Maps, ALS & Hospitals

On every call, there are choices that always have to be made.  Looking at this patient, is she a critical or not-critical patient.  The family wants a patient taken to Mukwonago hospital, is that an appropriate choice for this patient.  Given the nature of the illness or mechanism of injury, should we be looking for additional resources?  What resources do we have available to us?


ALS Resources

Helicopters

Helicopters are available for quick transport to a Level I or Level II trauma facility in the event of significant trauma, prolonged extrication, or a number of other factors.  To request a helicopter, notify IC, who will contact dispatch.  Dispatch then calls the appropriate agency to leave.  Neither the department or patient is charged if the helicopter does not land, so there is no downside to requesting it based upon the initial page or developing situations.

If a helicopter is landing on scene for transport, crash crew should be dispatched to provide a landing zone.  Other options include having the helicopter land at a nearby helipad (such as at a hospital) and transferring care at that location.

Policy WRS 009 outlines the on-scene chain of command and process to request a helicopter.

Flight For Life

For more information on Flight for Life, check out their website.

Flight For Life (FFL) has three airbases that they work out of: Waukesha, WI, McHenry, IL and Fond du Lac, WI.  Whitewater is served by both the McHenry base and the Waukesha base.  Crews based out of the Waukesha base may include a physician on the flight, otherwise all bases staff the ambulance with either nurses or critical care paramedics.

 

MedFlight

For more information on UW Med Flight, check out their website.

MedFlight operates out of UW Hospital in Madison.  All MedFlight crews are staffed with a physician and nurse(s).

Paramedic Intercept

Some calls warrant the need of advanced resources provided by paramedics.  These units are able to provide pain management care, advanced cardiac drugs, sedation, and much more.  Whitewater is surrounded by multiple paramedic units:

  • North: 799 (interceptor) and Ryan Brothers (full crew) out of Delavan
  • South: Medix out of Delavan (full crew)
  • East: Paratech out of Elkhorn/Walworth County
  • West: Janesville Paramedics out of Janesville (full crew)

Physician Intercept

A physician intercept is available through Mercy called MD-1.  These units are available out of Walworth or Janesville.  These units provide higher levels of care then a paramedic intercept.  Most substantially:

  1. Two paramedics are required to Rapid Sequence Intubation (RSI) a patient, whereas only one physician is required
  2. Physicians are able to prepare blood tubing (although they do not carry blood)
  3. Physicians are able to perform field amputations.

MD-1 and other physician response vehicles should not replace an ALS paramedic intercept, but can augment it when needed.

Hospitals

Every hospital is different and offers a unique set of skills to provide for patients we deliver. Choosing the right hospital is a critical choice that should be made prior to leaving the scene.

Trauma Rating

 

Every hospital is given a specific trauma rating by the State of Wisconsin.  These ratings range from Level V (lowest rating) to Level I (highest rating).  Some hospitals made be unclassified as they do not meet certain requirements established to be granted a trauma rating.  A facility can be designated as either: an Adult Trauma Center, a Pediatric Trauma Center or an Adult and Pediatric Trauma Center.  For those dual designated trauma centers, the Adult and Pediatric Trauma Rating may be different (i.e. a Level I Adult Trauma Center and Level II Pediatric Trauma Center).  The Wisconsin Department of Human Services provides a map of hospitals within Wisconsin and their assigned Trauma Rating.

 

Level I

A Level I Trauma Center provides the best case care for any seriously injured patient.  These hospitals are equipped with 24/7 staff and equipment, including Operating Rooms and Surgeons, to provide any necessary care.  These services include surgery (orthopedic, cardiac, neuro, oral/maxillofacial, and plastic), anesthesiology, radiology and internal medicine.   Level I also request that the hospital be a teaching facility and provide preventative and outreach programs.

  • UW Hospital – 600 Highland Ave Madison, WI 53792 (Adults and Pediatric)
  • Froedtert Hospital – 9200 W Wisconsin Ave Milwaukee, WI 53226 (Adults)
  • Children’s Hospital of Wisconsin – 9000 W Wisconsin Ave Milwaukee, WI 53226 (Pediatric)

Level II

A Level II Trauma Center provides virtually the same services as a Level I facility, however these facilities are not teaching hospitals.

  • Mercy Janesville – 1000 Mineral Point Ave Janesville, WI 53547
  • Aurora Summit – 36500 Aurora Dr Summit, WI 53066

Level III

A Level III Trauma Center does not offer the full range of services 24/7 that a Level I or Level II facility offers.  A Level III facility will partner with a Level II or Level I facility to transfer cases that are outside of its ability, however these facilities are staffed to be able to stabilize a patient for a longer transport via ambulance or helicopter.

  • Aurora Lakeland – W3985 County Road NN Elkhorn, WI 53121
  • Mercy Walworth – N2950 State Road 67 Lake Geneva, WI 53147
  • St. Mary’s Janesville – 3400 E Racine Street Janesville, WI 53546

Level IV

A Level IV Trauma Center is a facility that provides initial evaluation, stabilization and diagnostic capabilities before transferring the patient to a higher level trauma center, if necessary.

