He can't possibly be there for every accident or heart attack.

But Dr. Jeffrey M. Goodloe, medical director for the state Medical Control Board, saves lives of Oklahomans every day as overseer of the state's largest emergency services system.

He is also the first to point to the "real lifesavers" — all of the paramedics and emergency medical technicians who work for EMSA and fire departments in 16 communities and surrounding areas.

"People need to know that we're on guard, literally 24/7," Goodloe said. "We want to ensure when people depend on us, we're going to be there."

As the 15th busiest emergency medical service system in the nation, he knows it's a big responsibility. The system averages 160,000 service calls each year.

Under his medical license, about 3,000 EMSA and fire department emergency medical technicians and paramedics serve throughout both the Tulsa and Oklahoma City metro areas. That covers about 1.1 million people in a 1,100-square-mile area, he said.

As part of the same system, both Tulsa and Oklahoma City stand out among cities with a high sudden cardiac arrest survival rate. In a benchmark 2005 USA Today report, both were cited among the top tier of cities with cardiac arrest survival rates well above 20 percent.

How it works
Goodloe reports to the Medical Control Board, a panel of mostly emergency physicians who oversee EMS care throughout the specified area. All are unpaid volunteers. And they meet bimonthly.

At each meeting, there are new suggestions for changes to treatment, medications or equipment.

"I think the job of the Medical Control Board is to have some collective wisdom in considering them," said Dr. Jeff Dixon, who is board chairman and medical director for Hillcrest Medical Center's emergency department. "We've been pretty forward-thinking."

Goodloe is paid by the University of Oklahoma, where he also is an associate professor and director of emergency medical services for OU's School of Community Medicine in Tulsa.

"If you consider, it's beneficial to have an emergency physician as medical director doing what his specialty is. It's independent medical oversight. That's the key to it," said Jim Winham, director of clinical affairs for the eastern division of the Medical Control Board.

That independent oversight is "fairly unique and exceedingly important," said Stephen Williamson, president and chief executive officer at EMSA.

"In many cities, the medical director reports to the ambulance service administrator or fire chief rather than to an independent board of medical experts. This makes it hard, if not impossible, for the medical director to make tough decisions," he said.

"Decisions about clinical care and treatment protocols may be politicized or compromised. When you have independent oversight, the driving consideration is what is in the best interest of our patients."

Cutting-edge service
The Medical Director's Office works to keep the system's services up-to-date, if not on the leading edge, Goodloe said.

Take the recent launch of induced hypothermia to treat sudden cardiac arrest patients with ice-cold saline infusions — right in the field. Oklahoma's EMS system is among the first in the country to bring this brain function-saving technology to first responders.

"We have recognized that today's basic life support is in many ways yesterday's advanced life support," Goodloe said.

He and his team are now working on an updated treatment book that will be used systemwide, from dispatchers to paramedics. It is expected to roll out April 1.

"We believe we are the largest system in the U.S. that not only uses the one system-one book philosophy, but we're using it before the fire or ambulance squad gets there," Goodloe said.

The protocol will start with the dispatcher, providing care continuity until the patient enters the hospital emergency room, he said.

Some firmly believe a firefighter-based EMS system is more efficient, but Goodloe says the "two missions are complimentary, not competing."

Said Dr. Gerard Clancy, OU-Tulsa president, "I think it is time for our best thinking on how both can do more together. We have a long way to go to improve our health and health system. Every partnership, every synergy that can be fostered contributes to improving the health of Tulsa."

Kim Archer 581-8315
kim.archer@tulsaworld.com