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Nature Coast EMS Citizens' Academy teaches life-saving skills, recognizes life savers
BY: Buster Thompson Undercover Citizen (Chronicle Reporter)
Mar 1, 2019 Updated Mar 6, 2019
Nature Coast EMS Emergency Medical Technician Joe Ghigliotty, left, and Paramedic Victor DeJesus, push a stretcher and other gear into a house where a man fell and struck his head on the floor.
Editor's Note: This column is from a Chronicle reporter who attended the Nature Coast EMS Citizens' Academy.
I had a chance to save someone’s life.
He was an older man, a passenger trapped in a car that had been broadsided in Crystal River. Myself and others who stopped to help saw him gasping for air and felt his pulse soften.
We had a feeling he wasn’t going to survive, and he didn’t.
Leaning through the shattered glass of a side window, a woman and I took turns compressing the man’s chest, starting Cardiopulmonary Resuscitation, or CPR.
I remembered what Emergency Medical Technician (EMT) Ben Green and Paramedic/Nurse Cheryl Bray taught me and around 20 others about CPR during the Nature Coast EMS (NCEMS) Citizens’ Academy course last winter.
Like Green and Bray showed, I cycled through 30 compressions at a rate of 100-120 a minute, pushing down roughly two inches, to keep his blood flowing.
Most times, Green told me, the patient’s ribs crack under the pressure. They did for me, but life is more important than a few broken bones.
“You can’t harm them because they’re already dead,” Green had said. “Be respectful…try to give them dignity while still trying to save their life.”
NCEMS has made it a mission to certify as much of its community in bystander CPR, which increases a person’s chance of survival when their heart stops beating.
Bystander CPR has contributed to NCEMS’ rising survival rate for patients suffering from an out-of-hospital cardiac arrest, which is eight times higher than the recent national average rate of 12 percent from the American Heart Association.
“We get to someone’s house and their heart isn’t beating, and when we get them into the hospital, their heart is beating,” 11-year NCEMS CEO/President Mike Hall said in an interview.
We did our best, but there was nothing else we could do for our patient. I thanked Green and Bray in my head for at least giving me the tools to not be helpless during a crisis.
I sometimes drive by the roadside memorial the man's family placed for him, and I think about our county’s paramedics and EMTs with NCEMS, and how they’re reminded of a patient they couldn’t save.
How do they keep going shift after shift when they lose someone or experience tragedy on a regular basis? Why do they keep pursuing a career that has an average retirement age of 45?
“What we’re asked to be is superheroes,” NCEMS Operations Supervisor Dan Brady told our citizens’ academy class. “We’re expected to be the bridge between the problem and solution.”
Joe Ghigliotty grabbed a yogurt out of the fridge.
It was a light snack for the NCEMS EMT, who operates an ambulance — callsign “Medic 117” — alongside 10 and 12 other ambulances. He’ll drive to between eight and 16 calls a shift.
“We’re a pretty busy outfit here,” Ghigliotty told me during my ridealong with him and his partner, Paramedic Victor DeJesus. “Wherever the call load takes us is where we go.”
Ghigliotty has been helping saving lives with NCEMS, Citrus County’s sole EMS provider, for 12 years. DeJesus has been with NCEMS for a little over eight years.
After a few bites of his food, Ghigliotty cleaned around the kitchen of his agency’s zone station, a Beverly Hills home NCEMS owns.
NCEMS has several other bases its medics use to space out their coverage of the county and keep response times under their average of seven minutes and 30 seconds. These fire stations and homes also serve as a rest-stop for give ambulance crews that serve 24-hour shifts.
A loudspeaker in the living room sounded out a series of tones to alert Ghigliotty and DeJesus and others on the radio of an incoming emergency.
Medic 117 wasn’t dispatched, giving Ghigliotty a chance to make sure the house and the ambulance are tidy and in order, and for DeJesus to finish writing up reports from the previous calls.
Always time for a patient, rarely time for themselves.
A pair of other EMTs came into the house. They made up a basic life support (BLS) unit, one of several that accompanies advanced life support (ALS) crews to handle less-intensive calls.
They, along with an ALS crew, will get dispatched to a cardiac arrest if they’re the closest unit so someone can reboot the patient’s heart fast with up to 360 joules of electricity from an Automated External Defibrillators, or AED.
A person’s chance of survival decreases between 7 and 10 percent for each minute their heart isn’t beating, Green said. CPR and AEDs help keep the odds in the patient’s favor.
