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Education
Western Technical College program seeks to fix paramedic shortage
Peter Thomson, La Crosse Tribune 

Students working as emergency medical technicians and enrolled in the paramedic certification program at Western Technical College, including Nathan Allen, Kylie Nordie, center, and Samantha Lamberson, work through a training scenario with a mannequin Tuesday. EMTs at Western are getting their paramedic certification in nine months instead of 12, thanks to a state grant.

One patient after another, Nathan Allen does his best to cheat death.

“Everything we do is to fight the Grim Reaper,” said Allen, an emergency medical technician with Tri-State Regional Ambulance, part of Gundersen Health System. “Sometimes you win. Sometimes you lose. You just do everything you can to help that person, and then you go on to the next one.”

Allen is one of 10 EMTs hoping to make progress in that fight by taking an accelerated paramedics course at Western Technical College, which ends with a round of certification tests on Saturday.

Offered on a trial basis this year, the course allows students to earn their paramedic certification in nine months instead of 12, an abbreviated timeline meant to help rectify a local paramedic shortage.

Tornstrom

“There’s a shortage not just locally but nationally,” said Tom Tornstrom, executive director of Tri-State. “We’re getting busier and busier, our response volume is going up, and we need to keep up with the demand. Our paramedics all have to work a little bit harder to do that, so this is a real win-win for us.”

Tri-State employs about 35 EMTs and about 75 paramedics — each slightly below the ideal number, Tornstrom said.

EMTs, who typically receive between 100 and 150 hours of training, provide basic emergency care.

Paramedics, who go through 1,000-plus hours of training and must pass written and practical tests, provide basic and high-level treatment, including administering medication and performing advanced patient assessments.

Students in Western’s accelerated paramedic course say they want that extra certification not just for the higher salary or stature, but so they can do more for patients.

Allen, who’s based in Bloomington, said he’s naturally driven to help people, especially in high-pressure, life-or-death moments.

“I’ve always wanted to work in a fire department or rescue squad situation,” said Allen, 30 who also spent time in the National Guard and was deployed in Afghanistan in 2012-13. Perhaps the hardest part about being a first responder, he said, is when “there’s nothing you can do for a patient, and you just feel helpless.”

Samantha Lamberson, another soon-to-be paramedic who’s based in Arcadia, said she’s wanted to be a paramedic from the time she was young. Her first call as an EMT was a fatal car accident — the kind of event she finds both sobering and adrenaline-inducing.

“I like the thrill of it. Every day is different and you don’t know what it will bring,” Lamberson, 25, said. “The joy, I guess, of living in a small town is you get to hear things like, ‘Thank you. You saved my mom’s life.’”

Western officials say the accelerated paramedic course is a work in progress. Few — if any — schools in the Wisconsin Technical College System offer something like it.

Kevin Dean, dean of Western’s Health and Public Safety division, said the course could be offered in future years, assuming there’s enough funding and this initial cohort is deemed a success.

Western was able to do a trial run this year because of a $150,000 workforce development grant from the state of Wisconsin.

“I believe it’s been very successful, and we’ll be able to look at what went well and what didn’t work well, so we can improve the next time,” Dean said. “The need for paramedics is so great. Anything we can do to help, we’re going to do.”


Meet some of the outstanding nurses in the La Crosse and Winona area

Q&A: Wisconsin's "born-alive abortion" bill addresses rare circumstances

Steineke

A bill to be voted on by the state Assembly on Wednesday, among other abortion measures, would require doctors to exercise the same “skill, care and diligence to preserve the life and health” of babies born alive after abortions or attempted abortions as they give to “any other child born alive at the same gestational age.”

Democratic Gov. Tony Evers has said he will veto the bill, whose lead sponsor is Assembly Majority Leader Jim Steineke, R-Kaukauna. President Donald Trump brought national attention to the bill late last month at a rally in Green Bay, saying doctors were “executing” babies who survive abortions, which doctors deny. The measure is similar to a federal bill blocked in the U.S. Senate in February.

Here are some questions and answers about so-called “born-alive abortions.”

Q: Under what circumstances might abortions result in live babies?

A: Procedures typically used in elective abortions at clinics, such as injections to stop the heartbeat, suction or instruments and surgery, are generally not survivable, many doctors say. But fetuses might survive, or at least have a heartbeat initially, when labor is induced in hospitals for one of two reasons: the fetus has a lethal condition or the mother’s life is at risk.

“These are devastating situations,” said Dr. Kathy Hartke, legislative co-chair of the Wisconsin section of the American College of Obstetricians and Gynecologists. “They are women, families who want their babies.”

