Bike Medic Operations in the City of Alexandria officially began on June 13, 1997. The purpose of the Bike Medic is to reduce the time to treatment for patients stricken at large scale events and in areas of limited accessibility. The program has worked well - providing a boost to both community relations and morale for the personnel who ride.

History
In April 1995, Paramedic James Blivin noted that special events medical support required large amounts of time and personnel. He also determined that the units covering the event were frequently out of position, or effectively out of service during these events. The ambulances were sitting at idle or off, adding to the maintenance costs and increasing down time. A better method had to be found.

Paramedic Blivin, an avid bicycle rider, had noticed the success of Police Bike Patrols. At the time, there were few police bike patrols and no EMS bike operations. He formulated a thumbnail proposal and submitted it through the chain of command, quickly receiving a response. The Director of EMS asked that paramedic Blivin research the idea and submit a full proposal.

In January 1996, the Captain in charge of "Waterfront Operations" proposed incorporating the Bike Medics into the Waterfront Operational Plan, which includes all aspects of large crowds and assemblies at the waterfront areas of the City.

Following a presentation to the senior staff in April 1996, funding for the program was initiated. Initially, only $700 was spent, including equipment carriers and lighting for bikes, and personnel interested in the program were asked to use their personal bikes.

The first event covered by the new Bike Medic Team was the Red Cross Waterfront Festival. The new team was a success. During the event, several critical patients were treated. Bike Medics were first on the scene in all cases. The Bike Medics even handled a traffic accident near the event while all the regular units were busy on other calls. All the Bike Medics noticed increased positive interaction with the public. Many event goers asked questions, and made positive comments. The bike medics also were called upon to assist in searches for lost parents and children. In addition, several safety problems were found and corrected by the team.

Due to the success of the first event, the program was expanded to cover events occurring anywhere in the City. Additional funds were obtained and two Trek Police Mountain Bikes were purchased for the team. Seeing the need for more personnel and better training, Paramedic Blivin attended a Police Mountain Bike Patrol course offered by the Metropolitan Police Department, which enabled him to better train and operate the team. Several courses were offered to department personnel. The team increased to ten members.

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Operations
The team operates in Advanced Life Support (ALS) and Basic Life Support (BLS) modes. The ALS bike team consists of two ALS certified personnel, or one ALS provider and one BLS provider. Drugs, fluids, advanced airway, defibrillation, and monitoring equipment are carried. A BLS team consists of one or two BLS certified providers and BLS equipment to include an AED (Automatic External Defibrillator). Both teams carry a variety of injury treatments. These include bandages, ice packs, and splints. Both levels also carry oxygen. Since the bikes allow easier and more rapid access to patients at large events, they decrease the amount of time the patients have to go without medical care. Saddlebags mounted to a TOPEK rack carry the equipment. The Saddlebags are from Cannondale and include an interior frame. The department has purchased two Heartstart defibrillators for the use of the Bike Team. These replace the life-pak 5, which had been in use. The new units are much lighter and still provide a display of the cardiac rhythm. Rhythm analysis is important for the administration of several cardiac medications carried by the team.

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Training
Personnel are trained to ride under punishing conditions. The training includes slow rides, fast rides, up steep inclines, down and along inclines, over curbs, and down stairs. Each medic must be in shape and ready to ride a significant distance at response speed. A short summary of the city's public relations policy is included. A short course in maintenance and repair is also part of the training. Use of equipment specific to the bike medics is added as well. Retraining is accomplished on a rotating schedule.

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Current Operations
The bike team functioned in three events the first year. The second year saw fourteen events. These events included the Marine Corps Marathon held outside the city and as part of a massive cooperative effort between several departments. The use of the team shows signs of increasing as time goes on and was featured on the "Fire Line" show. Several race organizers and event organizers have specifically requested bike medics as part of the medical support for their events. The comments from the public have only been positive. With the bike medics increased visibility and ready access to the public, people have been requesting and getting information in increasing quantity. Since the bikes allow rapid access, the time to medical care in many events has decreased. Public safety has also increased since we are not trying to respond through large crowds with full-sized ambulances.

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Continued Enhancements
The team has recently added a transport cart to the team's responsibilities and a trailer to haul all the equipment to special events. We continue to expect that the demand and success of the team will increase in the coming years. New members will be added and new procedures developed as time and use continue.

The Team has become involved in the "Be Safe" program and continues an active role in other public relations and safety programs within the department.

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Additional Information
Currently the program coordinator is Paramedic John Rule.  He can be reached at john.rule@alexandriava.gov at any time. He can also be reached through the Fire Department main number - (703) 746-5200. Any information available will be passed on at your request.

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