Lending a Paw

ALEXIS ACHEY, EMT-B, & JASON R. ROACH, NREMT-P/CCEMT-P
EMS World.com

Alexis Achey was diagnosed with type-one diabetes at the age of 7. Her pancreas is unable to produce any insulin so she must obtain insulin through injections to maintain normal blood glucose levels. She went on an insulin pump at age 9, which granted her the freedom of not having to constantly carry and use time-consuming syringes.

But over the next few years she began noticing she was becoming hypoglycemic, although at a glucose level of 38 she saw no obvious symptoms.

After researching continuous glucose monitor options as a solution, she discovered diabetic alert dogs. These dogs are able to sense fluctuations in blood glucose levels at the core of the body and are able to alert their owner to the fluctuations prior to any electronic devices, which would detect a change at the extremities. Those minutes could mean the difference between a simple correction of a dangerous glucose level—while still conscious and coherent—or activating an emergency response system. Believing an alert dog would provide a greater benefit than any electronic monitor, in February 2012 she reached out toService Dogs by Warren Retrievers, an Orange, VA-based organization specializing in service dogs, and was placed on a waiting list. Service Dogs by Warren Retrievers works has worked with more than 250 families who have either been paired with a service dog already or are on a waiting list.

In August Alexis received a call saying she'd been matched with a black male puppy, and she was asked to name the dog. The matching process was based on a survey of her lifestyle and plans for later in life that Alexis had completed earlier. By September 2012 Alexis was paired with Winston, a 3-month old black lab. When Winston arrived he already knew basic obedience and immediately began scent training specific to Alexis. Pairing the dogs with an owner at a young age allows the dog to "grow up" on their owner's scent, so the dogs are not alerting to every blood sugar outside of their owner's normal range. A high blood sugar smells fruity or sweet to Winston, while a low blood sugar smells like acetone. Over four days of scent training, Winston learned to paw Alexis's leg for a high blood sugar or nudge her leg for a low blood sugar. This differentiation in alerts allows Alexis to determine how quickly her glucose is changing and therefore how urgent treatment must be. Winston often alerts Alexis on a daily basis. Illness and stress, which are common among college students like Alexis, can have a drastic effect on blood glucose levels.

In spring 2012, Alexis took and successfully completed the Virginia EMT-Basic certification course and by fall she joined University of Richmond EMS (UREMS). In her spare time she also volunteers with Tuckahoe Volunteer Rescue Squad (TVRS). Winston has been with Alexis since she first joined UREMS and is with her 24 hours a day, even while she's on duty. Bringing a service animal into an emergency scene may not always be appropriate, so Alexis has to use her discretion—based on the type of call, time of day and information relayed from dispatch—to determine whether Winston remains at her side, in the vehicle or with a friend. She also had to sign a waiver with the university stating she assumed all responsibility for any issues that might arise with having Winston on duty with her.

As of April 2013 Winston has responded on 10 calls with Alexis. Sometimes he patiently waits at the door but on other occasions he's played a therapeutic role for anxious patients, resulting in a more calm and relaxed environment. Winston has allayed patient fears about going in an ambulance and has helped patients relax in stressful situations. He has also allowed Alexis to participate in EMS, not only taking care of her needs but also introducing a new experience to prehospital EMS on the University of Richmond campus. Because Winston is always watching out for Alexis, she can focus all of her attention on serving others rather than maintaining a vigilant watch on her own medical needs.

Alexis Achey is an EMT-B with University of Richmond (VA) EMS and a volunteer with Tuckahoe Volunteer Rescue Squad. She will graduate from the University of Richmond in 2014 with bachelor of science degrees in physics and chemistry.

Jason R. Roach, NREMT-P/CCEMT-P, is a captain and field operations supervisor for Richmond Ambulance Authority in Richmond, VA.