Dr. Donna Harrison, executive director of the American Association of Prolife Obstetricians and Gynecologists, said babies can survive some injections and surgical techniques used in elective abortions.

Q: How often does this happen?

A: It appears to be quite rare. From 2003 to 2014, when at least 9.3 million abortions were done nationally, the Centers and Disease Control and Prevention found 143 “deaths involving induced terminations” but said that figure could be an underestimate.

Minnesota, one of a few states that require doctors to report abortions resulting in live babies, reported three cases in 2017 among more than 10,000 abortions. None survived.

Wisconsin doesn’t require such reporting. Wisconsin Right to Life, which supports Steineke’s bill, said it hasn’t heard of any cases in Wisconsin since 1982, when two babies survived abortion attempts in Madison and later died, according to a Wisconsin State Journal report at the time.

The Wisconsin Catholic Conference noted that 52 of 5,640 abortions in the state in 2017 were conducted at more than 20 weeks gestation, according to the state Department of Health Services. “It is these children who are the ones who might survive an attempted abortion,” Barbara Sella, the conference’s associate director, said this month in testimony supporting the bill.

Q: Didn’t Wisconsin pass a law in 2015 banning non-emergency abortions after 20 weeks?

A: Yes. The law prohibits abortions, including induced labor because of deadly fetal anomalies, at more than 20 weeks after fertilization. That is the same as 22 weeks gestation, which starts from the date of the woman’s last period, generally two weeks before she would ovulate, according to Dr. Steven Leuthner, a neonatologist and bioethicist at the Medical College of Wisconsin.

If the mother’s life is at risk, abortions can be performed later. Such medical emergencies can include preeclampsia, heart failure and severe hemorrhage, Hartke said.

In that situation, Hartke and Leuthner said, doctors typically induce labor. If that is done at 22 weeks to 24 weeks gestation or so — the earliest a baby might be viable — doctors generally ask parents if they want to try resuscitation or do comfort care, such as wrapping and cuddling the baby. The same choices are offered when a baby is born prematurely at the same stage, Leuthner said. With babies born at later stages, resuscitation is typically done unless other factors suggest it isn’t called for.

“You’re not delivering to end the baby’s life,” Leuthner said. “You’re delivering because you don’t want mom to die, and then you’re making a decision on what interventions you want to do for the baby or not, based on the baby’s potential outcome.”

Harrison said inducing labor or doing a Cesarean section to save the mother’s life, while also trying to save the baby, are not considered abortion. The bill would apply to cases in which doctors use injections or surgical procedures to try to end the life of the fetus while trying to save the mother’s life, she said.

Q: What fetal diagnoses are considered lethal, and when do pregnant women learn about them?

A: Deadly fetal abnormalities include a lack of kidneys, certain conditions involving additional chromosomes and anencephaly, or having no brain, Hartke said. Fetuses with such conditions won’t survive, regardless of when delivered, Leuthner said.

Some of the conditions can be picked up in blood tests or ultrasounds at about 10 to 15 weeks, but others aren’t found until a detailed ultrasound is conducted at 19 or 20 weeks, Hartke said.

Before the 2015 law, some hospitals offered induced terminations after 22 weeks gestation for lethal anomalies if women didn’t want to continue the pregnancies knowing the babies couldn’t survive. Now, the procedures can be performed only before 20 weeks after fertilization. Women desiring later terminations must continue their pregnancies or seek terminations out of state, Hartke and Leuthner said.

When hospitals previously did induced terminations at later stages, comfort care was generally provided because resuscitation was futile, said Dr. Douglas Laube, who provides abortions at Planned Parenthood in Madison and is former chairman of obstetrics and gynecology at UW-Madison. He does abortions at up 14 weeks at Planned Parenthood, while other providers do them up to 19 weeks.

“Oftentimes the anomalies are so profound, it’s impossible to do the life-saving measures one would normally want to do,” Laube said. “There’s no anatomy there to deal with.”

Q: So when could a baby be born alive after an abortion in Wisconsin?

A: If labor is induced before 20 weeks, or 22 weeks gestation, because of a lethal fetal anomaly, the baby might have a heartbeat and the umbilical cord might be pulsing, but the life isn’t considered viable, Hartke said. That is technically a live birth, but the life will typically last only minutes or hours, she said.

With induced terminations at later stages to save the mother’s life, a baby might be born alive, but Harrison doesn’t consider that abortion. Doctors say they offer the same options they do in any birth at the same stage: resuscitation or comfort care.

Q: What would the bill change?

