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EMS expects the unexpected
Shelley Fields
Using an infant CPR mannequin, Effingham County EMS Paramedic Shelley Fields and EMT-I Chris Boyd show what they did during a 2020 call involving the complicated delivery of premature twins. Fields and Boyd recently received the Georgia Emergency Medical Association’s 2020 Dr. Joseph E. Simon Pediatric Award of Excellence for their lifesaving efforts with the babies and their mother. They were also honored during Tuesday’s Effingham County Board of Commissioners meeting. - photo by Mark Lastinger/staff

 SPRINGFIELD — The dedicated professionals at Effingham County Emergency Medical Services (EMS) have learned to expect the unexpected.

Even the most experienced staffers end up being surprised at some point.

Paramedic Shelley Fields was 24 years into her career before she delivered her first baby. It arrived with major complications and double trouble.

“It was a set of twins that was born at 24 weeks,” EMS Director Wanda McDuffie said while recalling the 2020 case.

According to a report of the incident, Fields and her partner, EMT-I Chris Boyd, found the mother in a bathtub (without water). The first twin was born in the tub just before they got to the scene. It was motionless and wrapped in a towel.

An examination of the mother revealed that the second twin was breeched, with the legs and abdomen delivered, and the upper torso, arms and head still inside the birth canal. The umbilical cord of  Baby A was still inside, too.

Boyd tended to the first twin. He clamped the umbilical cord, performed CPR and took other measures.

Fields, meanwhile, cared for the mother and delivered the second twin.

A second EMS unit was called to transport the mother so that the twins could leave the scene immediately. Boyd remained and took over care of the mother.

Fields took over care of the twins for transport. The first baby required CPR and manual ventilation throughout the call due to a heart rate of less than 60. The second baby had a heart rate of 120 and required manual ventilation only. 

Fields was able to alternate use of the cardiac monitor for both twins throughout transport. She was also able to contact the receiving facility to request portable oxygen tanks and warm blankets to be waiting for their arrival at Memorial Health University Medical Center.

Dr. Brad Buckler, medical director of the neonatal intensive care nurseries said, “The care that the EMTs provided allowed the babies to arrive at the hospital, giving them a chance to survive. Without the resuscitation care provided the babies probably would not have survived prior to arrival at the hospital.”

The twins’ story continues to be a happy one. The babies are thriving. Their mother keeps Fields and Boyd updated about them, including sending them photos.

Fields and Boyd got addition good news recently when they were informed that they are the winners of the 2020 Dr. Joseph E. Simon Pediatric Award of Excellence. It is presented by Georgia Emergency Medical Services Association.

The call about the twins was one of 6,644 EMS answered in 2020. It had contact with 6,823 patients. 

“It was kind of a crazy year,” McDuffie said. “In March and April, our call volume dropped way down. There weren’t as many car wrecks and other accidents because people weren’t working or going anywhere.”

The pace started to return to normal last summer and has continued to escalate in 2021. EMS responded to more than 2,300 calls from January through April.

“Of course, we don’t transport that many,” McDuffie said. “We transport about 60 percent of our calls.”

EMS is set to receive a much-needed ambulance in late July or early August.

“It will be the first one with the new graphics,” McDuffie said. “We are kind of changing with the times and getting a fresh look.”

McDuffie and EMS staffers batted around ideas about colors and designs, and one was recently approved by County Manager Tim Callanan. All agreed that the Star of Life will remain prevalent in the new scheme.

The new ambulance will be a welcome addition. Some of the frontline EMS models have exceeded 300,000 miles.

“And there’s such a backlog of vehicles,” McDuffie. “Like the one that will be here in August, we ordered it in November and it took until April just to get the chassis. We ordered another one in March and we probably won’t get it until December.”

The lengthy wait is caused by a production lull during the COVID-19 pandemic. Chevrolet, Dodge and Ford were impacted by it.

“Bids for Dodges won’t even open until some time in midsummer — and that’s for 2022s,” McDuffie said.

Population growth spurred the need for another ambulance.

“Our goal is to put on another 12-hour truck that we can have during the peak hours of the day,” McDuffie said. “We are seeing a higher call volume.”

The hours from noon-9 p.m. are particularly problematic.

“It’s not uncommon to have no ambulances available in the county because they are all tied up on calls, trying to get back from Savannah or to Savannah in all that traffic,” McDuffie said. “That is our biggest delay. Having the new come on in July or August will help us have availability in the county.”