Ebola 'looms large' for paramedics preparing in Minn.

When Thomas Eric Duncan fell gravely ill with Ebola symptoms in Texas last month, it wasn't doctors or nurses who treated him first: It was three paramedics from the Dallas Fire-Rescue Department, Station 37.

Since Duncan's death, hospitals have been the focus of handling Ebola cases reported in the U.S. But in many places, fire stations remain at the front line of the battle against the disease. And if an initial Ebola case emerges in Minnesota, it could begin with a routine 911 call to check on a sick person.

"That is something that looms large in everybody's mind," said Matt Simpson, St. Paul's Deputy Chief of Emergency Medical Services.

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Ambulance crews are adding more protective equipment and procedures. "I put this out to our crews often. Keep it clean," Simpson says. "Go through your rig every single day and be very diligent. Make sure you're keeping it safe not only for yourselves, but your families, and for the patients that are going to continue to be put in these rigs on a daily basis."

But vigilance is nothing new for paramedics who daily face the threat of serious biological hazards. They include bacterial meningitis, HIV, hepatitis, tuberculosis and Middle East Respiratory Syndrome, among others.

"We have so many different bugs out there that we just have to be aware of," Simpson said.

And no one may know that better than the paramedics in St. Paul. One of them died five years ago, after apparently being infected by a patient he was called to help.

Ray Hain's widow, Gail, said it all started when he made a medic run in 1996. He performed CPR on a person who ended up dying from a heart attack.

"And when he was kneeling in his body fluids, whatever it was, he had some scabs on his knees," said Hain. "So that was the point of entrance."

An infection in his leg sent Hain to the hospital where doctors put him on IV antibiotics. Two years later Hain learned that infection had seriously damaged his heart. Despite a transplant, he died in 2009, leaving behind his wife and two daughters.

"They use the personal protective gear, so I felt like he would be covered," Hain said. "But it was just kind of one of those fluke things."

Paramedics are aware of the risks, according to Robert Ball, operations supervisor for Hennepin County Emergency Medical Services in Minneapolis.

"We're following the Minnesota Department of Health and CDC guidelines to ensure that we're taking the proper precautions for our staff and our equipment," Ball said.

For instance, Ball says crews have added extra thick gowns and asked operators to ask questions about travel history when people call 911 for medical assistance. The agency could designate a special vehicle to take someone to the airport for a flight out of state for treatment for Ebola.

But Ball said there's a limit to what emergency medical services can do. No one would want to keep a suspected Ebola patient waiting in a doctor's office or a regular clinic while a special vehicle is dispatched from far away.

Dave Page, who trains paramedics at Inver Hills Community College, said responders will likely have to meet this challenge like all the rest they see daily — with what they have.

"It's impractical for us to get out of ambulances every day in hazardous materials suits...with very expensive and very cumbersome equipment that would only panic people more, but that frankly are most of the time, not necessary," Page said.

Overreaction could also divert people's attention from other serious risks, he said. Page said whatever happens in coming days with Ebola, more Minnesotans will die this year of a different outbreak: the flu.