I provide down the road that that's a very important thing. Scott Poth is a firefighter in our department and off duty. He was credited with saving life of one of our local businessmen who had a medical condition and he performed CPR and was recognized by the American Heart Association for his efforts in doing that. And another one of our firefighters I introduced earlier, firefighter Brad Brighton Gross who as I said earlier was in the final fire department working as a paramedic on the ambulance was also recognized for a life-saving technique and emergency tracheotomy that saved the life of a nine year old boy a few years ago. So we have several people that have gone above and beyond the call of duty to save lives. Just in general looking at amounts and numbers of EMS calls, the white bar graph shows the approximate number of calls each year. And basically from 1995 on, we're looking at somewhere between 1600 and 2000 calls per year. That can vary a little bit from year to year. It varies on actually in the last couple of years there's been some scenarios where some of the major providers where there are continued calls like some of the nursing homes and the Sheboygan Clinic has gone to a program where they're not calling first responders so that attributed to a little bit of a drop in some of those numbers. But we're still very near the 1800 mark as far as first responder calls. So you can see it's a real active and we're real busy in that and we're real focused on it. Just kind of to break down the types of calls and I just pulled a year 2002 as an example on the types of calls we deal with. About 27% are attributed to accidents and that can be car accidents, accidents in the home, sporting accidents, those type of things. A lot of times broken bones, cervical spine injuries, those type of things. 27% big chunk is attributed to just random illnesses, could be flu-like illnesses or other things that aren't specifically identified. 9% respiratory problems, that's a common thing particularly when weather is difficult and cold and flu season. The one that I really wanna focus on though and we're gonna see some more slides on this is the cardiac related calls and that came to about 11%. And one of the most important aspects of what we do obviously the cardiac calls are very much a life-threatening situation. So to have quick access defibrillation in our community is a really positive thing. The numbers that you see up here, the white lines in the bar graphs are the number of times we actually use the defibrillation units on a patient throughout the course of each year. And then the red bar graph is the amount of saves from using that. Now what we have found and what studies are showing is that while it looks like the percentages aren't that great, I mean every one of those is two to three to four lives per year that are saved. Plus you have to remember that as I continue to talk here, we're gonna talk about witness cardiac arrest and quick defibrillation. And when we get calls quickly and put a defibrillation unit on a person who has a witness cardiac arrest, those rates change and they dramatically become better and the patients have a better outcome. This article here, we made a copy of this was in the USA today but it was based on a study at Mayo Clinic and it talked about witness cardiac arrest and improve odds of survival and that's the simulation we're gonna do tonight. You're talking to someone, they have a cardiac problem and have a cardiac arrest and now the process can move forward quickly and we can get people on scene use the defibrillation and the person generally will have a better outcome. You're shooting from the time of rest to the shock to be under six minutes and every minute that you decrease that time to make it less improves a person's chance of survival. And we looked at the defibrillation rates of when we actually had a witness cardiac arrest and used our defib and we saw that about 25 to 40% roughly success rate. Early defibrillation saves lives and this is one of our great success stories early on in our defibrillation and first responder processes was a student at South High School who had a heart problem at school through CPR, quick response and early defibrillation. The boy obviously survived and is doing great now it was a real positive thing. I can just tell you too as I don't get out and do those first responder calls as much anymore. I remember one of my best moments at the fire station was a few weeks earlier I had a call on a cold blue patient at Holy Name Church and we brought him back with a defib and CPR and a couple weeks later that patient walked into the fire station and thanked us and two years later I went to a smoke detector call at his house and he's still doing great. So those things do happen, they're very successful and there's many people that are still walking around today that can attribute their health now to good first responder service. Just a little bit about response times. I think we're blessed with some pretty good times in our city. Just want to point out station one which is downtown station three on the west side 25th Street station four on the north side, north 15th Street roughly about 2.5 minute response time on average to these calls. You see a little blip on the south side station two where we're about 3.6 or 3.7 minutes per average response time from that station. It's an area we're looking at because of the extension and expansion of the city to the south. It's created some longer runs and it's a concern to us and we're looking at seeing what we can do to try to address that in the future. And this is a mission statement of the fire department