The EMTs spoke with Ghigliotty and DeJesus about how a patient passed away on their latest call. Talking is a way to vent and decompress, keeping medics from going “too far down the rabbit hole,” NCEMS Education Director Jane Bedford told our class about the mental health dangers first responders face.
“You can’t hold onto a call, you have to be able to let that call go,” Ghigliotty said to me.
They just about finished their story when the EMTs were dispatched to their next call.
It didn’t take much longer for Ghigliotty and DeJesus to get their next patient, a man who tripped on his cane and fell on his head. We responded “Code One,” or non-emergency as the man was conscious and talking.
Falls are the most common calls NCEMS responds to.
To reduce the death rate, the agency started a pilot project a few years ago that focused on educating the community on fall-prevention measures, Hall said, but the successful program stopped after there was a cut NCEMS revenue from Medicare reimbursements.
“We continue to look from grant opportunities to make that sustainable because it really makes that difference,” Hall said.
When we arrived to the injured man’s house, Ghigliotty and DeJesus moved in sync to unload their stretcher and gear, and hustled into their patient’s house. They’re not normal partners, but it was like they had been for years.
Ghigliotty and DeJesus found the man sitting in his lounge chair with blood coming from his forehead. They patched their patient up, got his story of what happened and transported him to Bayfront Health Seven Rivers.
As Ghigliotty drove, DeJesus got some additional medical information from the man and shared a love for premium cigars, easing the moment and possibly the pain.
Hospital staff greeted Ghigliotty and DeJesus as old friends when they checked in their patient, who thanked the medics for their service and company, something more of us should do.
I also said my goodbyes to the medics, who already began to wipe and sweep down their mobile hospital for their next client.
Medics are like “filing cabinets,” Brady said.
It takes roughly 300 hours of schooling to complete the accredited Nature Coast Emergency Medical Institute and its EMT Program, and 1,214 hours to become a paramedic at the institute, which is led by Bedford.
Bedford told our Citizens’ Academy class her educational programs have a 100 percent first-time pass rate and a 100 percent job-placement rate, but there’s no greater exam than being on the road.
“You don’t study to pass the test,” she said. “You study because one day you’ll be the only thing between your patient and death.”
You can be as young as 17 years old to be certified as an EMT with NCEMS.
Some NCEMS members volunteer their own time to train for the agency’s Water Rescue Team, a respected unit of 21 EMTs and paramedics that join the U.S. Coast Guard and local authorities to save and treat people stranded on the water.
It began in 2014 after NCEMS recognized the need for in-water rescuers and medics after emergency crews responded to a boating accident in April 2011 that claimed the life of one man and injured nine other people, including children, on-board.
Ron Bray, NCEMS Educator and Water Rescue Coordinator, and some of his squad demonstrated a mock rescue for our class at Hunter Springs Cove, where they also practice during the day and night.
Bray said other agencies have praised NCEMS’ Water Rescue Team and its specialized training regiment.
“When we graduate a class of rescue swimmers, it’s a huge deal and the office comes to a stop” Bray said. “That’s how important they are.”
It would take much more news print to report a complete picture of how NCEMS grew from 10 ambulances and 40 employees in 2001 working out of an Inverness-area store plaza, to 17 ambulances and 86 EMTs and paramedics responding out of major administrative and ambulance-service buildings in Lecanto.
There are not enough words to justify how the non-for-profit soon became accredited by the Commission on Accreditation of Ambulance Services, or how it became the best EMS provider in Florida.
But if you want to learn more, my advice is to sign up for the next NCEMS Citizens’ Academy.
During the six-week course, attendees will not just get a behind-the-scenes into the agency, you’ll learn how to recognize symptoms of heart attacks and strokes, CPR and first aid to respond to a choking, tourniquet bleedings, stabilize broken bones, among many other subjects.
But the best part of the course is meeting dedicated and caring men and women, who have to struggle with the responsibility of helping a community and their neighbors during the worst of times.
“It’s about the high-quality, caring people that work here and how dedicated they are to what they do,” Hall said. “We’re here to serve.”
Contact Chronicle reporter Buster Thompson at 352-564-2916 or firstname.lastname@example.org.
To learn more about the Nature Coast EMS Citizens' Academy and to sign up, visit www.naturecoastems.org/citizens-academy.php.
If you're interested in registering for the next class, coming up in October, please email Heather Yates at
heather.yates@naturecoastems with the names of those who will be attending.
She will contact you when the date for the next class is set.