Eight stars dotted the sleeve of Mike Foster’s shirt as he spoke at the American Medical Response offices during one of his shifts in Lihue.
“Each of the stars represent five years of service,” Foster said. “Forty years. I’ve been doing this for that long. I just retired from 911 response, but that doesn’t mean I’m done. I will be doing off-the-road, non-emergency transfers — patients from the hospital to home, patients from home to hospital, hospital-to-hospital transfers, patients from hospital to the airport for air ambulance, you know, non-trauma critical cases.”
Foster, quietly reflecting on his 40 years with AMR, said he’s trying to get the ninth star — 45 years of service.
“The average career life of an Emergency Medical Technician or paramedic is 12 to 15 years,” Foster said. “I’ve been doing this for 40 years, and I’m trying to get that ninth star, and maybe more.”
“We’ve come a long way since the state gave the contract for medical response to the county back in the 1970s,” Foster said. “Each island made their own arrangements, and Maui and Kauai went under the American Medical Response umbrella. Others like Oahu made medical response a part of the fire department — their ambulances have “EMS” on them. I was part of the crew that started with Kauai AMR. Myself and Glenn Hamburg are the only ones who have at least 40 years of service. I started in 1979, and Glenn was one of my instructors.”
Tito Villanueva, the Kauai operations manager of AMR — a state-contracted medical transportation system that responds to 911 calls and provides advanced life support care and ambulances for residents and visitors — said AMR was acquired by International Life Support in late 1978 or 1979, making it one of the larger ambulance service providers globally.
Foster said his longevity with AMR is due in part to the association and cooperation AMR has with the police and fire departments and other government agencies.
“I have been blessed,” Foster said. “Without that association and cooperation, the job would be difficult. This is a very good system we have on Kauai. As an example, you know what they did to me on my final day with 911 response?”
“At 6:30 in the morning, we got a call for a traffic trauma critical response,” the 40-year paramedic said. “People from the different AMR stations were coming for final-day well-wishing and get-togethers. There were other calls coming in. We responded to the traffic call, and through the system’s status management we have in place, the other calls were taken care of. This all benefits the patient.”
Cody Bonilla, an EMT with AMR, said that, simply put, when one station responds to a call, others move around and overlap coverage to minimize the response time to other calls that may come in.
This maneuvering of assets is part of the collaborative association that helps with 911 calls, and other more routine situations, Foster said.
“We hear the calls coming in,” he said. “When fire responds, we are usually there monitoring the situation. If the police are summoned, we stand by monitoring for stress. This is a good system that works for us on Kauai. We all depend on each other.”
In non-emergency situations, AMR is also a collaborative partner with the falls-prevention program led by the state Department of Health and the Hawaii Fall Prevention Consortium.
The Kauai Fire Department has identified injury prevention as a key area to enhance its goal of preserving and protecting life. American Medical Response works with people in the more medical aspect of the program, offering free kits that provide critical medical information to first responders.
“These save precious time when responding,” Foster said. “It provides not only emergency contact information, but also a medication record, what medications are being used, allergies to medication, and other information that allows the first responder to perform more efficiently.”
Foster said there are more and more fire department personnel getting EMT training.
“When the fire department responds to a call, they (EMT-trained) are trained to do initial assessments and training,” Foster said. “When the AMR unit arrives, it picks up the initial treatments and provides continuation of support. This is tremendous benefit for not only us, but for patient care.”
He said AMR personnel also undergo training every two years, having to clock 72 hours of continuing education on new developments in the field, to maintain their readiness in response.
“Family support is important, too,” Foster said. “With the current work schedules, we are away from our families the equivalent of a year for every three years we’re on the job. This is really hard on families, and can be stressful.”
People should also know how to respond to emergency vehicles.
“There was a response in Kapaa where the driver wouldn’t respond to the sirens and lights,” Foster said. “He kept going normally, like nothing was happening. I tried different siren patterns, light patterns — nothing. He kept going and wouldn’t let us pass. We later found out, he and his partner were both deaf. But that’s why we have the lights…the old days, those lights were so dim, you could barely see them. We had to rely on the sirens. Today, we have lots of light, and people should be able to either see the lights or hear the sirens. They need to cooperate — someone’s life may depend on it.”
Prior to becoming a paramedic, Foster had six years of experience with the Lihue Airport Crash Fire department.
“Zack Octavio — he was just one man with paramedic training — came to talk to me,” Foster said. “That was when there were only two stations on Kauai. Zack was the only one on the Westside, and because of his training, he rode in the back, tending to the patient. He had to recruit other people working in the hospital to be his driver. He started talking to me about becoming a paramedic.”
“I started about a year after the state finalized its contract with the county,” Foster said. “At that time, there were only two stations — Medic 21 Lihue and Medic 20 Waimea. They hired people to start the Hanapepe station. Today, we have two stations in Lihue, and stations in Kapaa, Hanapepe and Waimea.”
Looking into the future, Villanueva said while he’s authorized to seek help from off-island, he has been blessed that his staff has been primarily from Kauai.
“I’m grateful for the 40 years,” Foster said. “To be here and watch the growth of AMR from two stations to five, and have the association, cooperation and help from the other agencies, is totally tremendous — me ke aloha!”
Dennis Fujimoto, staff writer and photographer, can be reached at 245-0453 or firstname.lastname@example.org.