1. Lewiston Emergency Medical Services Advisory Board September 27, 2010

2. Level of Service Lewiston Fire became ALS (Paramedics) in December of 1993. The department graduated nineteen paramedics; the remainder of responders were EMTs and Advanced EMTs.

3. Level of Service Prior to December of 1993 a patient having a heart attack received an IV, oxygen, basic assessment, and transport to local hospital. Today, a patient will receive an IV, oxygen, advanced assessment, cardiac monitoring, 12 lead EKG, aspirin, nitro, morphine, and transport to local hospital. Statistics show that damage to the heart is reduced with this level of treatment.

4. Level of Certification Emergency Medical Technician The 13 EMT’s on staff have the necessary skills to treat patients in areas such as O2 therapy, AED, basic assessment, spinal immobilization, and Epi- pen. EMT’s must complete 110 hours of training to become certified and they must complete 15 hours of continuing education each year to maintain certification.

5. Level of Certification Advanced EMT Currently there are 10 Advanced EMT’s on staff. They are trained in IV therapy, intubation of only adult patients and advanced patient assessment. Advanced EMT’s must complete 60 additional hours of training above an EMT and 24 hours of continuing education each year to maintain certification.

6. Level of Certification Paramedic The 33 Paramedics currently on staff are trained in Advanced Cardiac Life Support, Pediatric Advanced Life Support, advanced assessment and diagnosis, manual cardiac monitoring, cardiac pacing, defibrillation, medication administration, needle chest decompression, needle cricothyrotomy, intraosseous infusion for both adults and pediatrics, IV therapy, and intubation of adults and pediatrics.

7. Level of Certification Paramedic Paramedics are required to complete 1500 hours of training above an EMT. They must complete 36 hours of continuing education training each year to maintain certification.

8. Organizational Structure Fire Chief Emergency Services Division Chief 3 Battalion Chiefs 9 Captains 21 Engineers 12 Firefighters 14 Reserve Firefighters Prevention Division Chief 2 Inspectors Administrative Secretary Secretary

9. Organizational Structure Fire Chief 3 Battalion Chiefs 9 Captains 21 Engineers 12 Firefighters 10 Reserve Firefighters 8 Reserve FF Trainees Prevention Division Chief 2 Inspectors Administrative Secretary Administrative Secretary

10. Stations & Apparatus Station 1 - 300 13 th St. –One Engine –One Truck –One Rescue –Three Ambulances –One Battalion Chief –One Brush Station 2 - 1533 Grelle Ave. –Two Engines –Two Ambulances –Two HazMat –One Air Trailer Station 4 - 424 Burrell Ave. –Two Engines –One ARFF –One Ambulance –One Brush –One Service –One Decontamination Trailer –One HazMat Boom Trailer –One Public Education Trailer Asotin County Station - 2314 Appleside Blvd. –One Ambulance

11. Demographics 1600 sq miles of coverage area Over 60,000 residents

12. Percentage of Senior Population in 2000 – 65 or older 58% of the patients transported in 2009 were 65 or older.

13. Demographics 7039 EMS calls responded to in FY2009 5200 patients were transported in FY 2009 77% of patients transported are covered by Medicare and Medicaid

14. Demographics Average reimbursement from Medicare is 49%. Average reimbursement from Medicaid is 27%.