Six city firefighters now certified to perform breathing intervention in the field

LACONIA — The fire department is now among an elite class of organizations certified in rapid-sequence intubation, a lifesaving measure which could prevent unnecessary death in the field, city councilors learned at a budget hearing last week.

Rapid-sequence intubation, also referred to as crash intubation, is a technique emergency responders can use to quickly control a patient’s airway. The process involves administering an anesthetic followed by a neuromuscular blocking agent, effectively paralyzing them, to allow medical personnel to intubate them and re-establish their ability to breathe. 

“It’s like super advanced paramedicine, let’s put it that way,” Chief Tim Joubert said June 3 at the hearing. 

Joubert told councilors the city now has six of its firefighters qualified to perform the procedure, which could prove lifesaving in certain circumstances.

“Last year during Motorcycle Week we had three motorcycle accidents where if we had that, it could have made a big difference for people,” Joubert said. “Now, they have the ability to pretty much intubate any patient at any time, just like they do at the hospital where they paralyze that individual and maintain that airway — we can do that in the field now.”

Performing crash intubation in the field could prevent time lost through transport, either by road or air, to hospitals in Laconia or Concord and improve chances of survival.

“There are minimal departments in the state that have this,” Joubert said. “We have six people in Laconia that are certified in RSI.”

City Manager Kirk Beattie, who formerly served as the city’s fire chief, said it’s taken a long time for the department to reach this milestone. 

“That’s 20 years in the making, trying to get that to happen,” Beattie said.

The fire department will also be working with the Partnership for Public Health to apply for a three-year grant to fund community paramedicine in the city called a mobile integrated health program.

“The most expensive thing is an ambulance ride to the emergency room, and we can provide a service to potentially avoid that and get people proper care so 911’s not needed,” Joubert said. “We would have a paramedic that has the ability to do a lot of the things that they can do at the emergency room, at walk-in clinics, at these individuals homes, and be a part of a system that includes VNA, social services, and it’s another component to that.”

Paramedics would perform services such as welfare checks, taking blood pressure and other vital measurements and provide wound care. 

“A perfect example today is we had someone that was really, really sick with an infection, like, really, really sick, and just hadn’t been attended to,” Joubert said. “It kind of dropped through the cracks of the system, and that’s a perfect example of where we could have made a difference for that individual.”

Mayor Andrew Hosmer said he is in full support of the initiative and it could improve patient care within the city and potentially lessen the burden on emergency departments.

“I’m so glad you’re pursuing that,” Hosmer said. “I’m partial to the program because it just makes sense taking some level of health care to people where you find them, which is in their homes or out among the community and all the places that you serve. The idea of a little bit of health care which prevents the emergency room visit or things that can be addressed if you have contact with people on the street or in their homes.”

Joubert noted the program would also make identifying and transporting patients who need to access an emergency department easier and more efficient.

Council also learned an increase to a line item in the department’s proposed budget would fund a program to perform comprehensive preventive checks on firefighters for cancer.

“This is a big one in the fire service right now. Cancer, it’s there, it’s alive, it’s increasing,” Joubert said. “As an organization and as a city we need to make sure that we protect our people and we get them properly evaluated on a regular basis.”

The department is in the initial stages of creating a process for each firefighter to undergo a full body scan annually to check for cancer. Joubert said early detection is key to protecting the lives of the city’s firefighters.