When Lisa and Chris Brooks' 14-year-old son, David, was experiencing breathing complications related to cerebral palsy, they feared for his life and called 911.

Paramedics from the Upper Arlington Fire Division responded and transported David to a hospital where he was stabilized, but what the paramedics did after the run had a lasting impact on the Brooks family.

"A couple of paramedics came out and talked to us about David and the CARES program," Lisa Brooks said. "They talked to us about CPR and the street-by-street training program and how it pertained to our family.

"We invited some of our friends and family who are around David, and the paramedics came and taught us CPR."

CPR and training in the use of automated electronic defibrillators (AEDs) is just one aspect of the Community Assistance Referrals and Education Services program the fire department started last September.

It's also one way CARES has helped David and his parents.

"There's no need for him to be in the hospital, but he does need (intravenous) fluids," Lisa Brooks said. "They (UA paramedics) went back and had a meeting with (Nationwide Children's Hospital) and got the orders from the doctors and worked it out so they could administer the IV fluids.

"David didn't have to go to the hospital, which is huge for us. He didn't need to go to the hospital in the cold, which is very difficult for people in compromised medical conditions."

CARES has given the family home care and emotional boosts, Lisa Brooks said.

"It's been great because David gets excited about them coming," she said. "I'm constantly advocating for people with special needs, and I feel like they were reaching out and advocating for us. They've done multiple things that have had a positive impact on our family."

Core mission

Offering such help is at the core of CARES, UA firefighter/paramedic Mindy Gabriel said.

"We're able to help patients navigate the system in times when they don't really have any other options," she said. "We're building relationships with that patient, their families and their healthcare partners.

"We can help prevent emergency transports and provide alternative options (for care). It saves the patient and the system money."

Deputy fire Chief Mark Zambito said an ambulance trip, depending on the level of care a patient receives, can cost upwards of $1,2,00.

Although those costs, or a portion of them, typically are covered by insurance, he said patients can rack up another $12,000 or more on emergency room visits.

"If our patients have signs and symptoms that require a hospital trip, we will most definitely take them," Zambito said. "But for nonemergency, chronic illnesses and injuries, our paramedics can talk directly to our patients' doctors for a possible treatment plan, preventing that trip."

CARES is an outgrowth of another city-specific program, STAY UA, which Zambito said was started in 2009 to help older adults and residents with disabilities remain safely in their homes. CARES was established to extend the same kind of medical assistance and service coordination to the general population, he said.

"The goal of CARES is to provide resources to live a long, healthy life in Upper Arlington -- again, building off of STAY UA's innovativeness," Zambito said.

Education, training

CARES focuses on education, preventing injuries and building community partnerships to help improve residents' lives.

In addition to offering in-house CPR and AED training, CARES allows fire division personnel to provide nonemergency medical evaluations and information or plans for making homes safer for those with mobility or other health issues.

It links healthcare providers to vulnerable residents and those who need coordinated home care. It also offers safe-baby training for parents, distributes bicycle helmets to local children and has a special-needs registry so local emergency responders can meet with families such as the Brookses and other caregivers so they have a better understanding of residents' special needs when a medical emergency does arise.

Other partners

Dr. Catherine Quatman-Yates, a health services researcher and physical therapist in the Ohio State University Wexner Medical Center's Department of Physical Therapy, and Dr. Carmen Quatman, an orthopedic trauma surgeon in the OSU Wexner Medical Center's Department of Orthopedics, have been working with Upper Arlington's CARES program to create a holistic approach toward preventing falls among at-risk residents.

"The CARES program in UA is an innovative model of prevention that really gets to the heart of helping residents in Upper Arlington gain confidence to continue living safely in their own homes for as long as possible," Quatman-Yates said.

"What makes the program particularly special is that it helps connect residents to resources available within their own neighborhoods to help address potential medical risks, home-environment hazards and social and behavioral concerns that may otherwise remain unidentified or insufficiently addressed by other sectors and processes within of our healthcare systems."

Both doctors said CARES helps establish partnerships among residents, paramedics and community resources to help address health-risk factors in private homes -- something that's difficult to accomplish through health fairs and doctor visits.

They hope the program will catch on nationwide.

"EMS providers have a unique opportunity that many healthcare providers do not: to look, listen and get a feel for the patient's living environment," Quatman said. "Fatalities related to falls are most likely to occur in a person's own home.

"Reducing costs of health care through prevention strategies such as the CARES program could help reduce unnecessary resource utilization of the first-responder community and redirect those resources to create healthier, safer home environments for residents."

Zambito summed up CARES as "EMS prevention."

"For many years, we've done fire prevention and we've been very successful at it," Zambito said. "This is just the next step to preventing illness and injury."

Additional information about CARES, as well as how to request home visits, training and other services, is available online at uaoh.net/CARES, by calling 614-583-5100 or emailing CARES@uaoh.net.