Santee Sioux: Improving Access to Emergency Medical Services on a Tribal Reservation
People living on tribal reservations don’t always have the same access to medical care as people living in other communities. In 2012, the Santee Sioux Tribal Nation in Nebraska had about 1,200 members living on the reservation, but emergency medical services (EMS) had only five emergency medical technicians (EMTs) on staff. The average time for EMTs to respond to a call for help was almost 7 minutes. EMTs were on call for extended periods and were not always onsite at the ambulance station. Although all EMTs knew how to use the automated external defibrillator (AED), a machine that can start someone’s heart beating again after it stops, only one EMT was trained in advanced airway management, which involves putting a tube down someone’s throat to aid breathing.
The Santee Sioux Tribal Nation used a portion of its Preventive Health and Health Services (PHHS) Block Grant funds in 2013 to improve emergency response time and quality of medical care. Through recruitment efforts at health fairs and other community events, the Nation more than doubled the number of its EMS staff (from 5 to 13). An EMS director was hired and part-time EMT-Paramedics (EMT-Ps) were hired to lighten staff members’ workloads. The Nation also hired drivers so that EMTs and EMT-Ps could concentrate on responding to medical emergencies. All 13 EMTs learned to use the AED machine, and 8 of the 13 became certified in advanced airway management, substantially improving medical care for the reservation. The Nation also created a shift schedule to balance work times for EMTs and EMT-Ps so no one was working too many hours. Staff members scheduled to work stayed at the ambulance station during their shifts instead of staying at home.
By the end of that year, the average response time for emergency ambulance service went from 7 minutes to less than 5, and the quality of medical care provided by EMTs and EMT-Ps improved with the help of PHHS Block Grant funds.
Story year: 2015