When a young rider fell off a horse during a lesson at Columbia Horse Center this summer, instructor Ashley Davison knew just what to do.
"I told her to keep her head still, and I knew the questions to ask to determine if she had a concussion. When the paramedics came, I was able to speak their language," said Davison, 17.
Her knowledge and calm during an emergency came from her training with the EMT Academy, also known as Paramedic Pathways, a pilot program of Howard County public schools, the Department of Fire and Rescue Services and Howard Community College. Through it, Davison became a certified emergency medical technician-basic (EMT-B) on the road to becoming a paramedic.
Paramedic Pathways is the county's initiative to address the national shortage of paramedics at the local level. Begun in the fall 2003, the program was designed to recruit high school juniors to careers in emergency medical services (EMS). Students must have a 2.0 grade point average or better to stay in the program.
"We need to provide opportunities for kids to grow up and be engaged in the community," said Joseph A. Herr, chief of Howard County's Department of Fire and Rescue Services. Paramedic Pathways is his brainchild and the result of extensive talks with school system staff members and Ron Roberson, vice president of academic affairs at the community college.
EMS training gives young people "a skill set that will take them through a lifetime," said Herr, who joined the fire service at age 16.
In the first year of the EMT Academy, the teenagers were introduced to seven components, called modules, of basic emergency medicine. They started with a preparatory class on critical incident stress management. This is where they saw and heard about the graphic realities of the job and how to manage the resulting stress, said Ken Brown, a retired paramedic-firefighter and an EMS trainer with the county and Pathways program instructor.
They saw a cut-out portion of a rug covered in soot and showing the imprint of a child that died in a fire, Brown said. They also heard tapes of 911 calls and saw films of serious accidents.
"It's not uncommon to lose one or two students after that," Brown said.
Participants then learned about the airway and cardiopulmonary resuscitation, patient assessment, medical emergencies, trauma, infants and children and emergency medical services operations. Instruction was also given in physical fitness. They learned how to lift people to safely carry a patient up and down stairs.
Students received permission to visit the state morgue in Baltimore, where they observed several autopsies.
At the end of 11th grade, the students took state certification tests. Those who passed received the EMT-B, a basic life-support designation.
In 12th grade, in addition to completing standard academic requirements in their home schools, academy students reviewed their EMT certification and took a partial firefighter training course. They also began college-level prerequisites such as biology and speech at the community college.
The school system provides transportation to the Applications and Research Laboratory, where high school training classes are held. The Department of Fire and Rescue Services pays the instructors, mentors at firehouses and for ride-a-longs. Fire-and-rescue skills are practiced at the county's training academy in Clarksville.
For graduates who enroll in the emergency medical services-paramedics program at the community college, the fire department will pay for tuition, books and related fees.
Five of the 11 original students plan to pursue an associate of applied science (AAS) in paramedicine, said Capt. Joanne Rund, Paramedic Pathways coordinator. Two have decided to study nursing, and others are going on to four-year universities to study medicine. Only two are not continuing in some health-related field, Rund said.
"I think it's a great way to attract someone to the paramedic career," she said.
An EMT can administer basic first aid, CPR, attend minor fractures and assist a patient in administering doctor-prescribed medicines. A paramedic has advanced life-support training and can perform invasive procedures such as intubations. A paramedic also can give a patient medicine from the ambulance.
"I can't imagine doing anything else," said Lindsay Gross, a senior at Wilde Lake High School who is entering her second year in the academy. The program brought focus to her career goals and challenged her to become more physically fit.
"They kept stressing the importance of getting in shape," said Gross, which motivated her to start working out regularly. She has lost weight and become stronger.
Although trainees are not encouraged to volunteer at a firehouse at this stage, Gross was too excited not to get hands-on experience. She joined the Elkridge Volunteer Fire Department midyear, and after graduation in June she plans to finish the two-year program at the community college.
Even if students do not choose a career in emergency medical services or health, their knowledge and training is helpful if they encounter an emergency, Brown said.
"It streamlines everything we do and ultimately helps the patient," said the instructor, when he heard about Davison's experience at the horse center. He said other students have shared similar stories.
Recruiting from three schools the first year, expanding to five in 2004 and now being offered to all Howard's public high schools this year, the EMT Academy has 22 students enrolled for 2005-2006. Twelve are males; only three males enrolled in the first year, Rund said. Of the 16 students who started in 2004, 12 were certified and nine plan to continue in their senior year.
The pilot program continues to be modified, especially for seniors. The firefighter component will be postponed until college and replaced with more medical training and an intensified physical fitness program.
"It's a physically demanding job," Brown said. "We have people when they first start [in the program], they can't get the wheels of the stretcher off the ground."
In Howard County, rescue personnel are cross-trained. EMTs and paramedics also must be firefighters.
Brown and Rund hope to start a mentor program during which each student will be paired with a paramedic who will teach the student the strict standards of the profession.
Although the Howard students may be certified as EMT-basic while in high school, they must be 18 before they can take advanced life-support training and the national registry exam that is required to become a paramedic.