A: It’s not clear. The bill would require doctors to take the same actions with babies born live after abortions as they do with other babies at the same stage, such as those born prematurely. Doctors say they already offer the same options for both kinds of babies.

“I don’t think it would really have an impact,” Laube said. “It seems to me this is a bill that is a solution in search of a problem.”

Harrison said the bill would require doctors to give babies born alive after abortions “stabilization of treatment.” It would require resuscitation if the baby is advanced enough — typically 26 weeks or 27 weeks or later — that there’s no question resuscitation should be attempted, even if the “mom wants that baby dead,” she said.

Hartke said “resuscitation … doing CPR, possibly breaking ribs, bruising, intubating, putting IVs in, drawing labs on an infant who will not survive due to extreme prematurity or a lethal condition would be traumatizing, cruel and harmful.”


Schmidtke


Local
Funeral is Saturday in La Crosse for Navy sailor who died in 1941 Pearl Harbor attack

This photo of George E. Naegle was taken at the Great Lakes Naval Station in 1941.

More than 77 years after he died in the Japanese attack on Pearl Harbor, the funeral for Navy Seaman 1st Class George E. Naegle of La Crosse will be held Saturday with full military honors at the Cathedral of St. Joseph the Workman at 530 Main St.

The public is invited to the event at the church, which begins with visitation from 9 to 10 a.m. and continues with a few speeches before the funeral Mass begins at 10:30 a.m. The Mass will be followed by entombment and military honors at St. Joseph Mausoleum in the Catholic Cemetery along Losey Boulevard.

Mary Ann Lyden

“I am very happy that this is finally coming to completion,” Naegle’s niece, Mary Ann Lyden of La Crosse, said Tuesday before speaking to local television and radio news reporters at the church. She has been making funeral arrangements with the church and Schumacher-Kish Funeral and Cremation Services.

Lyden said that her late mother, Louise Naegle Weimar, who died in 1979, would have been very happy to know that Weimar’s brother was finally getting a funeral and burial in his hometown.

Weimar was George E. Naegle’s only sibling. Their father, George W. Naegle, died in 1974 at the age of 90, and their mother, Anna, died in 1957 at the age of 73.

Naegle’s parents also are buried in Catholic Cemetery. And his grandparents, Joseph and Ellen Naegle, are buried near the St. Joseph Mausoleum in the cemetery.

Lyden, who was only 5 years old when her uncle died, said she hopes to be at the Minneapolis-St. Paul International Airport on Friday for the arrival of the casket carrying his remains. A hearse will bring the casket from the airport to La Crosse.

Naegle would have been 100 years old this September if he was still alive, Lyden noted. He was a 1938 graduate of La Crosse Central High School, where he was a star football player. He enlisted in the Navy in 1939.

Monsignor Bernard McGarty of La Crosse, who is 94 years old and will be one of the speakers Saturday, also remembers Naegle playing lots of softball and baseball. McGarty was a few years behind Naegle at St. Mary’s Grade School, but remembers him.

“I’m pleased” that Naegle is finally returning to La Crosse for his funeral and burial, McGarty said. “I was a senior in high school when Pearl Harbor was attacked, and we knew right away that George was on the battleship Oklahoma,” he said.

Naegle’s remains were identified last year through DNA and other methods of analysis, the U.S. Defense Department’s POW/MIA Accounting Agency announced last September. Lyden and two of her sons, Randy and Robert, had provided the agency with swabs from the inside of their cheeks, as they were asked to do.

Naegle was assigned to the battleship, which was moored at Pearl Harbor in Hawaii, when it and other U.S. ships and aircraft were attacked by Japanese airplanes on Dec. 7, 1941. The battleship was hit by multiple torpedoes, which caused it to quickly capsize.

The attack on the ship resulted in the deaths of 429 crewmen, including Naegle, who was 22 at the time.

From December 1941 to June 1944, Navy personnel recovered the remains of the deceased crew, which were subsequently interred in cemeteries in Hawaii. Unidentified remains eventually were buried in 46 plots at the National Memorial Cemetery of the Pacific, also known as the Punchbowl, in Hawaii.

In 2015, the deputy secretary of defense ordered the disinterment of unknowns associated with the USS Oklahoma, and DPAA personnel began exhuming the remains from the Punchbowl for analysis.

As of March, DPAA has identified 200 sailors and Marines from the USS Oklahoma who were previously unidentified. The identification work has been going on at the DPAA laboratory at Offutt Air Force Base near Omaha, Neb.


This photo of George E. Naegle was taken at the Great Lakes Naval Station in 1941.


Steineke


Evers