Program Overview
Troy Fire Department’s Bicycle Paramedic Program was started in June 1994 as a trial program to be used during special events in the community. Two paramedics staffed mountain bikes carrying: both BLS and ALS equipment, an abbreviated drug bag, intubation supplies and a cardiac monitor, split between the two bikes. Although the bicycles were owned by the riders, the fire department and local hospital furnished all other equipment.

Use of the bike program shortened response times in crowded areas by as much as 3-5 minutes when compared to the use of golf carts and more traditional ALS units. Direct public contact was possible, and, as opposed to sitting in an ambulance, the paramedics were approached by and talked with many people. They received only positive comments on the program.

As a result of the success of the trial period, Troy Fire Department Bicycle Paramedics, now participate in many community events. Now in our eighth year, the program has increased to 15 members and five bicycles.

Bike Program Operations
When the Bike Program is working an event, we respond to calls that happen on the event site.  Our way of receiving the calls vary from event to event.  For larger events, I.E.: parades, large festivals, 5 & 10K runs, we are dispatched by an on-scene coordinator. For smaller events, we are paged over a public address system or notified by radio by on-scene police or other event staff.  Our response times vary by event.  For some events, the times can be as short as 15-30 seconds.  For parades or running races, the times can be up to 2-3 minutes.

Upon arrival at the scene, we notify our primary fire station so that they can document our location and incident. Once we have started treatment, we assess the patient and call for an ambulance as soon as possible if needed.

The Troy Fire Department Bike Program follow county protocols that are set up for all pre-hospital providers. These protocols include the use of needle cricothyrotomy, chest decompression, oral and nasal intubation, intravenous cannulation including external jugular veins, cardiac monitoring with defibrillation and cardioversion, and transcutaneous pacing.  The program currently can’t perform TCP because we carry the MRL Semi-Automatic External Defibrillator. The Bike program is intended to arrive on the scene rapidly, assess, and stabilize the patient prior to the arrival of the ambulance.  Therefore carrying only the drugs that could be used in the first 5-8 minutes of our arrival is necessary. We carry the first line of drugs for chest pain, cardiac arrest, respiratory problems, diabetic, seizures or anaphylaxis.

Upon arrival of the ambulance, the bike medics would assist the ambulance personnel in patient care and the packaging of the patient. The bike medics would then restock their supplies from the ambulance stock, this includes all drugs and IV supplies. We have a regional drug bag exchange program and the bike program is covered under that.

Equipment
Troy Fire Department furnishes all of the equipment used. Each bike consists of:
·        Cannondale “Police Edition” front suspension bike
·        Nightsun headlight system
·        Powergrip pedal retention device
·        Jandd “Expedition” rear rack
·        5 LED Vista light

Our bike program always operates in teams of two. This helps to distribute the weight of  all of the equipment. Equipment carried on the first bike consists of:
·        MRL LifeQuest semi-AED with manual override
·        V-Vac manual suction device
·        Kendrick Traction Device
·        Bike maintenance supplies
·        1000ml of 0.9% Sodium Chloride with tubing
·        Spare medical supplies

Equipment carried on the second bike consists of:
·        Assorted BLS supplies
§         Assorted Kling
§         Band Aids
§         Ice Packs
§         BP cuff
§         Stethoscope
§         500 ml sterile water
§         4x4’s
·        “Mini D” size cylinder of O2
·        Intubation equipment
·        Pulse oxymeter
·        Blood glucose monitor
·        Drug bag

In the drug bag is:
§         2-18g and 2-20g IV needles
§         IV start packs
§         1-1:1,000 Epinephrine (Epi-pen)
§         1-1:1,000 Epinephrine (Epi-pen Jr)
§         1-1:10,000 Epinephrine
§         1 mg of Atropine
§         1-5ml Albuterol
§         1 bottle of 150 grain Nitroglycerin
§         1-100 mg of Lidocaine
§         1-50 ml of Dextrose (D50) 25 grams
§         1-ASA
§         1-5mg Valium

With these drugs, we can handle almost any medical emergency for 5-8 minutes prior to the arrival of an ambulance. All the medical gear is carried in bicycle specific medical bags made by R&B Fabricating.

Training
All members of the bicycle unit are required to attend a 32-hour cyclist school. We follow the International Police Mountain Bike Association (IPMBA) standards for training. IPMBA has had a 32-hour EMS Cyclist course since 1997. Our program coordinator attended the first IPMBA EMS Cyclist course at the Nashville conference. Our department has one IPMBA EMS Cyclist Instructor Trainer and one IPMBA EMS Cyclist Instructor.

Also required is an annual training session with all members. This training consists of both basic cone courses and advanced on and off road skills. Our training officer develops new training sessions each year to hone team member’s skills.

Uniforms
All team members are required to purchase their own uniform. Troy FD does supply the first shirt and a white helmet. All uniform pieces are from Bratwear. Since Troy PD wears a navy blue shirt and the Miami County Sheriff Department wears yellow, we wear a bright red shirt and jacket.

2001 Statistics
Our bicycle paramedic programs public speaking and education program held 11 events with seven of these being bike rodeos for grade school age children. Including the bike rodeos and our free bike helmet giveaway, we gave 304 bike helmets away.

The Bicycle Program covered twenty-two events. For five of these events, two teams rode so as to provide better coverage.  Twenty-eight patients were treated during these events for numerous problems ranging from falls to a heart attack but only four needed transportation to the hospital.

For 2002, we are holding a 15-hour summer class for elementary age children. This will consist of both classroom and on-bike skills. This class will be in conjunction with the Troy Police Department.

Conclusion
Feel free to contact us anytime if you have any questions. Several team members are listed below to contact.

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