and I'm not gonna read it for you but basically Chief Sire already touched on while you asked us to come here and talk about first responder service tonight we do much more than that. Emergency services such as fire and rescue is something everybody knows we do but we're very active in community service and public education and our code enforcement and we have a very dedicated staff and department that is working very hard to provide a professional service. And I know some of you all are persons have done ride-alongs with us and have come and visit us at our department but I would like to invite you all to if you're interested in learning more about the fire department contact us and we'll set up a ride-along bringing into the department and explain whatever you wanna know about and spend some time with you. Hold on a second, can we get the lights please? What we're going to do right now is we're gonna move to a demonstration by our crew here and we're gonna simulate that this patient here and we're gonna have Lisa come up here and assist us and she's gonna be our actress tonight and she's gonna be the wife of this patient here. And what we're gonna do is simulate a witness cardiac arrest and firefighter Warner is going to kind of walk us through what's going on at the time and the crews are gonna come in here and deal with the patient as they would typically deal with the patient. So, Blaine, if you'd like to come up and use the mic here. Thank you very much. What we're gonna do is we're gonna give you a short demonstration and after that, we have one call that we just was on about two months ago that we're gonna play for you. It's an actual cardiac arrest call and we have our defibrillators hooked up. They actually do a voice recording and it shows the cardiac rhythm of a person and you can hear exactly what happens in the background. Lisa's, I'm sure, a good actor but you can't understand when we have a 57 year old or a 40 year old how much upset the wife is. You can hear the dog barking in the background and you can hear everything else. This is one of our success stories that we called the family today asking for permission to show it to you tonight. The gentleman was brought back from a witness cardiac arrest, had a pulse prior to the arrival of the ambulance, was talking and was taken to Milwaukee and is back to work three weeks later and a very productive citizen. So it just shows the benefit of a quick cardiac arrest, quick use of defibrillators, which maybe you see, I don't know if they have one in the courthouse yet but you see them all around the YMCA's, businesses and everything else. So it shows you the benefit of using a defibrillator real quickly. We'll show you an actual call and you can hear the family members of it. So this is gonna be just a little scenario of Lisa and finding her significant other and we're gonna say the call's already been placed. I don't know if you wanna come up and watch just a little bit closer to kind of see how the actual defibrillator works. The defibrillator we're using tonight is a practice defibrillator. It's not gonna actually shock anything but it will show you how it works and kind of a, unfortunately we can't, hopefully Lisa's a pretty good actor but Lisa was talking to her husband and she found him, he collapsed and then she's gonna come up and try to wake him up after she called 911 already because that's the first thing. They're watching TV and he's just good talking to me. You're welcome, please. What they're gonna be doing is they're gonna be placing them on the ground and they try again talking to the wife, convincing the wife. Little pulse. They're checking to see if he's breathing or has a pulse. Does he have any medical history, any heart problems? He has high blood pressure. I saw the information we need to gather. Now you can listen to the defibrillator. Please help me, what's going on. Talk to you. The defibrillator will tell a person what to do. Exactly how to, what to do. The defibrillator works, it looks at the person's rhythm and sees if it needs to be shocked or not. Your cord, your wrist, where? Does it take any medications, ma'am? For the blood pressure. Yes, high blood pressure, any other medical conditions? No. Analyzing now. Listen to her. Stand clear. We have heartburn from something he ate. Shock, advise. What time did that start? This morning. Yeah, yeah, yeah, yeah. I'll see, next time I don't know. Well, it looks like these two other aren't doing anything. They have to stay clear of the patient because it is giving you electrical shock. It's not that they're just standing around. They have to let the machine do its job. You can't touch the patient at the time. You can't do anything to interfere with it. Shock, advise. We're going to shock you. The machine then gave three shocks, which is Autolanker program to do. Check for pulse. No pulse. It starts to get hurt from the pulse. They then checked to see if the person has a heartbeat or not, if not. And this is the same thing that we teach to the police officers, do the same and everything else. They're going to do CPR for one minute. This is the same machine that is in every place. In fact, Johnsonville sausage put one in their place out on Conor trunk J. And within two weeks of after placing it out there, they had a person go into cardiac arrest approximately 40 years old. Okay, placed it on the person and brought the person back. It's now back out there working. So they work. They're ventilating. They're getting oxygen into the patient. As you hear, the machine tells them to stand back. So they have to do that. Okay, now in this scenario, they'd return to heartbeat, but the person's.