When every minute counts: Harlan woman knows importance of Emergency Medical Services

It took 33 minutes from the time they picked me up in Harlan until I was in the room in Omaha. -- ROBIN BUTLER On her lifesaving trip with Medivac

 SHELBY COUNTY — Robin Butler of Harlan knows first hand the importance of having an Emergency Medical Service with the ability to transfer patients in dire need of definitive care. An early morning transfer from Myrtue Medical Center (MMC) in Harlan to the University of Nebraska Medical Center (UNMC) in 2021 saved her life.
 In September 2021, Butler woke up with pain in her back. She was 44 years old.
 “At first, it felt like I needed to crack my back between my shoulder blades,” she said.
 She an her husband, Chad, had planned to go to the Iowa/Iowa State football game that day, so she didn’t wake him up right away.  She said she knew heart issues present differently in females, so when she began sweating profusely and having pain in both arms, she knew something was happening.
 “I told him, ‘I think we need to go to the hospital’.”
 The couple went to the Emergency Room at MMC, where she had tests done. “I wasn’t having a heart attack while I was at Myrtue, but the results were abnormal, so the doctor sent the results to UNMC,” Butler said.
 “UNMC said to get there as soon as possible.”
 Medivac Paramedic Ambulance Service in Harlan was dispatched to transfer Butler to Omaha. “It took 33 minutes from the time they picked me up in Harlan until I was in the room in Omaha,” Butler said.
 Her condition deteriorated during the trip in the ambulance. “Everything went from bad to worse on the way there. The pain started to increase, and they had given me all the medication they could.”
 Butler credits the Medivac staff, Mary Yates and driver Dave Keane, for saving her life. “They were amazing,” she said.
 When she got to UNMC, she was told she was having a ST-elevated myocardial infarction (STEMI). A STEMI is a total, or nearly total, blockage of a coronary artery that supplies oxygen-rich blood to part of the heart muscle. The lack of blood and oxygen causes that part of the heart to fail.
 “It was a widow-maker heart attack,” Butler said. “They call it that for a reason.”
 She underwent a procedure in which a stent was inserted.  
When she was finished with the procedure, Butler said she asked the doctor if she could still go to the game.
 “He said in 26 years he had never had anyone ask anything like that,” she laughed.
 Butler has had no issues  with her heart since. She is currently employed as a Medicare Insurance Agent and Financial Advisor at Bankers Life, and is a full time student. She is also employed as a behavior health specialist for Family Connections in Avoca.
 She said she realizes the need for prompt Emergency Medical Services in Shelby County, and is in support of the county-wide EMS measure, which will be on the ballot in November’s election.
 “With us being an hour out from a major hospital, I think it’s only responsible for us to have an Emergency Response System who could handle all these people in rural communities,” she said. “So many people are moving out to these communities. It’s important to have the basic life saving support, which includes ambulance service.”
 She also pointed out several people live alone and may not have the capability to drive themselves to the hospital. “They depend on that response.”
 “Sometimes, in a fast amount of time, you need to get somewhere,” she said. “It would be irresponsible, in my opinion to not have it.”
 Myrtue Medical Center’s Emergency Department Manager Jennifer Lefeber, RN BSN TCRN, agreed. “When it comes to transfers out of Myrtue Medical Center – it is absolutely vital that the new Shelby County EMS Department include the ability to do critical care transports of patients who need specialty services not offered locally,” Lefeber said.
 Lefeber said a STEMI is one of the most time-critical moments patients are transferred.   Currently, if you come into the Myrtue Emergency Department and are diagnosed as having a STEMI, we are able to call Medivac and they present for transfer within five minutes. Our goal is to get you on the way to a cath lab within 30 minutes of arrival to our door. With the assistance of Medivac, these times are often much less.”
 Butler said she is grateful for the quick reaction of the staff at Myrtue, Medivac, and UNMC. “I had a guardian angel with me.”
  On the ballot
November 7
  Shelby County voters will decide on a measure to fund county-wide Emergency Medical Services (EMS) at the November 7 election.
  Currently, when someone in Harlan calls 911, the private ambulance company Medivac Paramedic Ambulance Service  responds. If the call is outside of the Harlan response area, the nearest EMS volunteer squad is dispatched, along with Medivac, if needed. Since the early 1970’s, all Shelby County citizens have been served by a combination of volunteers and paid EMS providers. Local volunteers staff ambulances and provide basic first-response emergency care.
 The Shelby County Ambulance Commission contracts with Medivac for 24 hours a day/seven days a week coverage at the Paramedic level. This combination has served the county’s citizens well for over 40 years. Medivac additionally provides inter-facility transports to major medical centers in the Omaha metro area with highly specialized critical care equipment and personnel.
 However, the owners of Medivac are planning to retire. A state law passed last year allows counties to designate EMS an essential service, thereby providing funds to support it.
  For the fiscal year 2023-2024, the Shelby County Ambulance Commission (Hospital, City of Harlan, and County) has a designated amount of $373,850 through their general basic fund and special ambulance fund, that supports ambulance service in Shelby County. The EMS Advisory board said this allocation does not provide sufficient funds to continue the current framework, or support the newly formed department.
 If the EMS Public Measure passes, all Shelby County residents will pay for a share of the cost of EMS through a tax levy. The proposed amount is $.75 cents per $1,000 of taxable property within the county (not valuation). In addition, there will be an income surtax assessment on Iowa individuals’ income tax returns for Shelby County residents at a rate of 1%.
 The EMS Advisory Council stated property tax funding will be collected starting in September 2024. The 2024-2025 fiscal year will be dedicated to acquiring a facility, purchasing needed equipment and supplies, and developing the program.
  As funds are available, a Service Director will be hired to develop policies and programs, hire staff and apply for necessary licenses. A new county-run ambulance service could start operations July 1, 2025.
 The new Shelby County EMS would be fully staffed with six paramedics, six EMT’s and a coordinator. Along with the volunteer departments, constant coverage would be ensured throughout the county. It would be located in Harlan, which is centrally located in the county and has the highest concentration of the county’s population.
 Shelby County EMS Advisory Council has  public meetings planned in various communities:
· September 26, 7 p.m.,  Panama Parish Center
· September 27, 7 p.m.,  Shelby Community Center
· September 28, 7 p.m., Elk Horn Town Hall
· October 3, 7 p.m., Defiance Parish Center
· October 5, 7 p.m., CG Therkildsen Center, Harlan

Editor’s note: This is the first in a series of articles regarding the county-wide EMS measure planned between now and November 7.



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