Protecting the Golden Hour

(Dennis Terpin, Ph.D., is the retired emergency manager at the University of Illinois Chicago. He is a certified Occupational Hygiene and Safety Technician, Emergency Medical Technician-Paramedic, Safety Officer and Emergency Manager.)

Based on a Maui News article, Maui County officials say that a proposal to slash 10 to 20 percent from Emergency Medical Services is not “set in stone,” though they are still bracing for cuts as the state looks to save money during the pandemic. Any cut in Maui EMS services would further prolong response times to the hospital. The state Department of Health, which proposed changes, said it has been in talks with EMS providers in all four counties over the past few months in preparation for potential statewide budget reductions for the coming year.

Rapid onset of illness and trauma survival — The Emergency Medical Service pre-hospital (out-of-hospital) Golden Hour is the period after a rapid onset of illness and/or traumatic injury during which there is the highest likelihood that prompt medical care, transport and surgical treatment will increase survivability and even prevent death.

Factors that can affect the Golden Hour include severity of the life-threatening illness and injury. Distance — The actual road miles and road conditions to the incident and the subsequent transport time to hospital. Time — The time taken for the whole EMS, fire and rescue teams to respond to the incident and extricate or remove the patient from the home or other location. Advanced Life Support first responders’ crews can provide treatments from Basic Life Support ABC’s (Airway, Breathing and Circulation) and Advanced Life Support medical care, which can include seizing or altered mental status; respiratory failure; cardiac arrest; and unstable dysrhythmias. These and others are all medical conditions which, while still requiring transport to the hospital, treatment can be started in the field but a quick response time to the hospital is necessary.

The prehospital (Golden Hour) time starts from the moment of injury or illness and includes the time to call 911, dispatch EMS units, response to the scene, time on the scene to assess and manage, and response to the hospital.

Challenges facing the Golden Hour in West Maui include possible decrease in pre-hospital services, problems contacting emergency services and delayed responses. Hospital availability and access (reaching care within the “Golden Hour” – Total Response Time) are affected by communications capabilities, weather impact on mobilization and deployment of resources, integration into the healthcare delivery system, personnel and equipment out of service for other calls during extended travel time, political and cultural landscapes, and rural-urban paradox of prehospital care.

The West Maui Taxpayers Association has set three goals to protecting and improving pre-hospital care on West Maui. First, the WMTA plans to work with Maui Health Systems to establish a 24/7 Emergency Department with 4-5 ER Beds and Urgent Care Component. Second, WMTA plans to work with landowners in Olowalu to establish another fire and ambulance station there. Third, WMTA needs a “boots on the ground” command center during emergencies with West Side fire and police connectivity.

We all need to work together to protect our pre-hospital care in West Maui and bring the West Maui 24/7 Emergency Department, 4-5 ED beds and Urgent Care component to reality.

DENNIS A. TERPIN, West Maui Taxpayers Association

Police don’t enforce laws

Why do speeders race right by the Lahaina Police Department? Maybe they do nothing.

Another New Year’s Eve illegal fireworks show. Where were the most fireworks lit? Next to the Lahaina Police Department. Why? Maybe they do nothing.

Then there was a brush fire on New Year’s Eve. Where? Above the Lahaina Police Department. Maybe they do nothing.

Oversized truck tires, illegal tinted windows, homeless camps everywhere. West Maui should be proud of the do nothing Lahaina Police Department.

RON TATE, Lahaina

Political power used to defeat Trump

The viciousness and hate I see is astounding to witness. Political power used to destroy a president and no trial… just pure power welded by hate, anger and greed. #45 showed the nation and the world how corrupt our government has become, and showed who was part of it and how they did it. So, the powers to be want to destroy his legacy… but you will never change 74 million voters in this country and the care and love of this President. President Trump was never a politician before becoming president.

He earned his money the hard way: by his own wits and learned skills. He is not a polished politician — he speaks his truth and could not be bought. He would not play by D.C.’s political game rules, and the sewer we call the swamp hated him for it. His election was never accepted by the Democrats, and they fought him and tried to kick him out of the presidency since before he was sworn into office. For four years, it was allowed to happen, but then look at the great things he did while president of the United States.

They stated he started an insurrection and impeached him a second time for this. He always stated be peaceful, and with over 50 assemblies by his party, not one riot. The Democrats, on the other hand, have stood on podiums and voiced violence against Conservatives — even death and injury to the president’s family.

Yet the first time he asked for a street celebration in D.C., there was a riot. They blamed him, yet ANTIFA and BLM spoke a week earlier and stated, “We will create chaos!” They did just that.

We were played once again, and not once in the past year did any Democrat voice displeasure or call for a halt to the burning and destruction in liberal cities all spring and summer. Not once did they denounce the death and destruction we all witnessed.

Nothing is sacred… not even the Supreme Court is free. I pray there is a change here in the future, for if it is corrupted totally, as a nation we are lost.

Liberals allow the killing of live babies — a sacrilege beyond belief. For me, all life is sacred — all life. We all matter… all of us matter. No matter the color of your skin or creed, we all matter equally and with respect.

We all matter, and always have.

BOB PARIS, West Maui