Williamson County Emergency Medical Services In its 40 years of service, Williamson County EMS has received national and statewide recognition and has grown to 146 employees.[/caption] Williamson County Emergency Medical Services celebrated 40 years of service Jan. 1, and although some were looking at what is to come, longtime affiliates were recalling what it took to get here. “It is absolutely incredible when you look back 40 years and think it was so recent, and yet it was so long ago,” former Medical Director Dr. Stephen Benold said. Prior to having a countywide EMS organization, funeral homes were providing ambulance services in Williamson County and losing interest in it as national requirements for training and equipment were growing. In 1974 resident Kenneth Poteete convinced the county and city courts that Williamson County should provide the EMS service and the cities should provide fire service. This created an equal share in the cost, and EMS operations began Jan. 1, 1975. When Benold began working as the unofficial EMS medical director in 1978 he said the county, which had a smaller population, was able to operate with three ambulances. “EMS in the late ’70s was sort of what we called diesel and oxygen,” he said. “Diesel meaning push the pedal to the floor and drive like crazy to get the sick or the injured patient to the hospital, where definitive care could take place. Or … if [the patient was] short of breath, you would put the patient on oxygen. There just wasn’t a whole lot more that could be done. We had some basic drugs back then­—but just basic drugs.” Today the county’s EMS has grown to 18 ambulances, three command vehicles and 146 employees serving the entire county. In 1979 the Commissioners Court officially appointed Benold to the position of EMS medical director. He retired in 2011, and in his 32 years of service he said he watched the EMS organization grow more sophisticated with technology and medicine, which has required additional training, he said. In the mid-1990s paramedics suggested using paralytic medicines to perform intubations to open patients’ airways. Before Benold agreed, he required paramedics to train for more than a year. “It’s very difficult to put a tube in if [a patient still has] a gag reflex,” he said. “It’s a lot easier if I just give you a paralytic and completely paralyze you. The trouble is when you completely paralyze someone they’re not breathing.” The paramedics first trained with dummies and then worked alongside anesthesiologists with surgery patients who were already scheduled to receive the drug. “As new things came along we adopted them after investigation and training,” he said. During his tenure Benold said he also took it upon himself to prepare paramedics for the direction the industry was going. “The hospitals started doing emergency catheterization; then basically we could cure heart attacks, but the key is you have to diagnose it quickly,” he said. “I taught all the paramedics how to read a 12-lead electrocardiogram. It’s not like reading ‘Dick and Jane’; it’s more like reading a physics textbook. It took me years to train the paramedics to where if they said it was a heart attack, nine out of 10 times it was.” Although Benold no longer works with EMS, he and EMS Director Kenny Schnell both said they expect more efficiency to come in the future. “We do this thing called hospital data exchange, so if we transport a patient to a hospital we’re able to use their electronic patient records and it links it to our electronic patient care reporting system, so we get outcome data on that patient,” Schnell said. “The medic can see what was actually wrong with the patient.” EMS will also use this information to enhance education and training based on the data it receives. “It’s amazing the technology we have now to support what we’re going to do,” Schnell said.