By Janet Taylor, RN, CCEMT-P, CEN, CFRN
Missouri EMS Connection Editorial Advisor
This issue’s service spotlight is Pulaski County Ambulance District (PCAD). Pulaski County is in south central Missouri, where I-44 transects the district from east to west. Pulaski County surrounds Fort Leonard Wood Army Base and portions of the Mark Twain National Forest.
PCAD started in 1987 and is a stand-alone sales tax supported ALS/BLS ambulance district with four stations serving all of Pulaski County in addition to portions of Laclede and Camden Counties that are in the Richland School District. This includes coverage for the towns of Waynesville, St. Robert, Crocker, Richland, Laquey, Devil’s Elbow, Swedeborg, and Palace. The call volume averages 7,200 calls per year with nine ambulances, five of which are 24/7 and a sixth 12-hour truck during the day. PCAD headquarters is in Waynesville, with the other stations being in Crocker, Richland, and Laquey.
The population of Pulaski County is about 55,000, but with Fort Leonard Wood being in the service area, that number fluctuates when the Fort has basic training graduation. Fort Leonard Wood itself houses 5,400 active-duty soldiers and 2,700 civilians. In the days before and after a basic training graduation, thousands of family members flock to Pulaski County to see their loved ones.
PCAD is comprised of 46 employees: 20 paramedics, 21 EMTs, three RNs, and two office staff. The crew holds certifications in ACLS, PALS, PHTLS, AMLS, FP-C, CCP-C, EVOC, and GEMS. Education consists of quarterly training with online classes, skills validations, and hands-on scenarios. They serve as a preceptor site for numerous training programs in the area and support their youth and school communities through hands-only CPR and AED education programs.
PCAD is a progressive and safety-oriented organization and was an early adopter of power cots and power stair chairs. They worked closely with Ferno to test the Intraxx system and had the first ambulance deemed crash stable. The district continues to invest heavily in crew and patient safety through the purchase of custom Osage ambulances designed specifically for their operational needs.
Each ambulance is equipped with the Acetech vehicle and driver management system, providing four-camera coverage, driver safety and awareness technology, electrical system controls, and real-time vehicle monitoring that tracks location, status, and vehicle functions. The ambulances are also outfitted with Ferno Intraxx crash-stable mounting systems for equipment and supplies, Ferno INX self-loading power cots, and Ferno Transcend power stair chairs to improve patient handling while reducing injuries to personnel.
Because there is not a hospital located within their service area, PCAD’s protocols reflect the need to care for sick and injured patients for extended periods while en route to definitive care.
Protocols and equipment available include RSI and video intubation equipment, Zoll Z Vent ventilators with CPAP and BiPAP capabilities, Zoll Zenix cardiac monitors equipped with the full critical care package, IV pumps, Zoll NXT mechanical CPR devices, Zoll aspirators, and a robust formulary of medications. The district’s Zoll Zenix monitors represent the latest generation of cardiac monitoring technology, while the Zoll NXT mechanical CPR device provides consistent, high-quality chest compressions during cardiac arrest resuscitations. These technologies support PCAD’s mission of delivering advanced medical care to patients who often face extended transport times to definitive care.
PCAD is proud of its service to the community. Deputy Chief Mike McCart said, “We are a committed group of medical professionals who are dedicated to bringing the best care possible to our citizens. Not having a hospital in our county means we strive to bring the best medicine we can to the patient.”