  • Edgerton Hospital – 11101 N Sherman Road Edgerton, WI 53534

Unclassified

Some hospitals do not qualify for a trauma rating or have chosen not to be part of the Trauma Care System, thus earning an Unclassified designation.  These facilities operate similar to Level III and Level IV facilities and transfer patient care to a higher level facility when necessary.

  • Fort Hospital – 611 Sherman Ave Fort Atkinson, WI 53538

Specialty Resource

Hospitals may have certain capabilities that other hospitals do not.

Cardiac Cath Lab

The cath lab is a dedicated room that allows for the catheterization of patients with heart conditions.  This procedure allows for an in-depth review of the heart and helps determine what surgery is appropriate (if any).  More on Cardiac Catheterization can be found here.

  • Aurora Summit
  • Janesville Mercy Hospital & Trauma Center

Neonatal ICU

The neonatal ICU or NICU, is an intensive care unit specializing in the care for premature babies or for pregnancies with fetal distress.  More information on NICUs can be found here.

  • Aurora Summit Hospital

Hyperbaric Chamber

In the case of Carbon Monoxide poisoning, a Hyperbaric Chamber can be employed to assist in expelling the CO and increase the oxygen supply in the body.  To read more on CO Poisoning and the Hyperbaric Chamber, please see here.

  • Aurora Summit Hospital

Maps

Whitewater Fire and Rescue cover an area of approximately 120 square miles.  We cover the City of Whitewater, and parts (or all) of six townships across three county lines.  With this comes a number of concerns that each of us need to be mindful of.
Townships include Town of Whitewater and Richmond Township (in Walworth County), Koshkonong and Cold Springs (in Jefferson County) and Lima Center and Johnstown (in Rock County).  The City of Whitewater spans both Jefferson and Walworth County.

City Road Direction Prefix

The City of Whitewater splits its roadways into N and S or E and W based on how the road travels.  If it is parallel to Main St, the road will be an E/W road.  If the road is perpendicular to Main St, it will be a N/S road.  For example,  W Starin Rd is parallel to Main St, giving it the prefix of West, whereas N Fremont St is perpendicular giving it the prefix of North.

Now, as you may notice, many roads have both a N and S or E and W prefix.  That is because Whitewater is split into quadrants.  Main Street represents the North/South line for the city.  Any road that is perpindicular to Main St and is North of Main St will have a North prefix.  Any perpendicular road to the south of Main St will have a South Prefix. Similarly, the old dam on Main St is the E/W dividing line.  This would be just a little to the west of Jefferson St.  Any road perpendicular to this line and to the west will have a West prefix, and any road perpendicular and to the east of this line is denoted with an E prefix. These prefixes can help narrow down which way you need to turn.

 

County Fire Numbers

Every county has slightly different fire number schemes.  Knowing how each county operates will help narrow down which county (and direction) you will be traveling.

Tricky Roads!

There are a few roads in Whitewater that have some sort of tricky situation surrounding them.  Some share common (or the same) road names, some are split by a non-passable barrier, and others are not for normal vehicle traffic.

Can you find these similar roads on the large territory map?

  • S Scott St & W Scott St
  • Esterly St, Esterly Ave, Esterly Road – 2 are in City of Whitewater, one is in Town of Whitewater. Do you know which is which?
  • Wyman Mall – This roadway intersects W Main St and W Starin Rd through the University Center.  Although this use to be open to motor vehicle traffic, it is now pedestrian traffic only. A few university addresses still are listed on Wyman Mall for their buildings.
  • State Road 59 – State Road  59 runs through Whitewater, both to Jefferson County and Rock County. Knowing which 59 you need to travel to prior to leaving base is crucial, as you will be driving the opposite direction if you are wrong.
  • Highway 12 – Similar to 59, Highway 12 travels Walworth County and Jefferson County.  Again, you must know which direction you need to go to ensure that you end up in the right spot.
  • W South St – W South Street in Whitewater  intersects S Janesville St and S Elizabeth St, except that it has a corn field in the middle of it.
  • R&W Townline Road – Similar to W South St, this road has an obstacle in the middle of it. This time, though, it’s a lake. The ambulance can’t make it through that.
  • McMillin Road and McMillen Road – Which one is Rock County, and which is Jefferson county?
  • Walworth Ave, County S, and County N – The Highway 12 Bypass at Walworth Ave has 3 names.  Walworth Ave is the road’s name in the City of Whitewater, County Road S  is the name of the road in Walworth County (west of the stop lights) and County N is the name in Rock County.
  • County N – We have two County Road Ns, one in Rock County west of Walworth Ave, and one in Jefferson County north of Tratt St.
  • Buckingham Road is off of Hwy 12 in Jefferson County, whereas Buckingham Blvd is off of Walworth Ave in the City of Whitewater

Rock County

Rock County presents its own little challenge. Nearly every road that crosses over from either Jefferson or Walworth County changes names when entering Rock County. For example, R&W Townline Road turns into E Townline Road, Territorial Road turns into East Six Corners Road and McMillen Road to Hobbs Road.